Category: Statistics

J Magn Reson Imaging. 2022 Mar 15. doi: 10.1002/jmri.28156. Online ahead of print.

ABSTRACT

BACKGROUND: Moyamoya is a progressive intracranial vasculopathy, primarily affecting distal segments of the internal carotid and middle cerebral arteries. Treatment may comprise angiogenesis-inducing surgical revascularization; however, lack of randomized trials often results in subjective treatment decisions.

HYPOTHESIS: Compensatory presurgical posterior vertebrobasilar artery (VBA) flow-territory reactivity, including greater cerebrovascular reactivity (CVR) and reduced vascular delay time, portends greater neoangiogenic response verified on digital subtraction angiography (DSA) at 1-year follow-up.

STUDY TYPE: Prospective intervention cohort.

SUBJECTS: Thirty-one patients with moyamoya (26 females; age = 45 ± 13 years; 41 revascularized hemispheres).

METHODS: Anatomical MRI, hypercapnic CVR MRI, and DSA acquired presurgically in adult moyamoya participants scheduled for clinically indicated surgical revascularization. One-year postsurgery, DSA was repeated to evaluate collateralization.

FIELD STRENGTH: 3 T.

SEQUENCE: Hypercapnic T2* -weighted gradient-echo blood-oxygenation-level-dependent, T₂ -weighted turbo-spin-echo fluid-attenuated-inversion-recovery, T₁ -weighted magnetization-prepared-rapid-gradient-echo, and T₂ -weighted diffusion-weighted-imaging.

ASSESSMENT: Presurgical maximum CVR and response times were evaluated in VBA flow-territories. Revascularization success was determined using an ordinal scoring system of neoangiogenic collateralization from postsurgical DSA by two cerebrovascular neurosurgeons (R.V.C. with 8 years of experience; M.R.F. with 9 years of experience) and one neuroradiologist (L.T.D. with 8 years of experience). Stroke risk factors (age, sex, race, vasculopathy, and diabetes) were recorded.

STATISTICAL TESTS: Fisher’s exact and Wilcoxon rank-sum tests were applied to compare presurgical variables between cohorts with angiographically confirmed good (>1/3 middle cerebral artery [MCA] territory revascularized) vs. poor (<1/3 MCA territory revascularized) outcomes.

SIGNIFICANCE: two-sided P < 0.05. Normalized odds ratios (ORs) were calculated.

RESULTS: Criteria for good collateralization were met in 25 of the 41 revascularized hemispheres. Presurgical normalized VBA flow-territory CVR was significantly higher in those with good (1.12 ± 0.13 unitless) vs. poor (1.04 ± 0.05 unitless) outcomes. Younger (OR = -0.60 ± 0.67) and White (OR = -1.81 ± 1.40) participants had highest revascularization success (good outcomes: age = 42 ± 14 years, race = 84% White; poor outcomes: age = 49 ± 11 years, race = 44% White).

DATA CONCLUSION: Presurgical MRI-measures of VBA flow-territory CVR are highest in moyamoya participants with better angiographic responses to surgical revascularization.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY STAGE: 4.

PMID:35289460 | DOI:10.1002/jmri.28156

Lasers Surg Med. 2022 Mar 15. doi: 10.1002/lsm.23537. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: There are limited treatment options for nail psoriasis. It is important to find new therapies and improve existing ones. The aim of this study was to compare the effectiveness of pulsed dye laser (PDL) versus combined PDL and Nd:YAG lasers in patients with nail psoriasis.

METHODS: Fourteen patients (with a total of 126 nails affected by nail psoriasis) were treated with PDL (6 J/cm2, 7 mm, 0.45 milliseconds) on both hands and additionally with Nd:YAG (10 J/cm² , 6 mm, 15 milliseconds) on the right hand. Three treatment sessions were applied at 4-week intervals and patients were followed up for 6 months after the last session. Disease severity was assessed using the Nail Psoriasis Severity Index, both 8- and 32-point variant. Additionally, Dermatology Life Quality Index was assessed before and after treatment.

RESULTS: Overall, there was a statistical difference in 8- and 32-point NAPSI score before and after treatment for both hands. However, there was no statistical difference between the score for the right and left hands based on both scale variants. Some aspects of patients’ lives showed improvement due to the treatment.

CONCLUSIONS: Both PDL in monotherapy and combined Nd:Yag+PDL lasers are safe and effective in treatment of nail psoriasis, although combined therapy shows no advantage over the use of a single laser.

PMID:35289430 | DOI:10.1002/lsm.23537

J Sch Health. 2022 Mar 15. doi: 10.1111/josh.13174. Online ahead of print.

ABSTRACT

BACKGROUND: Breakfast after the bell (BAB), an alternative way to deliver breakfast after the school day begins, has been shown to increase participation in the School Breakfast Program. However, BAB occupies time that could otherwise be used for instruction and may affect academic performance. This study examined whether BAB affects math and literacy scores in third grade, an age not adequately studied in earlier literature.

METHODS: Using data on Arkansas students, we compared schools adopting BAB to corresponding “synthetic” control schools by minimizing preadoption differences in observables that can influence test scores.

RESULTS: We found little evidence of positive or negative effects on test scores. We also found little evidence of meaningful program effects over subsamples of schools by district enrollment size and BAB delivery method. Schools that adopted grab-and-go delivery and schools in districts with small enrollments, less than 600 students, showed statistically negative effects on math after BAB adoption. However, these effects were transitory and no longer present by the time the first fully exposed cohort reached third grade.

CONCLUSIONS: BAB can be incorporated into the school day without adversely impacting academic achievement, especially if adopting schools seek input from educators and nutrition personnel already experienced with BAB.

PMID:35289398 | DOI:10.1111/josh.13174

Am J Community Psychol. 2022 Mar 15. doi: 10.1002/ajcp.12593. Online ahead of print.

ABSTRACT

In the context of global democratic crises and pervasive neoliberal policies, civil society organizations (CSOs) play a critical role in promoting democratic processes and advancing social change on local, national, and transnational scales. However, such organizations also (need to) grapple with how they themselves put social justice and democratic principles into practice, and resist coloniality within. This article examines these questions in the case of People Powered-Global Hub for Participatory Democracy, a recently found transnational CSO that advocates globally for participatory democracy as a mechanism for social change and employs these principles in its own governance and operations. The analysis focusses on the creation of People Powered and its first year of practice. Drawing upon decolonial frameworks-and based on our own experiences as founding members of People Powered and our reading of interviews and documents-we identify concrete practices through which the organization seeks to enact epistemic justice, shift power, and emphasize relationality. We argue that People Powered’s decolonial roots, collectively articulated values and commitments, radical transparency, and its consistent employment of meaningful participation and reflexivity have built and are likely to sustain this transnational solidarity for social change. At the same time and perhaps critical for fostering solidarity and social change in the long term, People Powered embraces, rather than evades, tensions and contradictions that emerge in these efforts.

PMID:35289399 | DOI:10.1002/ajcp.12593

Biometrics. 2022 Mar 15. doi: 10.1111/biom.13662. Online ahead of print.

ABSTRACT

We introduce a time-interaction point process where the occurrence of an event can increase (self-excitement) or reduce (self-correction) the probability of future events. Self-excitement and self-correction are allowed to be triggered by the same event, at different time scales; other effects such as those of covariates, unobserved heterogeneity, and temporal dependence are also allowed in the model. We focus on capture-recapture data, as our work is motivated by an original example about estimation of the total number of drug dealers in Italy. To do so, we derive a conditional likelihood formulation where only subjects with at least one capture are involved in the inference process. The result is a novel and flexible continuous-time population size estimator. A simulation study and the analysis of our motivating example illustrate the validity of our approach in several scenarios. This article is protected by copyright. All rights reserved.

PMID:35289395 | DOI:10.1111/biom.13662

Brief Bioinform. 2022 Mar 14:bbac067. doi: 10.1093/bib/bbac067. Online ahead of print.

ABSTRACT

Over the past decade, statistical methods have been developed to estimate single nucleotide polymorphism (SNP) heritability, which measures the proportion of phenotypic variance explained by all measured SNPs in the data. Estimates of SNP heritability measure the degree to which the available genetic variants influence phenotypes and improve our understanding of the genetic architecture of complex phenotypes. In this article, we review the recently developed and commonly used SNP heritability estimation methods for continuous and binary phenotypes from the perspective of model assumptions and parameter optimization. We primarily focus on their capacity to handle multiple phenotypes and longitudinal measurements, their ability for SNP heritability partition and their use of individual-level data versus summary statistics. State-of-the-art statistical methods that are scalable to the UK Biobank dataset are also elucidated in detail.

PMID:35289357 | DOI:10.1093/bib/bbac067

Dent Mater. 2022 Mar 11:S0109-5641(22)00068-9. doi: 10.1016/j.dental.2022.03.003. Online ahead of print.

ABSTRACT

OBJECTIVES: To study the oxide layer stability of certified dental implants of system “P”, made based on TiO₂ alloy with carbon coating. To perform a comparative statistical analysis of the obtained data with the available data for the dental implants of systems “A” and “B”.

METHODS: X-ray microtomography and X-ray fluorescence analysis were used to study soft tissue biopsy specimens. Supernatants were studied by dynamic light scattering and transmission electron microscopy when simulating free emission of nanoscale metal oxide particles from the surface of dental implants as well as when simulating physical loading. A comparative analysis of three parameters of nanoscale particles was performed by statistical data analysis. The surface of the “P” system dental implant with surface treatment was analyzed by scanning electron microscopy.

RESULTS: Both free emission of nanoscale oxide layer particles and yield of nano- and microscale particles during simulation of physical load were confirmed. Statistically significant differences were noted in a comparative analysis of the size and frequency of occurrence of these particles in the supernatants obtained from the surfaces of three dental implant systems. The elemental composition of the particles and the composition and structure of the “P” system dental implants themselves were analyzed.

SIGNIFICANCE: The developed method of dynamic light scattering can be used to compare the stability of the oxide layer of standardized medical products manufactured on the basis of the TiO₂ alloy.

PMID:35289284 | DOI:10.1016/j.dental.2022.03.003

Am J Med Sci. 2022 Mar 11:S0002-9629(22)00110-0. doi: 10.1016/j.amjms.2022.03.003. Online ahead of print.

ABSTRACT

BACKGROUND: Few previous studies have investigated the multiple pathways that contribute to diabetes mellitus (DM) because of the complex, simultaneous interplay of attributing covariates. Structural equation modelling (SEM) is a robust multivariate approach that measures both direct and indirect effects of variables by simultaneously utilizing several regression equations. The current study applied SEM to test a hypothesized model of the covariates affecting DM among the adult population of the Sultanate of Oman.

METHODS: Data from a large nationally representative 2017 WHO STEPwise approach to surveillance survey were analyzed. Stata 16 software was used to perform SEM and path analysis of the sociodemographic, behavioral, anthropometric, and metabolic variables affecting normoglycemia and DM. A priori factor structure was hypothesized with special emphasis on observing direct and indirect effects, and the correlations that defined them.

RESULTS: Eight paths that directly affected DM status were established based on eight sociodemographic, metabolic, and behavioral variables (age, sex, educational status, physical activity level, body mass index, waist-to-hip ratio, systolic blood pressure, and family history of DM). The remaining variables (marital status, employment status, smoking, high-density lipoprotein level, total blood cholesterol level, fruit and vegetable intake, and type of oil used for cooking) showed variable indirect effects.

CONCLUSIONS: The results of this study further reinforce the evidence that lifestyle changes are vital for the prevention and control of DM. Individuals with a family history of DM and a high waist-to-hip ratio comprise a high-risk group and should be targeted with screening and lifestyle-intervention programs.

PMID:35289274 | DOI:10.1016/j.amjms.2022.03.003

Dent Mater. 2022 Mar 11:S0109-5641(22)00067-7. doi: 10.1016/j.dental.2022.03.001. Online ahead of print.

ABSTRACT

OBJECTIVES: Etching approaches [37% phosphoric acid, self-etching, 10-3 solution (3% ferric chloride dissolved in 10% citric acid), or 1.4% nitric acid] were evaluated regarding enamel shear bond strength (24 h), dentin microtensile bond strength (24 h and 2 years), failure mode, enzymatic activity of the hybrid layer, and nanoleakage (24 h and 2 years) of Prime&Bond Universal (PBU, Dentsply-Sirona) and Gluma Bond Universal (GBU, Kulzer).

METHODS: Adhesives were applied on blot-dried (wet-bonding, positive control) or air-dried (remaining groups) dentin after acid-etching (15 s) or in self-etch mode. Enamel and dentin bond strength tests used 160 human teeth (n = 10). Failure mode of tested samples and nanoleakage within the dentin-adhesive interface (n = 5) were analyzed by scanning electron microscopy. Dentin enzymatic activity was investigated by in situ zymography (n = 3).

RESULTS: Enamel bond strengths did not differ statistically among groups. Wet-bonding with 37% phosphoric acid showed similar dentin bond strength compared to 10-3 solution or 1.4% nitric acid at 24 h for both adhesives. None of the etchants inhibited enzymatic activity, and all groups showed dentin bond strength reduction after 2-year storage. GBU showed higher nanoleakage. Experimental etchants did not affect enamel bond strength. Dentin bond strength was not stable after 2 years, despite promising 24-hour results.

SIGNIFICANCE: This study suggests multiple etching approaches to optimize and achieve stable dentin bonding, while also offering in-depth information about the performance of recently released universal adhesive systems.

PMID:35289283 | DOI:10.1016/j.dental.2022.03.001

Health Technol Assess. 2022 Mar;26(17):1-180. doi: 10.3310/WCEI8321.

ABSTRACT

BACKGROUND: Current pathways recommend positron emission tomography-computerised tomography for the characterisation of solitary pulmonary nodules. Dynamic contrast-enhanced computerised tomography may be a more cost-effective approach.

OBJECTIVES: To determine the diagnostic performances of dynamic contrast-enhanced computerised tomography and positron emission tomography-computerised tomography in the NHS for solitary pulmonary nodules. Systematic reviews and a health economic evaluation contributed to the decision-analytic modelling to assess the likely costs and health outcomes resulting from incorporation of dynamic contrast-enhanced computerised tomography into management strategies.

DESIGN: Multicentre comparative accuracy trial.

SETTING: Secondary or tertiary outpatient settings at 16 hospitals in the UK.

PARTICIPANTS: Participants with solitary pulmonary nodules of ≥ 8 mm and of ≤ 30 mm in size with no malignancy in the previous 2 years were included.

INTERVENTIONS: Baseline positron emission tomography-computerised tomography and dynamic contrast-enhanced computer tomography with 2 years’ follow-up.

MAIN OUTCOME MEASURES: Primary outcome measures were sensitivity, specificity and diagnostic accuracy for positron emission tomography-computerised tomography and dynamic contrast-enhanced computerised tomography. Incremental cost-effectiveness ratios compared management strategies that used dynamic contrast-enhanced computerised tomography with management strategies that did not use dynamic contrast-enhanced computerised tomography.

RESULTS: A total of 380 patients were recruited (median age 69 years). Of 312 patients with matched dynamic contrast-enhanced computer tomography and positron emission tomography-computerised tomography examinations, 191 (61%) were cancer patients. The sensitivity, specificity and diagnostic accuracy for positron emission tomography-computerised tomography and dynamic contrast-enhanced computer tomography were 72.8% (95% confidence interval 66.1% to 78.6%), 81.8% (95% confidence interval 74.0% to 87.7%), 76.3% (95% confidence interval 71.3% to 80.7%) and 95.3% (95% confidence interval 91.3% to 97.5%), 29.8% (95% confidence interval 22.3% to 38.4%) and 69.9% (95% confidence interval 64.6% to 74.7%), respectively. Exploratory modelling showed that maximum standardised uptake values had the best diagnostic accuracy, with an area under the curve of 0.87, which increased to 0.90 if combined with dynamic contrast-enhanced computerised tomography peak enhancement. The economic analysis showed that, over 24 months, dynamic contrast-enhanced computerised tomography was less costly (£3305, 95% confidence interval £2952 to £3746) than positron emission tomography-computerised tomography (£4013, 95% confidence interval £3673 to £4498) or a strategy combining the two tests (£4058, 95% confidence interval £3702 to £4547). Positron emission tomography-computerised tomography led to more patients with malignant nodules being correctly managed, 0.44 on average (95% confidence interval 0.39 to 0.49), compared with 0.40 (95% confidence interval 0.35 to 0.45); using both tests further increased this (0.47, 95% confidence interval 0.42 to 0.51).

LIMITATIONS: The high prevalence of malignancy in nodules observed in this trial, compared with that observed in nodules identified within screening programmes, limits the generalisation of the current results to nodules identified by screening.

CONCLUSIONS: Findings from this research indicate that positron emission tomography-computerised tomography is more accurate than dynamic contrast-enhanced computerised tomography for the characterisation of solitary pulmonary nodules. A combination of maximum standardised uptake value and peak enhancement had the highest accuracy with a small increase in costs. Findings from this research also indicate that a combined positron emission tomography-dynamic contrast-enhanced computerised tomography approach with a slightly higher willingness to pay to avoid missing small cancers or to avoid a ‘watch and wait’ policy may be an approach to consider.

FUTURE WORK: Integration of the dynamic contrast-enhanced component into the positron emission tomography-computerised tomography examination and the feasibility of dynamic contrast-enhanced computerised tomography at lung screening for the characterisation of solitary pulmonary nodules should be explored, together with a lower radiation dose protocol.

STUDY REGISTRATION: This study is registered as PROSPERO CRD42018112215 and CRD42019124299, and the trial is registered as ISRCTN30784948 and ClinicalTrials.gov NCT02013063.

FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 17. See the NIHR Journals Library website for further project information.

PMID:35289267 | DOI:10.3310/WCEI8321