Category: Statistics

Eur J Orthop Surg Traumatol. 2022 Jan 15. doi: 10.1007/s00590-021-03177-9. Online ahead of print.

ABSTRACT

A recent article entitled “Full‑endoscopic (bi‑portal or uni‑portal) versus microscopic lumbar decompression laminectomy in patients with spinal stenosis: systematic review and meta‑analysis” written by Pairuchvej et al. (Eur J Orthop Surg Traumatol 30(4):595-611, 2019) published in “European Journal of Orthopaedic Surgery & Traumatology” has aroused our great interest. The authors concluded that compared with minimally invasive decompression surgery, full endoscopic spinal surgery had better pain relief (back pain and leg pain) in the treatment of lumbar spinal stenosis and had a lower complication rate, but no statistical difference in oswestry disability index score and operative time between both groups. Comparing to minimally invasive spinal surgery, bi-portal endoscopic spinal surgery had better back pain relief in the early stage, while uni-portal full endoscopic spinal surgery had better pain relief in the leg and a lower rate of complications.

PMID:35031849 | DOI:10.1007/s00590-021-03177-9

Eur Radiol. 2022 Jan 15. doi: 10.1007/s00330-021-08392-w. Online ahead of print.

ABSTRACT

OBJECTIVES: Patients with Crohn’s disease (CD) require multiple assessments with magnetic resonance enterography (MRE) from a young age. Standard MRE protocols for CD include contrast-enhanced sequences. Gadolinium deposits in brain tissue suggest avoiding gadolinium could benefit patients with CD. This study aimed to compare the accuracy of the simplified Magnetic Resonance Index of Activity (sMaRIA) calculated with and without contrast-enhanced sequences in determining the response to biologic drugs in patients with CD.

METHODS: This post hoc analysis of a prospective study included patients with CD with endoscopic ulceration in ≥ 1 intestinal segment starting biologic drug therapy. Two blinded radiologists used the sMaRIA to score images obtained at baseline and week 46 of treatment first using only unenhanced sequences (T2-sMaRIA) and 1 month later using both unenhanced and enhanced images (CE-sMaRIA). We calculated the rates of agreement between T2-sMaRIA, CE-sMaRIA, and ileocolonoscopy for different conceptualizations of therapeutic response.

RESULTS: A total of 46 patients (median age, 36 years [IQR: 28-47]) were included. Agreement with ileocolonoscopy was similar for CE-sMaRIA and T2-sMaRIA in identifying ulcer healing (kappa = 0.74 [0.55-0.93] and 0.70 [0.5-0.9], respectively), treatment response (kappa = 0.53 [0.28-0.79] and 0.44 [0.17 – 0.71]), and remission (kappa = 0.48 [0.22-0.73] and 0.43 [0.17-0.69]). The standardized effect size was moderate for both CE-sMaRIA = 0.63 [0.41-0.85] p < 0.001 and T2-sMaRIA = 0.58 [0.36-0.80] p < 0.001.

CONCLUSIONS: sMaRIA with and without contrast-enhanced images accurately classified the response according to different therapeutic endpoints determined by ileocolonoscopy.

KEY POINTS: • The simplified Magnetic Resonance Index of Activity is accurate for the assessment of Crohn’s disease activity, severity, and therapeutic response, using four dichotomic components that can be evaluated without the need of using contrast-enhanced sequences, representing a practical and safety advantage, but concerns have been expressed as to whether the lack of contrast sequences may compromise precision. • The simplified Magnetic Resonance Index of Activity can assess the response to biologic therapy in patients with Crohn’s disease without the need for intravenous contrast agents obtaining comparable results without and with contrast-enhanced sequences. • Avoiding intravenous contrast agents could reduce the duration of the MRE examination and its cost and would increase the acceptance and safety of MRE in clinical research in patients with Crohn’s disease.

PMID:35031844 | DOI:10.1007/s00330-021-08392-w

Eur Radiol. 2022 Jan 15. doi: 10.1007/s00330-021-08432-5. Online ahead of print.

ABSTRACT

PURPOSE: To compare the diagnostic performance and inter-observer agreement of five different CT chest severity scoring systems for COVID-19 to find the most precise one with the least interpretation time.

METHODS AND MATERIALS: This retrospective study included 85 patients (54 male and 31 female) with PCR-confirmed COVID-19. They underwent CT to assess the severity of pulmonary involvement. Three readers were asked to assess the pulmonary abnormalities and score the severity using five different systems, including chest CT severity score (CT-SS), chest CT score, total severity score (TSS), modified total severity score (m-TSS), and 3-level chest CT severity score. Time consumption on reporting of each system was calculated.

RESULTS: Two hundred fifty-five observations were reported for each system. There was a statistically significant inter-observer agreement in assessing qualitative lung involvement using the m-TSS and the other four quantitative systems. The ROC curves revealed excellent and very good diagnostic accuracy for all systems when cutoff values for detection severe cases were > 22, > 17, > 12, and > 26 for CT-SS, chest CT score, TSS, and 3-level CT severity score. The AUC was very good (0.86), excellent (0.90), very good (0.89), and very good (0.86), respectively. Chest CT score showed the highest specificity (95.2%) in discrimination of severe cases. Time consumption on reporting was significantly different (< 0.001): CT-SS > 3L-CT-SS > chest CT score > TSS.

CONCLUSION: All chest CT severity scoring systems in this study demonstrated excellent inter-observer agreement and reasonable performance to assess COVID-19 in relation to the clinical severity. CT-SS and TSS had the highest specificity and least time for interpretation.

KEY POINTS: • All chest CT severity scoring systems discussed in this study revealed excellent inter-observer agreement and reasonable performance to assess COVID-19 in relation to the clinical severity. • Chest CT scoring system and TSS had the highest specificity. • Both TSS and m-TSS consumed the least time compared to the other three scoring systems.

PMID:35031841 | DOI:10.1007/s00330-021-08432-5

Eur Radiol. 2022 Jan 15. doi: 10.1007/s00330-021-08376-w. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the potential of molecular amide proton transfer (APT) MRI for predicting the risk group of abdominal tumors in children, and compare it with quantitative T1 and T2 mapping.

METHODS: This prospective study enrolled 133 untreated pediatric patients with suspected abdominal tumors from February 2019 to September 2020. APT-weighted (APTw) imaging and quantitative relaxation time mapping sequences were executed for each subject. The region of interest (ROI) was generated with automatic artifact detection and ROI-shrinking algorithms, within which the APTw, T1, and T2 indices were calculated and compared between different risk groups. The prediction performance of different imaging parameters was assessed with the receiver operating characteristics (ROC) analysis and Student’s t-test.

RESULTS: Fifty-seven patients were included in the final analysis, including 24 neuroblastomas (NB), 18 Wilms’ tumors (WT), and 15 hepatoblastomas (HB). The APTw signal was significantly (p < .001) higher in patients with high-risk NB than those with low-risk NB, while the difference between patients with low-risk and high-risk WT (p = .69) or HB (p = .35) was not statistically significant. The associated areas under the curve (AUC) for APT to differentiate low-risk and high-risk NB, WT, and HB were 0.93, 0.58, and 0.71, respectively. The quantitative T1 and T2 values generated AUCs of 0.61-0.70 for the risk stratification of abdominal tumors.

CONCLUSIONS: APT MRI is a potential imaging biomarker for stratifying the risk group of pediatric neuroblastoma in the abdomen preoperatively and provides added value to structural MRI.

KEY POINTS: • Amide proton transfer (APT) imaging showed significantly (p < .001) higher values in pediatric patients with high-risk neuroblastoma than those with low-risk neuroblastoma, but did not demonstrate a significant difference in patients with Wilms’ tumor (p = .69) or hepatoblastoma (p = .35). • The associated areas under the curve (AUC) for APT to differentiate low-risk and high-risk neuroblastoma, Wilms’ tumor, and hepatoblastoma were 0.93, 0.58, and 0.71, respectively. • The quantitative T1 and T2 indices generated AUCs of 0.61-0.70 for dichotomizing the risk group of abdominal tumors.

PMID:35031842 | DOI:10.1007/s00330-021-08376-w

Planta. 2022 Jan 14;255(2):38. doi: 10.1007/s00425-022-03820-7.

ABSTRACT

Three known sugarcane aphid-resistant pollinator parents were sterilized in A3 cytoplasmic male sterility and were confirmed in this study to be resistant to sugarcane aphid allowing for the development of sugarcane aphid-resistant forage hybrids. We utilized A3 cytoplasmic male sterility and converted known sugarcane aphid-resistant sorghum TX 2783, and newly released R. LBK1 (Reg. No. GP-865, PI 687244) and R. LBK2 (Reg. No. GP-866, PI 687245) into A3 sterility to determine if the sterile counterparts would also equally express tolerance and or antibiosis to sugarcane aphid. Free-choice flat screen trials and life-table demographic studies were utilized and compared to know susceptible/fertile entries KS 585, and TX 7000, and known resistant/fertile entries TX 2783 and DKS 37-07. The R. LBK1 fertile entry was more tolerant than the known susceptible entries KS 585 and TX 7000, but was not as resistant as the other resistant entries, sustaining a damage rating of 6.0 across two different screen trials. The sterile A3 R. LBK2 showed a greater tolerance and expressed higher levels of antibiosis during aphid reproductive studies when compared to the known resistant and fertile TX 2783. All other fertile (R. LBK2, TX2783) and the A3 male sterile counterparts (A3 R. LBK2, A3 TX2783) were very similar in expression of high levels of tolerance and exhibited statistically similar damage ratings of 3.3-4.3 when exposed to sugarcane aphids. No entry, either fertile or sterile, was as tolerant as DKS 37-07, a known resistant commercial hybrid. Other plant measurements including percent loss in chlorophyll content, difference in plant height, and number of true leaves for sugarcane aphid infested versus non-infested were very consistent and highly correlated with damage ratings. Antibiosis was also exhibited in both fertile and sterile versions of the resistant lines. There was a 2 × reduction in fecundity between the R. LBK1 fertile and its sterile A3 R. LBK1 when compared to the susceptible KS 585 and TX 7000; however, the remaining fertile and sterile entries had 3.8 × to 5.8 × decrease in fecundity when compared to the susceptible KS 585 and TX 7000. Other measurements in life-table statistics such as nymphs produced/female/d, and the intrinsic rates of increased were significantly lower for all fertile and sterile lines, showing that antibiosis significantly affected sugarcane aphid reproduction. In conclusion, the A3 cytoplasmic male sterility shows consistency for maintaining the single dominant trait SCA-resistant trait of TX 2783 for expressing both antibiosis and tolerance, and great utility in the development of sugarcane aphid-resistant forage sorghums.

PMID:35031833 | DOI:10.1007/s00425-022-03820-7

Curr Protoc. 2022 Jan;2(1):e330. doi: 10.1002/cpz1.330.

ABSTRACT

Three-dimensional organoid cultures enable the study of stem cell and tissue biology ex vivo, providing improved access to cells for perturbation and live imaging. Typically, organoids are grown in hydrogel domes that are simple to prepare but that lead to non-uniform tissue growth and viability. We recently developed a simple alternative culture method to embed intestinal organoids in multilayered hydrogels, called “triple-decker sandwiches,” that align organoids in a common z-plane with uniform access to medium. This culture configuration improves the growth and survival of organoids over a wide working area and facilitates long-term confocal imaging and molecular perturbation. Here, we present protocols for preparing organoids in triple-decker sandwich cultures and using them for live imaging, immunostaining, and single-cell RNA sequencing. We have tested our methods on mouse and human intestinal organoids and expect them to be useful for other highly proliferative three-dimensional cell cultures. © 2022 Wiley Periodicals LLC. Basic Protocol 1: Pre-coating plates with PolyHEMA to prepare them for triple-decker sandwich culture Support Protocol 1: Preparing PolyHEMA solution to coat glass-bottom dishes Basic Protocol 2: Embedding intestinal organoids in triple-decker sandwiches Alternate Protocol 1: Seeding single cells or organoids at low density in triple-decker sandwiches Support Protocol 2: Embedding intestinal organoids in hydrogel domes Support Protocol 3: Production of Wnt3a-conditioned medium Support Protocol 4: Production of Rspo1-conditioned medium Basic Protocol 3: Live imaging of mouse intestinal organoids in triple-decker sandwich cultures Alternate Protocol 2: Live imaging of vital dye-treated mouse intestinal organoids in triple-decker sandwich cultures Basic Protocol 4: Immunofluorescence imaging of mouse organoids liberated from triple-decker sandwich cultures Alternate Protocol 3: Liberating and fixing mouse intestinal organoids from dome cultures Support Protocol 5: Measuring cell proliferation by EdU staining of mouse intestinal organoids Basic Protocol 5: Single-cell RNA sequencing and analysis of mouse intestinal organoids.

PMID:35030297 | DOI:10.1002/cpz1.330

Int Endod J. 2022 Jan 14. doi: 10.1111/iej.13681. Online ahead of print.

ABSTRACT

AIM: This preliminary randomised, prospective, controlled trial aimed to compare the clinical and radiographic outcomes of two regenerative endodontic procedures (REPs), revitalisation and a platelet-rich fibrin (PRF)-based technique, in the treatment of mature permanent teeth with necrotic pulps.

METHODOLOGY: The trial has been reported according to the Preferred Reporting Items for Randomised Trials in Endodontics 2020 guidelines. The study protocol was registered at the clinical trial registry (ClinicalTrials.gov) with identifier number NCT04158232. Twenty patients with mature necrotic anterior teeth with large periapical lesions were randomly allocated into two groups (n=10): group I, treated with revitalisation with the blood clot (BC) technique, and Group II, treated with a PRF-based technique. The follow-up was for 12 months. Periradicular healing was assessed using standardised radiographs taken at baseline, and at 6 and 12 months after treatment. An electric pulp tester was used to assess whether pulp sensibility had been regained during the follow-up period. Statistical analysis was conducted using Mann-Whitney test and Wilcoxon test for non-parametric data. For parametric data, repeated measures analysis of variance was used. The significance level was set at P≤0.05.

RESULTS: There was a significant increase in periradicular healing in both groups at 6 and 12 months, compared to that at baseline, with no significant difference between the studied groups after 12 months (P=0.143). There was a significant difference between the tooth sensibility readings at baseline, 6-month, and 12-month follow-up timepoints (P<0.001).

CONCLUSIONS: The findings of this preliminary trial indicate the potential for using REPs, such as revitalisation or PRF-based techniques, as treatment options for mature teeth with necrotic pulps. A higher level of evidence obtained through adequately powered clinical trials and longer follow-up periods are required to conclusively validate the different outcomes of REPs.

PMID:35030270 | DOI:10.1111/iej.13681

Int J Dent Hyg. 2022 Jan 14. doi: 10.1111/idh.12580. Online ahead of print.

ABSTRACT

INTRODUCTION: Parents and caregivers of pediatric patients usually tend to search for health information on social networks and other online platforms. At this point, the quality and reliability of these sources play an essential part in maintaining the oral health of pediatric patients.

AIM: The recent study aimed to analyze the reliability, quality, and content of YouTube^TM videos on pediatric oral health instructions, assess the efficacy of these videos, and help health providers lead the parents accessing accurate information on the subject mentioned.

DESIGN: The searching term was detected as “children oral health” (Google Trends Application). The first 150 videos were taken into the study. Six excluding criteria were used, and 40 videos have lasted for the further examinations. Content headings were determined according to the AAPD guidelines on pediatric oral health. The content analysis scores, reliability scores, and Global Quality Score were calculated for each of these 40 videos. SPSS 26 statistical software was used in the statistical analysis process of the data; p <0.05 was considered statistically significant.

RESULTS: The recent study results showed that according to content analyses, the videos were classified as ”poor” content with the mean values 4.07 (± 1.32). The mean reliability score 2.96 (± 0.69) has shown that the reliability of the videos was moderate. Mean Global Quality Score values were 2.95 (± 0.73), which means the subjects were moderate quality. The mean reliability of the rich content videos (3.39 ± 0.59) and the Global Quality Score score of them (3.43 ± 0.62) were statistically higher compared to the average values of the poor content videos (respectively; 2.73 ± 0.64; 2.69± 0.66) (p<0.05) The average number of likes, dislikes, length, interaction index and viewing rate of rich content videos were higher than the same features of poor content videos (p<0.05). The videos with rich content were determined in the first 50 videos listed for analyzes, and the distribution of the included videos on the list was equally.

CONCLUSION: The present study concluded that the YouTubeTM videos providing oral health instructions for pediatric patients and their parents had poor content, medium quality, and reliability. Although all the listed content headings were not mentioned in the videos, the content of them still may be useful and educational for individuals. However, dental hygiene practitioners and dentists should be aware of the need in this area and put more effort into improving the YouTube^TM videos on children’s oral health in a more detailed way regarding content headings, quality, and reliability.

PMID:35030292 | DOI:10.1111/idh.12580

Am J Occup Ther. 2022 Jan 1;76(1):7601180100. doi: 10.5014/ajot.2022.049202.

ABSTRACT

IMPORTANCE: Rates of occupational therapy service utilization among people with autism spectrum disorder (ASD) or intellectual disability (ID) have not been explored in population-based samples.

OBJECTIVE: To describe occupational therapy services delivered to Medicaid-eligible persons younger than age 65 yr identified as having ASD, ID, or both and to evaluate demographic factors associated with occupational therapy service utilization in this population.

DESIGN: Retrospective, case-control, cohort study using claims records from Medicaid Analytic eXtract files (2009-2012).

SETTING: Data from all 50 states and Washington, DC.

PARTICIPANTS: Beneficiaries identified as having ASD only, ASD+ID, or ID only who were younger than age 18 yr (N = 664,214) and ages 18-64 yr (N = 702,338). Outcomes and Measures: We analyzed Current Procedural Terminology® and Healthcare Common Procedure Coding System procedure codes, Medicaid Statistical Information System type of service codes, and Center for Medicare & Medicaid Services provider specialty codes.

RESULTS: Only 3.7% to 6.3% of eligible adult beneficiaries received occupational therapy; in contrast, 20.5% to 24.2% of children received occupational therapy. Significant predictors of service use varied by group; however, differences by race-ethnicity, eligibility on the basis of poverty, and geographic location were observed. Among children, the most frequent billing code was for “therapeutic activities” (43%-60%); among adults, it was “community/work reintegration training” (29%-39%).

CONCLUSIONS AND RELEVANCE: Billed procedure code patterns do not consistently reflect the unique occupational focus that occupational therapy providers deliver to people with developmental disabilities. Disparities in occupational therapy receipt warrant further attention to understand the social and structural factors affecting service delivery. What This Article Adds: Occupational therapy services paid for by Medicaid are used more frequently by children with ASD and ID than by adults with these diagnoses. Greater understanding of the intersectional factors that drive service delivery and disparities is needed.

PMID:35030249 | DOI:10.5014/ajot.2022.049202

Am J Clin Nutr. 2022 Jan 14:nqac005. doi: 10.1093/ajcn/nqac005. Online ahead of print.

ABSTRACT

BACKGROUND: Visualizations of the emerging obesity epidemic, such as with serial United States (US) color prevalence maps, provide graphic images that extend informative public health messages beyond those in written communications. Advances in low-cost 3D optical technology now allows for development of large image databases that include participants varying in race/ethnicity, body mass, height, age, and circumferences. When combined with contemporary statistical methods, these data sets can be used to create humanoid avatar images with pre-specified anthropometric features.

OBJECTIVE: The current study aimed to develop a humanoid avatar series with characteristics of representative US adults extending over the past six decades.

METHODS: 3D optical scans were conducted on a demographically diverse sample of 570 healthy adults. Image data was converted to principal components and manifold regression equations were then developed with body mass, height, age, and waist circumference as covariates. Humanoid avatars were generated for representative adults with these four characteristics as reported in Center for Disease Control surveys beginning in 1960-62 up to 2015-18.

RESULTS: There was a curvilinear increase in adult US population body mass, waist circumference, and body mass index (BMI) in males and females across the nine surveys spanning six decades. A small increase in average adult population age was present between 1960 and 2018; height changes were inconsistent. A series of four avatars developed at approximately 20-year intervals for representative males and females reveal the changes in body size and shape consistent with the emergence of the obesity epidemic. An additional series of developed avatars portray the shapes and sizes of males and females at key BMI cut points.

CONCLUSIONS: New mathematical approaches and accessible 3D optical technology combined with increasingly available large and diverse data sets across the lifespan now makes unique visualization of body size and shape possible on a previously unattainable scale. The study is registered at: https://clinicaltrials.gov/ct2/show/NCT03637855.

PMID:35030235 | DOI:10.1093/ajcn/nqac005