Category: Statistics

Oral Maxillofac Surg. 2022 Dec 29. doi: 10.1007/s10006-022-01133-3. Online ahead of print.

ABSTRACT

PURPOSE: Temporomandibular joint ankylosis (TMJA) in children is associated with retrognathia, reduction in pharyngeal airway volume (PAV), and obstructive sleep apnea (OSA). Distraction-osteogenesis (DO) is the proven method in the management of OSA. There is paucity in literature about the effect of distraction vector on PAV. It can be expected that an oblique vector would improve PAV and relieve OSA. Thus, the study was designed to explore the feasibility, advantages, and disadvantages of this modified technique for managing TMJA and OSA simultaneously.

MATERIALS AND METHOD: The investigators designed a prospective study on patients of TMJA with retrognathia. Ethical approval was obtained (IECPG-547/14.11.2018). In all patients, simultaneous ankylosis release and mandibular distraction were performed. Primary outcome variables were improvement in 3-dimensional (3D) PAV and maximal interincisal opening (MIO). Secondary outcome variables were changed mandibular length, distraction relapse, and re-ankylosis. Paired t-test and multivariate ANOVA were used to assess all the parameters.

RESULT: The study included 13 joints in 8 patients of TMJA with retrognathia (2 unilateral and 6 bilateral ankylosis) with mean age of 14.25 ± 7.37 years. Mean distraction performed was 19 ± 4.0 mm. There was a statistically significant improvement of PAV by 225% (p = 0.002), a reduction in Epworth’s scale (p = 0.017), an increase in MIO (p = 0.001), and an increase in mandibular length. Three patients had re-ankylosis at the 25-month follow-up.

CONCLUSION: The results of the present study conclude that modification of distraction vector improves 3D PAV and MIO in TMJA patients, with the added advantage of a reduction in overall treatment time and improved patient compliance.

PMID:36580189 | DOI:10.1007/s10006-022-01133-3

Res Child Adolesc Psychopathol. 2022 Dec 29. doi: 10.1007/s10802-022-01014-z. Online ahead of print.

ABSTRACT

Levels of emotional and behavioral problems in children and adolescents demonstrate secular changes over time, warranting ongoing investigation. Prior studies examining secular trends in a range of such problems have been conducted in the U.S. and internationally. Research in this area generally has not fully considered the school setting. This study compared emotional and behavioral problems across two cohorts of students in the U.S. assessed over a 22-year time period as part of measurement development efforts for the Scales for Assessing Emotional Disturbance Rating Scale (SAED-RSRS; Epstein et al., 2020). Specifically, analyses drew from data collected via teacher report on matched cohorts of students for the 1998 (data collected from 1996 to 1997; n = 1,148) and 2020 (data collected from 2016 to 2018; n = 1,148) editions of the SAED-RS. After establishing measurement invariance across cohorts and testing for gender differences, structural equation modeling revealed statistically significant cohort mean differences on two of the five factors of the SAED-RS, suggesting increases over time in Inability to Learn (β = 0.09, p = .024) and Physical Symptoms and Fears (β = 0.14, p = .005) that were comparable for girls and boys. There were no statistically significant differences on the remaining factors: Relationship Problems, Inappropriate Behavior, and Unhappiness/Depression. Supplemental item-level tests revealed differences on 8 of the 39 SAED-RS items. Findings suggest increases in specific problem areas that could benefit from ongoing monitoring and targeted interventions to support contemporary students.

PMID:36580170 | DOI:10.1007/s10802-022-01014-z

J Biol Phys. 2022 Dec 29. doi: 10.1007/s10867-022-09620-0. Online ahead of print.

ABSTRACT

Cell fate decision processes are regulated by networks which contain different molecules and interactions. Different network topologies may exhibit synergistic or antagonistic effects on cellular functions. Here, we analyze six most common small networks with regulatory logic AND or OR, trying to clarify the relationship between network topologies and synergism (or antagonism) related to cell fate decisions. We systematically examine the contribution of both network topologies and regulatory logic to the cell fate synergism by bifurcation and combinatorial perturbation analysis. Initially, under a single set of parameters, the synergism of three types of networks with AND and OR logic is compared. Furthermore, to consider whether these results depend on the choices of parameter values, statistics on the synergism of five hundred parameter sets is performed. It is shown that the results are not sensitive to parameter variations, indicating that the synergy or antagonism mainly depends on the network topologies rather than the choices of parameter values. The results indicate that the topology with “Dual Inhibition” shows good synergism, while the topology with “Dual Promotion” or “Hybrid” shows antagonism. The results presented here may help us to design synergistic networks based on network structure and regulation combinations, which has promising implications for cell fate decisions and drug combinations.

PMID:36580168 | DOI:10.1007/s10867-022-09620-0

Support Care Cancer. 2022 Dec 29;31(1):91. doi: 10.1007/s00520-022-07514-4.

ABSTRACT

BACKGROUND: The final conversion ratios among opioids used for successful switching are unknown. The aim of this study was to determine the initial and final conversion ratios used for a successful opioid switching in cancer patients, and eventual associated factors.

METHODS: Ninety-five patients who were successfully switched were evaluated. The following data were collected: age, gender, Karnofsky performance score, primary cancer, cognitive function, the presence of neuropathic, and incident pain. Opioids, route of administration, and their doses expressed in oral morphine equivalents used before OS were recorded as well as opioids use for starting opioid switching, and at time of stabilization. Physical and psychological symptoms were routinely evaluated by Edmonton Symptom Assessment Scale.

RESULTS: No statistical changes were observed between the initial conversion ratios and those achieved at time of stabilization for all the sequences of opioid switching. When considering patients switched to methadone, there was no association between factors taken into considerations.

CONCLUSION: Opioid switching is a highly effective and safe technique, improving analgesia and reducing the opioid-related symptom burden. The final conversion ratios were not different from those used for starting opioid switching. Patients receiving higher doses of opioids should be carefully monitored for individual and unexpected responses in an experienced palliative care unit, particularly those switched to methadone. Future studies should provide data regarding the profile of patients with difficult pain to be hospitalized.

PMID:36580152 | DOI:10.1007/s00520-022-07514-4

Strahlenther Onkol. 2022 Dec 29. doi: 10.1007/s00066-022-02034-w. Online ahead of print.

ABSTRACT

OBJECTIVES: To assess the potential of radiomic features (RFs) extracted from simulation computed tomography (CT) images in discriminating local progression (LP) after stereotactic body radiotherapy (SBRT) in the management of lung oligometastases (LOM) from colorectal cancer (CRC).

MATERIALS AND METHODS: Thirty-eight patients with 70 LOM treated with SBRT were analyzed. The largest LOM was considered as most representative for each patient and was manually delineated by two blinded radiation oncologists. In all, 141 RFs were extracted from both contours according to IBSI (International Biomarker Standardization Initiative) recommendations. Based on the agreement between the two observers, 134/141 RFs were found to be robust against delineation (intraclass correlation coefficient [ICC] > 0.80); independent RFs were then assessed by Spearman correlation coefficients. The association between RFs and LP was assessed with Mann-Whitney test and univariate logistic regression (ULR): the discriminative power of the most informative RF was quantified by receiver-operating characteristics (ROC) analysis through area under curve (AUC).

RESULTS: In all, 15/38 patients presented LP. Median time to progression was 14.6 months (range 2.4-66 months); 5/141 RFs were significantly associated to LP at ULR analysis (p < 0.05); among them, 4 RFs were selected as robust and independent: Statistical_Variance (AUC = 0.75, p = 0.002), Statistical_Range (AUC = 0.72, p = 0.013), Grey Level Size Zone Matrix (GLSZM) _zoneSizeNonUniformity (AUC = 0.70, p = 0.022), Grey Level Dependence Zone Matrix (GLDZM) _zoneDistanceEntropy (AUC = 0.70, p = 0.026). Importantly, the RF with the best performance (Statisical_Variance) is simply representative of density heterogeneity within LOM.

CONCLUSION: Four RFs extracted from planning CT were significantly associated with LP of LOM from CRC treated with SBRT. Results encourage further research on a larger population aiming to define a usable radiomic score combining the most predictive RFs and, possibly, additional clinical features.

PMID:36580087 | DOI:10.1007/s00066-022-02034-w

Neurol Neurochir Pol. 2022 Dec 29. doi: 10.5603/PJNNS.a2022.0083. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the efficacy of multi-layer skull base reconstruction after endoscopic transnasal surgery for invasive pituitary adenomas (IPAs).

CLINICAL RATIONALE FOR THE STUDY: Skull base reconstruction for IPAs.

MATERIAL AND METHODS: This retrospective analysis involved 160 patients with IPAs who underwent operations from October 2018 to October 2020. All patients were diagnosed with IPAs by pituitary enhanced magnetic resonance imaging, and all tumours were confirmed to be Knosp grades 3a, 3b, or 4. The experimental group and the control group comprised 80 patients in each, and we used different methods to reconstruct the skull base in each group. The comparison indicators included cerebrospinal fluid leakage, sellar floor bone flap (or middle turbinate) shifting, delayed healing of the skull base reconstructed tissue, nasal discomfort, and epistaxis. We used the chi-square test, and p < 0.05 was considered statistically significant.

RESULTS: In the experimental group, cerebrospinal fluid leakage occurred intraoperatively in 73 patients, two of whom had cerebrospinal fluid leakage postoperatively. Brain CT 12 months postoperatively showed no sellar floor bone flap (or middle turbinate) shifting. Endoscopic transnasal checks performed seven days after surgery showed that the skull base reconstructed tissue had healed in 74 patients and had failed to heal in six. However, endoscopic transnasal checks showed that all six of these patients’ pedicled nasoseptal flaps had healed well by 14 days after surgery. Other sequelae comprised nasal discomfort in four patients, and epistaxis in four. In the control group, cerebrospinal fluid leakage occurred intraoperatively in 71 patients, 14 of whom had cerebrospinal fluid leakage postoperatively. Brain CT 12 months postoperatively showed floor bone flap (or middle turbinate) shifting in 12 patients. Endoscopic transnasal checks performed seven days after surgery showed that the skull base reconstructed tissue had healed in 65 patients. In 12 patients, pedicled nasoseptal flaps had healed well by 14 days after surgery, while the remaining three patients required reoperation. Other sequelae comprised nasal discomfort in five patients, and epistaxis in six.

CONCLUSIONS: This new method of multi-layer skull base reconstruction could play an important role in endoscopic transnasal IPA surgery.

PMID:36580081 | DOI:10.5603/PJNNS.a2022.0083

Qual Manag Health Care. 2023 Jan-Mar 01;32(Suppl 1):S35-S44. doi: 10.1097/QMH.0000000000000396.

ABSTRACT

BACKGROUND AND OBJECTIVES: Although at-home coronavirus disease-2019 (COVID-19) testing offers several benefits in a relatively cost-effective and less risky manner, evidence suggests that at-home COVID-19 test kits have a high rate of false negatives. One way to improve the accuracy and acceptance of COVID-19 screening is to combine existing at-home physical test kits with an easily accessible, electronic, self-diagnostic tool. The objective of the current study was to test the acceptability and usability of an artificial intelligence (AI)-enabled COVID-19 testing tool that combines a web-based symptom diagnostic screening survey and a physical at-home test kit to test differences across adults from varying races, ages, genders, educational, and income levels in the United States.

METHODS: A total of 822 people from Richmond, Virginia, were included in the study. Data were collected from employees and patients of Virginia Commonwealth University Health Center as well as the surrounding community in June through October 2021. Data were weighted to reflect the demographic distribution of patients in United States. Descriptive statistics and repeated independent t tests were run to evaluate the differences in the acceptability and usability of an AI-enabled COVID-19 testing tool.

RESULTS: Across all participants, there was a reasonable degree of acceptability and usability of the AI-enabled COVID-19 testing tool that included a physical test kit and symptom screening website. The AI-enabled COVID-19 testing tool demonstrated overall good acceptability and usability across race, age, gender, and educational background. Notably, participants preferred both components of the AI-enabled COVID-19 testing tool to the in-clinic testing.

CONCLUSION: Overall, these findings suggest that our AI-enabled COVID-19 testing approach has great potential to improve the quality of remote COVID testing at low cost and high accessibility for diverse demographic populations in the United States.

PMID:36579707 | DOI:10.1097/QMH.0000000000000396

Qual Manag Health Care. 2023 Jan-Mar 01;32(Suppl 1):S29-S34. doi: 10.1097/QMH.0000000000000397.

ABSTRACT

BACKGROUND AND OBJECTIVES: COVID-19 symptoms change after onset-some show early, others later. This article examines whether the order of occurrence of symptoms can improve diagnosis of COVID-19 before test results are available.

METHODS: In total, 483 individuals who completed a COVID-19 test were recruited through Listservs. Participants then completed an online survey regarding their symptoms and test results. The order of symptoms was set according to (a) whether the participant had a “history of the symptom” due to a prior condition; and (b) whether the symptom “occurred first,” or prior to, other symptoms of COVID-19. Two LASSO (Least Absolute Shrinkage and Selection Operator) regression models were developed. The first model, referred to as “time-invariant,” used demographics and symptoms but not the order of symptom occurrence. The second model, referred to as “time-sensitive,” used the same data set but included the order of symptom occurrence.

RESULTS: The average cross-validated area under the receiver operating characteristic (AROC) curve for the time-invariant model was 0.784. The time-sensitive model had an AROC curve of 0.799. The difference between the 2 accuracy levels was statistically significant (α < .05).

CONCLUSION: The order of symptom occurrence made a statistically significant, but small, improvement in the accuracy of the diagnosis of COVID-19.

PMID:36579706 | DOI:10.1097/QMH.0000000000000397

Biometrics. 2022 Dec 29. doi: 10.1111/biom.13816. Online ahead of print.

ABSTRACT

In recent years, the study of species’ occurrence has benefited from the increased availability of large-scale citizen-science data. Whilst abundance data from standardized monitoring schemes are biased towards well-studied taxa and locations, opportunistic data are available for many taxonomic groups, from a large number of locations and across long timescales. Hence, these data provide opportunities to measure species’ changes in occurrence, particularly through the use of occupancy models, which account for imperfect detection. These opportunistic datasets can be substantially large, numbering hundreds of thousands of sites, and hence present a challenge from a computational perspective, especially within a Bayesian framework. In this paper, we develop a unifying framework for Bayesian inference in occupancy models that account for both spatial and temporal autocorrelation. We make use of the Pólya-Gamma scheme, which allows for fast inference, and incorporate spatio-temporal random effects using Gaussian processes (GPs), for which we consider two efficient approximations: Subset of Regressors and Nearest neighbour GPs. We apply our model to data on two UK butterfly species, one common and widespread and one rare, using records from the Butterflies for the New Millennium database, producing occupancy indices spanning 45 years. Our framework can be applied to a wide range of taxa, providing measures of variation in species’ occurrence, which are used to assess biodiversity change. This article is protected by copyright. All rights reserved.

PMID:36579700 | DOI:10.1111/biom.13816

Psychiatry Clin Neurosci. 2022 Dec 29. doi: 10.1111/pcn.13525. Online ahead of print.

ABSTRACT

AIM: This study aimed to examine the effect of Japanese policies for appropriate hypnotics use and novel hypnotics (e.g., melatonin receptor agonist [MRA] and orexin receptor antagonist [ORA]) on long-term prescriptions of hypnotics.

METHODS: This retrospective study was conducted using a large-scale health insurance claims database. Among subscribers prescribed hypnotics at least once between April 2005 and March 2021, those prescribed hypnotics for the first time after being included in the database in three periods (period 1, April 2012-March 2013; period 2, April 2016-March 2017; and period 3, April 2018-March 2019) were eligible. These were set considering the timing of the 2014 and 2018 medical fee revisions (2014 for polypharmacy of three or more hypnotics, 2018 for long-term prescription of benzodiazepine receptor agonists for >12 months). The duration of consecutive prescriptions of hypnotics over 12 months was evaluated. Factors associated with short-term prescriptions of hypnotics were also investigated.

RESULTS: In total, 186,535 participants were newly prescribed hypnotics. The mean duration of prescriptions was 2.9 months, and 9.3% of participants were prescribed hypnotics for 12 months. Prescription periods were not associated with short-term prescriptions of hypnotics. ORA use was associated with short-term prescriptions of hypnotics (adjusted hazard ratio, 1.077; 95% confidence interval, 1.035-1.120; p<0.001), but MRA use was not.

CONCLUSION: Japanese policies had no statistically significant effect on long-term prescriptions of hypnotics. Although this study suggests initiating ORA for insomniacs as a candidate strategy to prevent long-term prescriptions of hypnotics, further research is necessary to draw conclusions. This article is protected by copyright. All rights reserved.

PMID:36579672 | DOI:10.1111/pcn.13525