Category: Statistics

Hosp Pediatr. 2022 Feb 14:e2021006085. doi: 10.1542/hpeds.2021-006085. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Migraine headache is a common disorder in pediatrics, sometimes leading to hospital admission. Psychiatric comorbidities are prevalent in adults with migraine headache, but there is limited evidence in the pediatric population. This study aimed to examine the prevalence of psychiatric comorbidity in children hospitalized for migraine headache and assess the association of this comorbid state on treatment interventions and outcomes.

METHODS: This multicenter, retrospective cohort study examined data from the Pediatric Health Information System. Subjects included patients aged 6 to 18 hospitalized for migraine headache between 2010 and 2018, excluding those with complex chronic conditions. Associations of psychiatric comorbidity with treatments, length of stay (LOS), cost, and 30-day readmissions were assessed using the Fisher-exact, Wilcoxon-rank-sum test, and adjusted linear or logistic regression models.

RESULTS: The total 21 436 subjects included 6796 (32%) with psychiatric comorbidity, with prevalence highest for anxiety (2415; 11.2%), depression (1433; 6.7%), and attention-deficit/hyperactivity disorder (1411; 6.5%). Patients with psychiatric comorbidity were significantly more likely (P < .001) to receive dihydroergotamine (61% vs 54%), topiramate (23% vs 18%), and valproate (38% vs 34%), and have longer mean LOS (2.6 vs 2.0 days), higher average costs ($8749 vs $7040), and higher 30-day readmission (21% vs 17%).

CONCLUSIONS: Of children hospitalized for migraine headache, 32% have comorbid psychiatric disorders associated with increased use of medications, longer LOS, and increased cost of hospitalization and readmission. Prospective studies are recommended to identify optimal multidisciplinary care models for children with migraine headaches and psychiatric comorbidities in the inpatient setting.

PMID:35156120 | DOI:10.1542/hpeds.2021-006085

Front Glob Womens Health. 2022 Jan 28;2:804135. doi: 10.3389/fgwh.2021.804135. eCollection 2021.

ABSTRACT

INTRODUCTION: In Senegal, discontinuation due to sides effects of long-acting, reversible contraceptives (LARCs) is relatively low; 5% of new implant acceptors and 11% of new IUD acceptors stop using in their first year because of health or side effect concerns. This study investigated factors associated with LARC discontinuation in the first 12 months of use in Senegal and explored how LARC users cope with side effects.

METHODS: This mixed-method study involved quantitative interviews at five time points with LARC acceptors recruited from three service channels between February 2018 and March 2019. Qualitative interviews were conducted in August 2018 with a subset of those who experienced side effects. Logistic regression models identified factors associated with discontinuation due to side effects and discontinuation for any reason. Twelve-month discontinuation rates due to side effects were also estimated using a cumulative incidence function (CIF) approach to account for time to discontinuation.

RESULTS: In logistic models, method choice (IUD or implant) [OR = 3.15 (95% CI: 1.91-5.22)] and parity [OR = 0.81 (95% CI: 0.7-0.94)] were associated with discontinuation due to side effects; IUD users and women with fewer children were more likely to discontinue. Results for all-cause discontinuation were similar: method choice [OR = 2.39 (95% CI: 1.6-3.58)] and parity [OR = 0.86 (95% CI: 0.77-0.96)] were significant predictors. The 12-month side effect CIF discontinuation rate was 11.2% (95% CI: 7.9-15.0%) for IUDs and 4.9% (95% CI: 3.5-6.6%) for implants. Side effect experiences varied, but most women considered menstrual changes the least acceptable. No statistically significant differences across services channels were observed.

CONCLUSIONS: In this study in Senegal, the choice between implants and IUDs had a significant impact on continuation, and women with more children continued LARC methods longer, despite side effects.

PMID:35156087 | PMC:PMC8832161 | DOI:10.3389/fgwh.2021.804135

Front Digit Health. 2022 Jan 26;4:833912. doi: 10.3389/fdgth.2022.833912. eCollection 2022.

NO ABSTRACT

PMID:35156082 | PMC:PMC8825497 | DOI:10.3389/fdgth.2022.833912

Patterns (N Y). 2022 Feb 9:100453. doi: 10.1016/j.patter.2022.100453. Online ahead of print.

ABSTRACT

One of the impacts of the COVID-19 pandemic has been a push for researchers to better exploit synthetic data and accelerate the design, analysis, and modelling of clinical trials. The unprecedented clinical efforts caused by COVID-19 will certainly boost future robust and innovative approaches of statistical sciences applied to clinical fields. Here, we report the development of SASC, a simple but efficient approach to generate COVID-19 related synthetic clinical data through a web application. SASC takes basic summary statistics for each group of patients and attempts to generate single variables according to internal correlations. To assess the “reliability” of the results, statistical comparisons with Synthea, a known synthetic patient generator tool and, more importantly, with clinical data of real COVID-19 patients are provided. The source code and web application are available on GitHub at https://zenodo.org/record/5896935#.Ye6cpnrMJgC.

PMID:35156066 | PMC:PMC8825316 | DOI:10.1016/j.patter.2022.100453

Schizophr Bull Open. 2022 Jan 11;3(1):sgac001. doi: 10.1093/schizbullopen/sgac001. eCollection 2022 Jan.

ABSTRACT

BACKGROUND: Schizophrenia commonly co-occurs with cardiometabolic and inflammation-related traits. It is unclear to what extent the comorbidity could be explained by shared genetic aetiology.

METHODS: We used GWAS data to estimate shared genetic aetiology between schizophrenia, cardiometabolic, and inflammation-related traits: fasting insulin (FI), fasting glucose, glycated haemoglobin, glucose tolerance, type 2 diabetes (T2D), lipids, body mass index (BMI), coronary artery disease (CAD), and C-reactive protein (CRP). We examined genome-wide correlation using linkage disequilibrium score regression (LDSC); stratified by minor-allele frequency using genetic covariance analyzer (GNOVA); then refined to locus-level using heritability estimation from summary statistics (ρ-HESS). Regions with local correlation were used in hypothesis prioritization multi-trait colocalization to examine for colocalisation, implying common genetic aetiology.

RESULTS: We found evidence for weak genome-wide negative correlation of schizophrenia with T2D (r_g = -0.07; 95% C.I., -0.03,0.12; P = .002) and BMI (r_g = -0.09; 95% C.I., -0.06, -0.12; P = 1.83 × 10^-5). We found a trend of evidence for positive genetic correlation between schizophrenia and cardiometabolic traits confined to lower-frequency variants. This was underpinned by 85 regions of locus-level correlation with evidence of opposing mechanisms. Ten loci showed strong evidence of colocalization. Four of those (rs6265 (BDNF); rs8192675 (SLC2A2); rs3800229 (FOXO3); rs17514846 (FURIN)) are implicated in brain-derived neurotrophic factor (BDNF)-related pathways.

CONCLUSIONS: LDSC may lead to downwardly-biased genetic correlation estimates between schizophrenia, cardiometabolic, and inflammation-related traits. Common genetic aetiology for these traits could be confined to lower-frequency common variants and involve opposing mechanisms. Genes related to BDNF and glucose transport amongst others may partly explain the comorbidity between schizophrenia and cardiometabolic disorders.

PMID:35156041 | PMC:PMC8827407 | DOI:10.1093/schizbullopen/sgac001

Crit Care Explor. 2022 Feb 8;4(2):e0632. doi: 10.1097/CCE.0000000000000632. eCollection 2022 Feb.

ABSTRACT

BACKGROUND: Lung protective ventilation (LPV) is a key component in the management of acute respiratory distress syndrome and other acute respiratory pathology. Initiation of LPV in the emergency department (ED) is associated with improved patient-centered and system outcomes, but adherence to LPV among ED patients is low. The impact of an ED-based ICU (ED-ICU) on LPV adherence is not known.

METHODS: This single-center, retrospective, cohort study analyzed rates of adherence to a multifaceted LPV strategy pre- and post-implementation of an ED-ICU. LPV strategy components included low tidal volume ventilation, avoidance of severe hyperoxia and high plateau pressures, and positive end-expiratory pressure settings in alignment with best-evidence recommendations. The primary outcome was adherence to the LPV strategy at time of ED departure.

RESULTS AND CONCLUSIONS: A total of 561 ED visits were included in the analysis, of which 60.0% received some portion of their emergency care in the ED-ICU. Adherence to the LPV strategy was statistically significantly higher in the ED-ICU cohort compared with the pre-ED-ICU cohort (65.8% vs 41.4%; p < 0.001) and non-ED-ICU cohort (65.8% vs 43.1%; p < 0.001). Among the ED-ICU cohort, 92.8% of patients received low tidal volume ventilation. Care in the ED-ICU was also associated with shorter ICU and hospital length of stay. These findings suggest improved patient and resource utilization outcomes for mechanically ventilated ED patients receiving care in an ED-ICU.

PMID:35156050 | PMC:PMC8826963 | DOI:10.1097/CCE.0000000000000632

Adv Gerontol. 2021;34(6):953-960.

ABSTRACT

The work carried out an empirical analysis of the impact on the level of vitality of the parameters of the socio-economic situation of elderly people based on the data of a sociological survey. The modeling of the study of the influence included the choice of variables taking into account the criterion of the complexity of the measured parameters. The empirical basis for the study was the results of a survey (n=400) of elderly people living in cities and rural areas of the Tomsk region. Modeling and correlation analysis are used to test hypotheses. To identify the dependence, a formal model of the relationship of resilience with the selected parameters of the socio-economic situation is used as a system of indicators, to which the methods of mathematical statistics are applied to identify their impact on strengthening the resilience of older people. The results of the study confirm the influence of satisfaction with material prosperity on the resilience of elderly people. Correlations of resilience with different parameters, including gender, place of residence and higher education, were revealed.

PMID:35152614

Zhongguo Zhen Jiu. 2022 Feb 12;42(2):157-61. doi: 10.13703/j.0255-2930.20210719-0005.

ABSTRACT

OBJECTIVE: To compare the clinical therapeutic effect and the impacts on recurrence rate on chronic spontaneous urticaria (CSU) between the combined treatment of bloodletting therapy and auricular point sticking on the base of xuanfu theory and the oral solution of levocetirizine hydrochloride.

METHODS: A total of 86 patients with CSU were randomized into an observation group (43 cases, 1 case dropped off) and a control group (43 cases, 3 cases dropped off). In the observation group, bloodletting therapy at Dazhui (GV 14), Feishu (BL 13), Geshu (BL 17) and Pishu (BL 20) was combined with auricular point sticking at lung (CO₁₄), kidney (CO₁₀), shenmen (TF₄) and heart (CO₁₅), etc. This combined treatment was given once every two days. In the control group, the oral solution of levocetirizine hydrochloride was prescribed, 10 mL each time, once daily. The treatment lasted for 4 weeks in the two groups. Before and after treatment, urticaria activity score 7 (UAS7), the score of dermatology life quality index (DLQI) and the levels of serum immune globulin E (IgE), interleukin 4 (IL-4) and interferon γ (IFN-γ) were compared in the patients between the two groups. The clinical therapeutic effect was evaluated in patients of the two groups and the recurrence rate was followed up 4, 8 and 12 weeks after treatment separately.

RESULTS: After treatment, the scores of UAS7 and DLQI, as well as the levels of serum IgE and IL-4 were all reduced as compared with those before treatment in the two groups (P<0.05), and the level of serum IFN-γ was increased (P<0.05). The total effective rate was 83.3% (35/42) in the observation group and was 85.0% (34/40) in the control group. There was no statistical significance for the difference in the clinical therapeutic effect between the two groups (P>0.05). Eight and 12 weeks after treatment, the recurrence rates were 21.1% (4/19) and 26.3% (5/19) in the observation group, lower than 55.0% (11/20) and 65.0% (13/20) in the control group, respectively (P<0.05).

CONCLUSION: The combined therapy of bloodletting and auricular point sticking on the base of xuanfu theory relieves the clinical symptoms, regulates the levels of serum IgE, IL-4 and IFN-γ and improves the quality of life in the patients with CSU. The clinical therapeutic effect of this combined treatment is similar to the oral solution of levocetirizine hydrochloride. But, the recurrence rate of the combined treatment of bloodletting and auricular point sticking is lower and its long-term curative effect is better.

PMID:35152579 | DOI:10.13703/j.0255-2930.20210719-0005

Adv Gerontol. 2021;34(6):928-933.

ABSTRACT

The article presents pioneer results of assessing the impact of the pandemic on the resilience of the older adults of the Tomsk region. We assessed the resilience of older adults and its predictors basing upon the survey of 400 respondents aged 55-92 using the Connor-Davidson resilience scale (CD-RISC-25). The results reveal statistically significant relationship between the resilience, material well-being and emotional state of elderly respondents in the context of the coronavirus pandemic. The results of the study complement the existing approaches to assessing and measuring the parameters of the quality of life of the older adults, and can be used to design tools for strengthening the resilience in line with the concept of active ageing.

PMID:35152610

Brain Behav. 2022 Feb 13:e2524. doi: 10.1002/brb3.2524. Online ahead of print.

ABSTRACT

OBJECTIVES: Some acute ischemic stroke (AIS) patients still suffer from early neurological deterioration (END) after receiving intravenous thrombolysis (IVT), and these patients often have a poor prognosis. The purpose of our study is to observe the efficacy and safety of human urinary kallidinogenase (HUK) treatment in patients with END.

METHODS: This was a retrospective analysis and 49 patients with END who met the inclusion criteria were divided into the observation group and the control group. All patients received routine treatment of AIS, while patients in the observation group were treated with HUK within 24 h after IVT and the other group without HUK.

RESULTS: There were 24 patients in the observation group and 25 patients in the control group. After treatment, favorable prognosis (mRS scores ≤2) at 3 months in the observation group with 13 cases (54.17%) was significantly better than that in the control group with four cases (16%) (p = .001), and there was no statistical difference between the two groups in any hemorrhagic complication.

CONCLUSION: HUK is considered to be safe and may improve the prognosis of AIS patients with END after IVT. More clinical trials are needed to validate these results in the future.

PMID:35152571 | DOI:10.1002/brb3.2524