Category: Statistics

Pain. 2022 Apr 19. doi: 10.1097/j.pain.0000000000002653. Online ahead of print.

ABSTRACT

Chronic postsurgical pain (CPSP) is defined by pain intensity and pain-related functional interference. This study included measures of function in a composite score of patient-reported outcomes (PROs) to investigate the incidence of CPSP. Registry data were analyzed for PROs one day and 12 months postoperatively. Based on pain intensity and pain-related interference with function, patients were allocated to the groups “CPSPF” (at least moderate pain with interference), “Mixed” (milder symptoms) and “No CPSPF”. The incidence of CPSPF was compared to CPSP rates referring to published data. Variables associated with the PRO-12 score (composite PROs at 12 months; NRS 0-10) were analyzed by linear regression analysis. Of 2319 patients, 8.6%, 32.5% and 58.9% were allocated to the groups CPSPF, Mixed and No CPSPF. Exclusion of patients whose pain scores did not increase compared to the preoperative status, resulted in a 3.3% incidence. Of the patients without pre-existing pain, 4.1% had CPSPF. Previously published pain cut-offs of NRS >0, ≥3 or ≥4, used to define CPSP, produced rates of 37.5%, 9.7% and 5.7%. Pre-existing chronic pain, pre-operative opioid medication and type of surgery were associated with the PRO-12 score (all p<0.05). Opioid doses and PROs 24 hours postoperatively improved the fit of the regression model. A more comprehensive assessment of pain and interference resulted in lower CPSP rates than previously reported. Although inclusion of CPSP in the ICD-11 is a welcome step, evaluation of pain characteristics would be helpful in differentiation between CPSPF and continuation of pre-existing chronic pain.

PMID:35442934 | DOI:10.1097/j.pain.0000000000002653

IEEE Trans Cybern. 2022 Apr 20;PP. doi: 10.1109/TCYB.2022.3158702. Online ahead of print.

ABSTRACT

In this article, a novel version of the general regression neural network (Imp_GRNN) is developed to control a class of multiinput and multioutput (MIMO) nonlinear discrete-time (DT) systems. The improvements retain the features of the original GRNN along with a significant improvement of the control accuracy. The enhancements include developing a method to set the input-hidden weights of GRNN using the inputs recursive statistical means, introducing a new output layer and adaptable forward weighted connections from the inputs to the new layer, and suggesting an interval-type smoothing parameter to eradicate the need for selecting the parameter beforehand or adapting it online. Also, controller stability is studied using Lyapunov’s method for DT systems. The controller performance is tested with different simulation examples and compared with the original GRNN to verify its superiority over it. Also, Imp_GRNN performance is compared with an adaptive radial basis function network controller, an adaptive feedforward neural-network (NN) controller, and a proportional-integral-derivative (PID) controller, where it demonstrated higher accuracy in comparison with them. In comparison with the formerly proposed control methods for MIMO DT systems, our controller is capable of producing high control accuracy while it is model free, does not require complex mathematics, has low computational complexity, and can be utilized for a wide range of DT dynamic systems. Also, it is one of the few methods that aims to improve the control system accuracy by improving the NN structure.

PMID:35442895 | DOI:10.1109/TCYB.2022.3158702

Food Addit Contam Part A Chem Anal Control Expo Risk Assess. 2022 Apr 20:1-7. doi: 10.1080/19440049.2022.2066194. Online ahead of print.

ABSTRACT

Forty-two samples of feed, saliva, urines, and faeces collected from a cattle farm were investigated with the aim to evaluate the occurrence of glyphosate in faeces, urine and saliva. Glyphosate in the feed was also quantified to understand how it was assimilated by mammals. All cows excreted glyphosate in their faeces at concentrations between 57 and 983 ng g^-1. In contrast, only 55% of urine and one sample of saliva tested positive. Most of the feeds demonstrated a non-negligible presence of glyphosate. In particular, a silage containing soybeans from genetically modified cultivation showed a concentration one order of magnitude higher than the other feeds. This study aims to provide the first complete determination of glyphosate in a cattle farm, considering the possible re-entry into the environment through the spreading of liquid and solid sewage and its possible impact on groundwater.

PMID:35442859 | DOI:10.1080/19440049.2022.2066194

IEEE Trans Med Imaging. 2022 Apr 20;PP. doi: 10.1109/TMI.2022.3168888. Online ahead of print.

ABSTRACT

The analysis of connectivity between parcellated regions of cortex provides insights into the functional architecture of the brain at a systems level. However, the derivation of functional structures from voxel-wise analyses at finer scales remains a challenge. We propose a novel method, called localized topo-connectivity mapping with singular-value-decomposition-informed filtering (or filtered LTM), to identify and characterize voxel-wise functional structures in the human brain from resting-state fMRI data. Here we describe its mathematical formulation and provide a proof-of-concept using simulated data that allow an intuitive interpretation of the results of filtered LTM. The algorithm has also been applied to 7T fMRI data acquired as part of the Human Connectome Project to generate group-average LTM images. Generally, most of the functional structures revealed by LTM images agree in the boundaries with anatomical structures identified by T1-weighted images and fractional anisotropy maps derived from diffusion MRI. In addition, the LTM images also reveal subtle functional variations that are not apparent in the anatomical structures. To assess the performance of LTM images, the subcortical region and occipital white matter were separately parcellated. Statistical tests were performed to demonstrate that the synchronies of fMRI signals in LTM-derived functional parcels are significantly larger than those with geometric perturbations. Overall, the filtered LTM approach can serve as a tool to investigate the functional organization of the brain at the scale of individual voxels as measured in fMRI.

PMID:35442885 | DOI:10.1109/TMI.2022.3168888

Cancer Control. 2022 Jan-Dec;29:10732748221082791. doi: 10.1177/10732748221082791.

ABSTRACT

BACKGROUND: Decisional conflict (DC) is a psychological construct that an individual experiences in making a decision that involves risk, loss, regret, or challenges to one’s values. This study assessed DC in a cohort of South African men undergoing curative treatment for localised prostate cancer (LPC). The objectives were to (1) to examine the association between DC and prostate cancer knowledge (PCK), demographics, state anxiety, prostate cancer anxiety and time to treatment and (2) to compare levels of DC between treatment groups [prostatectomy (RP) and external beam radiation (RT)].

METHOD: Data, comprising the Decisional Conflict Scale (DCS), Prostate Cancer Knowledge (PCK), State-Trait Anxiety Inventory (STAI-S), the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) and demographic data from 83 participants of a larger prospective longitudinal observational study examining depression, anxiety and health related quality of life (DAHCaP) were analysed.

RESULTS: The mean age of participants was 63 years (RP 61yrs and RT 65yrs; p< 0.001). Most were of mixed ancestry (72.3%). The total DCS scores between the treatment groups (RP 25.00 and RT 18.75; p = 0.037) and two DCS sub-scores-uncertainty (p = 0.033), and support (p = 0.048), were significantly higher in the RP group. A statistically significant negative correlation was observed between state anxiety and time between diagnosis and treatment in the RP group (Spearman’s rho = -0.368; p = 0.030). There was no correlation between the DCS score and PCK within each treatment group (Spearman’s rho RP = -0.249 and RT = -0.001).

CONCLUSION: Decisional conflict was higher in men undergoing RP. Men were more anxious in the RP group regarding the time treatment was received from diagnosis. No correlation was observed between DC and PCK. Pre-surgical management of DC should include shared decision making (SDM) which is cognisant of patients’ values facilitated by a customised decision aid.

PMID:35442835 | DOI:10.1177/10732748221082791

Metab Syndr Relat Disord. 2022 Apr 18. doi: 10.1089/met.2021.0136. Online ahead of print.

ABSTRACT

Background: The rs7903146 variant in the TCF7L2 gene is associated with defects in postprandial insulin and glucagon secretion and increased risk of type 2 diabetes. However, it is unclear if this variant has effects on glucose metabolism that are independent of islet function. Methods: We studied 54 nondiabetic subjects on two occasions where endogenous hormone secretion was inhibited by somatostatin. Twenty-nine subjects were homozygous for the diabetes-associated allele (TT) and 25 for the diabetes-protective allele (CC) at rs7903146, but otherwise matched for anthropometric characteristics. On 1 day, glucagon infused at a rate of 0.65 ng/kg/min, and at 0 min prevented a fall in glucagon (nonsuppressed day). On the contrary, infusion commenced at 120 min to create a transient fall in glucagon (suppressed day). Subjects received glucose (labeled with [3-³H]-glucose) infused to mimic the systemic appearance of oral glucose. Insulin was infused to mimic a prandial insulin response. Endogenous glucose production (EGP) was measured using the tracer dilution technique. Results: Lack of glucagon suppression increased postchallenge glucose concentrations and impaired EGP suppression. However, in the presence of matched insulin and glucagon concentrations, genetic variation in TCF7L2 did not alter glucose metabolism. Conclusion: These data suggest that genetic variation in TCF7L2 alters glucose metabolism through changes in islet hormone secretion.

PMID:35442800 | DOI:10.1089/met.2021.0136

J Womens Health (Larchmt). 2022 Apr 18. doi: 10.1089/jwh.2021.0449. Online ahead of print.

ABSTRACT

Background: Excessive gestational weight gain (GWG) is consistently linked with maternal risk of obesity. However, the literature on its long-term cardiovascular risk is minimal and conflicting. We evaluated whether excessive GWG is associated with a high-risk cardiovascular profile among parous women in midlife. Materials and Methods: Participants were women in the multiethnic cohort Study of Women’s Health Across the Nation with a history of live birth(s). Excessive GWG was defined according to Institute of Medicine guidelines and collected by self-recall. Outcomes were the atherosclerotic cardiovascular disease (ASCVD) risk score and C-reactive protein (CRP), measured at the study baseline when mean age was 47 years, and at 10 follow-up visits (1996-2017). We estimated the association of excessive GWG with outcomes through linear mixed model regression. Results: The analytic sample included 1318 women with 3049 singleton births. Over 40% (536) reported one or more pregnancies with excessive GWG. Longitudinal models estimated that at a mean age of 67, women with a history of excessive GWG had a 9.8% (9.2, 10.5) 10-year ASCVD risk, compared to 9.5% (8.9, 10.1) for those without, and mean CRP of 2.20 mg/L (1.89, 2.57) versus 1.85 mg/L (1.61, 2.14), respectively, adjusted for participant characteristics. Conclusions: In this multiethnic cohort of parous women, a history of excessive GWG was associated with a small, but statistically significant difference in ASCVD risk, and a moderate, statistically significant difference in CRP across midlife. More research is necessary to understand the mechanistic pathway between excessive GWG and long-term maternal cardiovascular health.

PMID:35442810 | DOI:10.1089/jwh.2021.0449

Popul Health Manag. 2022 Apr;25(2):164-171. doi: 10.1089/pop.2021.0268.

ABSTRACT

Stigma is one of the most harmful forces affecting population health. When stigma exists in clinical settings, environments that should be pro-patient and stigma-free, stigma may become internalized and affect patients’ well-being. Informed by prior stigma research and the Intergroup Contact Theory, the authors elucidate statistical relationships between patients’ perceptions of clinic-based stigma and stigma’s impact on health among New York City’s diverse residents. The authors hypothesize that perceiving stigma in clinical settings would mediate the relationships between depression, general health, diabetes, and hypertension; they tested this through multiple logistic regressions conducted on pooled data from the New York City Community Health Survey (N = 18,596, 2016-2017). Among women, depression was associated with stigma (α = 4.07, P < 0.01), hypertension (γ = 2.31, P < 0.01), diabetes (γ = 2.18, P < 0.01), and poor general health (γ = 6.34, P < 0.01). Among men, depression was associated with stigma (α = 3.7, P < 0.01), hypertension (γ = 2.35, P < 0.01), diabetes (γ = 1.86, P < 0.01), and poor general health (γ = 5.14, P < 0.01). Overall, perceived stigma in clinics significantly increased adjusted odds of self-reporting poor general health (adjusted ORs [AOR] = 1.87 men; AOR = 2.05 women). Findings contribute to the literature on the Intergroup Contact Theory, which suggests that stigma should be low in diverse communities; findings indicate that stigma may be a mediator, justifying inclusion in epidemiological and health services research. In addition, study outcomes suggest that depression may be associated with clinic-based stigma, and this stigma has deleterious effects on physical health. Thus, clinicians should emphasize stigma reduction in their facilities, potentially through the adoption of trauma-informed approaches or delivery of care using non-stigmatizing communication strategies, such as Motivational Interviewing.

PMID:35442794 | DOI:10.1089/pop.2021.0268

Braz Oral Res. 2022 Apr 15;36:e054. doi: 10.1590/1807-3107bor-2022.vol36.0054. eCollection 2022.

ABSTRACT

This in vitro study evaluated the potential of CO2 laser (10.6 μm) combined with a stannous/fluoride-containing solution for preventing erosion in human/bovine enamel. Forty-eight samples of each substrate were randomly allocated to four groups (n = 12): W – distilled water; E – AmF/NaF/SnCl2 solution; L – CO2 laser; and LE – CO2 laser+AmF/NaF/SnCl2 solution. After surface treatments, samples were submitted to a 5-day erosive challenge, alternating immersions in 0.5% citric acid (2 minutes, 6x/day) and in artificial saliva. Optical profilometry (μm) and scanning electron microscopy (SEM) were used to determine surface loss and surface morphology, respectively. Data were statistically analyzed by two-way ANOVA and Tukey’s tests (p < 0.05). For human enamel, tissue loss was lower in group L (12.37 ± 4.46) than in group W (16.45 ± 2.76), and higher than in the groups treated with AmF/NaF/SnCl2 solution (E-5.44 ± 2.37; LE-5.55 ± 2.31). In group L, SEM images reveled a disorganized surface but fewer projections than in group W and LE showed fewer irregularities than W, E, and L. For bovine enamel, tissue loss in group L (13.90 ± 3.50) did not differ from that in group W (14.10 ± 2.98), and was higher than losses in groups E (5.70 ± 2.12) and LE (8.12 ± 2.56), which were statistically similar to each other. Groups W and L had similar aspects of demineralization, whereas groups E and LE showed homogenous surfaces. Surface-treated samples had no changes in their surfaces. CO2 laser was able to slightly prevent surface loss only on human enamel surface, but did not enhance the AmF/NaF/SnCl2 effect on the prevention of enamel erosion.

PMID:35442383 | DOI:10.1590/1807-3107bor-2022.vol36.0054

JAMA Psychiatry. 2022 Apr 20. doi: 10.1001/jamapsychiatry.2022.0685. Online ahead of print.

ABSTRACT

IMPORTANCE: All of Us is a landmark initiative for population-scale research into a variety of health conditions, including psychiatric disorders.

OBJECTIVE: To analyze the prevalence, comorbidity, and sociodemographic covariates of psychiatric disorders in the All of Us biobank.

DESIGN, SETTING, AND PARTICIPANTS: We estimated prevalence, overlap, and sociodemographic correlates for psychiatric disorders as reported in electronic health records for All of Us release 5 (N = 331 380).

EXPOSURES: Social and demographic covariates.

MAIN OUTCOMES AND MEASURES: Psychiatric disorders derived from International Statistical Classification of Diseases, Tenth Revision, Clinical Modification, codes across 6 broad domains: mood disorders, anxiety disorders, substance use disorders, stress-related disorders, schizophrenia, and personality disorders.

RESULTS: The analytic sample (N = 329 038) was 60.7% female (mean [SD] age, 50.9 [16.8] years). The prevalence of disorders ranged from 11.00% (95% CI, 10.68% to 11.32%) for any mood disorder to less than 1% (eg, obsessive-compulsive disorder, 0.18%; 95% CI, -0.16% to 0.52%), with mood disorders being the most common and personality disorders being the least. There was substantial overlap among disorders, with the majority of participants with a disorder (30 113/58 806, approximately 51%) having 2 or more registered diagnoses and tetrachoric correlations ranging from 0.43 to 0.74. Comparisons of prevalence across demographic categories revealed that non-Hispanic White people, individuals with low socioeconomic status, women and individuals assigned female at birth, and sexual minority individuals are at greatest risk for most disorders.

CONCLUSIONS AND RELEVANCE: Although rates of disorders among the All of Us cohort are lower than in the general population, considerable variation, comorbidity, and disparities exist across social groups. To improve the practice of equitable precision medicine, researchers can use comprehensive health data from large-scale resources such as All of Us.

PMID:35442391 | DOI:10.1001/jamapsychiatry.2022.0685