Category: Statistics

J Laparoendosc Adv Surg Tech A. 2022 Jun 7. doi: 10.1089/lap.2021.0752. Online ahead of print.

ABSTRACT

Background: Using ultrasound guidance has been demonstrated as a feasible alternative method for gastrostomy tube placement in the pediatric population. The aim of this study is to evaluate short- and long-term postoperative complications after ultrasound-guided gastrostomy tube placement (USGTP) and to compare them with complications after laparoscopic gastrostomy tube placement (LGTP). Methods: A retrospective chart review evaluated patients who underwent USGTP (n = 41) and LGTP (n = 120) at the same institution. Comparisons were made between the two groups in the context of demographics as well as 30-day and 6-month postoperative complications. A phone survey (n = 26) further identified USGTP complications potentially not captured in the electronic medical records. Results: There were no significant differences in age, gender, and indication for procedure between the two groups. Chart review revealed that USGTP and LGTP had statistically comparable rates of emergency department (ED) visits for postoperative complications. Among USGTP patients, 8% had a recorded ED visit within 30 days of the operation and 13% presented to the ED within 6 months, compared with 6% and 11%, respectively, in the LGTP group (P = .65, P = .69). The USGTP phone survey reported total complications over an average postoperative follow-up time of 34.6 months (range 8-87) and revealed a total ED visit rate of 35%, which is comparable with rates reported in the literature for minimally invasive feeding tube placement. Conclusion: USGTP is a safe and feasible alternative option for gastrostomy tube placement in the pediatric population and it has postoperative complication rates that are comparable with LGTP.

PMID:35671516 | DOI:10.1089/lap.2021.0752

Am J Occup Ther. 2022 Jul 1;76(4):7604345010. doi: 10.5014/ajot.2022.049022.

ABSTRACT

IMPORTANCE: Persistence on task-the voluntary continuation of a goal-directed action despite difficulties-is described as a behavioral component of involvement in an occupation; however, it has not yet been extensively studied in the context of pediatric occupational therapy.

OBJECTIVE: To describe persistent children, compared with their less persistent peers, in terms of age, sex, executive functions (EF), and perceived meaning of occupations and to assess whether intrapersonal factors, EF, and the perceived meaning of occupations can predict persistence.

DESIGN: Cross-sectional.

SETTING: A community in Israel.

PARTICIPANTS: Typically developing healthy children (N = 180) ages 6.0 to 12.5 yr and their parents.

OUTCOMES AND MEASURES: The Tower of Hanoi task (TOH; seven discs) was used to assess persistence on task. EF were assessed with the TOH (three discs) and the Verbal Working Memory test. Occupational meaning-challenge, value, sense of time, and autonomy-was assessed with the Perceived Meaning of Occupation Questionnaire.

RESULTS: Twenty-six children (14%) completed the task. They were older than their peers, performed better on most of the EF tests, and perceived more autonomy in their everyday activities (Mann-Whitney U = 1,185.0, p < .001). However, only the perceived autonomy of occupations was found to be a statistically significant factor that predicted persistence on task (B = -0.12, SE = 0.05, Wald = 7.60, p = .01).

CONCLUSIONS AND RELEVANCE: Perceived autonomy in everyday activities is crucial for persistence on task. Occupational therapy practitioners can promote children’s involvement and persistence in cognitive tasks by supporting a sense of autonomy in everyday activities, although further study is needed. What This Article Adds: This article highlights the contribution of perceived autonomy in everyday activities to children’s involvement and persistence on task by providing empirical data on children’s persistence on task with regard to their EF and perceived meaning of occupations. Children who persisted longer and completed tasks differed from their less persistent peers in terms of age and EF. However, perceived autonomy in everyday activities was the only predictor of task completion.

PMID:35671507 | DOI:10.5014/ajot.2022.049022

Am J Respir Crit Care Med. 2022 Jun 7. doi: 10.1164/rccm.202111-2657OC. Online ahead of print.

ABSTRACT

RATIONALE: The associations between ambient coarse particulate matter (PM2.5-10) and daily mortality is not fully understood at a global scale.

OBJECTIVES: To evaluate the short-term associations between PM2.5-10 and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide.

METHODS: We collected daily mortality (total, cardiovascular, respiratory) and air pollution data from 205 cities in 20 countries/regions. Concentrations of PM2.5-10 were computed as the difference between inhalable and fine particulate matter. A two-stage time-series analytic approach was applied, with over-dispersed generalized linear models and multilevel meta-analysis. We fitted two-pollutant models to test the independent effect of PM2.5-10 from co-pollutants (fine particulate matter, nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide). Exposure-response relationship curves were pooled and regional analyses were conducted.

MEASUREMENTS AND MAIN RESULTS: A 10 μg/m3 increase in PM2.5-10 concentration on lag 0-1 day was associated with increments of 0.51% (95% confidence interval [CI]: 0.18%, 0.84%), 0.43% (95%CI: 0.15%, 0.71%) and 0.41% (95%CI: 0.06%, 0.77%) in total, cardiovascular, and respiratory mortality, respectively. The associations varied by country and region. These associations were robust to adjustment by all co-pollutants in two-pollutant models, especially for PM2.5. The exposure-response curves for total, cardiovascular, and respiratory mortality were positive, with steeper slopes at lower exposure ranges and without discernible thresholds.

CONCLUSIONS: This study provides novel global evidence on the robust and independent associations between short-term exposure to ambient PM2.5-10 and total, cardiovascular and respiratory mortality, suggesting the need to establish a unique guideline or regulatory limit for daily concentrations of PM2.5-10.

PMID:35671471 | DOI:10.1164/rccm.202111-2657OC

Plast Reconstr Surg. 2022 Jun 8. doi: 10.1097/PRS.0000000000009321. Online ahead of print.

ABSTRACT

PURPOSE: The Pulvertaft weave continues as a staple technique for tendon coaptations. Many have proposed minor alterations to the original technique to improve its strength, though a lack of consensus exists. Our aim was to explore how the number of weaves and suture characteristics contribute to the overall strength of the coaptation.

METHODS: A comprehensive electronic search was conducted using PubMed, Cochrane Library, and Scopus. Criteria for inclusion consisted of cadaveric human or animal biomechanical studies evaluating ultimate failure load (Newtons, N) as well as number of weaves, suture characteristics, tendon source, and number of coaptations. Weaves with minimum averages of 75 N were deemed successful, and those with >120 N were considered high performing.

RESULTS: A total of 347 tendon transfers from 15 studies met inclusion criteria. Average strength by number of weaves was 36.4 N (n=52) for 1 weave; 54.2 N (n=58) for 2 weaves; 115.9 N (n=174) for 3 weaves; and 81.7 N (n=63) for 4 weaves. Statistical differences were observed between 1 and 2 weaves (p<0.0001); 2 and 3 weaves (p<0.0001); 3 and 4 weaves (p<0.003); and 2 and 4 weaves (p<0.0001). High performing tendon transfers utilized 3 weaves, 3-0 or 4-0 braided sutures, and figure-of-eight or mattress core sutures.

CONCLUSIONS: Contrary to the current dogma of ‘the more the better’, our findings show that Pulvertaft weave strength is optimized when 3 weaves are used to combine donor and recipient tendons. Braided sutures with either figure-of-eight or mattress sutures were associated with highest strength of repair.

PMID:35671455 | DOI:10.1097/PRS.0000000000009321

Plast Reconstr Surg. 2022 Jun 8. doi: 10.1097/PRS.0000000000009352. Online ahead of print.

ABSTRACT

BACKGROUND: Alveolar bone grafting is an important component of cleft lip and palate treatment, with iliac crest as the most common donor site. Although studies have attempted to quantify alveolar bone graft resorption, few have directly compared the outcomes of graft techniques. This study compared the long-term success rates of corticocancellous block to trephine cancellous-only alveolar bone grafting from the iliac crest.

METHODS: A retrospective review of all cleft lip and palate patients undergoing alveolar bone grafting over 14 years was performed. Power analysis was performed to determine sample size. Data including patient demographics, surgical technique, need for repeat grafting, complications, length of hospitalization, and follow-up were collected. Statistical analyses of outcomes were performed based on initial graft technique.

RESULTS: A total of 106 initial operations met criteria, with 73 using trephine technique, 30 utilizing corticocancellous block, and 3 undergoing open cancellous harvest. The overall regraft rate was 40% with an average follow-up of 43.5 months. Patients with corticocancellous block grafting had significantly lower rates of repeat grafting compared to trephine technique (16.7% vs. 47.9%, p<0.001). There was no significant difference in complications rates or length of admission between treatment groups.

CONCLUSIONS: The use of corticocancellous block alveolar bone grafting demonstrated significantly higher success rates when compared to cancellous-only trephine techniques with no difference in complication rates. Although this must be weighed against the minor disadvantages of open iliac harvest, surgeons should consider incorporating en bloc corticocancellous bone to optimize outcomes in alveolar bone grafting.

PMID:35671445 | DOI:10.1097/PRS.0000000000009352

Cancer Nurs. 2022 Mar 2. doi: 10.1097/NCC.0000000000001076. Online ahead of print.

ABSTRACT

BACKGROUND: Unrelieved chemotherapy-induced nausea (CIN) occurs 48% of patients undergoing chemotherapy and is one of the most debilitating symptoms that patients report.

OBJECTIVE: The aims of this study were to identify subgroups of patients with distinct CIN profiles and determine how these subgroups differed on demographic and clinical characteristics; severity, frequency, and distress of CIN; and the co-occurrence of common gastrointestinal symptoms.

METHODS: Patients (n = 1343) completed demographic questionnaire and Memorial Symptom Assessment Scale 6 times over 2 cycles of chemotherapy. Latent class analysis was used to identify subgroups of patients with distinct CIN profiles. Differences among these subgroups were evaluated using parametric and nonparametric statistics.

RESULTS: Four distinct CIN profiles were identified: none (40.8%), increasing-decreasing (21.5%), decreasing (8.9%), and high (28.8%). Compared with the none class, patients in the high class were younger, had a lower annual household income, had child care responsibilities, had a lower Karnofsky Performance Status score and a higher Self-administered Comorbidity Questionnaire score, and were more likely to have received chemotherapy on a 14-day cycle and a highly emetogenic chemotherapy regimen. In addition, patients in the high class reported high occurrence rates for dry mouth, feeling bloated, diarrhea, lack of appetite, abdominal cramps, difficulty swallowing, mouth sores, weight loss, and change in the way food tastes.

CONCLUSIONS: That 60% of the patients reported moderate to high CIN occurrence rates confirms that this unrelieved symptom is a significant clinical problem.

IMPLICATIONS FOR PRACTICE: Nurses need to evaluate patients’ level of adherence to their antiemetic regimen and make appropriate referrals for physical therapy, psychological services, and dietary counseling.

PMID:35671438 | DOI:10.1097/NCC.0000000000001076

Mol Pharm. 2022 Jun 7. doi: 10.1021/acs.molpharmaceut.2c00029. Online ahead of print.

ABSTRACT

Antibacterial drugs (AD) change the metabolic status of bacteria, contributing to bacterial death. However, antibiotic resistance and the emergence of multidrug-resistant bacteria increase interest in understanding metabolic network (MN) mutations and the interaction of AD vs MN. In this study, we employed the IFPTML = Information Fusion (IF) + Perturbation Theory (PT) + Machine Learning (ML) algorithm on a huge dataset from the ChEMBL database, which contains >155,000 AD assays vs >40 MNs of multiple bacteria species. We built a linear discriminant analysis (LDA) and 17 ML models centered on the linear index and based on atoms to predict antibacterial compounds. The IFPTML-LDA model presented the following results for the training subset: specificity (Sp) = 76% out of 70,000 cases, sensitivity (Sn) = 70%, and Accuracy (Acc) = 73%. The same model also presented the following results for the validation subsets: Sp = 76%, Sn = 70%, and Acc = 73.1%. Among the IFPTML nonlinear models, the k nearest neighbors (KNN) showed the best results with Sn = 99.2%, Sp = 95.5%, Acc = 97.4%, and Area Under Receiver Operating Characteristic (AUROC) = 0.998 in training sets. In the validation series, the Random Forest had the best results: Sn = 93.96% and Sp = 87.02% (AUROC = 0.945). The IFPTML linear and nonlinear models regarding the ADs vs MNs have good statistical parameters, and they could contribute toward finding new metabolic mutations in antibiotic resistance and reducing time/costs in antibacterial drug research.

PMID:35671399 | DOI:10.1021/acs.molpharmaceut.2c00029

J Med Internet Res. 2022 May 30. doi: 10.2196/38423. Online ahead of print.

ABSTRACT

BACKGROUND: Effective interventions aimed at correcting COVID-19 vaccine misinformation, known as fact-checking messages, are needed to combat the mounting anti-vaccine infodemic and alleviate vaccine hesitancy.

OBJECTIVE: This works investigates (a) the changes of the public’s attitude toward COVID-19 vaccines over time, (b) the effectiveness of COVID-19 vaccine fact-checking information on social media engagement and attitude change, and (c) the emotion and linguistic features of COVID-19 vaccine fact-checking information ecosystem.

METHODS: We collected a dataset of 12,553 COVID-19 vaccine fact-checking Facebook posts and their associated comments (N=122,362) from January 2020 – March 2022 and conducted a series of natural language processing and statistical analyses to investigate trends in public attitude toward the vaccine in COVID-19 vaccine fact-checking posts and comments, and emotional and linguistic features of the COVID-19 fact-checking information ecosystem.

RESULTS: The percentage of fact-checking posts relative to all COVID-19 vaccine posts peaked in May of 2020 and then steadily decreased as the pandemic progressed (r = -.92, df = 21, t = -10.94, 95% CI = [-.97, -.82], P < .001). The salience of COVID-19 vaccine entities was significantly lower in comments (M = 0.03, t = 39.28, P < .001) than in posts (M = 0.09). Third-party fact checkers have been taking a more important role with more fact-checking over time (r = .63, df = 25, t = 4.06, 95% CI = [.33, .82], P < .001). COVID-19 vaccine fact-checking posts continued to be more analytical (r = .81, df = 25, t = 6.88, 95% CI = [.62, .91], P < .001) and more confident (r = .59, df = 25, t = 3.68, 95% CI = [.27, .79], P = .001) over time. While comments did not exhibit a significant increase in confidence over time, tentativeness in comments decreased significantly (r = -.62, df = 25, t = -3.94, 95% CI = [-.81, -.31], P = .001). While hospitals receive less engagement than other information sources, the comments expressed more positive attitudinal valence in comments compared to other information sources (b = 0.06, 95% CI = [0.00, 0.12], t = 2.03, P = .043).

CONCLUSIONS: The percentage of fact-checking posts relative to all posts about the vaccine steadily decreased after May of 2020. As the pandemic progressed, third-party fact checkers played a larger role in posting fact-checking COVID-19 vaccine posts. COVID-19 vaccine fact-checking posts continued to be more analytical and more confident over time, reflecting increased confidence in posts. Similarly, tentativeness in comments decreased; this likewise suggests that public uncertainty diminished over time. COVID-19 fact-checking vaccine posts from hospitals yielded more positive attitudes toward vaccination than other information sources. At the same time, hospitals received less engagement than other information sources. This suggests that hospitals should invest more in generating engaging public health campaigns on social media.

PMID:35671409 | DOI:10.2196/38423

Biomed Instrum Technol. 2022 Apr 1;56(2):46-57. doi: 10.2345/1943-5967-56.2.46.

ABSTRACT

Manufacturers could improve the pulse tones emitted by pulse oximeters to support more accurate identification of a patient’s peripheral oxygen saturation (SpO2) range. In this article, we outline the strengths and limitations of the variable-pitch tone that represents SpO2 of each detected pulse, and we argue that enhancements to the tone to demarcate clinically relevant ranges are feasible and desirable. The variable-pitch tone is an appreciated and trusted feature of the pulse oximeter’s user interface. However, studies show that it supports relative judgments of SpO2 trends over time and is less effective at supporting absolute judgments about the SpO2 number or conveying when SpO2 moves into clinically important ranges. We outline recent studies that tested whether acoustic enhancements to the current tone could convey clinically important ranges more directly, without necessarily using auditory alarms. The studies cover the use of enhanced variable-pitch pulse oximeter tones for neonatal and adult use. Compared with current tones, the characteristics of the enhanced tones represent improvements that are both clinically relevant and statistically significant. We outline the benefits of enhanced tones, as well as discuss constraints of which developers of enhanced tones should be aware if enhancements are to be successful.

PMID:35671368 | DOI:10.2345/1943-5967-56.2.46

J Chem Theory Comput. 2022 Jun 7. doi: 10.1021/acs.jctc.2c00255. Online ahead of print.

ABSTRACT

Machine learning (ML) approaches have demonstrated the ability to predict molecular spectra at a fraction of the computational cost of traditional theoretical chemistry methods while maintaining high accuracy. Graph neural networks (GNNs) are particularly promising in this regard, but different types of GNNs have not yet been systematically compared. In this work, we benchmark and analyze five different GNNs for the prediction of excitation spectra from the QM9 dataset of organic molecules. We compare the GNN performance in the obvious runtime measurements, prediction accuracy, and analysis of outliers in the test set. Moreover, through TMAP clustering and statistical analysis, we are able to highlight clear hotspots of high prediction errors as well as optimal spectra prediction for molecules with certain functional groups. This in-depth benchmarking and subsequent analysis protocol lays down a recipe for comparing different ML methods and evaluating dataset quality.

PMID:35671364 | DOI:10.1021/acs.jctc.2c00255