Category: Statistics

J Clin Lab Anal. 2022 Mar 13:e24334. doi: 10.1002/jcla.24334. Online ahead of print.

ABSTRACT

BACKGROUND: Among patients with diabetic retinopathy (DR), no proof was available to confirm the prognostic significance of the neutrophil percentage-to-albumin ratio (NPAR). We hypothesized that NPAR plays a role in the incidence of DR in diabetic patients.

METHODS: We extracted all diabetes mellitus (DM) data from the National Health and Nutrition Examination Survey (NHANES) database between 1999 and 2018, NPAR was expressed as neutrophil percentage/albumin. Multivariable logistic regression and generalized additive model were utilized for the purpose of examining the correction between NPAR levels and DR. Subgroup analysis of the associations between NPAR and DR was carried out to investigate if the impact of the NPAR varied among different subgroups.

RESULTS: An aggregate of 5850 eligible participants were included in the present research. The relationship between NPAR levels and DR was positive linear. In the multivariate analysis, following the adjustment for confounders (gender, white blood cell, age, monocyte percent, red cell distribution width, eosinophils percent, bicarbonate, body mass index, iron, glucose, basophils percent, total bilirubin, creatinine, and chloride), higher NPAR was an independent risk factor for DR compared to lower NPAR (OR, 95% CI: 1.18, 1.00-1.39; 1.24, 1.04-1.48). For the purpose of sensitivity analysis, we found a trend of consistency (p for trend: 0.0190). The results of the subgroup analysis revealed that NPAR did not exert any statistically significant interactions with any of the other DR risk variables.

CONCLUSIONS: Elevated NPAR is associated with an elevated risk of occurrence of DR in diabetic patients.

PMID:35285099 | DOI:10.1002/jcla.24334

Pediatr Dermatol. 2022 Mar 14. doi: 10.1111/pde.14978. Online ahead of print.

ABSTRACT

BACKGROUND: Cutaneous changes in obese adults have been investigated in numerous studies, but this issue has not been adequately investigated in children.

OBJECTIVES: We aimed to determine the prevalence of skin manifestations in children with obesity by comparing them to normal-weight children.

METHODS: A cross-sectional study was conducted between June 2017 and January 2019 in which 82 children with obesity and 86 normal-weight healthy control children were enrolled. Study participants had detailed full-body skin examinations performed by the same dermatologist; mycological and Wood’s lamp examinations were performed when necessary. Sociodemographic and anthropometric measurements of the participants were recorded.

RESULTS: Striae distensae were the most common skin manifestation in children with obesity; striae were significantly higher in the obese than in the control group (72% vs. 26.7%, p < .001). The anatomical distribution of the striae distensae in the groups differed significantly. Striae distensae were most commonly observed on the buttocks in the control group, while the thighs were the most common site in the obese group. Acanthosis nigricans (63.4% vs. 3.5%, p < .001), acrochordons (17.1% vs. 1.2%, p < .001), keratosis pilaris (32.9% vs. 17.4%, p = .021), intertrigo (11% vs. 0%, p = .001), folliculitis (31.7% vs. 5.8%, p < .001), seborrheic dermatitis (12.2% vs. 3.5%, p = .035) and facial erythema (7.3% vs. 0%, p = .012) were found to be statistically significantly more common in the obese group compared to the control group.

CONCLUSIONS: Obesity in children is associated with numerous cutaneous manifestations. Further study is needed to identify whether weight loss can reduce skin manifestations in obese children.

PMID:35285075 | DOI:10.1111/pde.14978

Biom J. 2022 Mar;64(3):557-576. doi: 10.1002/bimj.202100023. Epub 2021 Dec 1.

ABSTRACT

In this article, we address the problem of simultaneous testing hypothesis about mean and covariance matrix for repeated measures data when both the mean vector and covariance matrix are patterned. In particular, tests about the mean vector under block circular and doubly exchangeable covariance structures have been considered. The null distributions are established for the corresponding likelihood ratio test statistics, and expressions for the exact or near-exact probability density and cumulative distribution functions are obtained. The application of the results is illustrated by both a simulation study and a real-life data example.

PMID:35285064 | DOI:10.1002/bimj.202100023

Biom J. 2022 Mar;64(3):481-505. doi: 10.1002/bimj.202000249. Epub 2021 Nov 10.

ABSTRACT

In this paper, we present the Type I multivariate zero-inflated Conway-Maxwell-Poisson distribution, whose development is based on the extension of the Type I multivariate zero-inflated Poisson distribution. We developed important properties of the distribution and present a regression model. The AIC and BIC criteria are used to select the best fitted model. Two real data sets have been used to illustrate the proposed model. Moreover, we conclude by stating that the Type I multivariate zero-inflated Conway-Maxwell-Poisson distribution produces a better fitted model for multivariate count data with excess of zeros.

PMID:35285065 | DOI:10.1002/bimj.202000249

Biom J. 2022 Mar;64(3):598-616. doi: 10.1002/bimj.202000222. Epub 2021 Dec 11.

ABSTRACT

The between-study variance or heterogeneity variance is an important parameter in random effects meta-analysis. This paper uses an M-estimation framework to introduce and discuss variance estimators for quantifying the uncertainty in estimates of the heterogeneity variance using the noniterative generalized method of moments estimator and some related method of moments estimators. An example is used to further illustrate the variance estimators, and simulation results are presented for assessing the empirical properties of the proposed variance estimators.

PMID:35285063 | DOI:10.1002/bimj.202000222

JPEN J Parenter Enteral Nutr. 2022 Mar 13. doi: 10.1002/jpen.2374. Online ahead of print.

ABSTRACT

BACKGROUND: Parenteral nutrition associated cholestasis (PNAC) in the neonatal intensive care unit (NICU) causes significant morbidity and associated healthcare costs. Laboratory detection of PNAC currently relies on elevated serum conjugated bilirubin levels in the aftermath of impaired bile flow. Here, we sought to identify fecal biomarkers, which when integrated with clinical data would better predict risk for developing PNAC.

METHODS: Using untargeted metabolomics in 200 serial stool samples from 60 infants, we applied statistical and machine learning approaches to identify clinical features and metabolic biomarkers with the greatest associative potential for risk of developing PNAC. Stools were collected prospectively from infants receiving parenteral nutrition (PN) with soybean oil-based lipid emulsion at a level IV NICU.

RESULTS: Low birthweight, extreme prematurity, longer duration of PN, and greater number of antibiotic courses were all risk factors for PNAC (p < 0.05). We identified 78 stool biomarkers with early predictive potential (p < 0.05). From these 78 biomarkers, we further identified 12 sphingomyelin lipids with high association for the development of PNAC in pre-cholestasis stool samples when combined with birth anthropometry.

CONCLUSIONS: We demonstrate the potential for stool metabolomics to enhance early identification of PNAC risk. Earlier detection of high-risk infants would empower proactive mitigation with alterations to PN for at-risk infants and optimization of caloric nutrition with PN for infants at lower risk. This article is protected by copyright. All rights reserved.

PMID:35285019 | DOI:10.1002/jpen.2374

J Med Virol. 2022 Mar 13. doi: 10.1002/jmv.27721. Online ahead of print.

ABSTRACT

Crimean Congo hemorrhagic fever (CCHF) is an acute viral infection that can cause death. The detection of host transcriptome is important for understanding differences in pathogenesis of the disease. Long noncoding RNAs (lncRNAs) regulate gene expression in different biological processes. They have also emerged as a key molecules for therapeutic target. We investigated the lncRNA gene expression profiles by utilizing the microarray for the first time in CCHF. LncRNAs were determined by the comparisons between case-control, fatal case-control, and fatal case-nonfatal case. Quantitative polymerase chain reaction (qPCR) was applied to validate the microarray results of some lncRNAs. In our study, 39 lncRNAs (5 downregulated, 34 upregulated) were found to be significantly regulated in the cases when compared to the controls (p<0,05; FC≥2). One hundred ten lncRNAs exhibited a statistically significant difference between fatal cases and controls. FER1L4, ECRP and LOC100133669 are important lncRNAs in both case and fatal case groups compared with controls. These lncRNAs may be considered as important therapeutic targets for the CCHF in further studies. This article is protected by copyright. All rights reserved.

PMID:35285033 | DOI:10.1002/jmv.27721

J Clin Immunol. 2022 Mar 14. doi: 10.1007/s10875-022-01222-8. Online ahead of print.

ABSTRACT

PURPOSE: X-linked agammaglobulinemia (XLA) is a primary immunodeficiency (PID) caused by a defect in the gene encoding for Bruton tyrosine kinase (BTK). In the absence of a functional BTK, patients have low or absent circulating B cells and low or absent serum immunoglobulin. Despite gammaglobulin replacement and prompt use of antimicrobial agents, patients with XLA continue to experience infectious and non-infectious complications throughout their lifetime. The purpose of this study was to understand self-perceived health status of US-based patients with XLA, and examine the associations amongst clinical characteristics, treatment experience, and quality of life (QoL).

METHODS: A 46 and 68 question survey, developed by the Immune Deficiency Foundation (IDF) and a Short Form-12item v2® (SF-12v2®) for adults and SF-10™ for children to assess QoL, were mailed by IDF to patients in 2017 and 2018. Those that self-identified as having XLA or males with agammaglobulinemia were selected for analysis. Mean physical and mental composite scores (PCS and MCS) from SF-12v2® and mean physical health component (PHS) and psychological health summary (PSS) from SF-10™ scores were compared to the US normative data.

RESULTS: Ninety-one patients completed the surveys: 58 (63.7%) adults and 33 (36.3%) children. For the combined surveys, the overall median age at time of the survey was 28.5 years (yrs); Inter-Quartile-Range (IQR) 13-49.5 yrs; the median age at diagnosis was 2 yrs (IQR = 0-4 yrs) and the median number of years with XLA diagnosis was 23 (IQR 10.75-40yrs). Amongst adult patients, physical scores were noted to be below the general adult population but did not reach statistical significance. In contrast, 2 or more chronic conditions impacted both physical and mental QoL (p < .001) and hospitalization was associated with significantly decreased physical health QoL (p < .001); three or more infections in the past 12 months exhibited impact on physical health although was not found to be statistically significant. Adult patients with public insurance fared worse in mental health domains compared to those with combined public and private or those with private alone (p = 0.001). Employment status did not impact QoL. None of these variables met statistical significance nor demonstrated impact within the pediatric population in either physical or mental domains of health.

CONCLUSION: Our study provides further insight into what factors impact both physical and mental domains of health amongst patients with XLA. Early detection to prevent the development of associated morbidity, as well as vigilant care to prevent hospitalizations and infections, can limit the impact this disease may have on the overall well-being of XLA patients.

PMID:35284987 | DOI:10.1007/s10875-022-01222-8

Strahlenther Onkol. 2022 Mar 13. doi: 10.1007/s00066-022-01909-2. Online ahead of print.

ABSTRACT

PURPOSE: Hypofractionated radiotherapy for prostate cancer is well established for definitive treatment, but not well defined in the postoperative setting. The purpose of this analysis was to assess oncologic outcomes and toxicity in a large cohort of patients treated with conventionally fractionated three-dimensional (3D) conformal radiotherapy (CF) and hypofractionated volumetric modulated arc therapy (HF) after radical prostatectomy.

METHODS: Between 1994 and 2019, a total of 855 patients with prostate carcinoma were treated by postoperative radiotherapy using CF (total dose 65-72 Gy, single fraction 1.8-2 Gy) in 572 patients and HF (total dose 62.5-63.75 Gy, single fraction 2.5-2.55 Gy) in 283 patients. The association of treatment modality with biochemical control, overall survival (OS), and gastrointestinal (GI) and genitourinary (GU) toxicity was assessed using logistic and Cox regression analysis.

RESULTS: There was no difference between the two modalities regarding biochemical control rates (77% versus 81%, respectively, for HF and CF at 24 months and 58% and 64% at 60 months; p = 0.20). OS estimates after 5 years: 95% versus 93% (p = 0.72). Patients undergoing HF had less frequent grade 2 or higher acute GI or GU side effects (p = 0.03 and p = 0.005, respectively). There were no differences in late GI side effects between modalities (hazard ratio 0.99). Median follow-up was 23 months for HF and 72 months for CF (p < 0.001).

CONCLUSION: For radiation therapy of resected prostate cancer, our analysis of this largest single-centre cohort (n = 283) treated with hypofractionation with advanced treatment techniques compared with conventional fractionation did not yield different outcomes in terms of biochemical control and toxicities. Prospective investigating of HF is merited.

PMID:35284951 | DOI:10.1007/s00066-022-01909-2

Alcohol Alcohol. 2022 Mar 12:agac009. doi: 10.1093/alcalc/agac009. Online ahead of print.

ABSTRACT

BACKGROUND: Excessive alcohol consumption is associated with poor diet. Mixed reports in literature, so far, emphasize on the detailed understanding of relationships between diet composition and binge drinking at different drinking thresholds.

OBJECTIVE: We examined the association of alcohol consumption thresholds with macronutrient composition, caloric intake and anthropometric measures from the NHANES 2017-2018 dataset.

METHODS: A total of 2320 participants’ data were analyzed. Energy and nutrient content from daily food and beverage intake were assessed via two dietary recall interviews. Physical examination and Alcohol Use Questionnaire including details about lifetime and current usage patterns were obtained. Correlations were evaluated using the Rao-Scott F Adjusted Chi-square statistic and Wald F-test. Sample-weighted multiple linear regression models were built to analyze the associations among volume of alcohol consumed, weight history and macronutrient intake.

RESULTS: Waist circumference was significantly higher in 0- < 4 drinks/episode (low-quantity) drinkers than 4-7 drinks/episode (medium-quantity) and 8-11 drinks/episode (high-quantity) drinkers. High-quantity drinkers consumed significantly more kilocalories (2569.91) compared with low-quantity drinkers (2106.73). Low-quantity drinkers consumed more energy from carbohydrate and fat than medium and high-quantity drinkers. Very high-quantity drinkers (12+ drinks/episode) consumed less fiber (12.81 g) than low-quantity drinkers (16.67 g).

CONCLUSIONS: We observed an association between high alcohol intake and differences in eating habits and body composition. The findings suggest a need to compare more specific drinking patterns and their impact on nutrient intake. Although some results conflicted with previous studies, the mechanisms underlying alcohol’s effect on ingestive and digestive metabolic pathways are still unclear and require further investigation.

PMID:35284941 | DOI:10.1093/alcalc/agac009