Category: Statistics

Gait Posture. 2022 Feb 17;94:45-50. doi: 10.1016/j.gaitpost.2022.02.020. Online ahead of print.

ABSTRACT

BACKGROUND: Children with cerebral palsy (CP) may have difficulties under dual-task conditions. Spatiotemporal gait parameters have deteriorated with concurrent tasks in children with CP. However, how dual-task training affects gait parameters in children with spastic diplegic CP has not been clarified.

RESEARCH QUESTION: How does dual-task training program effect gait, functional skills, and health-related quality of life in children with spastic diplegic CP?

METHODS: Eleven children with spastic diplegic CP (median age 11 y, range 7-16 y; 4 female; 7 male) Gross Motor Function Classification System level 1-2 and obtained 27 and higher scores from Modified Mini Mental Test included in the study. The study was planned as a self-controlled clinical research design. Children were recruited to conventional physiotherapy program for 8 weeks and dual-task training program added to conventional physiotherapy program for following 8 weeks. Children were evaluated at baseline, after conventional physiotherapy program, and after dual-task training program. Children’s gait was evaluated with Zebris™ FDM-2 device and Edinburgh Visual Gait Score, functional mobility skills with 1 min Walk Test (1MWT), and health-related quality of life with the Pediatric Quality of Life Inventory (PedsQL) – CP module.

RESULTS: The difference in step length, step time, stride time, cadence and gait speed of spatiotemporal parameters of gait during dual-task performance were found statistically significant in children with spastic diplegic CP, after dual-task training program (p < 0,05). After dual-task training, statistically significant gains were found in 1MWT, movement and balance subtitle of PedsQL-CP module Parent Form (p < 0,05).

SIGNIFICANCE: Dual-task training program added to a conventional physiotherapy program provides more gains in terms of functionality of children with spastic diplegic CP will contribute to the improvement of the motor functional level.

PMID:35247824 | DOI:10.1016/j.gaitpost.2022.02.020

Gait Posture. 2022 Feb 25;94:51-57. doi: 10.1016/j.gaitpost.2022.02.030. Online ahead of print.

ABSTRACT

BACKGROUND: Older adults benefit most from engaging in higher-intensity physical activity, which is often determined using step rate thresholds. Fixed step rate thresholds that correspond to moderate (MPA) and vigorous-intensity physical activity (VPA) have been developed for heuristic activity promotion. The activPAL monitor uses step rate thresholds to determine activity intensity. Stepping thresholds may also vary based on body mass index (BMI) or aerobic fitness level in older adults. Despite the various thresholds used in the literature, it is unclear whether they produce similar outcomes.

RESEARCH QUESTION: How does time spent in physical activity intensities compare between different step rate thresholds in older adults?

METHODS: Thirty-eight participants (24♀; 67 ± 4 years; BMI: 26.6 ± 4.4 kg/m²) wore an activPAL monitor 24-hr/day for up to 7-d (total: 205-d). Aerobic fitness (V̇O₂max: 23 ± 8 ml/kg/min) was determined via indirect calorimetry during a maximal, graded cycling test. Time spent in each intensity category (light-physical-activity [LPA], MPA, VPA) was determined using the fixed (MPA/VPA) 100/130, 110/130, and activPAL step rate thresholds (74/212), as well as BMI-adjusted absolute (108.5 ± 2.5/134.0 ± 4.8) and BMI-adjusted relative (40%/60% V̇O₂max; 111.4 ± 14.7/132.0 ± 19.0) cut-offs. Times spent in each intensity category were compared between methods.

RESULTS: The activPAL and 100/130 thresholds yielded less LPA and more MPA than all other methods. The activPAL had no time spent in VPA at all. The BMI-adjusted absolute and relative thresholds produced statistically equivalent time in LPA and MPA (via equivalence testing), but not VPA. No two methods yielded similar time spent in LPA, MPA, or VPA.

SIGNIFICANCE: The choice of step rate threshold has a major impact on physical activity intensity outcomes in older adults. Inherently, strategies that adjust for older adults’ body size and/or aerobic fitness level provide a more individualized data processing strategy than fixed thresholds that assume the same threshold for all older adults.

PMID:35247825 | DOI:10.1016/j.gaitpost.2022.02.030

Poult Sci. 2022 Jan 18;101(5):101735. doi: 10.1016/j.psj.2022.101735. Online ahead of print.

ABSTRACT

Exogenous β-glucanase (BGase) improves nutrient digestibility and production performance in laying hens fed barley-based diets, but the effect of enzyme and the dosage on β-glucan depolymerization and fermentation in the gastrointestinal tract is poorly understood. The objectives of the study were to determine the effects of hulless barley (HB) and BGase levels on digestive tract β-glucan depolymerization and fermentation in laying hens. A total of 108 Lohman-LSL Lite hens were housed in cages and fed 2 levels of HB (CDC Fibar; 0 and 73%) by substituting wheat in the diet and graded levels of BGase (Econase GT 200 P from ABVista; 0, 0.01 and 0.1% – 0, 20,000, and 200,000 BU/kg) in a 2 × 3 factorial arrangement. Birds were fed experimental diets for 8 weeks, starting at 35 wk of age. Digestive tract samples were collected at the end of the experiment. Statistical significance was set at P ≤ 0.05. Beta-glucan peak molecular weight was lower with the 0.1 compared to both 0 and 0.01% BGase levels, whereas weight average molecular weight was lower with the 0.1 compared to 0% BGase for 73% HB. The maximum molecular weight for the smallest 10% β-glucan molecules decreased with the increasing BGase. Overall, β-glucan molecular weight in the ileum was higher when the birds were given 73 in comparison to 0% HB diets. Total and major short chain fatty acids (SCFA) in the ileum were lower with 0.1 and 0.01 (except propionic acid) compared to 0% BGase in the birds fed 73% HB, but not 0% HB. Interactions between the main effects were found for the cecal acetic and isobutyric acids. In conclusion, exogenous BGase depolymerized high molecular weight β-glucan in HB and wheat. The effects of HB and BGase on carbohydrate fermentation were not apparent, although it appears ileal SCFA concentrations were lower with increasing levels of BGase.

PMID:35247816 | DOI:10.1016/j.psj.2022.101735

Schizophr Res. 2022 Mar 2;243:86-97. doi: 10.1016/j.schres.2022.02.019. Online ahead of print.

ABSTRACT

We report primary results of the Disease Recovery Evaluation and Modification (DREaM) study, a randomized, open-label, delayed-start trial designed to compare the effectiveness of paliperidone palmitate (PP) versus oral antipsychotics (OAP) in delaying time to first treatment failure (TtFTF) in participants with recent-onset schizophrenia or schizophreniform disorder. DREaM included: Part I, 2-month oral run-in; Part II, 9-month disease progression phase (PP or OAP); Part III, 9 months of additional treatment (PP/PP; OAP rerandomized: OAP/OAP or OAP/PP). PP/PP and OAP/OAP comprised the 18-month extended disease progression (EDP) analysis. A total of 235 participants were randomized to PP (n = 78) or OAP (n = 157) in Part II. No statistically significant differences in TF between treatment groups were identified during Part II (PP 29.5%, OAP 24.8%; P = 0.377), Part III (PP/PP 14.3%, OAP/PP 15.8%, OAP/OAP 28.6%; P = 0.067) or the EDP analysis (PP/PP 28.6%, OAP/OAP 44.4%; NNT = 6; P = 0.080). Using a modified definition of TF excluding treatment supplementation with another antipsychotic, a common approach to managing dose adjustments, significant differences were observed between treatment groups in Part III (PP/PP 4.1%, OAP/PP 14.0%, OAP/OAP 27.0%; P = 0.002) and EDP (PP/PP 14.3%, OAP/OAP 42.9%; P = 0.001). Safety results were consistent with the known safety profile of PP. Although significant treatment differences were not observed during the first 9 months of DREaM, numerical differences favoring PP emerged in the last 9 months and significant differences were observed when TF criteria were limited to their most impactful components. These results highlight the potential benefit of initiating PP early in the course of schizophrenia and provide valuable insights for future clinical trials in recent-onset schizophrenia or schizophreniform disorder. Clinicaltrials.gov identifier: NCT02431702.

PMID:35247794 | DOI:10.1016/j.schres.2022.02.019

Health Place. 2022 Mar 2;74:102771. doi: 10.1016/j.healthplace.2022.102771. Online ahead of print.

ABSTRACT

Current efforts to characterize movers and identify predictors of moving have been limited. We used the ARIC cohort to characterize non-movers, short-distance movers, and long-distance movers, and employed best subset algorithms to identify important predictors of moving, including interactions between characteristics. Short- and long-distance movers were notably different from non-movers, and important predictors of moving differed based on the distance of the residential move. Importantly, systematic inclusion of interaction terms enhanced model fit and was substantively meaningful. This work has important implications for epidemiologic studies of contextual exposures and those treating residential mobility as an exposure.

PMID:35247797 | DOI:10.1016/j.healthplace.2022.102771

Int J Nurs Stud. 2022 Feb 12;129:104204. doi: 10.1016/j.ijnurstu.2022.104204. Online ahead of print.

ABSTRACT

BACKGROUND: In recent years, numerous dementia caregiving interventions for informal caregivers of community-dwelling people with dementia have been developed. However, it remains unclear which non-pharmacological interventions are effective and preferred for their depression and anxiety symptoms, quality of life, and caregiver burden.

OBJECTIVES: To compare and rank the efficacy of different non-pharmacological interventions on depression, anxiety, quality of life, and caregiver burden for informal caregivers of people with dementia.

DESIGN: A systematic review and network meta-analysis.

METHODS: Relevant randomized controlled trials on the efficacy of non-pharmacological interventions for informal caregivers of people with dementia were extracted from seven electronic databases. A network meta-analysis was then performed to evaluate the relative efficacy of the non-pharmacological interventions for informal caregivers of people with dementia. The quality of the data was assessed using the Cochrane Risk of Bias tool.

RESULTS: A total of 85 randomized controlled trials on 11 non-pharmacological interventions were included in the final analysis. Acceptance and commitment therapy, behavioral activation, mindfulness-based intervention, multicomponent intervention, psychoeducation, and cognitive behavioral therapy might reduce depression. Notably, psychoeducation was the only effective intervention against anxiety. Only support groups had a statistically significant effect on the quality of life. When considering decreasing caregiver burden, case management, psychoeducation, and multicomponent intervention would be the effective interventions.

CONCLUSIONS: Several non-pharmacological interventions seemed to be effective in treating depression and anxiety, improving quality of life, and reducing caregiver burden for informal caregivers of people with dementia. Healthcare professionals should be encouraged to apply these non-pharmacological interventions for informal caregivers of people with dementia during routine care.

PMID:35247788 | DOI:10.1016/j.ijnurstu.2022.104204

Neuroimage Clin. 2022 Mar 1;34:102979. doi: 10.1016/j.nicl.2022.102979. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Chronic active multiple sclerosis (MS) lesions are characterized by a paramagnetic rim at the edge of the lesion and are associated with increased disability in patients. Quantitative susceptibility mapping (QSM) is an MRI technique that is sensitive to chronic active lesions, termed rim + lesions on the QSM. We present QSMRim-Net, a data imbalance-aware deep neural network that fuses lesion-level radiomic and convolutional image features for automated identification of rim + lesions on QSM.

METHODS: QSM and T2-weighted-Fluid-Attenuated Inversion Recovery (T2-FLAIR) MRI of the brain were collected at 3 T for 172 MS patients. Rim + lesions were manually annotated by two human experts, followed by consensus from a third expert, for a total of 177 rim + and 3986 rim negative (rim-) lesions. Our automated rim + detection algorithm, QSMRim-Net, consists of a two-branch feature extraction network and a synthetic minority oversampling network to classify rim + lesions. The first network branch is for image feature extraction from the QSM and T2-FLAIR, and the second network branch is a fully connected network for QSM lesion-level radiomic feature extraction. The oversampling network is designed to increase classification performance with imbalanced data.

RESULTS: On a lesion-level, in a five-fold cross validation framework, the proposed QSMRim-Net detected rim + lesions with a partial area under the receiver operating characteristic curve (pROC AUC) of 0.760, where clinically relevant false positive rates of less than 0.1 were considered. The method attained an area under the precision recall curve (PR AUC) of 0.704. QSMRim-Net out-performed other state-of-the-art methods applied to the QSM on both pROC AUC and PR AUC. On a subject-level, comparing the predicted rim + lesion count and the human expert annotated count, QSMRim-Net achieved the lowest mean square error of 0.98 and the highest correlation of 0.89 (95% CI: 0.86, 0.92).

CONCLUSION: This study develops a novel automated deep neural network for rim + MS lesion identification using T2-FLAIR and QSM images.

PMID:35247730 | DOI:10.1016/j.nicl.2022.102979

Mult Scler Relat Disord. 2022 Feb 26;60:103712. doi: 10.1016/j.msard.2022.103712. Online ahead of print.

ABSTRACT

BACKGROUND: In the current COVID-19 pandemic, Multiple Sclerosis (MS) patients represent a population of particular interest as they might be at higher risk of COVID-19 infection and it’s complications. The present study aimed to investigate a one year follow up of patients with MS during the COVID-19 pandemic, in Qom province, Iran.

METHODS: This study was performed at the MS Clinic of Beheshti Hospital from June 1, 2020 to November 1, 2021. 202 patients with a diagnosis of MS and negative self-reported history of COVID-19 at the beginning of the pandemic, were enrolled. First, the demographic characteristics of patients were collected. Second, the patients underwent serological testing for anti-SARS-CoV-2 IgG antibodies. Then, a year later, they were revalauted and asked about the occurrence of clinical relapse leading to hospitalization, disease progression, DMT profile, COVID-19 vaccination, and history of COVID-19 infection. We considered six weeks after COVID-19 regarding relapse occurrence. Eventually, statistical analysis was carried out by using SPSS 26.0 RESULTS: Of 202 patients, 26 patients (12.87%) had initially a positive index antibody result. During the follow-up periods, 25 patients (12.37%) were infected with COVID-19 which was mainly mild (74.8%), and significantly lower than general population. 118 patients (58.41%) were vaccinated for COVID-19 which reduced the risk of COVID-19 development (P<001). Except a case of myelitis associated with vaccination, no serious adverse event was reported. Additionally, only one patient developed MS relapse following COVID-19 infection. Except clinical relapse (P = 0.001), other demographic and MS characteristics, and DMT type were not associated with COVID-19. In terms of MS course, 12 patients (5.94%) discontinued their DMTs regardless of the DMT adverse events or treatment failure. 41 patients (20.3%) experienced a clinical relapse, of whom 12 were escalated to a second line DMT. Further, 27 patients (13.4%) noted a history of worsening disability which mainly occurred after COIVD-19 infection.

CONCLUSION: The present study showed a significant lower incidence of COVID-19 infection in MS patients. Except for clinical relapse, other demographic and MS characteristics, and DMT type were not associated with COVID-19 infection. In addition, COVID-19 vaccination reduced the risk of COVID-19 development, and the prognosis was favorable in the majority of MS patients.

PMID:35247752 | DOI:10.1016/j.msard.2022.103712

Biochem Biophys Res Commun. 2022 Feb 25;602:35-40. doi: 10.1016/j.bbrc.2022.02.091. Online ahead of print.

ABSTRACT

OBJECTIVE: The aims of this study were to understand whether podocyte injury is involved in proteinuria after rapid ascent to high altitude and to explore whether hypoxia-inducible factor (HIF)-1α is involved in the adaptive regulation of this proteinuria.

METHODS: Rats in the experimental group were housed in a low-pressure oxygen chamber to simulate a high-altitude environment (5,000 m). The intervention group was placed under the same conditions as the experimental group and prolyl-hydroxylase inhibitor (PHI) was intraperitoneally injected. The control group was housed in a low altitude environment (500 m). On days 0, 7, 14, and 28, urinary albumin quantification and electrophoresis were performed. The expression levels of CD2-associated protein (CD2AP), nephrin and HIF-1α were detected by immunofluorescence.

RESULTS: The medium and large molecule proteins with molecular weights ranging from 63 to 75 kD were present in the urine of rats in the experimental group and that the urinary albumin levels first increased and then decreased with time and the increase on day 14 was most significant (24.58 ± 4.30 mg on day 14 VS 5.13 ± 1.58 mg on day 0). Electron microscopy revealed podocyte lesions in rats in the experimental group. Immunofluorescence results showed that the protein expression levels of CD2AP and nephrin in the glomeruli of rats in the experimental group were lower than those in the control group (P < 0.001) and that the expression levels of which in the intervention group were higher than those in the experimental group (P < 0.001). The expression of HIF-1α protein in the renal tissues of rats in the experimental group was higher than that in the control group (P < 0.001) and lower than that in the intervention group (P < 0.001).

CONCLUSION: The podocyte injury may be involved in the occurrence of proteinuria after rapid ascent to high altitude. PHI may have a potential role in reducing proteinuria by upregulating local HIF-1α expression in the kidney to alleviate podocyte injury.

PMID:35247702 | DOI:10.1016/j.bbrc.2022.02.091

J Chromatogr B Analyt Technol Biomed Life Sci. 2022 Feb 28;1195:123200. doi: 10.1016/j.jchromb.2022.123200. Online ahead of print.

ABSTRACT

Untargeted lipidomics using liquid chromatography high-resolution mass spectrometry (LC-HRMS) was performed using polarity switching, and in positive and negative polarity separately on the same set of serum samples, and the performances of the methods were evaluated. Polarity switching causes an increase in the cycle time of the HRMS measurements (1.18 s/cycle vs 0.27 s/cycle), resulting in fewer data points across chromatographic peaks. The coefficient of variation (CV) was on average lower for the added isotopically labelled standards in pooled samples (QC) and patient samples using separate polarities (QC = 5.6%, samples = 12.5%) compared to polarity switching (QC = 8.5%, samples = 13.4%), but the difference was not statistically significant. For the endogenous features measured in the QCs polarity switching resulted in on average significantly higher CVs (3.80 (p = 4.25e-30) and 3.3 percentage points (p = 6.84e-40), for positive and negative modes, respectively) however still acceptable for an untargeted method (mean CVs of 17.9% and 12.2% in positive and negative modes respectively). A slightly larger number of endogenous features were detected using the separate polarities, but the large majority of features (>95%) were detected with both methodologies. The overlap of features detected in both positive and negative polarities was low (4.1%) demonstrating the importance of using both polarities for untargeted lipidomics. When investigating the effects of a treatment on multiple sclerosis patients it was found that both methodologies gave highly similar biological results, further confirming the applicability of polarity switching.

PMID:35247679 | DOI:10.1016/j.jchromb.2022.123200