Category: Statistics

J Bone Joint Surg Am. 2021 Dec 17. doi: 10.2106/JBJS.21.00341. Online ahead of print.

ABSTRACT

BACKGROUND: Statistical models using machine learning (ML) have the potential for more accurate estimates of the probability of binary events than logistic regression. The present study used existing data sets from large musculoskeletal trauma trials to address the following study questions: (1) Do ML models produce better probability estimates than logistic regression models? (2) Are ML models influenced by different variables than logistic regression models?

METHODS: We created ML and logistic regression models that estimated the probability of a specific fracture (posterior malleolar involvement in distal spiral tibial shaft and ankle fractures, scaphoid fracture, and distal radial fracture) or adverse event (subsequent surgery [after distal biceps repair or tibial shaft fracture], surgical site infection, and postoperative delirium) using 9 data sets from published musculoskeletal trauma studies. Each data set was split into training (80%) and test (20%) subsets. Fivefold cross-validation of the training set was used to develop the ML models. The best-performing model was then assessed in the independent testing data. Performance was assessed by (1) discrimination (c-statistic), (2) calibration (slope and intercept), and (3) overall performance (Brier score).

RESULTS: The mean c-statistic was 0.01 higher for the logistic regression models compared with the best ML models for each data set (range, -0.01 to 0.06). There were fewer variables strongly associated with variation in the ML models, and many were dissimilar from those in the logistic regression models.

CONCLUSIONS: The observation that ML models produce probability estimates comparable with logistic regression models for binary events in musculoskeletal trauma suggests that their benefit may be limited in this context.

PMID:34921550 | DOI:10.2106/JBJS.21.00341

J Magn Reson Imaging. 2021 Dec 18. doi: 10.1002/jmri.28035. Online ahead of print.

ABSTRACT

BACKGROUND: Ultra-high field magnetic resonance imaging (MRI) has obvious advantages in acquiring high-resolution images. 7 T MRI has been clinically approved and 21.1 T MRI has also been tested on rodents.

PURPOSE: To examine the effects of ultra-high field on mice behavior and neuron activity.

STUDY TYPE: Prospective, animal model.

ANIMAL MODEL: Ninety-eight healthy C57BL/6 mice and 18 depression model mice.

FIELD STRENGTH: 11.1-33.0 T SMF (static magnetic field) for 1 hour and 7 T for 8 hours. Gradients were not on and no imaging sequence was used.

ASSESSMENT: Open field test, elevated plus maze, three-chambered social test, Morris water maze, tail suspension test, sucrose preference test, blood routine, biochemistry examinations, enzyme-linked immunosorbent assay, immunofluorescent assay.

STATISTICAL TESTS: The normality of the data was assessed by Shapiro-Wilk test, followed by Student’s t test or the Mann-Whitney U test for statistical significance. The statistical cut-off line is P < 0.05.

RESULTS: Compared to the sham group, healthy C57/6 mice spent more time in the center area (35.12 ± 4.034, increased by 47.19%) in open field test and improved novel index (0.6201 ± 0.02522, increased by 16.76%) in three-chambered social test a few weeks after 1 hour 11.1-33.0 T SMF exposure. 7 T SMF exposure for 8 hours alleviated the depression state of depression mice, including less immobile time in tail suspension test (58.32% reduction) and higher sucrose preference (increased by 8.80%). Brain tissue analysis shows that 11.1-33.0 T and 7 T SMFs can increase oxytocin by 164.65% and 36.03%, respectively. Moreover, the c-Fos level in hippocampus region was increased by 14.79%.

DATA CONCLUSION: 11.1-33.0 T SMFs exposure for 1 hour or 7 T SMF exposure for 8 hours did not have detrimental effects on healthy or depressed mice. Instead, these ultra-high field SMFs have anti-depressive potentials.

EVIDENCE LEVEL: 1 TECHNICAL EFFICACY: Stage 1.

PMID:34921571 | DOI:10.1002/jmri.28035

Acta Ortop Mex. 2021 May-Jun;35(3):257-260.

ABSTRACT

INTRODUCTION: The evaluation and management of acetabular bone loss in total hip arthroplasty is a challenge for orthopedic surgeons, we wish in this study to determine the inter-observer concordance in the Paprosky classification for acetabular defects.

MATERIAL AND METHODS: Observational, descriptive, longitudinal, prospective study. It was performed using anteroposterior hip radiographs of patients scheduled for primary total hip arthroplasty or revision with acetabular bone defect, Sinapse local X-ray system, 20 X-rays were assessed per observer taken randomly (doctors assigned to the joint replacement service with minimum experience of five years) using the Paprosky classification spontaneously, (without previous classes) for acetabular defects, inter-observer concordance was assessed using Cohen’s Kappa coefficient.

RESULTS: An interobserver agreement was obtained on average for the Paprosky classification of acetabular defects using the Cohen’s Kappa coefficient, the concordance analysis was done using the statistical program statistical package for the social sciences of 0.237.

CONCLUSIONS: Both the null hypothesis (Kappa greater than 0.80 value considered optimal) and the alternative hypothesis (Kappa from 0.41 to 0.80 value equal to moderate to good) did not agree with our study (Kappa equal to 0.237) value equal to mild, in addition , it was shown that the greater the acetabular defect, the lower the interobserver agreement in surgeons in our institution.

PMID:34921534

Cancer Med. 2021 Dec 17. doi: 10.1002/cam4.4449. Online ahead of print.

ABSTRACT

BACKGROUND: Neoadjuvant therapy with dual HER2 blockade improved pathological complete response (pCR) rate in HER2-positive breast cancer patients. Nevertheless, it would be desirable to identify patients exquisitely responsive to single agent trastuzumab to minimize or avoid overtreatment. Herein, we evaluated the predictive and prognostic value of basal primary tumor miRNA expression profile within the trastuzumab arm of NeoALTTO study (ClinicalTrials.gov Identifier: NCT00553358).

METHODS: RNA samples from baseline biopsies were randomized into training (n = 45) and testing (n = 47) sets. After normalization, miRNAs associated with Event-free survival (EFS) and pCR were identified by univariate analysis. Multivariate models were implemented to generate specific signatures which were first confirmed, and then analyzed together with other clinical and pathological variables.

RESULTS: We identified a prognostic signature including hsa-miR-153-3p (HR 1.831, 95% CI: 1.34-2.50) and hsa-miR-219a-5p (HR 0.629, 95% CI: 0.50-0.78). For two additional miRNAs (miR-215-5p and miR-30c-2-3p), we found a statistically significant interaction term with pCR (p.interaction: 0.017 and 0.038, respectively). Besides, a two-miRNA signature was predictive of pCR (hsa-miR-31-3p, OR 0.70, 95% CI: 0.53-0.92, and hsa-miR-382-3p, OR: 1.39, 95% CI: 1.01-1.91). Notably, the performance of this predictive miRNA signature resembled that of the genomic classifiers PAM50 and TRAR, and did not improve when the extended models were fitted.

CONCLUSION: Analyses of primary tumor tissue miRNAs hold the potential of a parsimonious tool to identify patients with differential clinical outcomes after trastuzumab based neoadjuvant therapy.

PMID:34921525 | DOI:10.1002/cam4.4449

Acta Ortop Mex. 2021 May-Jun;35(3):245-251.

ABSTRACT

PURPOSE: Compare functional and radiological outcomes of three different designs of reverse shoulder arthroplasty according to distalization and lateralization shoulder angle, in heterogenic diagnostics (fracture, cuff arthropathy, fracture sequela and osteoarthritis).

MATERIAL AND METHODS: Prospective cohort of 33 patients of reverse shoulder arthroplasty (RSA) between December 2014 and July 2017 with a minimum one year of follow-up. We defined three groups, G: 10 patients with Grammont (155o, Medialized Glena), B: 9 patients with Bio-RSA (155º, lateralized bone glena) and A: 14 patients with Arrow (135o, lateralized metallic glena). We analyze demographic, clinical, functional and radiological outcomes (lateralization shoulder angle (LSA) and distalization shoulder angle (DSA)). For the statistical analysis, ANOVA, T-tests and linear regression tests were used, with a statistical significance of 5%.

RESULTS: The LSA was significantly higher in group A (98o A, 79o G, 80o B) (p < 0.05). In DSA, group B was significantly higher than A (52o B, 39o A) (p < 0.05) and not significant to G (48o G) (p = 0.06). There was no correlation of LSA and DSA with external rotation (p = 0.51) and active elevation (p = 0.41), respectively. There was no significant clinical (anterior elevation, external rotation, internal rotation) and functional outcomes (adjusted Constant score and subjective shoulder evaluation) differences between the different RSA models (p > 0.05).

CONCLUSIONS: The LSA was higher in the Arrow and the DSA was higher in Bio-RSA. We did not find Clinical – Radiological correlation in this heterogeneous series of patients.

PMID:34921532

J Vet Intern Med. 2021 Dec 17. doi: 10.1111/jvim.16298. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic profiling identifies seasonal variance of serum metabolites in humans. Despite the presence of seasonal disease patterns, no studies have assessed whether serum metabolites vary seasonally in dogs.

HYPOTHESIS: There is seasonal variation in the serum metabolite profiles of healthy dogs.

ANIMALS: Eighteen healthy, client-owned dogs.

METHODS: A prospective cohort study. Serum metabolomic profiles were assessed monthly in 18 healthy dogs over a 12-month period. Metabolic profiling was conducted using a canine-specific proton nuclear magnetic resonance spectroscopy platform, and the effects of seasonality were studied for 98 metabolites using a cosinor model. Seasonal component was calculated, which describes the seasonal variation of each metabolite.

RESULTS: We found no evidence of seasonal variation in 93 of 98 metabolites. Six metabolites had statistically significant seasonal variance, including cholesterol (mean 249 mg/dL [6.47 mmol/L] with a seasonal component amplitude of 9 mg/dL [0.23 mmol/L]; 95% confidence interval [CI] 6-13 mg/dL [0.14-0.33 mmol/L], P < .008), with a peak concentration of 264 mg/dL (6.83 mmol/L) in June and trough concentration of 236 mg/dL (6.12 mmol/L) in December. In contrast, there was a significantly lower concentration of lactate (mean 20 mg/dL [2.27 mmol/L] with a seasonal component amplitude of 4 mg/dL [0.42 mmol/L]; 95% CI 2-6 mg/dL [0.22-0.62 mmol/L], P < .001) during the summer months compared to the winter months, with a peak concentration of 26 mg/dL (2.9 mmol/L) in February and trough concentration of 14 mg/dL (1.57 mmol/L) in July.

CONCLUSIONS AND CLINICAL IMPORTANCE: We found no clear evidence that seasonal reference ranges need to be established for serum metabolites of dogs.

PMID:34921444 | DOI:10.1111/jvim.16298

Influenza Other Respir Viruses. 2021 Dec 17. doi: 10.1111/irv.12940. Online ahead of print.

ABSTRACT

INTRODUCTION: Respiratory syncytial virus (RSV) is the major cause of lower respiratory tract illness in young children and can also cause influenza-like illness (ILI). Here we investigated the epidemiological features of RSV infection in pediatric ILI cases in Lombardy (a region in Northern Italy accounting nearly 10 million inhabitants) from 2014-2015 to 2020-2021 winter seasons.

MATERIAL AND METHODS: Data for this study were retrieved and statistically analyzed from the database of virological influenza surveillance of the regional reference laboratory for Lombardy within the Italian influenza surveillance network (InfluNet).

RESULTS: RSV accounted for nearly 19% of pediatric ILI with a risk of infection nearly two-fold greater than that of individuals ≥15 years. RSV positivity rate increased to 28% considering 0-5 years old children. Although in children ≤5 years the risk of infection from influenza viruses resulted nearly two-fold higher than the risk of RSV infection, the age group 4-6 months and 7-12 months showed a five-fold greater risk of infection from RSV than from influenza. Children ≤5 years of age with pre-existing underlying health conditions had a nearly five-fold greater risk of getting RSV infection than otherwise healthy 0-5 years old children. RSV was identified in ILI cases <15 years of age in all considered winter seasons except in the 2020-2021 season.

DISCUSSION: Sentinel surveillance of ILI allowed us to identify groups at higher risk of RSV and influenza infection and to define the start, duration, timing, and intensity of the RSV and influenza community circulation. This surveillance approach can be implemented to assess the RSV circulation and impact in a real-time manner.

PMID:34921508 | DOI:10.1111/irv.12940

J Oral Rehabil. 2021 Dec 17. doi: 10.1111/joor.13298. Online ahead of print.

ABSTRACT

BACKGROUND: Orthodontic treatment is a common clinical method of malocclusion. Studies have found that neurons in the sensorimotor cortex of the brain undergo adaptive remodeling in response to changes in oral behavior or occlusion.

OBJECTIVE: To explore whether orthodontic treatment could be sufficient to cause neuroplastic changes in the corticomotor excitability of the masseter muscle.

METHODS: Fifteen Angle Class II malocclusion patients who were receiving the orthodontic treatment participated in the study. Cortical excitability was assessed by electromyographic activity changes evoked by transcranial magnetic stimulation. Four orthodontic time points were recorded, including baseline, day 1, day 7, and day 30. Motor evoked potentials (MEPs) were recorded in the masseter muscle and the first dorsal interosseous muscle (FDI) serving as a control. The data were analyzed by stimulus-response curves and corticomotor mapping. Statistical analyses involved repeated measures analysis of variance, two-way ANOVA and post-hoc Tukey tests.

RESULTS: Motor evoked potentials (MEPs) of the masseter muscle were significantly decreased during orthodontic treatment compared with baseline (P<0.001). MEPs of masseter muscle were dependent on session and stimulus intensity (P<0.001), whereas MEPs of FDI were only dependent on stimulus intensity (P=0.091). Finally, Post hoc Tukey tests demonstrated that MEPs of masseter muscle on days 1 and 7, with 70% to 90% stimulus intensities, were higher compared with baseline values. (P<0.001) CONCLUSIONS: The present study suggested that orthodontic treatment can lead to neuroplastic changes in the corticomotor control of the masseter muscle, which may add to our understanding of the adaptive response of subjects to changes of oral environment during the orthodontic treatment.

PMID:34921434 | DOI:10.1111/joor.13298

Br J Psychol. 2021 Dec 17. doi: 10.1111/bjop.12547. Online ahead of print.

ABSTRACT

Previous studies on perceptual grouping found that people can use spatiotemporal and featural information to group spatially separated rigid objects into a unit while tracking moving objects. However, few studies have tested the role of objects’ self-motion information in perceptual grouping, although it is of great significance to the motion perception in the three-dimensional space. In natural environments, objects always move in translation and rotation at the same time. The self-rotation of the objects seriously destroys objects’ rigidity and topology, creates conflicting movement signals and results in crowding effects. Thus, this study sought to examine the specific role played by self-rotation information on grouping spatially separated non-rigid objects through a modified multiple object tracking (MOT) paradigm with self-rotating objects. Experiment 1 found that people could use self-rotation information to group spatially separated non-rigid objects, even though this information was deleterious for attentive tracking and irrelevant to the task requirements, and people seemed to use it strategically rather than automatically. Experiment 2 provided stronger evidence that this grouping advantage did come from the self-rotation per se rather than surface-level cues arising from self-rotation (e.g. similar 2D motion signals and common shapes). Experiment 3 changed the stimuli to more natural 3D cubes to strengthen the impression of self-rotation and again found that self-rotation improved grouping. Finally, Experiment 4 demonstrated that grouping by self-rotation and grouping by changing shape were statistically comparable but additive, suggesting that they were two different sources of the object information. Thus, grouping by self-rotation mainly benefited from the perceptual differences in motion flow fields rather than in deformation. Overall, this study is the first attempt to identify self-motion as a new feature that people can use to group objects in dynamic scenes and shed light on debates about what entities/units we group and what kinds of information about a target we process while tracking objects.

PMID:34921401 | DOI:10.1111/bjop.12547

Perspect Psychiatr Care. 2021 Dec 18. doi: 10.1111/ppc.13001. Online ahead of print.

ABSTRACT

PURPOSE: This study was aimed at comparing the conscientious intelligence levels of nursing students and determining the factors affecting their conscientious intelligence.

DESIGN AND METHODS: Two hundred and forty nursing students were involved in the study.

FINDINGS: There were no statistically significant differences between the first and fourth-year students in terms of the mean scores they obtained from the compassion, responsibility toward the creator, conscious awareness, and social sensitivity sub-dimensions. Of the students, those who chose the profession willingly, those who were women and those who did not perceive nursing as a profession just to earn money obtained higher mean scores in the Conscientious Intelligence Scale.

PRACTICE IMPLICATIONS: The results of the study revealed that Nurse Academics should make more attempts to improve students’ conscientious intelligence.

PMID:34921416 | DOI:10.1111/ppc.13001