Category: Statistics

Glob Chang Biol. 2022 Apr 20. doi: 10.1111/gcb.16187. Online ahead of print.

ABSTRACT

Identifying climate refugia is key to effective biodiversity conservation under a changing climate, especially for mountain-specialist species adapted to cold conditions and highly threatened by climate warming. We combined species distribution models (SDMs) with climate forecasts to identify climate refugia for high-elevation bird species (Lagopus muta, Anthus spinoletta, Prunella collaris, Montifringilla nivalis) in the European Alps, where the ecological effects of climate changes are particularly evident and predicted to intensify. We considered future (2041-2070) conditions (SSP585 scenario, four climate models) and identified three types of refugia: (1) in-situ refugia potentially suitable under both current and future climate conditions, ex-situ refugia suitable (2) only in the future according to all future conditions, or (3) under at least three out of four future conditions. SDMs were based on a very large, high-resolution occurrence dataset (2901-12,601 independent records for each species) collected by citizen scientists. SDMs were fitted using different algorithms, balancing statistical accuracy, ecological realism and predictive/extrapolation ability. We selected the most reliable ones based on consistency between training and testing data and extrapolation over distant areas. Future predictions revealed that all species (with the partial exception of A. spinoletta) will undergo a range contraction towards higher elevations, losing 17%-59% of their current range (larger losses in L. muta). We identified ~15,000 km² of the Alpine region as in-situ refugia for at least three species, of which 44% are currently designated as protected areas (PAs; 18%-66% among countries). Our findings highlight the usefulness of spatially accurate data collected by citizen scientists, and the importance of model testing by extrapolating over independent areas. Climate refugia, which are only partly included within the current PAs system, should be priority sites for the conservation of Alpine high-elevation species and habitats, where habitat degradation/alteration by human activities should be prevented to ensure future suitability for alpine species.

PMID:35441422 | DOI:10.1111/gcb.16187

Trop Med Int Health. 2022 Apr 19. doi: 10.1111/tmi.13754. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe the urological outcomes in children with congenital Zika syndrome (CZS) and investigate the relationship between clinical and urological findings in this population.

METHODS: This cross-sectional study involved children with CZS followed up by a referral center for children with microcephaly in the state of Paraiba in northeast Brazil. Urological evaluation included clinical history, urine culture results, ultrasonography of the urinary tract, and urodynamic evaluation, following the protocol proposed by Costa Monteiro et al. (2017). Descriptive statistical analysis was performed in addition to association and correlation tests, considering clinical and urodynamic variables.

RESULTS: Among the 88 children with CZS (35.5±5.5 months), 97.7% had microcephaly and 51% presented urinary tract infection (UTI) confirmed with clinical history and lab tests. The number of confirmed UTI episodes varied from one to 14 per child. Urodynamic evaluation confirmed the presence of an overactive bladder in 78 children and incomplete voiding in 50. Urodynamic findings were associated with the number of confirmed UTI episodes, child’s sex, and actual weight, in addition to the use of anticonvulsant and myorelaxant drugs.

CONCLUSIONS: UTIs were confirmed in most children. Other urological outcomes observed were overactive bladder and low bladder capacity, which were associated with the number of confirmed UTI episodes, use of anticonvulsants and myorelaxants, and the child’s sex and weight. These are treatable conditions, and it is paramount that pediatricians, neonatologists, and infection disease specialists are aware of them to make clinical decisions and help reduce the risk of renal damage and other morbidities.

PMID:35441418 | DOI:10.1111/tmi.13754

Suicide Life Threat Behav. 2022 Apr 20. doi: 10.1111/sltb.12870. Online ahead of print.

ABSTRACT

INTRODUCTION: Suicidal ideation (SI) has numerous limitations in predicting suicidal behavior. The Suicide Crisis Syndrome (SCS) is proposed as an alternative method of detecting risk. This study compares the relative utility of SI and SCS in statistically predicting SI and behaviors at one-month follow-up.

METHODS: 382 psychiatric patients (98 inpatients, 284 outpatients) completed baseline measures and provided information about suicide-related outcomes one month later. Participants were grouped based on responses to measures assessing SCS and SI.

RESULTS: Rates of follow-up suicidal behavior were significantly higher among those reporting both SCS and SI (22.2%) than those reporting SI alone (6.0%) or neither SCS nor SI (0.9%). SCS alone (8.3%) had descriptively, but not statistically, higher rates of suicidal behavior than those with neither SCS nor SI, and did not differ from SI alone and the combination of SCS and SI. Those reporting SI-with and without SCS-had higher levels of follow-up suicidal thoughts than those without SI.

CONCLUSION: The SCS was equivalent to SI, and incrementally informative alongside SI, in detecting individuals at risk of future suicidal behavior, whereas SI was more strongly related to future SI than SCS. The combination of SCS and SI may be clinically useful in detecting individuals who are at risk for suicide.

PMID:35441411 | DOI:10.1111/sltb.12870

Ultrasound Obstet Gynecol. 2022 Apr 20. doi: 10.1002/uog.24916. Online ahead of print.

ABSTRACT

OBJECTIVES: Currently, there is little evidence related to the effects of the Omicron variant on pregnancy outcomes, particularly in unvaccinated women. This study aims to compare pregnancy outcomes of SARS-CoV-2 infected, unvaccinated women during the pre-Delta, Delta, and Omicron waves.

METHODS: This was a retrospective cohort study at two tertiary care facilities: Sancaktepe Training and Research Hospital, Istanbul, Turkey, and St. George’s University Hospitals NHS Foundation Trust, London, UK. Included were people testing RT-PCR positive for SARS-CoV-2 during pregnancy, between April 01, 2020 and February 14, 2022, and divided into three epochs: (i) pre-Delta, 1 Apr 2020 to 8 Jun 2021 in Turkey, and 1 Apr 2020 to 31 Jul 2021 in the UK; (ii) Delta, 9 Jun 2021 to 27 Dec 2021 in Turkey, and 1 Aug 2021 to 27 Dec 2021 in the UK; and (iii) Omicron, after 27 Dec 2021 in each of Turkey and the UK, according to the date of their positive RT-PCR test. Baseline data collected included maternal age, parity, body mass index (BMI), smoking status, gestational age at diagnosis, and comorbidities. The primary outcome was the need for oxygen supplementation, classified as oxygen support via nasal cannula or breather mask, non-invasive mechanical ventilation with continuous positive airway pressure (CPAP) or high-flow oxygen, mechanical ventilation with intubation, or extracorporeal membrane oxygenation (ECMO). Inferences were made after balancing of confounders, using an evolutionary search algorithm.

RESULTS: 1285 RT-PCR-proven SARS-CoV-2 infections of unvaccinated pregnant women were identified during the pre-Delta (N=870), Delta (N=339), and Omicron (N=77) epochs. In the confounder-balanced cohort, infection during the Delta wave was associated with increased need for nasal oxygen support (RR 2.53, 95% confidence interval [CI] 1.75-3.65, P<.001), CPAP or high-flow oxygen (RR 2.50, 95% CI 1.37-4.56, P=.002), mechanical ventilation (RR 4.20, 95% CI 1.60-11.0, P=.003), and ECMO (RR 11.0, 95% CI 1.43-84.7, P=.021). The maternal mortality rate was also 3-4 fold higher during the Delta wave compared to pre-Delta (5.3% vs 1.5%, P=0.010). An infection during the Omicron wave was not associated with an increased need for nasal oxygen support (RR 0.62, 95% CI 0.25-1.55, P=0.251), CPAP or high-flow oxygen (RR 1.07, 95% CI 0.36-3.12, P=0.906), or mechanical ventilation (RR 0.44, 95% CI 0.06-3.45, P=0.438). The maternal mortality rate was similar during the Omicron wave and the pre-Delta period (1.3% vs 1.3%, P=0.999). Nasal oxygen support during the Omicron wave was significantly lower compared to Delta-wave infection (RR 0.26, 95% CI 0.11-0.64, P=0.003). Perinatal outcomes were available for a subset of the confounder-balanced cohort. Preterm birth below 34 weeks’ gestation was significantly increased (P<0.001) during the Delta wave compared with pre-Delta.

CONCLUSIONS: Among unvaccinated pregnant women, SARS-CoV-2 infection during (vs. before) the Delta wave was associated with increased requirement for oxygen support (including ECMO) and higher maternal mortality. Disease severity and pregnancy complications were similar during the Omicron wave (vs. pre-Delta). SARS-CoV-2 infection in unvaccinated pregnant women carries considerable risks of morbidity and mortality, and COVID-19 vaccination remains key. Miscommunication of risks of Omicron infection may adversely impact the vaccination rate among pregnant women, who are already at increased risk of complications related to COVID-19. This article is protected by copyright. All rights reserved.

PMID:35441407 | DOI:10.1002/uog.24916

Head Neck. 2022 Apr 20. doi: 10.1002/hed.27062. Online ahead of print.

ABSTRACT

Recurrent salivary gland carcinomas (RSCs) are poorly characterized and their clinical features and treatment options have not yet been fully described. The goal of this study was to analyze the therapeutic strategies and oncological outcomes of RSC patients through a literature review analysis. This systematic review was performed according to the PRISMA statements. Inclusion criteria for the systematic review were based on the population, intervention, comparison, and outcomes according to (PICO) framework. Two thousand seven hundred and four records were selected and 1817 recurrences were studied. Three hundred and sixty-five patients underwent salvage surgery (20.1%) and their 5-year mortality rate, overall survival and disease-free survival were 35%, 70%, and 42%, respectively. RSCs are aggressive neoplasms with a high rate of distant metastases (28.9%). Salvage surgery can be considered in patients with limited local and/or regional recurrences, even in case of single distant relapse, appearing within the first 3 years of follow-up.

PMID:35441406 | DOI:10.1002/hed.27062

Proteins. 2022 Apr 20. doi: 10.1002/prot.26349. Online ahead of print.

ABSTRACT

Protein structural classification (PSC) is a supervised problem of assigning proteins into pre-defined structural (e.g., CATH or SCOPe) classes based on the proteins’ sequence or 3D structural features. We recently proposed PSC approaches that model protein 3D structures as protein structure networks (PSNs) and analyze PSN-based protein features, which performed better than or comparable to state-of-the-art sequence or other 3D structure-based PSC approaches. However, existing PSN-based PSC approaches model the whole 3D structure of a protein as a static (i.e., single-layer) PSN. Because folding of a protein is a dynamic process, where some parts (i.e., sub-structures) of a protein fold before others, modeling the 3D structure of a protein as a PSN that captures the sub-structures might further help improve the existing PSC performance. Here, we propose to model 3D structures of proteins as multi-layer sequential PSNs that approximate 3D sub-structures of proteins, with the hypothesis that this will improve upon the current state-of-the-art PSC approaches that are based on single-layer PSNs (and thus upon the existing state-of-the-art sequence and other 3D structural approaches). Indeed, we confirm this on 72 datasets spanning ∼44,000 CATH and SCOPe protein domains.

PMID:35441395 | DOI:10.1002/prot.26349

J Bone Miner Res. 2022 Apr 20. doi: 10.1002/jbmr.4548. Online ahead of print.

ABSTRACT

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to have weak but beneficial effects on bone health, including fracture risk, but many epidemiological studies are likely confounded. We explored the relationship between NSAIDs and fracture risk in a post hoc analysis of a well-documented, randomized, placebo-controlled study of the bisphosphonate, clodronate, in which treatment reduced osteoporotic fracture risk by 23%. Concurrent medication use at baseline was used to identify those prescribed oral NSAIDs. Only verified, incident fractures were included in the analysis. A total of 1082 (20.8%) women reported use of NSAIDs at baseline. They were slightly, but significantly, younger (mean 79 versus 80 years, p = 0.004), heavier (mean 66.7 versus 64.7 kg, p < 0.001) than nonusers, with slightly higher femoral neck bone mineral density (FN-BMD, 0.66 versus 0.64 g/cm² , p < 0.001). In an adjusted model, NSAID use was associated with a significant increase in osteoporotic fracture risk over the 3-year study period (hazard ratio [HR] 1.27; 95% confidence interval [CI], 1.01-1.62; p = 0.039). However, this increase in risk was not statistically significant in the placebo group (HR 1.11; 95% CI, 0.81-1.52). In women receiving clodronate, the effect of the bisphosphonate to reduce osteoporotic fracture risk was not observed in those receiving NSAIDs (HR 0.95; 95% CI, 0.65-1.41; p = 0.81) in contrast to those not using NSAIDs (HR 0.71; 95% CI, 0.58-0.89; p = 0.002). In a subset with hip BMD repeated at 3 years, BMD loss during clodronate therapy was greater in those women receiving NSAIDs than in nonusers (eg, total hip -2.75% versus -1.27%, p = 0.078; femoral neck -3.06% versus -1.12%, p = 0.028), and was not significantly different from that observed in women receiving placebo. The efficacy of the bisphosphonate, clodronate, to reduce fracture risk was largely negated in those receiving NSAIDs. Although the mechanism is unclear, this clinically significant observation requires exploration in studies of commonly used bisphosphonates. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

PMID:35441396 | DOI:10.1002/jbmr.4548

J Clin Lab Anal. 2022 Apr 20:e24442. doi: 10.1002/jcla.24442. Online ahead of print.

ABSTRACT

BACKGROUND: Renal cell carcinoma is difficult to diagnose and unpredictable in disease course and severity. There are no specific biomarkers for diagnosis and prognosis estimation feasible in clinical practice. Long non-coding RNAs (lncRNAs) have emerged as potent regulators of gene expression in recent years. Aside from their cellular role, their expression patterns could be used as a biomarker of ongoing pathology.

METHODS: In this work, we used next-generation sequencing for global lncRNA expression profiling in tumor and non-tumor tissue of RCC patients. The four candidate lncRNAs have been further validated on an independent cohort. PVT1, as the most promising lncRNA, has also been studied using functional in vitro tests.

RESULTS: Next-generation sequencing showed significant dysregulation of 1163 lncRNAs; among them top 20 dysregulated lncRNAs were AC061975.7, AC124017.1, AP000696.1, AC148477.4, LINC02437, GATA3-AS, LINC01762, LINC01230, LINC01271, LINC01187, LINC00472, AC007849.1, LINC00982, LINC01543, AL031710.1, and AC019197.1 as down-regulated lncRNAs; and SLC16A1-AS1, PVT1, LINC0887, and LUCAT1 as up-regulated lncRNAs. We observed statistically significant dysregulation of PVT1, LUCAT1, and LINC00982. Moreover, we studied the effect of artificial PVT1 decrease in renal cell line 786-0 and observed an effect on cell viability and migration.

CONCLUSION: Our results show not only the diagnostic but also the therapeutic potential of PVT1 in renal cell carcinoma.

PMID:35441392 | DOI:10.1002/jcla.24442

Aust Occup Ther J. 2022 Apr 19. doi: 10.1111/1440-1630.12803. Online ahead of print.

ABSTRACT

INTRODUCTION: Current research evidence suggests that people with schizophrenia have sensory processing difficulties. Sensory modulation has growing evidence for use in this population. This study aimed to evaluate the extent to which health, social, cognitive, and occupational functioning outcomes were impacted by sensory modulation interventions for people with schizophrenia.

METHODS: A prospective observational cohort study using a waitlist control design was used in two large hospital and health services in Queensland, Australia. The study recruited patients who used sensory modulation (n = 30) across the two hospitals and those who did not use sensory modulation interventions as a control (n = 11). Results were analysed using a series of planned comparisons including independent and paired t-tests, and mixed ANOVA was used whenever statistically indicated. The analysed measures were pre- and post-intervention scores.

RESULTS: This study found no statically significant differences between the control and intervention groups at both pre- and post-intervention. However, analysis of results from within the intervention group showed statistically significant improvements between pre- and post-test scores on distress, occupational functioning, and health and social functioning but not on sensory processing and global cognitive processing. Further analysis of results from this study, compared with those from an earlier study on the general population showed significant differences in Low Registration and Sensation Avoiding, as measured by the Adult/Adolescent Sensory Profile, between participants with schizophrenia and those without schizophrenia.

CONCLUSION: This study provides evidence to suggest that sensory modulation interventions can be complementary to standard care when utilised appropriately in clinical settings. Findings also suggest that the sensory profile of people with schizophrenia is different to that of the general population and this may have clinical implications. Further longitudinal research is needed with larger and randomised samples, using more targeted measures to better explore effectiveness of sensory modulation interventions.

PMID:35441391 | DOI:10.1111/1440-1630.12803

Stat Med. 2022 Apr 19. doi: 10.1002/sim.9369. Online ahead of print.

ABSTRACT

Cluster/group randomized controlled trials (CRTs) have a long history in the study of health sciences. CRT is a special type of intervention trial in which a complete group is randomly assigned to a study condition (or intervention). It is typically performed when individual randomization is difficult/impossible without substantial risk of contamination across study arms or prohibitive from the cost or group dynamics point of view. In this article, the aim is to design and analyze four-level longitudinal cluster randomized trials. The main interest here is to study the difference between treatment groups over time for such a four-level hierarchical data structure. This work is motivated by a real-life study for education based HIV prevention. Such trials are not only popular for administrative convenience, ethical considerations, subject compliance, but also help to reduce contamination bias. A random intercept mixed effects linear regression including a time by intervention interaction is used for modeling. Closed form expression of the power function to detect the interaction effect is determined. Sample size equations depend on correlation among schools but not on correlations among classes or students while, the power function depends on the product of number of units at different levels. Optimal allocation of units under a fixed cost by minimizing the expected standardized variance is also determined and are shown to be independent of correlations among units in any level. Results of detailed simulation studies find the theoretical power estimates based on the derived formulae close to the empirical estimates.

PMID:35441378 | DOI:10.1002/sim.9369