Tag: statistics

J Speech Lang Hear Res. 2022 Aug 3:1-14. doi: 10.1044/2022_JSLHR-21-00619. Online ahead of print.

ABSTRACT

PURPOSE: Amyotrophic lateral sclerosis (ALS) impacts bulbar and respiratory musculature, which may contribute to impaired swallow function (dysphagia) and respiratory-swallow coordination. The purpose of this pilot study was to examine if respiratory-swallow coordination in individuals with ALS was perturbed compared to healthy controls. We further explored relationships between measures of respiratory function and self-reported swallowing outcomes on respiratory-swallow coordination.

METHOD: We employed a cross-sectional design with eight participants with ALS and eight age- and sex-matched healthy participants. Respiratory inductance plethysmography and a nasal cannula were used to capture respiratory-swallow phase patterns during a standardized clinical swallow examination. The advantageous respiratory-swallow phase pattern was defined if exhalation surrounded the swallow (E-E). Spirometry was used to capture indices of respiratory function (forced vital capacity % predicted, peak cough flow [PCF]). Validated questionnaires were used to collect information regarding ALS-related bulbar functional status and swallowing-related concerns.

RESULTS: Compared to the matched healthy cohort, individuals with ALS demonstrated higher rates of non-E-E respiratory-swallow phase patterning and worse bulbar/swallow dysfunction. Group (ALS), swallow tasks, and PCF were significantly associated with respiratory-swallow phase pattern.

CONCLUSIONS: These preliminary findings support altered respiratory-swallow phase patterning in ALS. Future work should employ an instrumental assessment to quantify swallowing physiology and elucidate the relationship between perturbed respiratory-swallow coordination and swallowing function.

PMID:35921660 | DOI:10.1044/2022_JSLHR-21-00619

Plast Reconstr Surg. 2022 Jul 29. doi: 10.1097/PRS.0000000000009573. Online ahead of print.

ABSTRACT

BACKGROUND: To compare the clinical effects of long-pulse-width 1064nm Nd:YAG laser assisted ear correction model and simple ear correction model in the treatment of congenital auricular deformities in over-aged ears.

METHODS: 129 children (179 ears) with congenital auricular deformities aged more than 2 months were included in the study. Among them, 84 cases (observation group, 119 ears) were treated with the ear correction model after long-pulse-width 1064nm Nd:YAG laser irradiation, while 45 cases (60 ears) were treated with the ear correction model only. The affected ears of the two groups were measured, the correction time was calculated, and the family members of the patients filled in the satisfaction questionnaire before and after the treatment.

RESULTS: The level of satisfaction of the two groups after the treatment improved. The level of satisfaction of the observation group was higher than that of the control group. The days of correction in the observation group was less than that in the control group (P＜0.05). The measurements of the affected ears in the two groups were significantly different after treatment. The difference after treatment of each measurement in the observation group was higher than that in the control group. The therapeutic effect of the observation group was significantly better than that of the control group, and the differences were statistically significant.

CONCLUSION: Long-pulse-width 1064nm Nd:YAG laser combined with the ear correction model can effectively improve the success rate of correction of congenital auricular deformities in over-aged ears.

PMID:35921652 | DOI:10.1097/PRS.0000000000009573

Pediatrics. 2022 Jul 1;150(1):e2022057991. doi: 10.1542/peds.2022-057991.

ABSTRACT

Every year in the United States, approximately 3500 infants die of sleep-related infant deaths, including sudden infant death syndrome (SIDS) (International Statistical Classification of Diseases and Related Health Problems 10th Revision [ICD-10] R95), ill-defined deaths (ICD-10 R99), and accidental suffocation and strangulation in bed (ICD-10 W75). After a substantial decline in sleep-related deaths in the 1990s, the overall death rate attributable to sleep-related infant deaths have remained stagnant since 2000, and disparities persist. The triple risk model proposes that SIDS occurs when an infant with intrinsic vulnerability (often manifested by impaired arousal, cardiorespiratory, and/or autonomic responses) undergoes an exogenous trigger event (eg, exposure to an unsafe sleeping environment) during a critical developmental period. The American Academy of Pediatrics recommends a safe sleep environment to reduce the risk of all sleep-related deaths. This includes supine positioning; use of a firm, noninclined sleep surface; room sharing without bed sharing; and avoidance of soft bedding and overheating. Additional recommendations for SIDS risk reduction include human milk feeding; avoidance of exposure to nicotine, alcohol, marijuana, opioids, and illicit drugs; routine immunization; and use of a pacifier. New recommendations are presented regarding noninclined sleep surfaces, short-term emergency sleep locations, use of cardboard boxes as a sleep location, bed sharing, substance use, home cardiorespiratory monitors, and tummy time. In addition, additional information to assist parents, physicians, and nonphysician clinicians in assessing the risk of specific bed-sharing situations is included. The recommendations and strength of evidence for each recommendation are published in the accompanying policy statement, which is included in this issue.

PMID:35921639 | DOI:10.1542/peds.2022-057991

Sports Med Arthrosc Rev. 2022 Sep 1;30(3):162-165. doi: 10.1097/JSA.0000000000000350. Epub 2022 Aug 3.

ABSTRACT

Interest in use of perinatal allogenic tissues including clinical-grade minimally manipulated umbilical cord tissue-derived allograft formulations to treat knee osteoarthritis (OA) patients is increasing. Limited studies have characterized these formulations and evaluated their safety and efficacy in knee OA patients. We developed such formulation and reported the presence of growth factors, cytokines, hyaluronic acid, and exosomes. We reported that its administration is safe, and resulted in 50% pain reduction and improvement in knee injury and osteoarthritis outcome score (over 10%) and 36-item short form survey (25%). Another study reported no adverse events post injection of similar formulation and statistically significant (P<0.001) improvement in visual analog scale and Western Ontario and McMaster Universities Osteoarthritis Index scores and reduction in medication usage in patients (77.8%). We also summarized the clinical trials registered on ClinicalTrials.gov utilizing umbilical cord tissue for knee OA treatment. In conclusion, available studies are preliminary but pave the way to higher level appropriately powered investigations, and these formulations should be considered as nonoperative alternative to manage knee OA.

PMID:35921598 | DOI:10.1097/JSA.0000000000000350

J Infect Dis. 2022 Aug 3:jiac318. doi: 10.1093/infdis/jiac318. Online ahead of print.

ABSTRACT

To inform public health policy, it is critical to monitor COVID-19 vaccine effectiveness (VE), including against acquiring infection. We estimated VE using self-reported vaccination in a retrospective cohort of repeat blood donors who donated during the first half of 2021, demonstrating a viable approach for monitoring of VE via serological surveillance. Using Poisson regression, we estimated an overall VE of 88.8% (95% CI: 86.2-91.1), adjusted for demographic covariates and variable baseline risk. Time since first reporting vaccination, age, race-ethnicity, region, and calendar time were statistically significant predictors of incident infection.

PMID:35921537 | DOI:10.1093/infdis/jiac318

Gut Microbes. 2022 Jan-Dec;14(1):2106103. doi: 10.1080/19490976.2022.2106103.

ABSTRACT

How the gut microbiota is organized across space is postulated to influence microbial succession and its mutualistic relationships with the host. The lack of dynamic or perturbed abundance data poses considerable challenges for characterizing the spatial pattern of microbial interactions. We integrate allometric scaling theory, evolutionary game theory, and prey-predator theory into a unified framework under which quasi-dynamic microbial networks can be inferred from static abundance data. We illustrate that such networks can capture the full properties of microbial interactions, including causality, the sign of the causality, strength, and feedback loop, and are dynamically adaptive along spatial gradients, and context-specific, characterizing variability between individuals and within the same individual across time and space. We design and conduct a gut microbiota study to validate the model, characterizing key spatial determinants of the microbial differences between ulcerative colitis and healthy controls. Our model provides a sophisticated means of unraveling a complete atlas of how microbial interactions vary across space and quantifying causal relationships between such spatial variability and change in health state.

PMID:35921525 | DOI:10.1080/19490976.2022.2106103

Hepatology. 2022 Aug 3. doi: 10.1002/hep.32704. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: Implantation of a transjugular intrahepatic portosystemic shunt (TIPS) improves survival in cirrhotic patients with refractory ascites and portal hypertensive bleeding. However, the indication for TIPS in older adult patients (≥70 years) is debated and a specific prediction model developed in this particular setting is lacking. The aim of this study was to develop and validate a multivariable model for an accurate prediction of mortality in older adults.

APPROACH & RESULTS: We prospectively enrolled 411 consecutive patients observed at 4 referral centers with de novo TIPS implantation for refractory ascites or secondary prophylaxis of variceal bleeding (derivation cohort) and an external cohort of 415 patients with similar indications for TIPS (validation cohort). Older adult patients in the two cohorts were 99 and 76 respectively. A cause-specific Cox competing risks model was used to predict liver-related mortality, with orthotopic liver transplant and death for extrahepatic causes as competing events. Age, alcoholic etiology, creatinine levels and international normalized ratio in the overall cohort, and creatinine and sodium levels in older adults were independent risk factors for liver-related death by multivariable analysis.

CONCLUSIONS: After TIPS implantation, mortality is increased by ageing, but TIPS placement should not be precluded in patients older than 70 years. In older adults, creatinine and sodium levels are useful predictors for decision making. Further efforts to update the prediction model with larger sample size are warranted.

PMID:35921493 | DOI:10.1002/hep.32704

Sci Transl Med. 2022 Aug 3;14(656):eabn7571. doi: 10.1126/scitranslmed.abn7571. Epub 2022 Aug 3.

ABSTRACT

Triple-negative breast cancer (TNBC) is an aggressive subtype associated with early metastatic recurrence and worse patient outcomes. TNBC tumors express molecular markers of the epithelial-mesenchymal transition (EMT), but its requirement during spontaneous TNBC metastasis in vivo remains incompletely understood. We demonstrated that spontaneous TNBC tumors from a genetically engineered mouse model (GEMM), multiple patient-derived xenografts, and archival patient samples exhibited large populations in vivo of hybrid E/M cells that lead invasion ex vivo while expressing both epithelial and mesenchymal characteristics. The mesenchymal marker vimentin promoted invasion and repressed metastatic outgrowth. We next tested the requirement for five EMT transcription factors and observed distinct patterns of utilization during invasion and colony formation. These differences suggested a sequential activation of multiple EMT molecular programs during the metastatic cascade. Consistent with this model, our longitudinal single-cell RNA analysis detected three different EMT-related molecular patterns. We observed cancer cells progressing from epithelial to hybrid E/M and strongly mesenchymal patterns during invasion and from epithelial to a hybrid E/M pattern during colony formation. We next investigated the relative epithelial versus mesenchymal state of cancer cells in both GEMM and patient metastases. In both contexts, we observed heterogeneity between and within metastases in the same individual. We observed a complex spectrum of epithelial, hybrid E/M, and mesenchymal cell states within metastases, suggesting that there are multiple successful molecular strategies for distant organ colonization. Together, our results demonstrate an important and complex role for EMT programs during TNBC metastasis.

PMID:35921474 | DOI:10.1126/scitranslmed.abn7571

Microb Biotechnol. 2022 Aug 3. doi: 10.1111/1751-7915.14124. Online ahead of print.

ABSTRACT

There was inconsistent evidence regarding the use of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for microorganism identification with/without antibiotic stewardship team (AST) and the clinical outcome of patients with bloodstream infections (BSI). In a systematic review and meta-analysis, we evaluated the effectiveness of rapid microbial identification by MALDI-TOF MS with and without AST on clinical outcomes. We searched PubMed and EMBASE databases from inception to 1 February 2022 to identify pre-post and parallel comparative studies that evaluated the use of MALDI-TOF MS for microorganism identification. Pooled effect estimates were derived using the random-effects model. Twenty-one studies with 14,515 patients were meta-analysed. Compared with conventional phenotypic methods, MALDI-TOF MS was associated with a 23% reduction in mortality (RR = 0.77; 95% CI: 0.66; 0.90; I² = 35.9%; 13 studies); 5.07-h reduction in time to effective antibiotic therapy (95% CI: -5.83; -4.31; I² = 95.7%); 22.86-h reduction in time to identify microorganisms (95% CI: -23.99; -21.74; I² = 91.6%); 0.73-day reduction in hospital stay (95% CI: -1.30; -0.16; I² = 53.1%); and US$4140 saving in direct hospitalization cost (95% CI: $-8166.75; $-113.60; I² = 66.1%). No significant heterogeneity sources were found, and no statistical evidence for publication bias was found. Rapid pathogen identification by MALDI-TOF MS with or without AST was associated with reduced mortality and improved outcomes of BSI, and may be cost-effective among patients with BSI.

PMID:35921430 | DOI:10.1111/1751-7915.14124

Sci Adv. 2022 Aug 5;8(31):eabp9908. doi: 10.1126/sciadv.abp9908. Epub 2022 Aug 3.

ABSTRACT

Invertebrates constitute the majority of animal species and are critical for ecosystem functioning and services. Nonetheless, global invertebrate biodiversity patterns and their congruences with vertebrates remain largely unknown. We resolve the first high-resolution (~20-km) global diversity map for a major invertebrate clade, ants, using biodiversity informatics, range modeling, and machine learning to synthesize existing knowledge and predict the distribution of undiscovered diversity. We find that ants and different vertebrate groups have distinct features in their patterns of richness and rarity, underscoring the need to consider a diversity of taxa in conservation. However, despite their phylogenetic and physiological divergence, ant distributions are not highly anomalous relative to variation among vertebrate clades. Furthermore, our models predict that rarity centers largely overlap (78%), suggesting that general forces shape endemism patterns across taxa. This raises confidence that conservation of areas important for small-ranged vertebrates will benefit invertebrates while providing a “treasure map” to guide future discovery.

PMID:35921404 | DOI:10.1126/sciadv.abp9908