Tag: statistics

BMC Musculoskelet Disord. 2022 Nov 8;23(1):966. doi: 10.1186/s12891-022-05908-3.

ABSTRACT

BACKGROUND: A biopsychosocial rehabilitation is recommended for chronic nonspecific low back pain (CNLBP); however, its effectiveness compared to the traditional supervised exercise therapy of CNLBP treatment is still unclear.

METHODS: This was a parallel-group randomized controlled clinical trial. The sample consisted of 180 participants of both sexes, aged ≥18 years, with CNLBP for ≥3 months. Using web randomization and concealed allocation, they were assigned to three groups; graded activity receiving cognitive-behavioral therapy, group-based combined exercise therapy and education (GA; n = 59), supervised group-based combined exercise therapy and education (SET; n = 63), and a control group receiving usual care (n = 58). Interventions were administered for 4 weeks (8 sessions). The primary outcome was pain intensity. Outcome measures were collected baseline, after interventions (4 weeks), and during two follow-up periods (3 and 6 months).

RESULTS: After the intervention, GA had a significant large effect on pain reduction compared to the control group (MD of 22.64 points; 95% CI = 16.10 to 29.19; p < 0.0001; Cohen’s d = 1.70), as well as SET compared with the control group (MD of 21.08 points; 95% CI = 14.64 to 27.52; p < 0.0001; Cohen’s d = 1.39), without significant difference between two intervention groups. At 3 and 6 months of follow-up, GA had a statistically significantly better effect in reducing pain, disability and fear-avoidance beliefs, and improving spinal extensor endurance, range of extension and quality of life compared to SET and the control group. A statistically significantly better effect of SET compared with the control group was found in reducing pain, disability, fear-avoidance beliefs, and improving the physical component of quality of life. Harms were not reported.

CONCLUSION: This study suggests that graded activity and group-based supervised exercise therapy have beneficial effects over the control group in the treatment of CNLBP. The graded activity was more beneficial than supervised group-based exercise therapy only during the follow-up.

TRIAL REGISTRATION: Clinicaltrials.gov (NCT04023162; registration date: 17/07/2019).

PMID:36348309 | DOI:10.1186/s12891-022-05908-3

BMC Geriatr. 2022 Nov 8;22(1):842. doi: 10.1186/s12877-022-03553-y.

ABSTRACT

BACKGROUND: Hip fractures are a global problem, and it will probably increase. Hip fractures impair health aspects which creates demands on postoperative care. This study describes and compares patients with hip fracture in 2008 and in 2018. An increased knowledge of this group could be a basis how to optimize aftercare and dimension rehabilitation.

METHODS: Using a comparative cross-sectional study to describe and compare patients with hip fracture from 2018 and 2008 at Örebro University Hospital regarding age, sex, multimorbidity, fracture type, surgical materials, surgery within 24 hours, length of stay, postoperative walking ability, physical activity level and hand grip strength. Data was collected from 76 patients with hip fracture from 2018 and 78 patients from 2008. Outcome measures considering functioning were walking ability (Functional Ambulation Categories), physical activity level (Classification system of physical activity) and hand grip strength (Jamar hand dynamometer). Statistical analyses used were hypothesis tests and regressions analysis.

RESULTS: No differences in age, sex, fracture type, proportion of surgery within 24 hours or length of stay between the cohorts. The cohort 2018 had more multimorbidity in number of diagnoses and ASA-classification preoperatively. In 2018 70% of the participants were dependent in walking ability (physical human support) compared to 43% 2008 (p = 0.007). Proportion of physically inactive was 9% in 2018 compared to 21% 2008 (p = 0.047). Hand grip strength was 5.1 kg better in 2018 (p = 0.011). Adjusted for age, sex, ASA-classification (American Society of Anaesthesiologists Classification System), surgical materials and number of days between surgery and testing the cohort of 2018 had a lower odds to have independent walking ability and higher odds to be physical active. Differences in hand grip strength decreased to 4.7 kg. Participants in 2018 suffered significantly more multimorbidity.

CONCLUSIONS: Study indicated differences in patients’ postoperative functioning between 2018 and 2008 with more impaired walking ability, more multimorbidity, higher proportion of physically active and better hand grip strength 2018. The results are important for future reasoning regarding care needs of patients with hip fracture.

PMID:36348295 | DOI:10.1186/s12877-022-03553-y

BMC Bioinformatics. 2022 Nov 8;23(1):469. doi: 10.1186/s12859-022-05012-2.

ABSTRACT

Early detection of cancers has been much explored due to its paramount importance in biomedical fields. Among different types of data used to answer this biological question, studies based on T cell receptors (TCRs) are under recent spotlight due to the growing appreciation of the roles of the host immunity system in tumor biology. However, the one-to-many correspondence between a patient and multiple TCR sequences hinders researchers from simply adopting classical statistical/machine learning methods. There were recent attempts to model this type of data in the context of multiple instance learning (MIL). Despite the novel application of MIL to cancer detection using TCR sequences and the demonstrated adequate performance in several tumor types, there is still room for improvement, especially for certain cancer types. Furthermore, explainable neural network models are not fully investigated for this application. In this article, we propose multiple instance neural networks based on sparse attention (MINN-SA) to enhance the performance in cancer detection and explainability. The sparse attention structure drops out uninformative instances in each bag, achieving both interpretability and better predictive performance in combination with the skip connection. Our experiments show that MINN-SA yields the highest area under the ROC curve scores on average measured across 10 different types of cancers, compared to existing MIL approaches. Moreover, we observe from the estimated attentions that MINN-SA can identify the TCRs that are specific for tumor antigens in the same T cell repertoire.

PMID:36348271 | DOI:10.1186/s12859-022-05012-2

Environ Sci Pollut Res Int. 2022 Nov 9. doi: 10.1007/s11356-022-23874-0. Online ahead of print.

ABSTRACT

To solve coordination between economic development and pollutant emissions, it is necessary to face the innovation problem of energy saving and emission reduction. Promoting the effective integration of tech and the financial system is an effective way to solve this problem. According to panel data for prefecture-level cities in China, this paper is based on the pilot policy of combining science and technology with finance implemented in 2011 as a quasi-natural experiment and uses the difference-in-differences (DID) method to evaluate the impact of Science and Technology Financial Policies (STFP) on the air pollutant emission, meanwhile, considering the spatial overflow effect of policy implementation. The research results show that: (1) The STFP has certain inhibitions on pollutant emissions, and this finding holds after a series of robustness tests. (2) The policy has different effects on cities that have different scale, different regions, and different government efficiency. (3) From the results of mechanism analysis, the policy mainly enhances regional pollutant emission reduction capacity through ways such as increasing regional green total factor productivity, enhancing regional science and technology levels, and promoting regional industrial structure optimization. (4) The policy shows a negative spatial spillover effect in reducing pollutant emissions.

PMID:36348242 | DOI:10.1007/s11356-022-23874-0

Health Justice. 2022 Nov 8;10(1):33. doi: 10.1186/s40352-022-00195-5.

ABSTRACT

BACKGROUND: The transition to the community after incarceration presents challenges for returning citizens, including the immediate need to secure housing, employment, and income. Additionally, health care is essential for this population due to high rates of chronic physical health and mental health problems and substance use disorders. There is growing recognition of the need for interventions that support returning citizens as they navigate community reintegration while simultaneously tending to physical and behavioral health needs. We developed and pilot tested a peer support intervention designed to provide social, emotional, and logistic support and promote linkage and engagement in healthcare for returning citizens. We tested the intervention with US military veterans in Massachusetts who were being released from prison and jail. Outcomes related to linkage to and engagement in healthcare were evaluated using an historical comparison group. Engagement in peer support, housing status, and reincarceration rates were monitored for the intervention group.

RESULTS: There were 43 veterans in the intervention group, and 36 in the historical comparison group. For linkage to primary care within 90 days of release, there were no statistically significant differences between the intervention and comparison groups (58% versus 67%). Intervention participants were significantly more likely to receive substance use treatment than the comparison group (86% versus 19%, p < .0001) and the mean monthly substance use visits was greater in the intervention group (0.96 versus 0.34, p < .007). Engagement in mental health services was greater for the intervention group than the comparison group (93% versus 64%, p < .003). There were no significant differences between groups for emergency department use and hospitalization. At the end of the study period, the majority of intervention participants who had been released for over a year were living in permanent housing (84%). Recidivism among the was low, with 7% re-arrested during the study period.

CONCLUSIONS: Augmenting reentry support through intensive peer support appears to have substantial benefits for veterans in terms of engaging them in health care and contributing to their longer-term stability, including housing and recidivism. Flexible reentry support such as this intervention may be well suited to meet the widely varying needs of returning citizens.

PMID:36348203 | DOI:10.1186/s40352-022-00195-5

J Racial Ethn Health Disparities. 2022 Nov 8. doi: 10.1007/s40615-022-01440-1. Online ahead of print.

ABSTRACT

BACKGROUND: Prior studies establish that Black neighborhoods and older persons experience higher rates of COVID-19 death than white neighborhoods and younger persons. However, such works point to the effect of age on COVID-19 mortality and the racial and ethnic inequalities present in COVID-19 deaths as independent vectors of inequality, neglecting to consider the multiplicative impact of structural conditions.

METHODS: Using weekly ZIP code counts of deaths from March 2020 through July 2021 from the Chicago Department of Public Health (n = 4168) and measures of structural characteristics derived from the 5-year estimates of the 2019 American Community Survey, the current study examined how place, racial composition, and the age structure of communities act in tandem to shape the number of deaths due to COVID-19. We used STATA to estimate negative binomial models predictive of COVID-19 mortality.

RESULTS: Findings from our statistical analysis revealed that in predominately Black neighborhoods, racial composition amplified the association of age structure (65 +) on COVID-19 mortality by 40%. Neighborhoods that were not predominately black did not show this multiplicative risk of death. Our findings underscore that the elevated risk of death in in older Black communities is attributed to historic and contemporary structural inequality.

CONCLUSIONS: Although society typically frames pandemics as natural disasters, doing such undermines dimensions of marginalization that amplify vulnerability among select populations. To begin eliminating such inequalities, the USA must deal with the entrenched limitations of institutions that render unequal attention and care to sectors of its population.

PMID:36348182 | DOI:10.1007/s40615-022-01440-1

Obes Surg. 2022 Nov 9. doi: 10.1007/s11695-022-06345-w. Online ahead of print.

ABSTRACT

INTRODUCTION: The inflammatory state that accompanies adiposity and the metabolic syndrome (MetS) is called “low-grade” inflammation. White blood cell count (WBC) has been proposed as an emerging biomarker for predicting future cardiovascular events, MetS and mortality. Bariatric surgery (BS) improves comorbidities associated with obesity and the MetS and the surgically induced weight loss is known to improve inflammatory status.

OBJECTIVES: To analyze the improvement of low-grade inflammation associated to obesity in patients with metabolically healthy severe obesity (MHSO) and patients with metabolically unhealthy obesity (MUSO) (severe obesity with MetS) after primary bariatric surgery as well as the protective effect of BS against the development of MetS in patients with MHSO by reducing the WBC.

MATERIALS AND METHODS: Retrospective analysis of prospectively collected data of patients undergoing laparoscopic primary BS (gastric by-pass or sleeve gastrectomy) from January 2004-December 2015. Outcomes included changing of low-grade inflammation in terms of leukocytes, neutrophils, lymphocytes, and platelets.

RESULTS: Twenty-one patients with MHSO and 167 patients with MUSO underwent laparoscopic primary BS. The preoperative values of leukocyte and platelet were statistically higher in the group of patients with MHSO. In both groups, there was significant postoperative decrease of inflammatory markers. The greatest drop in WBC occurred in the second postoperative year. No patient of the group of patients with MHSO developed MetS within five postoperative years.

CONCLUSIONS: Surgically induced weight loss plays an important role for improvement in chronic inflammation associated to obesity because of reduction of visceral fat mass. MHSO associates a low-grade chronic inflammatory status comparable to MUSO. The improvement or decrease of low-grade inflammation in patients with metabolically healthy severe obesity after bariatric surgery could have a protective effect against the development of MetS and medical conditions associated with severe obesity.

PMID:36348177 | DOI:10.1007/s11695-022-06345-w

Med Biol Eng Comput. 2022 Nov 8. doi: 10.1007/s11517-022-02703-z. Online ahead of print.

ABSTRACT

Medical images of patients must be securely transmitted and kept private in telemedicine. To secure such medical images, this paper proposes a single round chaotic image encryption scheme based on a permutation-diffusion structure. A combined chaotic key generator (CCKG) is proposed to enhance key sensitivity and generation in order to improve the security of medical images to be encrypted. CCKG is used to produce the initial seeds for the fractional order chaotic system (FOCS) and Lorenz system (LS) for the permutation and diffusion processes, respectively. CCKG together with proposed permutation and diffusion methods enhances cipher image security in single round. Using zigzag transform (ZT) scanning, the plain image is first permuted block by block. The type of scanning used on each block is heavily influenced by the ZT selection from FOCS and LS. Following block-wise permutation, the permutation order (PO) generated from LS performs overall permutation. Based on the pixel positions, the overall permuted image is divided into odd and even parts. Then these parts of the images are diffused separately by the random pixel matrices generated by LS and FOCS. The cipher image is formed by combining the odd and even parts after diffusion. Secret key analysis, statistical analysis, differential attack analysis, and simulations confirm that with a single round of image encryption, the proposed system is competent, robust and effective.

PMID:36348143 | DOI:10.1007/s11517-022-02703-z

Results Probl Cell Differ. 2022;70:103-156. doi: 10.1007/978-3-031-06573-6_4.

ABSTRACT

What holds together the world in its innermost, what life is, how it emerges, functions, and evolves, has not only been an epic matter of endless romantic sunset poetry and philosophy, but also manifests explicitly in its perhaps most central organization unit-genomes. Their 3D architecture and dynamics, including the interaction networks of regulatory elements, obviously co-evolved as inseparable systems allowing the physical storage, expression, and replication of genetic information. Since we were able to fill finally the much-debated centennial gaps in their 3D architecture and dynamics, now entire new perspectives open beyond epigenetics reaching as far as a general understanding of living systems: besides the previously known DNA double helix and nucleosome structure, the latter compact into a chromatin quasi-fibre folded into stable loops forming stable multi-loop aggregates/rosettes connected by linkers, creating hence the again already known chromosome arms and entire chromosomes forming the cell nucleus. Instantly and for the first time this leads now to a consistent and cross-proven systems statistical mechanics genomics framework elucidating genome intrinsic function and regulation including various components. It balances stability/flexibility ensuring genome integrity, enabling expression/regulation of genetic information, as well as genome replication/spread. Furthermore, genotype and phenotype are multiplisticly entangled being evolutionarily the outcome of both Darwinian natural selection and Lamarckian self-referenced manipulation-all embedded in even broader genome ecology (autopoietic) i(!)n- and environmental scopes. This allows formulating new meta-level functional semantics of genomics, i.e. notions as communication of genes, genomes, and information networks, architectural and dynamic spaces for creativity and innovation, or genomes as central geno-/phenotype entanglements. Beyond and most fundamentally, the paradoxical-seeming local equilibrium substance stability in its entity though far from a universal heat-death-like equilibrium is solved, and system irreversibility, time directionality, and thus the emergence of existence are clarified. Consequently, real deep understandings of genomes, life, and complex systems in general appear in evolutionary perspectives as well as from systems analyses, via system damage/disease (its repair/cure and manipulation) as far as the understanding of extraterrestrial life, the de novo creation and thus artificial life, and even the raison d’etre.

PMID:36348106 | DOI:10.1007/978-3-031-06573-6_4

Results Probl Cell Differ. 2022;70:35-69. doi: 10.1007/978-3-031-06573-6_2.

ABSTRACT

The purpose of our studies is to elucidate the nature of massive control of the whole genome expression with a particular emphasis on cell-fate change. The whole genome expression is coordinated by the emergence of a critical point (CP: a peculiar set of biphasic genes) with the genome acting as an integrated dynamical system. In response to stimuli, the genome expression self-organizes into local sub-, near-, and super-critical states, each exhibiting distinct collective behaviors with its center of mass acting as a local attractor, coexisting with the whole genome attractor (GA). The CP serves as the organizing center of cell-fate change, and its activation makes local perturbation to spread over the genome affecting GA. The activation of CP is in turn elicited by genes with elevated temporal variance (oscillating-mode genes), normally in charge to keep genome expression at pace with microenvironment fluctuations. When oscillation exceeds a given threshold, the CP synchronizes with the GA driving genome expression state transition. The expression synchronization wave invading the entire genome is fostered by the fusion-splitting dynamics of silencing pericentromere-associated heterochromatin domains and the consequent folding-unfolding transitions of transcribing euchromatin domains. The proposed mechanism is a unified step toward a time-evolutional transition theory of biological regulation.

PMID:36348104 | DOI:10.1007/978-3-031-06573-6_2