Tag: statistics

Pediatr Nephrol. 2022 Nov 24. doi: 10.1007/s00467-022-05818-5. Online ahead of print.

ABSTRACT

BACKGROUND: Nocturnal enuresis (NE) is a multifactorial and complex condition. One less understood factor in its pathophysiology is the enuretic inability to wake up when the bladder is full (impaired arousal).

OBJECTIVE: We aimed to investigate the relationship between sleep and NE in children and adolescents.

METHODS: A systematic review was performed following the PRISMA guidelines, and the electronic databases MEDLINE (via PubMed) and SCOPUS were searched until March 2022. Eligibility criteria were studies that recruited patients aged five-17 years with a diagnosis of NE according to the International Child Continence Society (ICCS), Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5), or International Classification Criteria of Sleep Disorders-Third edition (ICSD-3) who had their sleep assessed using validated questionnaires and/or polysomnography. The tool used to analyze the risk of bias in the included studies was the risk of bias in non-randomized studies of exposure.

RESULTS: Of 1582 citations screened, nine were included, giving 1685 participants, 581 with NE. All studies were observational and half had a low risk of bias. Four studies evaluated sleep by questionnaires only; two used questionnaires and polysomnography; two used only polysomnography, and one used sleep logs and actigraphy. Sleep questionnaires showed that children with enuresis had more sleep problems than controls, especially parasomnias, breathing disorders, and daytime sleepiness. Among the polysomnography parameters, the sleep stage architecture and periodic limb movements during sleep had conflicting data between the two studies.

LIMITATIONS: The studies evaluated sleep through heterogeneous tools. They used different questionnaires; even those considered by polysomnography did not record the same channels.

CONCLUSION: It seems that enuretic children and adolescents sleep differently from those who are non-enuretic. More studies are needed to clarify the best way to assess sleep and better understand this relationship. The review protocol was registered with PROSPERO, CRD42021266338. There was no funding.

PMID:36427087 | DOI:10.1007/s00467-022-05818-5

Shock. 2022 Nov 28. doi: 10.1097/SHK.0000000000002051. Online ahead of print.

ABSTRACT

BACKGROUND: Interleukin (IL)-6 is a multifunctional cytokine with both a pro- and anti-inflammatory role. In many studies, IL-6 increases rapidly after burn injury and is associated with poor outcomes. However, there are two aspects to IL-6; it can signal via its soluble IL-6 Receptor (sIL-6R), which is referred to as trans-signalling and is regarded as the proinflammatory pathway. The role of sIL-6R post-burn injury has yet to be explored in its entirety. We hypothesized that patients with a lower ratio of IL-6 to sIL-6R would have worse outcomes.

METHODS: Patients admitted to our burn centre within seven days of injury were included in this study. Patients were divided into two groups based on IL-6 and sIL-6R levels measured within the first seven days post-burn injury. Patients were in the high ratio group if their IL-6:sIL-6R ratio was ≥0.185. Clinical outcomes included organ biomarkers, morbidities, and hospital length of stay. Groups were compared using Student’s t-test, Mann-Whitney U, and Fisher’s exact test as appropriate; a P value of <0.05 was considered statistically significant.

RESULTS: We studied 86 patients with a median age of 50 (36 – 66) and a median total body surface area (TBSA) burn of 18% (10 – 31). There were 40 patients categorized with a low IL-6:sIL-6R ratio and 46 patients with a high IL-6:sIL-6R ratio. Patients in the high IL-6:sIL-6R ratio group had a significantly greater TBSA burn (p < 0.001) and a significantly greater proportion of patients with inhalation injury (p = 0.001). Levels of IL-6 were significantly higher in patients with a high IL-6:sIL-6R ratio (p < 0.0001). However, levels of sIL-6R were not significantly different among the low and high groups (p = 0.965). Mortality was significantly greater in the high IL-6:sIL-6R ratio group (3% vs. 26%; p = 0.002).

CONCLUSIONS: Interestingly, patients with a higher ratio of IL-6:sIL-6R had significantly greater mortality. Using sIL-6R as a marker for the proinflammatory immune response, we expected patients with a lower IL-6:sIL-6R ratio to have poor outcomes, typically associated with a hyperinflammatory or exaggerated immune response. However, the absolute value of sIL-6R did not differ. This suggests that classical signalling of IL-6 via its membrane-bound receptor, with an anti-inflammatory function, is essential.

PMID:36427079 | DOI:10.1097/SHK.0000000000002051

Shock. 2022 Nov 28. doi: 10.1097/SHK.0000000000002059. Online ahead of print.

ABSTRACT

INTRODUCTION: Little is known regarding peripheral blood mononuclear cell telomere length (PBMC-TL) and response to traumatic injury. The objective of this study was to characterize the role of PBMC-TL in coagulation and clinical outcomes after injury.

METHODS: Plasma and buffy coats were prospectively collected from trauma patients and healthy volunteers. DNA was purified and PBMC-TL quantified by qPCR. Thrombin generation kinetics were expressed as lag time (LT, minutes), peak height (PH, nM), time to peak (ttPeak, min), and endogenous thrombin potential (ETP, nM*min). Results in median and quartiles [Q1, Q3]. Wilcoxon rank sum testing; p < 0.05 considered significant.

RESULTS: Forty-two younger patients (21 [20, 22] years, 69% male) and 39 older patients (62 [61, 64] years, 79% male) were included. There was no significant difference in Clinical Frailty Scores between groups. Younger patients had longer total PBMC-TL (0.40 Mb [0.30, 0.49] vs. 0.29 Mb [0.23, 0.33], p < 0.001) and longer average PBMC-TL per chromosome (4.3 kb [3.3, 5.3] vs. 3.2 kb [2.5, 3.7], p < 0.001). When older patients were stratified by 50th percentile of PBMC-TL, there were no differences in thrombin generation; however, those with shorter telomeres were less likely to be discharged home (29% vs. 77%, p = 0.004). Older patients in the bottom quartile of PBMC-TL had shorter LT (2.78 min [2.33, 3.00] vs. 3.33 min [3.24, 3.89], p = 0.030) and were less likely to be discharged home (22% vs. 90%, p = 0.006) than those in the top quartile of PBMC-TL. Multivariable logistic regression models revealed both increased age and shorter PBMC-TL to be independent predictors of discharge disposition other than home.

CONCLUSION: In older trauma patients, shorter PBMC-TL is associated with accelerated initiation of thrombin generation and lower likelihood of being discharged to home.

PMID:36427074 | DOI:10.1097/SHK.0000000000002059

Schmerz. 2022 Nov 24. doi: 10.1007/s00482-022-00677-3. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Psychometric tests can provide important information for diagnostics and progression in chronic pain patients. Between 2008 and 2018, the electronic system painDETECT® was used in the outpatient pain clinic of the Hannover Medical School (MHH). The aim of this retrospective study was to evaluate the pain symptomatology data recorded using painDETECT® and the treatment procedures used in the patient cohort examined over a period of 15 months.

MATERIAL AND METHODS: A statistical analysis of baseline and follow-up data was performed. The analysis comprised pain-related parameters recorded by use of the painDETECT® system as well as outpatient records.

RESULTS: Baseline data of 459 patients (66% women) could be evaluated. The most common clinical pictures were spinal pain, headache, facial pain, and somatoform disorders, mostly with many years of previous treatment. Approximately 40% showed evidence of neuropathic pain components or central sensitization. With a mean pain intensity of VAS 6 (0-10), a predominantly high degree of chronicity was present. Approximately one third showed a high degree of pain-related functional impairment. Slightly more than half showed evidence of clinically relevant depression. Approximately 80% showed clinically relevant sleep disturbances. Follow-up data were available for 145 patients (31.6%). The proportion of patients receiving a nonpharmacological form of treatment increased by 44.1% (physical therapy) and by 24.1% (psychotherapeutic procedures) during the observation period. The use of co-analgesics increased by approximately 30% over the course.

CONCLUSION: In the outpatient setting, an extension of treatment can be successful for high-grade chronic pain patients. Close structural networking with the clinics for rehabilitation medicine and for psychosomatics and psychotherapy at the MHH can be a favorable prerequisite for this.

PMID:36427073 | DOI:10.1007/s00482-022-00677-3

Psychol Rep. 2022 Nov 25:332941221142003. doi: 10.1177/00332941221142003. Online ahead of print.

ABSTRACT

Problematic use of social networking sites (SNS) has a negative impact on mental health. It has been found that people who score high on neuroticism are especially vulnerable towards engaging with SNS in a problematic way but it is not clear which psychological mechanisms explain this relationship. We addressed this issue by examining the mediating role of fear of missing out and self-control in the relationship between neuroticism and problematic SNS use. For this purpose, we conducted a cross-sectional study (n = 151, 69.5% female, M_age = 26.23, SD = 7.52) and tested for parallel mediation using structural equation modelling. Neuroticism was found to be predictive of increased levels of problematic SNS use. Moreover, neuroticism was associated with both increased levels of fear of missing out and decreased levels of self-control. However, only fear of missing out was found to robustly mediate the relationship between neuroticism and problematic use of SNS. These findings suggest that fear of missing out could be an intervention target to prevent people scoring high on neuroticism from engaging in problematic SNS use.

PMID:36427043 | DOI:10.1177/00332941221142003

Top Cogn Sci. 2022 Nov 25. doi: 10.1111/tops.12632. Online ahead of print.

ABSTRACT

What is the function of immature vocalizing in early learning environments? Previous work on infants in the United States indicates that prelinguistic vocalizations elicit caregiver speech which is simplified in its linguistic structure. However, there is substantial cross-cultural variation in the extent to which children’s vocalizations elicit responses from caregivers. In the current study, we ask whether children’s vocalizations elicit similar changes in their immediate caregivers’ speech structure across two cultural sites with differing perspectives on how to interact with infants and young children. Here, we compare Tseltal Mayan and U.S. caregivers’ verbal responses to their children’s vocalizations. Similar to findings from U.S. dyads, we found that children from the Tseltal community regulate the statistical structure of caregivers’ speech simply by vocalizing. Following the interaction burst hypothesis, where clusters of child-adult contingent response alternations facilitate learning from limited input, we reveal a stable source of information that may facilitate language learning within ongoing interaction.

PMID:36426721 | DOI:10.1111/tops.12632

Fa Yi Xue Za Zhi. 2022 Aug 25;38(4):500-506. doi: 10.12116/j.issn.1004-5619.2021.511103.

ABSTRACT

OBJECTIVES: To study the genetic polymorphism and population genetic parameters of 16 X-STR loci in Xinjiang Uygur population.

METHODS: The Goldeneye^® DNA identification system 17X was used to amplify 16 X-STR loci in 502 unrelated individuals (251 females and 251 males). The amplified products were detected by 3130xl genetic analyzer. Allele frequencies and population genetic parameters were analyzed statistically. The genetic distances between Uygur and other 8 populations were calculated. Multidimensional scaling and phylogenetic tree were constructed based on genetic distance.

RESULTS: In the 16 X-STR loci, a total of 67 alleles were detected in 502 Xinjiang Uygur unrelated individuals. The allele frequencies ranged from 0.001 3 to 0.572 4. PIC ranged from 0.568 8 to 0.855 3. The cumulative discrimination power in females and males were 0.999 999 999 999 999 and 0.999 999 999 743 071, respectively. The cumulative mean paternity exclusion chance in trios and in duos were 0.999 999 997 791 859 and 0.999 998 989 000 730, respectively. The genetic distance between Uygur population and Kazakh population was closer, and the genetic distance between Uygur and Han population was farther.

CONCLUSIONS: The 16 X-STR loci are highly polymorphic and suitable for identification in Uygur population, which can provide a powerful supplement for the study of individual identification, paternity identification and population genetics.

PMID:36426695 | DOI:10.12116/j.issn.1004-5619.2021.511103

Psychooncology. 2022 Nov 25. doi: 10.1002/pon.6069. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe HRQoL, post-traumatic stress and post-traumatic growth of parents of long-term survivors of childhood cancer and study associated factors.

METHODS: Parents of survivors of the Dutch Childhood Cancer Survivor Study LATER cohort below 30 years and diagnosed 1986-2001 were invited to complete the TNO-AZL Questionnaire for Adult’s HRQoL (e.g. sleep and aggressive emotions), Self-Rating Scale for Post-traumatic Stress Disorder, Post-traumatic Growth Inventory, and Illness Cognition Questionnaire. HRQoL domain scores were compared to references using Mann-Whitney U tests. Correlations between post-traumatic stress, growth and HRQoL were evaluated. Medical characteristics of their child and illness cognitions were studied as associated factors of HRQOL, post-traumatic stress and growth. P<.05 was considered statistically significant.

RESULTS: Parents (n=661 of n=448 survivors, 56% female, mean time since child’s diagnosis: 21.3[SD: 3.3] years) reported better HRQoL in social functioning and aggressive emotions than references (r=.08-.17). Mothers additionally reported better HRQoL in pain, daily activities, sexuality, vitality, positive and depressive emotions (r=.07-.14). Post-traumatic stress was symptomatic in 3%, and associated with worse HRQoL (r=-.27-.48). Post-traumatic growth was positively associated to post-traumatic stress and better HRQoL (r=.09-.12). Cancer recurrence was associated to better HRQoL (β=.37-.46). Acceptance illness cognitions were associated to better (β=.12-.25), and helplessness to worse outcomes (β=.14-.38).

CONCLUSIONS: HRQoL of parents of young adult survivors of childhood cancer is comparable to references or slightly better. Only a small proportion reports symptomatic post-traumatic stress. Improving acceptance and reducing feelings of helplessness may provide treatment targets for parents with psychosocial problems. This article is protected by copyright. All rights reserved.

PMID:36426662 | DOI:10.1002/pon.6069

Musculoskeletal Care. 2022 Nov 25. doi: 10.1002/msc.1718. Online ahead of print.

ABSTRACT

INTRODUCTION: The National Institute for Health and Care Excellence (NICE) suggest there is no role for routine radiography in the diagnosis of osteoarthritis (OA). It is not known how consistent this recommendation is across international guidelines, or the impact of UK guidance on domestic OA X-ray request rates.

METHODS: A systematic search identified guideline recommendations on the role of radiography in OA diagnosis. Full texts underwent dual screening and appraisal using the AGREE II tool. A narrative synthesis was performed. Consultation data were extracted from a UK primary care database: the Consultations in Primary Care Archives (CiPCA). The annual proportion of X-ray requests per 100 OA consulters from 2000 to 2012 were calculated. Joinpoint regression analysis examined if there were changes in the trend of X-ray request rates and compared these with the publication dates of UK guidelines.

RESULTS: Eighteen evidence-based OA guidelines were included in the review. Eleven recommended a clinical diagnosis of OA without radiographic confirmation. Seven recommended routine radiography; these guidelines were predominantly for radiologists. A mean of 17.3 X-rays per 100 patients were requested in patients consulting for OA per year between 2000 and 2012. A statistically significant reduction in X-ray request rates was seen in 2003.

CONCLUSION: Recommendations on the role of radiography in OA vary between medical specialty and countries. UK guidelines appear to have had a limited impact on X-ray request rates in OA.

PMID:36426659 | DOI:10.1002/msc.1718

J Clin Nurs. 2022 Nov 25. doi: 10.1111/jocn.16471. Online ahead of print.

ABSTRACT

BACKGROUND: Single studies support the presence of several post-COVID-19 symptoms; however, there is no evidence for the synthesis of symptoms.

OBJECTIVE: We attempt to provide an overview of the persistent symptoms that post-COVID-19 patients encounter, as well as the duration of these symptoms to help them plan their rehabilitation.

DESIGN: Systematic review and meta-analysis.

PARTICIPANTS: A total of 16 studies involving 8756 patients post-COVID-19 were included.

METHODS: The CINAHL, PubMed, EMBASE, Scopus, and Web of Science databases were searched from 2019 to August 2021. Observational studies that reported data on post-COVID-19 symptoms were included. The methodological quality of the studies was assessed using the Joanna Briggs Institute Critical Appraisal for Observational Studies. We included medium- to high-quality studies. We used a random-effects model for the meta-analytical pooled prevalence of each post-COVID-19 symptom, and I² statistics for heterogeneity.

RESULTS: From the 2481 studies identified, 16 met the inclusion criteria. The sample included 7623 hospitalised and 1133 non-hospitalised patients. We found the most prevalent symptoms were fatigue and dyspnea with a pooled prevalence ranging from 42% (27%-58%). Other post-COVID-19 symptoms included sleep disturbance 28% (14%-45%), cough 25% (10%-44%), anosmia/ageusia 24% (7%-47%), fever 21% (4%-47%), myalgia 17% (2%-41%), chest pain 11% (5%-20%), and headache 9% (2%-20%). In addition to physical symptoms, anxiety/depression was also prevalent 27% (8%-53%).

CONCLUSIONS: Fatigue and dyspnea were the most prevalent post-COVID-19 symptoms and experienced up to 12 months.

RELEVANCE TO CLINICAL PRACTICE: Multiple persistent symptoms are still experienced until 12 months of post-Covid 19. This meta-analysis should provide some awareness to nurses to highlights the unmet healthcare needs of post-COVID-19 patients. Long-term monitoring for the evaluation and treatment of symptoms and conditions and rehabilitation programs should be conducted.

PMID:36426658 | DOI:10.1111/jocn.16471