Tag: statistics

J Dig Dis. 2022 Nov 2. doi: 10.1111/1751-2980.13142. Online ahead of print.

ABSTRACT

AIMS: Guidelines suggest bismuth-containing quadruple (BQT) or concomitant regimens (CT) as first line therapy in our geographic area. Both schedules contain metronidazole.

METHODS: We recruited naïve subjects with H. pylori infection in the period January 2020-December 2021, receiving either CT or BQT. Before therapy, patients collected a fecal sample using the THD fecal test device. H. pylori DNA was extracted and mutations rdxA/frxA and A2143G in genes for metronidazole and clarithromycin resistance were respectively investigated using RT-PCR with high resolution melting curve.

RESULTS: Ninety-six patients were enrolled: 29 received BQT and 67 CT. The overall eradication rate was 94.8%, in detail 100% for BQT and 92.5% for CT, respectively. Metronidazole resistance was found in 18 subjects (18.8%), while clarithromycin resistance in 19 (19.8%). All 18 patients with metronidazole resistance experienced eradication. Five had assumed BQT and 13 CT. The eradication rate in metronidazole-sensitive strains was 93.6%. Of these, 24 received BQT with 100% success, and 54 had CT with 5 failures (success 90.7%). Two failing patients were resistant to clarithromycin, and the remaining 3 were susceptible to both clarithromycin and metronidazole. We did not observe any statistical significance in the eradication rate between metronidazole-resistant and sensitive strains (100% versus 93.6%, respectively, p = 0.58).

CONCLUSIONS: Our results suggest that metronidazole resistance does not influence the eradication rate of BQT and CT regimens in our geographical area, even if such result needs to confirmed in a larger sample.

PMID:36321440 | DOI:10.1111/1751-2980.13142

Biol Lett. 2022 Nov;18(11):20220309. doi: 10.1098/rsbl.2022.0309. Epub 2022 Nov 2.

ABSTRACT

The strength of species interactions may have profound effects on population dynamics. Empirical estimates of interaction strength are often based on the assumption that the interaction strengths are constant. Barents Sea (BS) cod and capelin are two fish populations for which such an interaction has been acknowledged and used, under the assumption of constant interaction strength, when studying their population dynamics. However, species interactions can often be nonlinear in marine ecosystems and might profoundly change our understanding of food chains. Analysing long-term time series data comprising a survey over 37 years in the Arcto-boreal BS, using a state-space modelling framework, we demonstrate that the effect of capelin on cod is not linear but shifts depending on capelin abundance: while capelin is beneficial for cod populations at high abundance; below the threshold, it becomes less important for cod. Our analysis therefore shows the importance of investigating nonlinearity in species interactions and may contribute to an improved understanding on species assemblages.

PMID:36321432 | DOI:10.1098/rsbl.2022.0309

J Appl Gerontol. 2022 Nov 2:7334648221137060. doi: 10.1177/07334648221137060. Online ahead of print.

ABSTRACT

Medicare implemented Bundled Payments for Care Improvement (BPCI) Model 3 in 2013, in which participating skilled nursing facilities (SNFs) were accountable for episode costs. We performed comparative interrupted time series analyses to evaluate associations between SNF BPCI participation and nurse staffing levels, using Medicare claims, resident assessments, and facility-level and market-level files of 2010-2017. For persistent-participating SNFs, BPCI was associated with improved certified nursing assistant (CNA) staffing levels (differential change = .03 hours, p = .025). However, BPCI was not related to changes in registered nurse (RN) and all licensed nurse hours, and nurse skill mix. Among drop-out SNFs, BPCI was associated with increased RN staffing levels (differential change = .02 hours, p = .009), leading to a higher nurse skill ratio (0.51 percentage points, p = .016) than control SNFs. Bundled payments for care improvement had no impact on CNA and all licensed nurse staffing levels. In conclusion, BPCI was associated with statistically significant but small increases in nurse staffing levels.

PMID:36321398 | DOI:10.1177/07334648221137060

Psychol Med. 2022 Nov 2:1-9. doi: 10.1017/S003329172200321X. Online ahead of print.

ABSTRACT

BACKGROUND: Abnormal auditory processing of deviant stimuli, as reflected by mismatch negativity (MMN), is often reported in schizophrenia (SCZ). At present, it is still under debate whether this dysfunctional response is specific to the full-blown SCZ diagnosis or rather a marker of psychosis in general. The present study tested MMN in patients with SCZ, bipolar disorder (BD), first episode of psychosis (FEP), and in people at clinical high risk for psychosis (CHR).

METHODS: Source-based MEG activity evoked during a passive auditory oddball task was recorded from 135 patients grouped according to diagnosis (SCZ, BD, FEP, and CHR) and 135 healthy controls also divided into four subgroups, age- and gender-matched with diagnostic subgroups. The magnetic MMN (mMMN) was analyzed as event-related field (ERF), Theta power, and Theta inter-trial phase coherence (ITPC).

RESULTS: The clinical group as a whole showed reduced mMMN ERF amplitude, Theta power, and Theta ITPC, without any statistically significant interaction between diagnosis and mMMN reductions. The mMMN subgroup contrasts showed lower ERF amplitude in all the diagnostic subgroups. In the analysis of Theta frequency, SCZ showed significant power and ITPC reductions, while only indications of diminished ITPC were observed in CHR, but no significant decreases characterized BD and FEP.

CONCLUSIONS: Significant mMMN alterations in people experiencing psychosis, also for diagnoses other than SCZ, suggest that this neurophysiological response may be a feature shared across psychotic disorders. Additionally, reduced Theta ITPC may be associated with risk for psychosis.

PMID:36321391 | DOI:10.1017/S003329172200321X

J Periodontal Res. 2022 Nov 2. doi: 10.1111/jre.13066. Online ahead of print.

ABSTRACT

Selective outcome reporting (SOR) is a type of bias that can compromise the validity of results and affect evidence-based practice. SOR can overestimate the effect of an intervention and lead to conclusions that a treatment is effective when it is not. This study aimed to investigate the prevalence of SOR in publications of RCTs on nonsurgical periodontal therapy (NSPT) and to verify associated factors. The protocols were searched and selected on the www.clinicaltrials.gov platform up to January 16, 2022. Corresponding publications were identified, and data extraction and discrepancy analysis were performed. The risk of bias was assessed according to the RoB2 tool. One hundred forty-five studies (174 publications) were included. The prevalence of SOR was 49.7% and was unclear in nearly one third of studies (27.6%). Only 31.7% of the primary outcomes were completely described in the publications. The overall risk of bias was high in 60% of the included studies. SOR was associated with statistical significance (p < .001), and multiple publications of the same study (p = .005). Our study demonstrated the high prevalence of SOR, highlighting the need to improve the quality of reporting of RCTs on NSPT studies.

PMID:36321390 | DOI:10.1111/jre.13066

J Ultrasound Med. 2022 Nov 2. doi: 10.1002/jum.16122. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this meta-analysis was to evaluate the diagnostic value of contrast-enhanced ultrasound (CEUS) and high-resolution magnetic resonance imaging (HR-MRI) in patients with carotid vulnerable plaques.

METHODS: A systematic review was conducted in PubMed, Embase, Cochrane Library, and Web of Science using the search terms carotid artery, atherosclerotic plaque, CEUS, contrast-enhanced ultrasound, HR-MRI, and high-resolution magnetic resonance. Studies published since the establishment of the library until December 2021 were retrieved. The statistical analyses were performed with Meta-DiSc version 1.4. Beyond that, the potential sources of heterogeneity for CEUS and HR-MRI were explored.

RESULTS: Nine articles were included in this study. For CEUS, the pooled sensitivity and specificity for detecting carotid vulnerable plaques 91% (95% confidence interval [CI]: 84%, 95%) and 67% (95% CI: 54%, 79%), respectively. For HR-MRI, the pooled sensitivity and specificity were 78% (95% CI: 72%, 83%) and 65% (95% CI, 56%, 73%), respectively. The area under the summary receiver operating characteristic curve for CEUS and HR-MRI were 0.9218 and 0.8129, respectively. However, the difference in diagnostic accuracy between CEUS and HR-MRI diagnostic accuracy was not statistically significant.

CONCLUSIONS: The study shows that the sensitivity of CEUS was higher than that of HR-MRI, and the specificity was similar to HR-MRI. CEUS and HR-MRI provide a similar diagnostic yield in detecting a vulnerable plaque. Thus, CEUS may be a useful tool for the diagnosis of carotid vulnerable plaques.

PMID:36321389 | DOI:10.1002/jum.16122

Pediatrics. 2022 Nov 2:e2021055271. doi: 10.1542/peds.2021-055271. Online ahead of print.

ABSTRACT

BACKGROUND: The number of youth presenting to hospitals with suicidality and/or self-harm has increased substantially in recent years. We implemented a multihospital quality improvement (QI) collaborative from February 1, 2018 to January 31, 2019, aiming for an absolute increase in hospitals’ mean rate of caregiver lethal means counseling (LMC) of 10 percentage points (from a baseline mean performance of 68% to 78%) by the end of the collaborative, and to evaluate the effectiveness of the collaborative on LMC, adjusting for secular trends.

METHODS: This 8 hospital collaborative used a structured process of alternating learning sessions and action periods to improve LMC across hospitals. Electronic medical record documentation of caregiver LMC was evaluated during 3 phases: precollaborative, active QI collaborative, and postcollaborative. We used statistical process control to evaluate changes in LMC monthly. Following collaborative completion, interrupted time series analyses were used to evaluate changes in the level and trend and slope of LMC, adjusting for covariates.

RESULTS: In the study, 4208 children and adolescents were included-1314 (31.2%) precollaborative, 1335 (31.7%) during the active QI collaborative, and 1559 (37.0%) postcollaborative. Statistical process control analyses demonstrated that LMC increased from a hospital-level mean of 68% precollaborative to 75% (February 2018) and then 86% (October 2018) during the collaborative. In interrupted time series analyses, there were no significant differences in LMC during and following the collaborative beyond those expected based on pre-collaborative trends.

CONCLUSIONS: LMC increased during the collaborative, but the increase did not exceed expected trends. Interventions developed by participating hospitals may be beneficial to others aiming to improve LMC for caregivers of hospitalized youth with suicidality.

PMID:36321386 | DOI:10.1542/peds.2021-055271

Neurol Neurochir Pol. 2022;56(5):435-440. doi: 10.5603/PJNNS.2022.0062.

ABSTRACT

INTRODUCTION: Multiple sclerosis (MS) usually occurs in young adults and, due to its long-lasting course and variety of symptoms, can affect their vocational activity. Our study aimed to evaluate employment status and working activity for persons with MS with regard to disease-related factors, quality of life, and depression.

MATERIAL AND METHODS: 250 subjects with MS (62 men, 188 women, aged 19-71 years, mean 42.2) responded to a survey into various aspects of their employment. Relationships were sought between work-related issues and disease-related variables [MS type and duration, major symptoms, disability level on the Expanded Disability Status Scale (EDSS)], quality of life (WHOQOL- -BREF, World Health Organisation Quality of Life brief questionnaire) and depression (BDI, Beck Depression Inventory). Statistical analysis included Mann-Whitney U, Student’s t, and Pearson’s chi-squared tests.

RESULTS: 71.2% of the patients were employed, and 49.1% perceived an impact of the disease upon their working activity (i.e. job loss, problems with finding a new one, and/or forced change of type and/or character of employment). Unemployed subjects had higher EDSS scores (4.05 vs. 2.34, p < 0.001) and longer disease durations (13.6 vs. 9.4, p < 0.001) than employed ones. They also scored higher on BDI (15.4 vs. 9.05, p < 0.001) and lower in all domains of WHOQOL-BREF (p < 0.001).

CONCLUSIONS: The consequences of MS negatively influence many work-related factors. Unemployment is associated with a higher frequency of depression and a lower quality of life in MS patients.

PMID:36321375 | DOI:10.5603/PJNNS.2022.0062

J R Soc Interface. 2022 Nov;19(196):20220402. doi: 10.1098/rsif.2022.0402. Epub 2022 Nov 2.

ABSTRACT

A quantitative analysis of human gait patterns in space-time provides an opportunity to observe variability within and across individuals of varying motor capabilities. Impaired gait significantly affects independence and quality of life, and thus a large part of clinical research is dedicated to improving gait through rehabilitative therapies. Evaluation of these paradigms relies on understanding the characteristic differences in the kinematics and underlying biomechanics of impaired and unimpaired locomotion, which has motivated quantitative measurement and analysis of the gait cycle. Previous analysis has largely been limited to a statistical comparison of manually selected pointwise metrics identified through expert knowledge. Here, we use a recent statistical-geometric framework, elastic functional data analysis (FDA), to decompose kinematic data into continuous ‘amplitude’ (spatial) and ‘phase’ (temporal) components, which can then be integrated with established dimensionality reduction techniques. We demonstrate the utility of elastic FDA through two unsupervised applications to post-stroke gait datasets. First, we distinguish between unimpaired, paretic and non-paretic gait presentations. Then, we use FDA to reveal robust, interpretable groups of differential response to exosuit assistance. The proposed methods aim to benefit clinical practice for post-stroke gait rehabilitation, and more broadly, to automate the quantitative analysis of motion.

PMID:36321374 | DOI:10.1098/rsif.2022.0402

Radiat Prot Dosimetry. 2022 Nov 1:ncac206. doi: 10.1093/rpd/ncac206. Online ahead of print.

ABSTRACT

In response to mounting radiofrequency health concerns, this study was constituted to provide critical scientific data and assess any potential exposure from global system for mobile communication mobile phones. Specific absorption rate (SAR) from phones approved by the regulator and untested/unapproved phones were measured with a ComoSAR system. The maximum 10 g SAR (0.51 W/kg) and 1 g SAR (0.99 W/kg) measured were 25 and 62% of the International Commission on Non-Ionizing Radiation Protection and Federal Communication Commission limits, respectively. The approved phone produced statistically significant higher SAR values relative to the untested phone. SAR values of the right ear were relatively higher. All maximum SAR values were recorded on the right ear. The regulatory approval status of the phone, phone’s orientation to the head, operating frequency channel and in which ear (right or left) the phone is used influenced the SAR measured. The SAR values of the approved phone compared favourably with similar studies while the unapproved phone does not.

PMID:36321330 | DOI:10.1093/rpd/ncac206