Tag: statistics

JAMA Psychiatry. 2022 Aug 17. doi: 10.1001/jamapsychiatry.2022.2386. Online ahead of print.

ABSTRACT

IMPORTANCE: Improved understanding of the boundaries and connections between positive symptoms, negative symptoms, and role functioning in schizophrenia is critical, given limited empirical support for clear distinctions among these clinical areas. This study’s use of network psychometrics to investigate differential associations and structural overlap between positive symptoms, negative symptoms, and functional domains in schizophrenia may contribute to such understanding.

OBJECTIVE: To apply network analysis and community detection methods to examine the interplay and structure of positive symptoms, negative symptoms, and functional domains in individuals with schizophrenia.

DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study in 5 geographically distributed research centers in the US as part of the Consortium on the Genetics of Schizophrenia-2 from July 1, 2010, through January 31, 2014. Data were analyzed from November 2021 to June 2022. Clinically stable outpatients with schizophrenia or schizoaffective disorder were included. Participants were excluded if they had evidence of neurologic or additional Axis I psychiatric disorders. Other exclusion criteria included head injury, stroke, and substance abuse. Of 1415 patients approached, 979 were included in the final analysis.

MAIN OUTCOMES AND MEASURES: Measures included the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms, and the Role Functioning Scale. Main outcomes were expected influence, which assesses the relative importance of items to the network and is defined as the association of an item with all others, and community detection and stability, defined as the presence of statistical clusters and their replicability.

RESULTS: Participants with complete data included 979 outpatients (mean [SD] age, 46 [11] years; 663 male [67.7%]; 390 participants [40%] self-identified as African American, 30 [3%] as Asian, 7 [0.7%] as Native American, 8 [0.8%] as Pacific Islander, 412 [42.1%] as White, 125 [12.8%] as more than 1 race, and 5 [0.5%] did not identify). Anhedonia had the highest expected influence in the most comprehensive network analysis, showing connections with negative and positive symptoms and functional domains. Positive symptoms had the lowest expected influence. Community detection analyses indicated the presence of 3 clusters corresponding to positive symptoms; negative symptoms and work functioning; functional domains, including independent living, family relationships, and social network; and avolition, anhedonia, and work functioning. Hallucinations and delusions replicated in 1000 bootstrapped samples (100%), while bizarre behavior and thought disorder replicated in 390 (39%) and 570 (57%), respectively. In contrast, negative symptoms and work functioning replicated between 730 (73%) and 770 (77%) samples, respectively, and the remaining functional domains in 940 samples (94%).

CONCLUSIONS AND RELEVANCE: The high centrality of anhedonia and its connections with multiple functional domains suggest that it could be a treatment target for global functioning. Interventions for work functioning may benefit from a specialized approach that focuses primarily on avolition.

PMID:35976655 | DOI:10.1001/jamapsychiatry.2022.2386

JAMA Netw Open. 2022 Aug 1;5(8):e2227211. doi: 10.1001/jamanetworkopen.2022.27211.

ABSTRACT

IMPORTANCE: Appropriate clinical decision-making relies on accurate data interpretation, which in turn relies on the use of suitable statistical models. Long tails and early crossover-2 features commonly observed in immune checkpoint inhibitor (ICI) survival curves-raise questions as to the suitability of Cox proportional hazards regression for ICI survival analysis. Cox proportional hazards-Taylor expansion adjustment for long-term survival data (Cox-TEL) adjustment may provide possible solutions in this setting.

OBJECTIVE: To estimate overall survival and progression-free survival benefits of ICI therapy vs chemotherapy using Cox-TEL adjustment.

DATA SOURCES: A PubMed search was performed for all cataloged publications through May 22, 2022.

STUDY SELECTION: The search was restricted to randomized clinical trials with search terms for ICIs and lung cancer, melanoma, or urothelial carcinoma. The publications identified were further reviewed for inclusion.

DATA EXTRACTION AND SYNTHESIS: Cox proportional hazards ratios (HRs) were transformed to Cox-TEL HRs for patients with short-term treatment response (ie, short-term survivor) (ST-HR) and difference in proportions for patients with long-term survival (LT-DP) by Cox-TEL. Meta-analyses were performed using a frequentist random-effects model.

MAIN OUTCOMES AND MEASURES: Outcomes of interest were pooled overall survival (primary outcome) and progression-free survival (secondary outcome) HRs, ST-HRs, and LT-DPs. Subgroup analyses stratified by cancer type also were performed.

RESULTS: A total of 1036 publications was identified. After 3 levels of review against inclusion criteria, 13 clinical trials (7 in non-small cell lung cancer, 3 in melanoma, and 3 in urothelial carcinoma) were selected for the meta-analysis. In the primary analysis, pooled findings were 0.75 (95% CI, 0.70-0.81) for HR, 0.86 (95% CI, 0.81-0.92) for ST-HR, and 0.08 (95% CI, 0.06-0.10) for LT-DP. In the secondary analysis, the pooled values for progression-free survival were 0.77 (95% CI, 0.64-0.91) for HR, 1.02 (95% CI, 0.84-1.24) for ST-HR, and 0.10 (95% CI, 0.06-0.14) for LT-DP.

CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis of ICI clinical trial results noted consistently larger ST-HRs vs Cox HRs for ICI therapy, with an LT-DP of approximately 10%. These results suggest that Cox HRs may not provide a full picture of survival outcomes when the risk reduction from treatment is not constant, which may aid in the decision-making process of oncologists and patients.

PMID:35976648 | DOI:10.1001/jamanetworkopen.2022.27211

J Ultrasound. 2022 Aug 17. doi: 10.1007/s40477-022-00709-9. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate and compare the mammographic and ultrasonographic features of TNBC with non-TNBC.

METHODS: A retrospective review of 193 invasive breast cancer patients (TNBC = 32 and non-TNBC = 161) was collected from January 2014 to June 2019. The imaging features were reviewed according to the 5th edition of the American College of Radiology Breast Imaging Reporting and Data System lexicon. We used the student t-test, Mann-Whitney U test, and Fisher’s exact test for statistical analyses.

RESULTS: Mass without calcifications was the most mammographic feature of TNBC (22 of 32, 68.8%) and more commonly found in TNBC than in non-TNBC (p = 0.007). The irregular shape (19 of 28, 67.9%) and indistinct margin (10 of 28, 35.7%) were the most common findings in the TNBC group. However, TNBC lesions appeared as round or oval shape and microlobulated margin more frequently than non-TNBC lesions (p < 0.001). Additionally, the tumor size and histological grade of TNBC were significantly higher than non-TNBC (p < 0.001).

CONCLUSION: TNBC has distinct imaging features compared to non-TNBC. The imaging features on mammography combined with ultrasonography can be used to detect and differentiate this subtype from other breast cancers.

PMID:35976611 | DOI:10.1007/s40477-022-00709-9

Qual Life Res. 2022 Aug 17. doi: 10.1007/s11136-022-03217-9. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to (1) describe the health-related quality of life (HRQoL) outcomes experienced by children born very preterm (28-31 weeks’ gestation) and extremely preterm (< 28 weeks’ gestation) at five years of age and (2) explore the mediation effects of bronchopulmonary dysplasia (BPD) and severe non-respiratory neonatal morbidity on those outcomes.

METHODS: This investigation was based on data for 3687 children born at < 32 weeks’ gestation that contributed to the EPICE and SHIPS studies conducted in 19 regions across 11 European countries. Descriptive statistics and multi-level ordinary linear squares (OLS) regression were used to explore the association between perinatal and sociodemographic characteristics and PedsQL^™ GCS scores. A mediation analysis that applied generalised structural equation modelling explored the association between potential mediators and PedsQL^™ GCS scores.

RESULTS: The multi-level OLS regression (fully adjusted model) revealed that birth at < 26 weeks’ gestation, BPD status and experience of severe non-respiratory morbidity were associated with mean decrements in the total PedsQL^™ GCS score of 0.35, 3.71 and 5.87, respectively. The mediation analysis revealed that the indirect effects of BPD and severe non-respiratory morbidity on the total PedsQL^™ GCS score translated into decrements of 1.73 and 17.56, respectively, at < 26 weeks’ gestation; 0.99 and 10.95, respectively, at 26-27 weeks’ gestation; and 0.34 and 4.80, respectively, at 28-29 weeks’ gestation (referent: birth at 30-31 weeks’ gestation).

CONCLUSION: The findings suggest that HRQoL is particularly impaired by extremely preterm birth and the concomitant complications of preterm birth such as BPD and severe non-respiratory morbidity.

PMID:35976599 | DOI:10.1007/s11136-022-03217-9

Environ Sci Pollut Res Int. 2022 Aug 17. doi: 10.1007/s11356-022-21962-9. Online ahead of print.

ABSTRACT

Few studies have evaluated the association between air pollutants and neural tube defects (NTDs). Moreover, the existing research ignores the lag effect of air pollution on health and provides inconsistent epidemiological evidence. We aim to estimate the association between air pollution and NTDs during the first trimester of pregnancy and identify specific susceptible windows. Birth data was collected from the Birth Defects Surveillance Network in Lanzhou from September 1, 2014, to December 31, 2019. Air quality and meteorological data were collected from ambient air monitoring stations and China Meteorological Data Network. The log connection function of the Poisson distribution function is used to establish a DLNM model to estimate the exposure-effect relationship and exposure-lag relationship association between air pollutants levels and NTDs. There were 320,787 perinatal infants in Lanzhou from September 1, 2014, to December 31, 2019, and 486 cases of NTDs (1.5‰). The result indicates that exposure to inhalable particles (PM₁₀) at lag 2-4 weeks was significantly associated with the risk of NTDs, with the most significant impact at the lag 2 week (RR=1.048, 95%CI, 1.015-1.084). Exposure to fine particulate matter (PM_2.5) at the lag 2 week was significantly associated with the risk of NTDs, with the most significant impact at the lag 2 week (RR=1.077, 95%CI, 1.004-1.155). Exposure to sulfur dioxide (SO₂) and nitrogen dioxide (NO₂) at lag 3-6weeks was significantly associated with the risk of NTDs, with the most significant impact at the lag 4 week (RR=1.220, 95%CI, 1.105-1.348; RR=1.143, 95%CI, 1.048-1.245). This study provides further evidence that exposure to air pollutants in the first trimester of pregnancy significantly increases the risk of neural tube defects.

PMID:35976594 | DOI:10.1007/s11356-022-21962-9

Environ Sci Pollut Res Int. 2022 Aug 17. doi: 10.1007/s11356-022-22431-z. Online ahead of print.

ABSTRACT

Many studies have detected a relationship between diarrhea morbidity rates with the changes in precipitation, temperature, floods, droughts, water shortage, etc. But, most of the authors were cautious in their studies, because of the lack of empirical climate-health data and there were large uncertainties in the future projections. The study aimed to refine the link between the morbidity rates of diarrhea in some Egyptian governorates representative of the three Egyptian geographical divisions with the meteorological changes that occurred in the 2006-2016 period for which the medical data are available, as a case study. Medical raw data was collected from the Information Centre Department of the Egyptian Ministry of Health and Population. The meteorological data of temperature and precipitation extremes were defined as data outside the 10th-90th percentile range of values of the period of study, and their analysis was done using a methodology similar to the one recommended by the WMO and integrated in the CLIMDEX software. Relationships between the morbidity rates of diarrhea in seven Egyptian governorates and the meteorological changes that occurred in the period 2006 to 2016 were analyzed using multiple linear regression analysis to identify the most effective meteorological factor that affects the trend of morbidity rate of diarrhea in each governorate. Statistical analysis revealed that some meteorological parameters can be used as predictors for morbidity rates of diarrhea in Cairo, Alexandria, and Gharbia, but not in Aswan, Behaira, and Dakahlia where the temporal evolution cannot be related with meteorology. In Red Sea, there was no temporal trend and no significant relationships between the diarrhea morbidity rate and meteorological parameters. The predictor meteorological parameters for morbidity rates of diarrhea were found to be depending on the geographic locations and infrastructures in these governorates. It was concluded that the meteorological data that can be used as predictors for the morbidity rate of diarrhea is depending on the geographical location and infrastructures of the target location. The socioeconomic levels as well as the infrastructures in the governorate must be considered confounders in future studies.

PMID:35976593 | DOI:10.1007/s11356-022-22431-z

Environ Sci Pollut Res Int. 2022 Aug 17. doi: 10.1007/s11356-022-22476-0. Online ahead of print.

ABSTRACT

We synthesized iron-coated pine-bark biochar (Fe-PBB) and determined the optimal conditions for removing the antibiotic tetracycline from water. The Fe-PBB was synthesized by depositing iron oxide on pyrolyzed pine-bark waste via a facile co-precipitation method. Characterization (SEM, EDX, and TGA) showed successful deposition of a mass of approximately 27% (w/w) iron on the PBB to synthesize Fe-PBB. Fe-PBB exhibited five times higher adsorption capacity (~ 10 mg/g) for tetracycline compared with PBB. The effects of initial tetracycline concentration, pH, temperature, and Fe-PBB dose on the adsorption removal of tetracycline from water were systematically investigated and optimized using a statistical experimental design and response surface methodology. The empirical relationship between the experimental factors and tetracycline removal was modeled, statistically validated through the analysis of variance, and used to predict the optimal conditions for adsorption removal of tetracycline. We found that ≥ 95% of the tetracycline can be removed at a tetracycline concentration of 1 mg/L, pH of 7, temperature of 50 °C, and a Fe-PBB dose of 2 g/L. The adsorption isotherm modeling study suggests that the adsorption of tetracycline can be attributed to the pore filling phenomenon and multilayer adsorption on the Fe-PBB. A thermodynamics study showed that the adsorption occurs spontaneously with an endothermic reaction.

PMID:35976587 | DOI:10.1007/s11356-022-22476-0

Eur J Orthop Surg Traumatol. 2022 Aug 17. doi: 10.1007/s00590-022-03362-4. Online ahead of print.

ABSTRACT

PURPOSE: To verify whether robotics was useful for surgeons who had less experience with spinal deformity surgery.

METHODS: A retrospective review was conducted of 70 consecutive patients who underwent robotic-assisted pedicle screw placements with open procedures using a spine robotic system (Mazor X Stealth Edition) at a single institution from April 2021 to April 2022. Gertzbein-Robbins grades were used to assess the deviation of the 599 pedicle screws in the postoperative CT images. The rate of Grade A was considered the perfect accuracy rate, and the rate of Grades C, D, and E was calculated as the deviation rate. The perfect accuracy rate and deviation rate were compared between the spinal deformity and the non-deformity groups. The perfect accuracy rate, deviation rate, and screw insertion time were compared in the spinal deformity cases between the expert surgeon group and the less-experienced surgeon group.

RESULTS: The deviation rate of the spinal deformity group was higher than that of the non-deformity group even though there was no statistically significant difference (spinal deformity group: 2.3%, non-deformity group: 1.2%, p = 0.350). In the spinal deformity cases, there was no significant difference in the perfect accuracy rate between the expert surgeon group and the less-experienced surgeon group, but the deviation rate was significantly lower in the less-experienced surgeon group (expert surgeon group: 5.0%, less-experienced surgeon group: 0%, p = 0.008). The screw insertion time was significantly shorter in the less-experienced surgeon group.

CONCLUSION: Robotics is particularly useful for surgeons with less experience in spinal deformity surgery.

PMID:35976573 | DOI:10.1007/s00590-022-03362-4

Child Psychiatry Hum Dev. 2022 Aug 17. doi: 10.1007/s10578-022-01410-y. Online ahead of print.

ABSTRACT

Internet use among children is increasing. This requires parents to develop digital parenting competencies as they are responsible for their children’s well-being. In the current study the digital parenting self-efficacy perceptions of Turkish parents are examined with regard to the parental role, educational status, age, number of children, and Internet use experiences. Data were collected from a stratified sample of 7150 Turkish parents (i.e., only the mother or father in each family) from twenty-six provinces through the Digital Parenting Self-Efficacy Perception Scale. Descriptive statistics, comparison tests, and cluster analysis were used to analyze the data. The findings reveal that the participants’ perceived digital parenting efficacy is high, and that perceptions change in terms of the parental role, educational status, age, number of children, and the Internet use experience.

PMID:35976543 | DOI:10.1007/s10578-022-01410-y

Metabolomics. 2022 Aug 17;18(9):69. doi: 10.1007/s11306-022-01927-2.

ABSTRACT

BACKGROUND & AIMS: A metabolomic study of hepatolithiasis has yet to be performed. The purpose of the present study was to characterize the metabolite profile and identify potential biomarkers of hepatolithiasis using a metabolomic approach.

METHODS: We comprehensively analyzed the serum metabolites from 30 patients with hepatolithiasis and 20 healthy individuals using ultra-high performance liquid chromatography-tandem mass spectrometry operated in negative and positive ionization modes. Statistical analyses were performed using univariate (Student’s t-test) and multivariate (orthogonal partial least-squares discriminant analysis) statistics and R language. Receiver operator characteristic (ROC) curve analysis was performed to identify potential predictors of hepatolithiasis.

RESULTS: We identified 277 metabolites that were significantly different between hepatolithiasis serum group and healthy control serum group. These metabolites were principally lipids and lipid-like molecules and amino acid metabolites. The steroid hormone biosynthesis pathway was enriched in hepatolithiasis serum group. In all specific metabolites, 75 metabolites were over-expressed in hepatolithiasis serum group. The AUC values for 60 metabolites exceeded 0.70, 4 metabolites including 18-β-Glycyrrhetinic acid, FMH, Rifampicin and PC (4:0/16:2) exceeded 0.90.

CONCLUSIONS: We have identified serum metabolites that are associated with hepatolithiasis for the first time. 60 potential metabolic biomarkers were identified, 18-β-Glycyrrhetinic acid, FMH, Rifampicin and PC (4:0/16:2) may have the potential clinical utility in hepatolithiasis.

PMID:35976530 | DOI:10.1007/s11306-022-01927-2