Tag: statistics

Arch Argent Pediatr. 2022 Nov 24:e202202598. doi: 10.5546/aap.2022-02598.eng. Online ahead of print.

ABSTRACT

Introduction. Usually, during anorectal manometry, only the presence or absence of rectoanal inhibitory reflex (RAIR) is investigated. Studies have reported that a detailed analysis may provide data of interest. Our hypothesis is that RAIR measurement may provide information to detect organic causes (tethered cord, lipoma, etc.) in patients in whom a functional cause had been previously considered. Objectives. To compare RAIR duration in anorectal manometry between patients with refractory functional constipation (RFC) and myelomeningocele (MMC). Population and methods. Observational, analytical, cross-sectional study (2004-2019). Patients with chronic constipation and functional and organic fecal incontinence (myelomeningocele). The anorectal manometry was performed with a water-perfused system, and the duration of RAIR was measured with different volumes (20, 40, and 60 cc). Group 1 (G1): 81 RFC. Group 2 (G2): 54 MMC. Patients with developmental delay, compliant anal sphincter, sacral agenesis and non-cooperative patients were excluded. Results. A total of 135 individuals were included (62 were male). Their median age was 9.57 years in G1 and 9.63 years in G2. Average duration in G1 versus G2 with 20 cc: 8.89 versus 15.21 seconds; 40 cc: 11.41 versus 21.12 seconds; 60 cc: 14.15 versus 26.02 seconds. The difference in RAIR duration with the varying volumes was statistically significant (p = 0.0001). Conclusion. RAIR duration was longer with increasing balloon inflation volumes in both populations. RAIR duration was longer in patients with MMC than in those with RFC. Spinal injury should be ruled out in patients with prolonged RAIR.

PMID:36413143 | DOI:10.5546/aap.2022-02598.eng

J Am Med Inform Assoc. 2022 Nov 22:ocac216. doi: 10.1093/jamia/ocac216. Online ahead of print.

ABSTRACT

OBJECTIVE: Accurate and rapid phenotyping is a prerequisite to leveraging electronic health records for biomedical research. While early phenotyping relied on rule-based algorithms curated by experts, machine learning (ML) approaches have emerged as an alternative to improve scalability across phenotypes and healthcare settings. This study evaluates ML-based phenotyping with respect to (1) the data sources used, (2) the phenotypes considered, (3) the methods applied, and (4) the reporting and evaluation methods used.

MATERIALS AND METHODS: We searched PubMed and Web of Science for articles published between 2018 and 2022. After screening 850 articles, we recorded 37 variables on 100 studies.

RESULTS: Most studies utilized data from a single institution and included information in clinical notes. Although chronic conditions were most commonly considered, ML also enabled the characterization of nuanced phenotypes such as social determinants of health. Supervised deep learning was the most popular ML paradigm, while semi-supervised and weakly supervised learning were applied to expedite algorithm development and unsupervised learning to facilitate phenotype discovery. ML approaches did not uniformly outperform rule-based algorithms, but deep learning offered a marginal improvement over traditional ML for many conditions.

DISCUSSION: Despite the progress in ML-based phenotyping, most articles focused on binary phenotypes and few articles evaluated external validity or used multi-institution data. Study settings were infrequently reported and analytic code was rarely released.

CONCLUSION: Continued research in ML-based phenotyping is warranted, with emphasis on characterizing nuanced phenotypes, establishing reporting and evaluation standards, and developing methods to accommodate misclassified phenotypes due to algorithm errors in downstream applications.

PMID:36413056 | DOI:10.1093/jamia/ocac216

Phys Sportsmed. 2022 Nov 22:1-6. doi: 10.1080/00913847.2022.2148492. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of the study was to evaluate the effect of Osgood-Schlatter disease (OSD) on knee joint function in elite young soccer players. Our hypothesis was that knee joint function in elite young soccer players was impaired following OSD compared with soccer players with no history of OSD.

METHOD: In young male soccer players (n = 36) from elite academies (mean ±SD, age: age: 15,3 ± 1,7 years; height: 1,7 ± 0,06 m; weight: 63,5 ± 8 kg; BMI: 20,7 ± 2). The duration between the completion of treatment or the last complaint to the study commencement was 31 ± 19 months.

RESULTS: The average treatment duration of OSD among study participants was 18,5 ± 12 days (95%, 14-23), and the disease most often manifested in winter and spring, 33% and 31% of cases, respectively. Soccer players with a history of OSD were statistically different in IKDC and KOOS scores when compared with soccer players with no previously reported OSD (Mann-Whitney, p < 0,0001). The soccer players with a history of OSD also use NSAIDs more frequently compared with soccer players with no history of OSD (36% vs 3% respectively).

CONCLUSIONS: OSD among young soccer players, when symptoms resolve, continue about one month and they can return to regular training and participation in games. Wherein, the negative effects in knee joint function were significantly more likely in soccer players with previous OSD history when compared with their peers with no history of OSD. While oral non-steroidal anti-inflammatory drugs was also more widely employed in soccer players with previous OSD history. Potentially this may lead to performance deficits and disadvantages for their future careers and coaches and physicians should be informed.

PMID:36413052 | DOI:10.1080/00913847.2022.2148492

J Int Med Res. 2022 Nov;50(11):3000605221135147. doi: 10.1177/03000605221135147.

ABSTRACT

OBJECTIVE: To apply deep learning to a data set of dental panoramic radiographs to detect the mental foramen for automatic assessment of the mandibular cortical width.

METHODS: Data from the seventh survey of the Tromsø Study (Tromsø7) were used. The data set contained 5197 randomly chosen dental panoramic radiographs. Four pretrained object detectors were tested. We randomly chose 80% of the data for training and 20% for testing. Models were trained using GeForce RTX 2080 Ti with 11 GB GPU memory (NVIDIA Corporation, Santa Clara, CA, USA). Python programming language version 3.7 was used for analysis.

RESULTS: The EfficientDet-D0 model showed the highest average precision of 0.30. When the threshold to regard a prediction as correct (intersection over union) was set to 0.5, the average precision was 0.79. The RetinaNet model achieved the lowest average precision of 0.23, and the precision was 0.64 when the intersection over union was set to 0.5. The procedure to estimate mandibular cortical width showed acceptable results. Of 100 random images, the algorithm produced an output 93 times, 20 of which were not visually satisfactory.

CONCLUSIONS: EfficientDet-D0 effectively detected the mental foramen. Methods for estimating bone quality are important in radiology and require further development.

PMID:36412242 | DOI:10.1177/03000605221135147

Suicide Life Threat Behav. 2022 Nov 22. doi: 10.1111/sltb.12929. Online ahead of print.

ABSTRACT

INTRODUCTION: Suicide is a leading cause of death for men in the United States. Men traditionally have been hesitant to seek help, based on masculine norms of stoicism and self-reliance, among other factors. Man Therapy (MT) is an online suicide prevention and mental health initiative that provides promise for facilitating male help-seeking.

METHODS: This study draws on data from a randomized controlled trial which examined effects of MT on a sample of men residing in Michigan aged 25-64. The current study utilized logistic regression to test MT’s effect on nonprofessional and professional help-seeking, controlling for marital status, education, and sexual orientation.

RESULTS: A statistically significant positive association was found between MT and professional help-seeking (OR = 1.55, p = 0.049). A significant inverse association was also found with marital status, with partnered men less likely to seek professional help (OR = 0.53, p = 0.007). There was no significant association between MT and nonprofessional help-seeking.

CONCLUSION: Man Therapy demonstrates the promise of web-based suicide prevention efforts to reach men who typically do not engage in help-seeking, providing a gateway to vital professional support. As technology continues to emerge, further suicide research is needed on use of this modality with working-age men from diverse backgrounds.

PMID:36412229 | DOI:10.1111/sltb.12929

J Dermatol. 2022 Nov 22. doi: 10.1111/1346-8138.16644. Online ahead of print.

ABSTRACT

Psoriasis is a systemic, chronic, immunologically-mediated disease affecting approximately 2%-4% of the worldwide population. It is well known that psoriasis is associated with several comorbidities such as metabolic syndrome, cardiovascular disease, and malignancy. Although meta-analyses and large prospective cohort studies have shown an increased risk of malignancies in patients with psoriasis worldwide, an association between psoriasis and malignancy onset has not yet been established in Japan. We retrospectively analyzed 360 patients with psoriasis at our hospital to evaluate the incidence and types of malignancies in these patients. The incidence rate of malignancy was 14.4% (52/360). Colorectal cancer was the most commonly associated malignancy (20.9%), followed by skin cancer (16.4%), gastric cancer (10.4%), and lung cancer (10.4%). The calculated age- and sex-standardized incidence ratio of malignancies was 1.235 (95% CI 0.952-1.601) which indicated that the malignancy rate was higher in patients with psoriasis than in the general population, although the difference was not statistically significant. Furthermore, the multivariate analysis revealed increased risk of malignancy in males (HR = 3.15; 95% CI 1.381-7.187; p < 0.001), psoriasis onset at older age (HR = 1.08; 95% CI 1.058-1.111; p < 0.01), and psoriatic erythroderma (HR = 4.44; 95% CI 1.354-14.581; p < 0.05). We also observed that treatment with biological agents tends to reduce the risk of developing malignancy; however, no statistical significance was found. These results suggest that periodic screening for malignancy should be recommended in patients with psoriasis having these risk factors and in those with poorly controlled psoriatic inflammation.

PMID:36412216 | DOI:10.1111/1346-8138.16644

AIDS. 2022 Nov 23. doi: 10.1097/QAD.0000000000003436. Online ahead of print.

ABSTRACT

OBJECTIVE: To systematically assess the efficacy, safety, and tolerability of isoniazid preventive therapy (IPT) for tuberculosis (TB) in people living with human immunodeficiency virus (PLHIV).

DESIGN: Systematic review and meta-analysis.

METHODS: A thorough literature search was performed using PubMed, Cochrane CENTRAL, and Google Scholar from their inception to June 30, 2021. All randomized controlled trials (RCTs) investigating the efficacy, safety, or tolerability of IPT on PLHIV compared to placebo or active comparators were included in the study. The heterogeneity among the studies was identified by using the I2 statistic and Cochran’s Q test.

RESULTS: Out of the 924 non-duplicate RCTs identified through database searching and other sources, 26 studies comprising 38005 patients were included. The overall effect estimate identified the reduction of active TB incidence (OR 0.69; 95% CI 0.57, 0.84; P < 0.001), but not all-cause mortality (OR 0.91; 95% CI 0.82, 1.02; P = 0.10) with IPT compared to the control. Additionally, no significant association was identified between the use of IPT and the risk of peripheral neuropathy (OR 1.50; 95% CI 0.96, 2.36; P = 0.08) and hepatotoxicity (OR 1.21; 95% CI 0.97, 1.52; P = 0.09).

CONCLUSIONS: This systematic review and meta-analysis identified a significant reduction in the incidence of active TB, but not all-cause mortality, among PLHIV who received IPT compared to the control. Lesser number of outcomes may be the reason for non-significant results in terms of safety outcomes of IPT. Therefore, there is a need for extensive and long-term studies to address these issues further, especially in TB/HIV endemic areas.

PMID:36412204 | DOI:10.1097/QAD.0000000000003436

Chronobiol Int. 2022 Nov 22:1-9. doi: 10.1080/07420528.2022.2148182. Online ahead of print.

ABSTRACT

The present study had two main aims. First, to investigate whether shift/night workers had a higher prevalence and severity of COVID-19 compared with day workers. Second, to investigate whether people regularly working in face-to-face settings during the pandemic exhibited a higher prevalence and severity of COVID-19 compared with those having no need to be in close contact with others at work. Data consisted of 7141 workers from 15 countries and four continents who participated in the International COVID Sleep Study-II (ICOSS-II) between May and December 2021. The associations between work status and a positive COVID-19 test and several indications of disease severity were tested with chi-square tests and logistic regressions adjusted for relevant confounders. In addition, statistical analyses were conducted for the associations between face-to-face work and COVID-19 status. Results showed that shift/night work was not associated with an increased risk of COVID-19 compared to day work. Still, shift/night workers reported higher odds for moderate to life-threatening COVID-19 (adjusted odds ratio (aOR) = 2.71, 95%-confidence interval = 1.23-5.95) and need for hospital care (aOR = 5.66, 1.89-16.95). Face-to-face work was associated with an increased risk of COVID-19 (aOR = 1.55, 1.12-2.14) but not with higher disease severity. In conclusion, shift/night work was not associated with an increased risk of COVID-19, but when infected, shift/night workers reported more severe disease. Impaired sleep and circadian disruption commonly seen among shift/night workers may be mediating factors. Working face-to-face increased the risk of COVID-19, likely due to increased exposure to the virus. However, face-to-face work was not associated with increased disease severity.

PMID:36412198 | DOI:10.1080/07420528.2022.2148182

Sci Med Footb. 2022 Nov;6(4):405-414. doi: 10.1080/24733938.2021.1943756. Epub 2021 Aug 17.

ABSTRACT

BACKGROUND: The aim was to investigate the association of injuries with male football player continuity, progression and chances of reaching the First team in an elite academy.

METHODS: Injuries and exposure time were prospectively recorded, following the FIFA guidelines, over 6 seasons (2011-2017) in Under (U)12, U14, U16, U19, 2nd/3rd team and First team players from the same professional football club.

RESULTS: U19 and 2nd/3rd team players progressing to the next level had a lower injury burden and higher match availability compared to players that did not progress. Injury burden was lower in players progressing from U12 to U14. All players progressing from the 2nd/3rd teams to the First team had a match availability higher than 84% and did not suffer an anterior cruciate ligament (ACL) rupture or an injury requiring over 200 (+200) days to return to play. In U19 and 2nd/3rd team players, injuries requiring +100 and +200 days to return to play, ACL ruptures and groin pain, but not hamstring and ankle ligament injuries, were associated with lower odds of continuing in the academy each season.

CONCLUSION: Injuries were negatively associated with player progression, and injury prevention and return-to-play strategies should be a priority for football academies.

PMID:36412177 | DOI:10.1080/24733938.2021.1943756

J Geriatr Psychiatry Neurol. 2022 Nov 22:8919887221135552. doi: 10.1177/08919887221135552. Online ahead of print.

ABSTRACT

INTRODUCTION: People with suspected Alzheimer’s disease and related dementias (ADRD) and their families experience a burdensome process while seeking a diagnosis. These challenges are problematic in the most common dementia syndromes, but they can be even more distressing in rarer, atypical syndromes such as rapidly progressive dementias (RPDs), which can be fatal within months from onset. This study is an examination of the diagnostic journey experience from the perspective of caregivers of people who died from the prototypic RPD, sporadic Creutzfeldt-Jakob Disease (sCJD).

METHODS: eIn this mixed-methods study, qualitative data were drawn from interviews with former caregivers of 12 people who died from sCJD. Chart review data were drawn from research and clinical chart data about the person with sCJD. Data were analyzed by a multidisciplinary research team using qualitative and descriptive statistical analysis.

RESULTS: We identified 4 overarching themes that characterized the experience of the diagnostic journey in sCJD: clinician knowledge, clinician communication, experiences of uncertainty, and the caregiver as advocate. We also identified 4 phases along the diagnostic journey: recognition, the diagnostic workup, diagnosis, and post-diagnosis. Sub-themes within each phase include struggles to recognize what is wrong, complex processes of testing and referrals, delay and disclosure of diagnosis, and access to resources post-diagnosis.

CONCLUSIONS: Findings suggest that more work is needed to improve clinician diagnostic knowledge and communication practices. Furthermore, caregivers need better support during the diagnostic journey. What we learn from studying sCJD and other RPDs is likely applicable to other more common dementias.

PMID:36412170 | DOI:10.1177/08919887221135552