Tag: statistics

Int J Biometeorol. 2022 Oct 12. doi: 10.1007/s00484-022-02383-2. Online ahead of print.

ABSTRACT

Urolithiasis was a global disease and it was more common in southern China. This study looked into the association between daily temperature and urolithiasis hospital admissions in Ganzhou, a large prefecture-level city in southern China. In Ganzhou City from 2016 to 2019, a total of 60,881 hospitalized cases for urolithiasis from 69 hospitals and meteorological data were gathered. The effect of high ambient temperature on urolithiasis hospital admissions was estimated using a distributed lag nonlinear model. Stratified analysis was done to examine sex differences. The study found that in Ganzhou of China, the exposure-response curves approximated a “J” shape which across genders were basically similar. The maximum lag effect occurred on the second day after high temperatures for males but on the third day for females. Compared to the 10 °C reference temperature and considering the cumulative lag effect of 10 days, the relative risks of the daily mean temperature at the 95th percentile on the total, male, and female hospital admissions for urolithiasis were 2.026 (95% CI: 1.628, 2.521), 2.041 (95% CI: 1.603, 2.598), and 2.030 (95% CI: 1.552, 2.655), respectively, but the relative risks between sex were not statistically significant (p = 0.977). Urolithiasis morbidity risk in China could be exacerbated by high temperatures. The effect of high temperature on urolithiasis was similar across genders.

PMID:36222915 | DOI:10.1007/s00484-022-02383-2

Knee Surg Sports Traumatol Arthrosc. 2022 Oct 12. doi: 10.1007/s00167-022-07181-2. Online ahead of print.

ABSTRACT

Supervised learning is the most common form of machine learning utilized in medical research. It is used to predict outcomes of interest or classify positive and/or negative cases with a known ground truth. Supervised learning describes a spectrum of techniques, ranging from traditional regression modeling to more complex tree boosting, which are becoming increasingly prevalent as the focus on “big data” develops. While these tools are becoming increasingly popular and powerful, there is a paucity of literature available that describe the strengths and limitations of these different modeling techniques. Typically, there is no formal training for health care professionals in the use of machine learning models. As machine learning applications throughout medicine increase, it is important that physicians and other health care professionals better understand the processes underlying application of these techniques. The purpose of this study is to provide an overview of commonly used supervised learning techniques with recent case examples within the orthopedic literature. An additional goal is to address disparities in the understanding of these methods to improve communication within and between research teams.

PMID:36222893 | DOI:10.1007/s00167-022-07181-2

Biol Cybern. 2022 Oct 12. doi: 10.1007/s00422-022-00945-6. Online ahead of print.

ABSTRACT

Sequential behavior unfolds both in space and in time. The same spatial trajectory can be realized in different manners in the same overall time by changing instantaneous speeds. The current research investigates how speed profiles might be given behavioral significance and how cortical networks might encode this information. We first demonstrate that rats can associate different speed patterns on the same trajectory with distinct behavioral choices. In this novel experimental paradigm, rats follow a small baited robot in a large megaspace environment where the rat’s speed is precisely controlled by the robot’s speed. Based on this proof of concept and research showing that recurrent reservoir networks are ideal for representing spatio-temporal structures, we then test reservoir networks in simulated navigation contexts and demonstrate they can discriminate between traversals of the same path with identical durations but different speed profiles. We then test the networks in an embodied robotic setup, where we use place cell representations from physically navigating robots as input and again successfully discriminate between traversals. To demonstrate that this capability is inherent to recurrent networks, we compared the model against simple linear integrators. Interestingly, although the linear integrators could also perform the speed profile discrimination, a clear difference emerged when examining information coding in both models. Reservoir neurons displayed a form of statistical mixed selectivity as a complex interaction between spatial location and speed that was not as abundant in the linear integrators. This mixed selectivity is characteristic of cortex and reservoirs and allows us to generate specific predictions about the neural activity that will be recorded in rat cortex in future experiments.

PMID:36222887 | DOI:10.1007/s00422-022-00945-6

Matern Child Nutr. 2022 Oct 12:e13436. doi: 10.1111/mcn.13436. Online ahead of print.

ABSTRACT

The objective of this paper is to describe gestational weight gain (GWG), to assess the applicability of the 2009 Institute of Medicine (IOM) guidelines, and to derive a GWG adequacy classification within a French cohort. We included twins from the national, prospective, population-based JUmeaux MODe d’Accouchement (JUMODA) cohort study (2014-2015). Following the IOM approach, we selected a ‘standard’ population of term pregnancies with ‘optimal’ birthweight (≥2500 g; n = 2562). GWG adequacy (insufficient; adequate; excessive) was defined using IOM recommendations (normal body mass index [BMI]: 16.8-24.5 kg [also utilized for underweight BMI]; overweight: 14.1-22.7 kg; obese: 11.4-19.1 kg). Additionally, using the IOM approach, we determined the 25th and 75th percentiles of GWG in our standard population to create a JUMODA-derived GWG adequacy classification. GWG and GWG adequacy were described, overall and by BMI and parity. In the JUMODA standard population of term twin livebirths with optimal birthweight, mean GWG was 16.1 kg (standard deviation 6.3). Using IOM recommendations, almost half (46.5%) of the women had insufficient and few (10.0%) had excessive GWG, with similar results regardless of BMI or parity. The 25th and 75th percentiles of GWG in the JUMODA standard population (underweight: 13-21 kg; normal weight: 13-20 kg; overweight: 11-19 kg; obese: 7-16 kg) were lower than the IOM recommendations. The IOM recommendations classified a relatively high percentage of French women as having insufficient and a low percentage as having excessive GWG. Additional research to evaluate recommendations in relation to adverse perinatal outcomes is needed to determine whether the IOM recommendations or the JUMODA-derived classification is more appropriate for French twin gestations.

PMID:36222213 | DOI:10.1111/mcn.13436

Clin Implant Dent Relat Res. 2022 Oct 12. doi: 10.1111/cid.13141. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study is to retrospectively evaluate the clinical outcomes of alveolar ridge preservation (ARP) in the compromised extraction sockets using autogenous cortical-lamina anchoring technique (CAT).

MATERIAL AND METHODS: Twenty patients were treated with ARP in the compromised extraction sockets by applying CAT. Then implant placement and crown delivery was performed. A planned follow-up was performed by analyzing various outcome measures to evaluate the clinical outcomes, including primary outcome measures [radiographic assessment of residual alveolar ridge height (RARH) and residual alveolar ridge width (RARW)] and secondary outcome measures [clinical assessment of the healing of the soft and hard tissue, survival rates of implants, marginal bone loss (MBL) evaluation of implants, buccal bone thickness (BBT), and esthetic treatment outcomes].

RESULTS: Among the 20 patients, 17 were consecutively treated and 3 dropped out after implant crown delivery because of loss to follow-up. After the ARP, the initial RARH (12.37 mm) significantly increased to 19.29 mm (P < .05). No significant difference was detected in the RARW before (7.92 ± 1.18 mm) and after (7.92 ± 1.18 mm) the ARP, but reduce to 6.99 ± 1.18 mm at the implant placement and 6.64 ± 0.77 mm at the 3-year follow-up (P < .05). The MBL at the implant crown delivery (0.13 ± 0.12 mm) significantly increased to 0.31 ± 0.14 mm at 1-year follow-up and 0.56 ± 0.23 mm at 3-year follow-up, respectively. The bone loss was limited (<1 mm) but statistically significant (P < .05). The BBT at the implant placement (2.53 ± 0.56 mm) significantly reduced to 2.23 ± 0.44 mm at implant crown delivery and 2.14 ± 0.40 mm at 3-year follow-up, respectively. The bone loss was also limited (<0.5 mm) but statistically significant (P < .05). Each implant site showed acceptable aesthetic outcome and the average score was 16.4. The incisions healed uneventful in all patients and the implant survival rate was 100% during the 3-year follow-up.

CONCLUSION: Autogenous CAT was successfully applied to preserve the height and width of alveolar ridge in the compromised extraction sockets.

PMID:36222202 | DOI:10.1111/cid.13141

Angiology. 2022 Oct 12:33197221129351. doi: 10.1177/00033197221129351. Online ahead of print.

ABSTRACT

SARS-Cov-2 has been suggested to promote thrombotic complications and higher mortality. The aim of the present study was to evaluate the impact of SARS-CoV-2 positivity on in-hospital outcome and 30-day mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) enrolled in the International Survey on Acute Coronary Syndromes ST-segment elevation Myocardial Infarction (ISACS-STEMI COVID-19 registry. The 109 SARS-CoV-2 positive patients were compared with 2005 SARS-CoV-2 negative patients. Positive patients were older (P = .002), less often active smokers (P = .002), and hypercholesterolemic (P = .006), they presented more often later than 12 h (P = .037), more often to the hub and were more often in cardiogenic shock (P = .02), or requiring rescue percutaneous coronary intervention after failed thrombolysis (P < .0001). Lower postprocedural Thrombolysis in Myocardial Infarction 3 flow (P = .029) and more thrombectomy (P = .046) were observed. SARS-CoV-2 was associated with a significantly higher in-hospital mortality (25.7 vs 7%, adjusted Odds Ratio (OR) [95% Confidence Interval] = 3.2 [1.71-5.99], P < .001) in-hospital definite in-stent thrombosis (6.4 vs 1.1%, adjusted Odds Ratio [95% CI] = 6.26 [2.41-16.25], P < .001) and 30-day mortality (34.4 vs 8.5%, adjusted Hazard Ratio [95% CI] = 2.16 [1.45-3.23], P < .001), confirming that SARS-CoV-2 positivity is associated with impaired reperfusion, with negative prognostic consequences.

PMID:36222189 | DOI:10.1177/00033197221129351

Pediatr Int. 2022 Oct 12:e15384. doi: 10.1111/ped.15384. Online ahead of print.

ABSTRACT

BACKGROUND: Beta-blockers have gradually become an attractive option for the treatment of infantile hemangiomas. Topical application is more preferred over oral administration since their potential systemic adverse effects. The aim of this study is to investigate the effect of betaxolol in treating superficial infantile hemangioma.

METHODS: 74 infants admitted to the First Affiliated Hospital of Xinjiang Medical University from 2018 to 2019 were observed and recorded. The changeable indicators such as color, size, tension and thickness were monthly recorded and evaluated according to visual analog scales. Multi-factor analysis of variance with repeated measurements and Kruskal-Wallis H nonparametric test were performed to compare the clinical effectiveness across different groups.

RESULTS: After six months of treatment, 33.78% (25/74) got excellent results, 55.41% (41/74) had good response, 8.11% (6/74) had moderate response and 2.70% (2/74) had poor response respectively. Neither local discomforts nor systemic complications had been found. There was no significant difference in gender and location of occurrence among groups (P > 0.05), while the effect of topical application of betaxolol was optimum in the children aged 0-3 months (P = 0.002). None of three age groups had statistically significant discrepancy of heart rate and blood pressure after accepting treatment (one month, P = 0.618; four months, P = 0.138; six months, P = 0.757).

CONCLUSIONS: Our study showed that topical administration of betaxolol was effective and well-tolerated for superficial infantile hemangiomas, particularly in the early proliferative stage. However, its safety and efficacy need continuous studies to be confirmed.

PMID:36222187 | DOI:10.1111/ped.15384

J Biosci. 2022;47:43.

ABSTRACT

The use of synthetic data is gaining an increasingly prominent role in data and machine learning workflows to build better models and conduct analyses with greater statistical inference. In the domains of healthcare and biomedical research, synthetic data may be seen in structured and unstructured formats. Concomitant with the adoption of synthetic data, a sub-discipline of machine learning known as deep learning has taken the world by storm. At a larger scale, deep learning methods tend to outperform traditional methods in regression and classification tasks. These techniques are also used in generative modeling and are thus prime candidates for generating synthetic data in both structured and unstructured formats. Here, we emphasize the generation of synthetic data in healthcare and biomedical research using deep learning methods for unstructured data formats such as text and images. Deep learning methods leverage the neural network algorithm, and in the context of generative modeling, several neural network architectures can create new synthetic data for a problem at hand including, but not limited to, recurrent neural networks (RNNs), variational autoencoders (VAEs), and generative adversarial networks (GANs). To better understand these methods, we will look at specific case studies such as generating realistic clinical notes of a patient, the generation of synthetic DNA sequences, as well as to enrich experimental data collected during the study of heterotypic cultures of cancer cells.

PMID:36222162

Pediatrics. 2022 Oct 12:e2021054307. doi: 10.1542/peds.2021-054307. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Discharge from the emergency department (ED) involves a complex series of steps to ensure a safe transition to home and follow-up care. Preventable, discharge-related serious safety events (SSEs) in our ED highlighted local vulnerabilities. We aimed to improve ED discharge by implementing a standardized discharge process with emphasis on multidisciplinary communication and family engagement.

METHODS: At a tertiary children’s hospital, we used the model for improvement to revise discharge care. Interventions included a new discharge checklist, a provider huddle emphasizing discharge vital signs, and a scripted discharge review of instructions with families. We used statistical process control to evaluate performance. Primary outcomes included elimination of preventable, discharge-related SSEs and Press Ganey survey results assessing caregiver information for care of child at home. A secondary outcome was number of days between preventable low-level (near-miss, no or minimal harm) events. Process measures included discharge checklist adoption and vital sign acquisition. Balancing measures were length of stay (LOS) and return rates.

RESULTS: Over the study period, there were no preventable SSEs and low-level event frequency improved to a peak of >150 days between events. Press Ganey responses regarding quality of discharge information did not change (62%). Checklist use was rapidly adopted, reaching 94%. Vital sign acquisition increased from 67% to 83%. There was no change in the balancing measures of median LOS or return visit rates.

CONCLUSIONS: The development and implementation of a standardized discharge process led to the elimination of reported discharge-related events, without increasing LOS or return visits.

PMID:36222092 | DOI:10.1542/peds.2021-054307

Endocrinol Metab (Seoul). 2022 Oct 12. doi: 10.3803/EnM.2022.1519. Online ahead of print.

ABSTRACT

BACKGROUND: The present study investigates whether modifiable behavioral factors of current cigarette smoking, heavy alcohol consumption, and regular exercise are associated with risk of lower extremity amputation (LEA) in diabetic patients.

METHODS: A total of 2,644,440 diabetic patients (aged ≥20 years) was analyzed using the database of the Korean National Health Insurance Service. Cox proportional hazard regression was used to assess adjusted hazard ratios (HRs) for the behavioral factors with risk of LEA under adjustment for potential confounders.

RESULTS: The risk of LEA was significantly increased by current cigarette smoking and heavy alcohol consumption (HR, 1.436; 95% confidence interval [CI], 1.367 to 1.508 and HR, 1.082; 95% CI, 1.011 to 1.158) but significantly decreased with regular exercise (HR, 0.745; 95% CI, 0.706 to 0.786) after adjusting for age, sex, smoking, alcohol consumption, exercise, low income, hypertension, dyslipidemia, body mass index, using insulin or oral antidiabetic drugs, and diabetic duration. A synergistically increased risk of LEA was observed with larger number of risky behaviors.

CONCLUSION: Modification of behaviors of current smoking, heavy alcohol intake, and exercise prevents LEA and can improve physical, emotional, and social quality of life in diabetic patients.

PMID:36222086 | DOI:10.3803/EnM.2022.1519