Tag: statistics

J Alzheimers Dis. 2022 Oct 18. doi: 10.3233/JAD-220474. Online ahead of print.

ABSTRACT

BACKGROUND: There are socioeconomic inequalities in dementia risk. Underlying pathways are not well known.

OBJECTIVE: To investigate whether modifiable health and lifestyle factors for brain health mediate the association of socioeconomic status (SES) and cognitive functioning in a population without dementia.

METHODS: The “LIfestyle for BRAin health” (LIBRA) score was computed for 6,203 baseline participants of the LIFE-Adult-Study. LIBRA predicts dementia in midlife and early late life, based on 12 modifiable factors. Associations of SES (education, net equivalence income, and occupational status) and LIBRA with cognitive functioning (composite score) were investigated using adjusted linear regression models. Bootstrapped structural equation modelling (SEM) was used to investigate whether LIBRA mediated the association of SES and cognitive functioning.

RESULTS: Participants were M = 57.4 (SD = 10.6, range: 40-79) years old; 50.3% were female. Both, SES (Wald: F(2)=52.5, p < 0.001) and LIBRA (Wald: F(1)=5.9, p < 0.05) were independently associated with cognitive functioning; there was no interaction (Wald: F(2)=2.9, p = 0.060). Lower SES and higher LIBRA scores indicated lower cognitive functioning. LIBRA partially mediated the association of SES and cognitive functioning (IE: =0.02, 95% CI [0.02, 0.03], p < 0.001). The proportion mediated was 12.7%.

CONCLUSION: Differences in cognitive functioning due to SES can be partially attributed to differences in modifiable health and lifestyle factors; but to a small extent. This suggests that lifestyle interventions could attenuate socioeconomic inequalities in cognitive functioning. However, directly intervening on the social determinants of health may yield greater benefits for dementia risk reduction.

PMID:36278347 | DOI:10.3233/JAD-220474

J Back Musculoskelet Rehabil. 2022 Oct 14. doi: 10.3233/BMR-220132. Online ahead of print.

ABSTRACT

BACKGROUND: Due to the influence of spinal and respiratory movements, it is difficult to accurately measure the range of motion of each joint.

OBJECTIVE: To conduct a three-dimensional (3D) measurement of each joint in the shoulder complex in different postures in the sagittal plane of the upper extremity.

METHODS: Thirteen healthy adults with no history of shoulder surgery for trauma or chronic pain were enrolled in the present study. The computed tomography (CT) imaging data of the shoulder complex were acquired in four postures via the reconstruction and alignment of 3D images. The angles of the postural changes were measured, and rotation vectors were used for descriptions and statistical analyses.

RESULTS: There was a statistical difference in the rotation angles between the dominant and non-dominant sides of the sternoclavicular joint when the posture changed from a resting position to a posterior inferior position. During the postural change from a resting position to a horizontal position, the regression coefficient (β) of the humerothoracic joint to the sternoclavicular joint was 0.191, and the β of the humerothoracic joint to the glenohumeral joint was 0.621. During the postural change from the horizontal position to the rear upper position, the β of the humerothoracic joint to the sternoclavicular joint was 0.316, and the β of the humerothoracic joint to the glenohumeral joint was 0.845. During the postural change from the resting position to the rear lower position, the β of the humerothoracic joint to the glenohumeral joint was 0.991.

CONCLUSION: The application of the image alignment technique enabled the direct and accurate measurement of the bony structures of the shoulder joint. The helical approach accurately described the scapulohumeral rhythm during 3D motion. There was a scapulohumeral rhythm of the shoulder complex during 3D composite sagittal movement, with different ratios for different joints and postures.

PMID:36278340 | DOI:10.3233/BMR-220132

J Back Musculoskelet Rehabil. 2022 Oct 12. doi: 10.3233/BMR-220005. Online ahead of print.

ABSTRACT

BACKGROUND: The unilateral biportal endoscopic (UBE) technique has been widely used in spine surgery. At present, a traditional rigid working channel is available for the UBE system. A metal semicircular canal is located in the working channel. However, due to the metal material of the working channel, arthroscopy and instruments are constrained from moving in UBE surgery. Additionally, an assistant is needed during the procedure to hold the traditional working channel.

OBJECTIVE: For simplicity of operation and convenient movement of the arthroscopy and instrument, we describe a new method for establishing operative channels in UBE surgery.

METHODS: We retrospectively reviewed 50 patients who underwent unilateral biportal endoscopic discectomy (UBED) from February 2020 to August 2020 via our new method. The Oswestry Disability Index (ODI) and visual analogue scale (VAS) score were measured preoperatively and 1 month, 3 months, 6 months and 12 months postoperatively. Statistical comparisons were made using analysis of covariance and paired t tests.

RESULTS: The VAS scores for back pain at the five time points were 5.20 ± 2.57, 1.96 ± 0.95, 1.50 ± 0.84, 1.64 ± 1.08 and 1.18 ± 0.39. The leg pain VAS scores were 7.02 ± 2.25, 2.02 ± 1.27, 1.48 ± 0.89, 1.32 ± 0.79 and 0.88 ± 0.52. The ODI values were 51.08 ± 19.97, 19.62 ± 15.51, 8.26 ± 7.40, and 7.54 ± 6.42 to 3.24 ± 1.10. The postoperative ODIs and VAS scores of low back pain and leg pain were significantly lower than those before surgery, and differences were statistically significant (all p< 0.05). The pressure of the closed outflow was significantly higher than that of the open outflow (37.35 ± 13.11 mm Hg vs. 24.55 ± 12.64 mm Hg p= 0.003). After we tightened the infusion strap to open the outflow, the pressure decreased significantly (26.4 ± 14.08 mm Hg vs. 37.35 ± 13.11 mm Hg p= 0.015). There were 2 cases of complications, including 1 case of postoperative recurrence and 1 case of dural tears.

CONCLUSION: This study demonstrates the technical feasibility, safety, and efficacy of modified channel establishment in UBE surgery.

PMID:36278335 | DOI:10.3233/BMR-220005

Thorac Cancer. 2022 Oct 24. doi: 10.1111/1759-7714.14694. Online ahead of print.

ABSTRACT

BACKGROUND: The present study aimed to evaluate the performance of several machine learning (ML) algorithms in predicting 1-year afatinib continuation and 2-year survival after afatinib initiation and to identify the differences in survival outcomes between ML-classified strata.

METHODS: Data that were also used in the RESET study were retrospectively collected from 16 hospitals in South Korea. A stratified random sampling method was applied to split the data into training and test sets (70:30 split ratio). Clinical information, such as age, sex, tumor stage, smoking, performance status, metastasis, type of metastasis, dose adjustment, and pathologic information on EGFR mutations were inputted. Training was performed using eight ML algorithms: logistic regression, decision tree, deep neural network, random forest, support vector machine, boosting, bagging, and the naïve Bayes classifier. The model performance was assessed based on sensitivity, specificity, and accuracy. Area under the receiver operator characteristic curve (AUC) was calculated and compared between the ML models using DeLong’s test. A Kaplan-Meier (KM) curve was used to visualize the identified strata obtained from the ML models.

RESULTS: No significant differences in the input variables were observed between the training and test datasets. The best-performing models were support vector machine in predicting 1-year afatinib continuation (AUC 0.626) and decision tree in 2-year survival after afatinib start (AUC 0.644), although the performances of the ML models were comparable and did not display any predictive roles. KM analysis and log-rank test revealed significant differences between the strata identified from the ML model (p < 0.001) in terms of both time-on-treatment (TOT) and overall survival (OS).

CONCLUSION: The performances of ML models in our study found no discernible roles in predicting afatinib-related outcomes, although the identified strata revealed different TOT and OS in the KM analysis. This implies the strength of ML in predicting the survival outcome, as well as the limitation of electronic medical record-based variables in ML algorithms. Careful consideration of variable inclusion is likely to improve the general model performance.

PMID:36278315 | DOI:10.1111/1759-7714.14694

Int J Clin Pharmacol Ther. 2022 Oct 24. doi: 10.5414/CP204257. Online ahead of print.

ABSTRACT

OBJECTIVE: Theracurmin, which contains the curcumin composition, CR-033P, has been demonstrated to be highly bioavailable. To compare the pharmacokinetics of the three compositions, CR-033P, CR-043P using modified starch as an alternative to the dispersant gum ghatti used in the CR-033P, and TS-P1 containing the newly developed amorphous curcumin, a randomized double-blind crossover study (3-way, 3-period) was conducted.

MATERIALS AND METHODS: A single dose of the curcumin capsules (TS-P1 45 mg, CR-033P 90 mg, and CR-043P 90 mg) was administered to healthy adult participants. Blood sampling was performed 24 hours after capsule administration, and the plasma concentration of total curcumin was determined using high-performance liquid chromatography coupled with tandem mass spectrometry.

RESULTS: TS-P1 and CR-043P tended to have a slightly lower area under the concentration time curve (AUC) _0-24h than CR-033P, while TS-P1 displayed bioequivalence to CR-043P. Further, TS-P1 displayed bioequivalence to CR-033P in terms of AUC_0-12h, while that of CR-043P tended to be lower than that of CR-033P. TS-P1 had a higher AUC_0-12h than CR-043P. A statistically significant difference (p < 0.001) was found between the preparations in terms of C_max. TS-P1 tended to have a higher C_max than CR-033P, CR-043P tended to have a slightly lower C_max than CR-033P, and TS-P1 tended to have a higher C_max than CR-043P.

CONCLUSION: The newly developed TS-P1 composition seemed to display similar curcumin systemic exposure except for a higher plasma concentration than the CR-033P composition. Further, only a few significant differences were found between CR-043P and CR-033P.

PMID:36278294 | DOI:10.5414/CP204257

Int J Health Serv. 2022 Oct 22:207314221134038. doi: 10.1177/00207314221134038. Online ahead of print.

ABSTRACT

Many of the simple and low-cost child diarrhea morbidities interventions, such as adequate home care, access to health care services, and improved sanitation and hygiene practices, are far beyond the reach of many households in developing countries, and Namibia is not an exception to this. In this study, a quantitative cross-sectional study design using a multivariable log-binomial model was used to examine the effect of household demographic characteristics on diarrhea morbidity in children aged zero to 48 months using data collected from the 2013 Namibia Demographic and Health Survey. Household demographic characteristics such as household’s wealth index and main language spoken at home had lower risks on child diarrhea morbidity, while characteristics such as age of household head, toilet facilities shared with other households, current age of child, residency of the child, and child vaccination status had higher risks. The Namibian government, together with nongovernmental organizations, should make necessary vaccines interventions compulsory to prevent diarrheal diseases during the first few years of the child’s life and continuously enhance initiatives that invest in good sanitation and hygiene infrastructure within Rukwangali- and Lozi-speaking communities in the country.

PMID:36278288 | DOI:10.1177/00207314221134038

Korean J Intern Med. 2022 Oct 25. doi: 10.3904/kjim.2022.007. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: The concentration of serum ferritin, a storage form of iron, may be associated with carcinogenesis in various cancers. There are only limited studies on the relationship between serum ferritin levels and colorectal cancer (CRC) risk, especially in the Asian population. This study aimed to analyze the association between CRC incidence and serum ferritin levels.

METHODS: This was a national cohort study that used health checkup and insurance claims data of the Korean population. CRC incidence according to the serum ferritin level was analyzed during 2008-2018 in 17,116 participants.

RESULTS: The hazard ratio (HR) of CRC incidence decreased as serum ferritin levels increased (Q1: HR, 1.000 [95% confidence interval [CI], reference]; Q2: HR, 0.811 [95% CI, 0.558 to 1.178]; Q3: HR, 0.654 [95% CI, 0.442 to 0.968]; Q4: HR, 0.443 [95% CI, 0.285 to 0.687]; p = 0.0026). In subgroup analysis, 40 to 64 years of age, sex, body mass index of < 25 kg/ m2, presence of metabolic syndrome, absence of diabetes mellitus, and absence of anemia had HRs of < 0.5 (95% CI) in the highest quartiles compared with that in the lowest quartiles.

CONCLUSIONS: This study shows an inverse association between serum ferritin and CRC risk. Serum ferritin measurement can aid in identifying young adults requiring active CRC screening.

PMID:36278251 | DOI:10.3904/kjim.2022.007

J Agrar Chang. 2022 Oct;22(4):831-854. doi: 10.1111/joac.12497. Epub 2022 May 31.

ABSTRACT

Agricultural extensification refers to an expansive, low-input production strategy that is land rather than labour limited. Here, we present a robust method, using the archaeological proxies of cereal grain nitrogen isotope values and settlement size, to investigate the relationship between agricultural intensity and population size at Neolithic to Bronze/Iron Age settlement sites in northern Mesopotamia, the Aegean and south-west Germany. We conclude that urban form-in particular, density of occupation-as well as scale shaped the agroecological trajectories of early cities. Whereas high-density urbanism in northern Mesopotamia and the Aegean entailed radical agricultural extensification, lower density urbanism in south-west Germany afforded more intensive management of arable land. We relate these differing agricultural trajectories to long-term urban growth/collapse cycles in northern Mesopotamia and the Aegean, on the one hand, and to the volatility of early Iron Age elite power structures and urban centralization in south-west Germany, on the other.

PMID:36278250 | PMC:PMC9580239 | DOI:10.1111/joac.12497

Front Pharmacol. 2022 Oct 6;13:933519. doi: 10.3389/fphar.2022.933519. eCollection 2022.

ABSTRACT

Objective: To investigate the efficacy of Integrative medicine (IM), compare with Western medicine (WM), in the treatment of rheumatoid arthritis (RA) in a cohort study. Methods: This is a cohort study with recruitment of RA patients from 10 hospitals in China. The primary outcome was change in disease activity score 28 (DAS28) during 4 follow-up visits. Generalized estimating equation (GEE) models that controlled for variables were used to investigate a time trend and assess group differences in the primary outcome and secondary outcomes after propensity score matching (PSM). Results: A total of 3195 patients with RA received IM (n = 1379, 43.2%) or WM (n = 1816, 56.8%). Following 1:1 propensity score matching, 1,331 eligible patients prescribed IM were compared to 1,331 matched patients prescribed WM. The GEE analysis with PSM showed that the IM was more beneficial to significantly decrease the levels of VAS, PGA and PhGA (VAS: odds ratio (OR), 0.76; 95% CI, 0.63-0.92; p = 0.004; PGA: OR, 0.76; 95% CI, 0.64-0.92; p = 0.007; and PhGA: OR, 0.77; 95% CI, 0.64, 0.93; p = 0.004), and reduce DAS28 (OR, 0.84; 95% CI, 0.73-0.98; p = 0.030) in the per-protocol population. Conclusion: This study suggests that compare to WM, IM has advantages in improving RA-related outcomes. However, the statistical significance might not reveal significant clinical difference. Further studies should be focused on specific treatment strategies and/or disease stages.

PMID:36278204 | PMC:PMC9582451 | DOI:10.3389/fphar.2022.933519

Nat Commun. 2022 Oct 23;13(1):6311. doi: 10.1038/s41467-022-34024-y.

ABSTRACT

Bromodomain and extraterminal (BET) proteins including BRD4 play important roles in oncogenesis and immune inflammation. Here we demonstrate that cancer cells with loss of the retinoblastoma (RB) tumor suppressor became resistant to small molecule bromodomain inhibitors of BET proteins. We find that RB binds to bromodomain-1 (BD1) of BRD4, but binding is impeded by CDK4/6-mediated RB phosphorylation at serine-249/threonine-252 (S249/T252). ChIP-seq analysis shows RB knockdown increases BRD4 occupancy at genomic loci of genes enriched in cancer-related pathways including the GPCR-GNBIL-CREB axis. S249/T252-phosphorylated RB positively correlates with GNBIL protein level in prostate cancer patient samples. BET inhibitor resistance in RB-deficient cells is abolished by co-administration of CREB inhibitor. Our study identifies RB protein as a bona fide intrinsic inhibitor of BRD4 and demonstrates that RB inactivation confers resistance to small molecule BET inhibitors, thereby revealing a regulatory hub that converges RB upstream signaling onto BRD4 functions in diseases such as cancer.

PMID:36274096 | DOI:10.1038/s41467-022-34024-y