Tag: statistics

J Clin Sleep Med. 2022 Aug 15. doi: 10.5664/jcsm.10228. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: To describe the outcomes of central sleep apnea (CSA) requiring home supplemental oxygen therapy in otherwise healthy term infants.

METHODS: All children <1 year of age undergoing polysomnography (PSG) between 2015-2020 at the Queensland Children’s Hospital were retrospectively studied. Children with gestational age <37 weeks, underlying syndrome, cleft palate, those with obstructive apnea-hypopnea index (OAHI) >50% of total apnea-hypopnea index (AHI) or with underlying cardiac or pulmonary parenchymal pathology were excluded. PSG parameters were extracted for periods both on and off supplemental oxygenation.

RESULTS: Fifty-two [mean (SD) age at PSG 32.6 (34.7) days; 21F] term infants were included. There was a statistically significant improvement in AHI on supplemental oxygen [Mean (SD) in room air 50.2 (36.3) vs 11.6 (9), p< 0.001 on supplemental oxygen], in both rapid eye movement (REM) and non-rapid eye movement (NREM) sleep, as well as in mean oxygen saturations (96.6% in room air to 98.9% on oxygen; p<0.001). There was no statistically significant change in transcutaneous carbon dioxide levels or sleep duration. Oxygenation was prescribed for a median (interquartile range=IQR) age of 197 (127) days.

CONCLUSIONS: CSA in term infants who are otherwise healthy generally has a good prognosis, with oxygen therapy prescribed for around six months. Oxygen therapy was associated with improved saturations and decrease in AHI when assessed with PSG.

PMID:35962944 | DOI:10.5664/jcsm.10228

J Clin Sleep Med. 2022 Aug 15. doi: 10.5664/jcsm.10232. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: To evaluate (determinants of) treatment success of mandibular advancement device (MAD) application in a selected phenotype of patients with obstructive sleep apnea (OSA).

METHODS: 90 non-obese patients with moderate OSA (obstructive apnea-hypopnea index (OAHI) ≥ 15 and < 30/h) without comorbidities were prospectively included. Polysomnography (PSG) was performed at baseline and with MAD. A drug-induced sleep endoscopy (DISE) with jaw thrust was performed in 83%.

RESULTS: OAHI reduction ≥ 50% was observed in 73%, OAHI reduction ≥ 50% with OAHI < 10/h in 70%, complete OSA resolution (OAHI < 5/h) in 40%. Patients with non-positional OSA showed a significantly higher rate of complete OSA resolution: post-test probability increased to 67%. In patients with total disappearance of collapse at velum level and at all levels during DISE with jaw thrust, the drop in OAHI was impressive with an infinitively high positive likelihood ratio. However, the proportion of patients having non-positional OSA or the DISE-characteristics as described above was < 20%. The change in snoring disturbance based on a Visual Analogue Scale was 76% (IQR 40-89%, p<0.001) and a statistically significant amelioration in Epworth Sleepiness Scale (especially in somnolent subjects) was observed. High adherence was reported.

CONCLUSIONS: In this pre-defined OSA phenotype, MAD was effective in reduction of OAHI and in amelioration of symptoms. Stratification by non-positional OSA and findings on DISE with jaw thrust increased treatment success defined as reduction in OAHI. However, the clinical relevance can be questioned because only a small number of patients demonstrated these characteristics.

PMID:35962942 | DOI:10.5664/jcsm.10232

Pain Ther. 2022 Aug 13. doi: 10.1007/s40122-022-00424-7. Online ahead of print.

ABSTRACT

INTRODUCTION: A recent phase 3, randomized, placebo- and tramadol-controlled trial (56-week treatment/24-week safety follow-up) demonstrated efficacy of tanezumab 10 mg in patients with chronic low back pain (CLBP) and a history of inadequate response to standard-of-care analgesics. Here, we report on the clinical meaningfulness of treatment response in this study, focused on secondary measures of pain, interference with daily functions, overall disease status, and satisfaction with treatment.

METHODS: Patients received placebo (up to week 16; n = 406), subcutaneously administered (SC) tanezumab 5 mg (every 8 weeks; n = 407), SC tanezumab 10 mg (every 8 weeks; n = 407), or orally administered tramadol prolonged-release (100-300 mg/day; n = 605) for 56 weeks. Patient’s global assessment of low back pain (PGA-LBP), Brief Pain Inventory-short form (BPI-sf), Treatment Satisfaction Questionnaire for Medication (TSQM), and modified Patient-Reported Treatment Impact (mPRTI) were assessed at weeks 16 and 56.

RESULTS: At week 16, significant (p < 0.05) improvements over placebo were evident with tanezumab for the PGA-LBP (10 mg) and most BPI-sf (both doses), TSQM (both doses), and mPRTI (both doses) items assessed. Improvements over baseline persisted for the PGA-LBP and BPI-sf at week 56. However, the magnitude of improvements was modestly lower at week 56 relative to week 16. Tramadol did not improve PGA-LBP or BPI-sf scores versus placebo at week 16. Most differences between tanezumab and tramadol at week 56 did not reach the level of statistical significance for all endpoints.

CONCLUSIONS: The totality of the evidence as captured by measures of pain, interference with daily function, patient overall assessment of disease status, and satisfaction with treatment demonstrates the clinically meaningful benefit of tanezumab for some patients with CLBP compared with placebo.

CLINICALTRIALS: gov: NCT02528253.

PMID:35962939 | DOI:10.1007/s40122-022-00424-7

Med Biol Eng Comput. 2022 Aug 13. doi: 10.1007/s11517-022-02631-y. Online ahead of print.

ABSTRACT

High-quality computed tomography (CT) images are key to clinical diagnosis. However, the current quality of an image is limited by reconstruction algorithms and other factors and still needs to be improved. When using CT, a large quantity of imaging data, including intermediate data and final images, that can reflect important physical processes in a statistical sense are accumulated. However, traditional imaging techniques cannot make full use of them. Recently, deep learning, in which the large quantity of imaging data can be utilized and patterns can be learned by a hierarchical structure, has provided new ideas for CT image quality improvement. Many researchers have proposed a large number of deep learning algorithms to improve CT image quality, especially in the field of image postprocessing. This survey reviews these algorithms and identifies future directions.

PMID:35962932 | DOI:10.1007/s11517-022-02631-y

Environ Sci Pollut Res Int. 2022 Aug 13. doi: 10.1007/s11356-022-22524-9. Online ahead of print.

ABSTRACT

Herein, an iron-doped ZIF-8-loaded multi-walled carbon nanotube (FZM) was synthesized and its adsorption performance on tetracycline (TC) was investigated. The experimental conditions (solution pH, temperature, adsorbent dose) were optimized by Box-Behnken design (BBD) in response surface methodology (RSM). The results show that the adsorption effect of TC by FZM is optimal under the conditions of temperature = 298 K, pH = 6, and contact time = 360 min. The adsorption processes of TC by FZM follow the pseudo-second-order (PSO) kinetic and Freundlich isotherm models, indicating that chemisorption is the dominant factor and the adsorption reaction is multi-layer, with a theoretical maximum saturation capacity of 1111.11 mg/g at 298 K. The adsorption thermodynamic results indicate that the adsorption of TC by FZM is a spontaneous and endothermic process. The mechanism of TC adsorption by FZM possibly occurs through hydrogen bonding, surface complexation, π-π interaction, and electrostatic interaction. From the statistical results, the optimal adsorption capacity of TC by FZM is 599.78 mg/g at a pH of 7.1, a temperature of 312.5 K, and an adsorbent dose of 64.43 mg/L, with a deviation of 1.73% from the actual value. Furthermore, regeneration experiments demonstrate that FZM has excellent reusability with a 15% loss of adsorption capacity after four cycles. This study provides some insights to study the adsorption behavior of TC by MOFs and the optimization of the adsorption experimental conditions, and also shows the potential of FZM for TC removal.

PMID:35962890 | DOI:10.1007/s11356-022-22524-9

Lifetime Data Anal. 2022 Aug 13. doi: 10.1007/s10985-022-09571-7. Online ahead of print.

ABSTRACT

Dynamic (or varying) covariate effects often manifest meaningful physiological mechanisms underlying chronic diseases. However, a static view of covariate effects is typically adopted by standard approaches to evaluating disease prognostic factors, which can result in depreciation of some important disease markers. To address this issue, in this work, we take the perspective of globally concerned quantile regression, and propose a flexible testing framework suited to assess either constant or dynamic covariate effects. We study the powerful Kolmogorov-Smirnov (K-S) and Cramér-Von Mises (C-V) type test statistics and develop a simple resampling procedure to tackle their complicated limit distributions. We provide rigorous theoretical results, including the limit null distributions and consistency under a general class of alternative hypotheses of the proposed tests, as well as the justifications for the presented resampling procedure. Extensive simulation studies and a real data example demonstrate the utility of the new testing procedures and their advantages over existing approaches in assessing dynamic covariate effects.

PMID:35962886 | DOI:10.1007/s10985-022-09571-7

Matern Child Health J. 2022 Aug 13. doi: 10.1007/s10995-022-03486-3. Online ahead of print.

ABSTRACT

OBJECTIVES: Worry and loneliness looms large in American schools, especially in the social years of early adolescence where friendships are in flux and children strive to fit in and do well academically. We examine a nationally-representative sample of American 5th graders to document the extent of academic worry and loneliness, its costs for academic performance, and how social class can disrupt or exacerbate its associations.

METHODS: Based on a nationally representative longitudinal survey (ECLS-K 2010-2011) of childhood (N = 5750), we examine if a child’s self-reported worry and loneliness are associated with standardized math and reading scores using OLS regression. We explore whether these associations vary by socioeconomic status.

RESULTS: We find that academic worry is a strong predictor of math and reading skill. The association is amplified for disadvantaged students. Patterns hold when accounting for a host of other factors and are replicated in the ECLS-K 1998-1999. Loneliness and its association with math and reading performance was not statistically significant.

CONCLUSIONS FOR PRACTICE: As academic worry is negatively associated with standardized math and reading skills, practitioners can be especially attuned to how these patterns are amplified for children in low socioeconomic households. Utilizing a nationally representative survey of early adolescence, we show that worry (and less so loneliness) is associated with math and reading skills and that these associations are moderated by socioeconomic status-disadvantaged students have a higher negative association with math and reading performance when they worry about their academic performance compared to advantaged students.

PMID:35962876 | DOI:10.1007/s10995-022-03486-3

Acta Biotheor. 2022 Aug 13;70(4):22. doi: 10.1007/s10441-022-09446-2.

ABSTRACT

Causal pluralism can be defended not only in respect to causal concepts and methodological guidelines, but also at the finer-grained level of causal inference from a particular source of evidence for causation. An argument for this last variety of pluralism is made based on an analysis of causal inference from randomized experiments (RCTs). Here, the causal interpretation of a statistically significant association can be established via multiple paths of reasoning, each relying on different assumptions and providing distinct elements of information in favour of a causal interpretation.

PMID:35962877 | DOI:10.1007/s10441-022-09446-2

J Nephrol. 2022 Aug 13. doi: 10.1007/s40620-022-01389-8. Online ahead of print.

ABSTRACT

BACKGROUND: Indications for kidney biopsy in adult IgA vasculitis (IgAV) remain debated and there are very few studies on this subject. The aim of this study was to establish a correlation between renal histological and clinical-laboratory data.

METHODS: A retrospective multicenter study was conducted using three databases from French hospitals, gathered between 1977 and 2020. The study included 294 adult patients with IgAV who had undergone kidney biopsy assessed according to the prognostic “Pillebout classification”. Different statistical models were used to test the correlations between histological and clinical-laboratory data: Cochran Armitage, ANOVA, Kruskal-Wallis and logistic regression.

RESULTS: The patients were primarily men (64%), with a mean age of 52 years. The main organs and tissues involved were: dermatological 100%, digestive 48% and rheumatological 61%. All had features of kidney involvement. The median serum creatinine was 96 µmol/L serum albumin 35 g/L, and C-reactive protein 28 mg/L. Of the patients, 86% (n = 254) had hematuria and median proteinuria was 1.8 g/day. The only statistically significant correlation between the pathological stages and the clinical-laboratory data was the presence of hematuria (p = 0.03, 66% class I to 92% class IV). In multivariate analysis, only albuminemia was associated with extracapillary proliferation (p = 0.02; OR 0.94) and only age was associated with stages 3-4 (p = 0.03; OR 1.02).

CONCLUSION: Our study suggests that there is no strict baseline correlation between renal pathology and clinical-laboratory data. Given the current knowledge, it seems relevant to recommend a kidney biopsy in the presence of significant and persistent proteinuria or unexplained kidney function decline.

PMID:35962864 | DOI:10.1007/s40620-022-01389-8

Eur Eat Disord Rev. 2022 Aug 13. doi: 10.1002/erv.2944. Online ahead of print.

ABSTRACT

OBJECTIVE: This systematic review aimed to highlight the usefulness of the clinical examination of the oral cavity for the diagnostic suspicion of anorexia (AN) and bulimia nervosa (BN), being of main interest to the paediatric dentist and paediatrician due to the early onset of symptoms in Eating Disorders (EDs).

METHOD: A systematic search, applying PICO question, was carried out in biomedical and other electronic databases from 2005 to 2020. Both case reports and case series of patients under 65 years of age with AN and BN were included. Data were extracted and statistically analysed.

RESULTS: A sample of 111 studies was obtained (n = 192; 92.78% female). The most prevalent diagnosis was restrictive type AN (n = 110; 57.29%). Only 16 (8.33%) patients had been clinically examined at the oral cavity, indicating the presence or absence of oral manifestations (OM) and showing dental erosion (n = 10) as the most frequent.

CONCLUSION: There is a lack of information about the oral examination of anorexic and bulimic patients. Dental erosion and other oral manifestations can help us to make an early ED diagnosis. Clinical observation and basic erosive wear examination (BEWE) Index are necessary steps to detect and record any anomaly in oral cavity during the evaluation of these patients.

PMID:35962774 | DOI:10.1002/erv.2944