Tag: statistics

Psychol Med. 2022 Jul 14:1-10. doi: 10.1017/S0033291722002069. Online ahead of print.

ABSTRACT

BACKGROUND: This confirmatory study aimed to examine whether we can foresee recurrence of depressive symptoms using personalized modeling of rises in restlessness.

METHODS: Participants were formerly depressed patients (N = 41) in remission who (gradually) discontinued antidepressants. Participants completed five smartphone-based Ecological Momentary Assessments (EMA) a day, for a period of 4 months, yielding a total of 21 180 observations. Statistical Process Control by means of Exponentially Weighted Moving Average (EWMA) control charts was used to detect rises in the EMA item ‘I feel restless’, for each individual separately.

RESULTS: An increase in restlessness was detected in 68.3% of the participants with recurring depressive symptoms, and in 26.3% of those who stayed in remission (Fisher’s exact test p = 0.01, sensitivity was 68.3%, specificity was 73.7%). In the participants with a recurrence and an increase in restlessness, this increase could be detected in the prodromal phase of depression in 93.3% of the cases and at least a month before the onset of the core symptoms of depression in 66.7% of the cases.

CONCLUSIONS: Restlessness is a common prodromal symptom of depression. The sensitivity and specificity of the EWMA charts was at least as good as prognostic models based on cross-sectional patient characteristics. An advantage of the current idiographic method is that the EWMA charts provide real-time personalized insight in a within-person increase in early signs of depression, which is key to alert the right patient at the right time.

PMID:35833374 | DOI:10.1017/S0033291722002069

Foot Ankle Spec. 2022 Jul 14:19386400221107004. doi: 10.1177/19386400221107004. Online ahead of print.

ABSTRACT

Background: In orthopaedic surgery departments, foot and ankle fellowship directors are tasked to create a robust clinical curriculum for trainees, while division chiefs manage the division’s delivery of patient care. The primary aim of this study was to describe characteristics of foot and ankle surgery fellowship directors and division chiefs in an effort to recognize trends or disparities in leadership traits. Methods: The American Orthopaedic Foot and Ankle Society (AOFAS) fellowship directory for 2021 to 2022 was reviewed for AOFAS-recognized fellowship programs in the United States. Between March 2021 and June 2021, 48 fellowship directors and 23 publicly recognized division chiefs were administered an electronic survey to collect demographic, educational, and professional data. Univariate and bivariate statistical analyses were performed. Results: A total of 42 of the 48 (87.5%) fellowship directors and 18 of the 23 (78.3%) division chiefs responded to the questionnaire. Of the 48 fellowship directors, 45 (93.8%) were male, 43 (89.6%) identified as Caucasian, their average age at leadership appointment was 42.6 ± 7.5 (range, 32-70) years, and the average time between fellowship graduation and leadership appointment was 9.9 ± 7.8 (range, 0-36) years. Of the 23 chiefs, 22 (95.7%) were male, 20 (87.0%) identified as Caucasians, their average age at leadership appointment was 41.7 ± 7.8 (range, 32-53) years, and the average time between fellowship graduation and leadership appointment was 9.8 ± 6.8 (range, 2-21) years. The average H-index for the chiefs was greater than that of the fellowship directors (18.4 vs 13.4, P = .0373) when controlling for years of training>. Conclusion: The majority of current leaders identify as middle-age Caucasian males, demonstrate high research productivity, and have attended a select number of the same residency and fellowship training programs. By demonstrating the lack of diversity within foot and ankle surgery leadership, this study serves as a call to action for making inclusivity a priority.Levels of Evidence: Level IV: Cross-sectional study.

PMID:35833388 | DOI:10.1177/19386400221107004

Cancer Med. 2022 Jul 14. doi: 10.1002/cam4.5023. Online ahead of print.

ABSTRACT

PURPOSE: Infertility is a critical late toxicity that impacts adolescent and young adult (AYA, ages 15-39 years) cancer survivors. International oncology societies recommend discussing fertility preservation (FP) for all AYA patients, regardless of stage or prognosis. We aim to understand Canadian medical oncologists’ perceptions, attitudes, and knowledge toward FP and pregnancy in patients with cancer, including advanced stages and high risk for recurrence.

METHODS: An anonymous electronic survey utilizing hypothetical scenarios was sent to medical oncologists in the province of Ontario, Canada. Descriptive statistics were used to summarize all data. Logistic regression models were constructed to identify factors that predicted FP discussions and referrals.

RESULTS: The survey was received by 91 medical oncologists, and the response rate was 44%. Fifty-eight percent of respondents offer FP for all patients. Physicians are more likely to refer patients for FP before curative intent therapy than before palliative chemotherapy (95% vs. 39.5%, p < 0.001). Most respondents (86%) are comfortable discussing FP; however, only 31% self-reported feeling up-to-date on knowledge of current FP methods. Female physicians were more likely to report up-to-date knowledge and confidence discussing FP with patients. Forty percent of respondents identified that concerns about the welfare of the resulting offspring should not be a cause for denying patients assistance in reproduction.

CONCLUSION: There is a significant difference in physician attitude toward offering FP based on the cancer stage. Increased awareness of standard of care guidelines and resources for difficult situations may improve the frequency of discussions about FP in motivated cancer patients.

PMID:35833372 | DOI:10.1002/cam4.5023

Psychol Med. 2022 Jul 14:1-11. doi: 10.1017/S0033291722001490. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with bipolar disorder (BD) show reduced fractional anisotropy (FA) compared to patients with major depressive disorder (MDD). Little is known about whether these differences are mood state-independent or influenced by acute symptom severity. Therefore, the aim of this study was (1) to replicate abnormalities in white matter microstructure in BD v. MDD and (2) to investigate whether these vary across depressed, euthymic, and manic mood.

METHODS: In this cross-sectional diffusion tensor imaging study, n = 136 patients with BD were compared to age- and sex-matched MDD patients and healthy controls (HC) (n = 136 each). Differences in FA were investigated using tract-based spatial statistics. Using interaction models, the influence of acute symptom severity and mood state on the differences between patient groups were tested.

RESULTS: Analyses revealed a main effect of diagnosis on FA across all three groups (p_tfce-FWE = 0.003). BD patients showed reduced FA compared to both MDD (p_tfce-FWE = 0.005) and HC (p_tfce-FWE < 0.001) in large bilateral clusters. These consisted of several white matter tracts previously described in the literature, including commissural, association, and projection tracts. There were no significant interaction effects between diagnosis and symptom severity or mood state (all p_tfce-FWE > 0.704).

CONCLUSIONS: Results indicated that the difference between BD and MDD was independent of depressive and manic symptom severity and mood state. Disruptions in white matter microstructure in BD might be a trait effect of the disorder. The potential of FA values to be used as a biomarker to differentiate BD from MDD should be further addressed in future studies using longitudinal designs.

PMID:35833369 | DOI:10.1017/S0033291722001490

J Cosmet Dermatol. 2022 Jul 14. doi: 10.1111/jocd.15241. Online ahead of print.

ABSTRACT

BACKGROUND: A new Hyaluronic acid (HA) formulation was developed based on high molecular weight (MW) compounds used on the surface of the skin while using peptides to stimulate the high MW HA production by fibroblasts and keratinocytes from within the skin layers. Detailed science has been submitted to this journal in a previous publication. This multicenter study aims to validate the science by demonstrating the safety and efficacy of the product in the clinical realm.

OBJECTIVES: This study evaluated the efficacy and safety of a topical HA serum in facial skin.

METHODS: An open label clinical study was undertaken over 4 months from November 2021 – March 2022. Participants applied the topical serum twice daily and were provided a gentle cleanser and an SPF 30+ to use in the morning. Follow-up visits were conducted at weeks 2, 4, and 8. At every visit, participants were measured for hydration post 15 minutes of cleansing the skin and post 15 minutes of product application for cumulative skin hydration sensor measurements. Additional procedures included; participant assessments and satisfaction, investigator assessments, biopsies and photography.

RESULTS: At each follow-up visit there was an increase in the hydration measurements compared to baseline, both in immediate scores and cumulative long-term scores. At weeks 4 and 8 there was a statistically significant increase in hydration compared to baseline and the prior visit. Participants assessments progressively increased over 2, 4- and 8-week intervals with significantly favorable ratings in all measured parameters. Similarly, investigator assessment grades were statistically significant (p<.0001) for decreased fine lines/wrinkling, crepiness, texture, erythema, and dryness, and increased (p<.0001) for moisture/hydration. Histology revealed increased CD44 staining in 6 of the 7 participants biopsied, denoting increased HA stimulation. In all of the participant biopsies, H&E staining demonstrated improvement in solar elastosis. Photography revealed remarkable improvement in erythema, tone and texture.

CONCLUSIONS: Study results demonstrated that the formulation produced significant improvements in immediate and long-term hydration effects on the skin as measured by the skin hydration sensor, ‘wearifi’ technology, comparison of pre and post biopsies, and participant and investigator assessments. This high MW HA formulation produced excellent clinical improvement in skin health and hydration.

PMID:35833366 | DOI:10.1111/jocd.15241

J Sci Food Agric. 2022 Jul 14. doi: 10.1002/jsfa.12121. Online ahead of print.

ABSTRACT

Response surface methodology (RSM) is a widely used mathematical and statistical technique for modelling and optimizing the process for the extraction of bioactive compounds. In this review, the optimization approach through the use of experimental designs and empirical models for response prediction and the utilization of desirability function for multiple response optimization are explained. Furthermore, this paper reviews recent studies on the application of RSM to optimize bioactive compounds extraction processes such as conventional solvent extraction (CSE), microwave assisted extraction (MAE), supercritical fluid extraction (SFE), and ultrasound assisted extraction (UAE). Finally, the challenges associated with the use of RSM and efforts made to improve RSM in the extraction process are also highlighted. Overall, this review informs many aspects of RSM that are occasionally ignored or sparsely discussed in optimization of bioactive compound extraction processes and summarizes significant applications where it proved suitable. This article is protected by copyright. All rights reserved.

PMID:35833361 | DOI:10.1002/jsfa.12121

J Telemed Telecare. 2022 Jul 14:1357633X221113711. doi: 10.1177/1357633X221113711. Online ahead of print.

ABSTRACT

The COVID 19 pandemic resulted in widespread telehealth implementation. Existent health disparities were widened, with under-represented minorities (URM) disproportionately affected by COVID. In this study, we assess the role of telehealth in improving access to care in the URMs and vulnerable populations. We noted a statistically significant increase in the number of visits in Hispanic or Latino patients (15.2% increase, p < 0.01) and Black patients (19% increase, p < 0.01). Based on payer type, there was a statistically significant increase in the number of visits in the Medicare (10.2%, p = 0.0001) and Medicaid (16.2%, p < 0.01) groups. We also noted increased access to care with telehealth in patients who were 65 and older (10.6%, p = 0.004). This highlights the importance of telehealth in increasing access to care and promoting health equity in the URM and vulnerable patient populations.

PMID:35833345 | DOI:10.1177/1357633X221113711

Hepatology. 2022 Jul 14. doi: 10.1002/hep.32669. Online ahead of print.

NO ABSTRACT

PMID:35833336 | DOI:10.1002/hep.32669

Scand J Rheumatol. 2022 Jul 14:1-4. doi: 10.1080/03009742.2022.2092269. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the relationship between reported coronavirus disease 2019 (COVID-19)-like symptoms and the presence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies in patients with an immune-mediated inflammatory disorder or post-solid organ transplantation (IMIDT) with and without immunosuppressive medication (imed) and controls.

METHOD: The IENIMINI cohort was a prospective cohort study set up in the Netherlands in March 2020, with 2 monthly (paper) or weekly (online) questionnaires about COVID-19-like symptoms. Participants from this cohort who reported these symptoms between March 2020 and November 2020 were approached for this substudy. SARS-CoV-2 antibodies were tested using a total antibody assay.

RESULTS: Of the 1203 participants approached, 629 agreed to participate and were sent a fingerprick test; 565 participants collected a capillary blood sample, of which 562 were usable. Analysis showed that 57/202 (28.2%) of the tested IMIDT group with imed, 48/16 3(29.4%) of the IMIDT group without imed, and 69/197 (35.0%) of the control group tested positive for SARS-CoV-2 antibodies. Seroprevalences of SARS-CoV-2 antibodies between males and females, biological disease-modifying anti-rheumatic drug users and non-users, and those who had had a serious disease period (defined as an episode with dyspnoea and fever) and those who had not, were not statistically different between the three groups.

CONCLUSIONS: Approximately 30% of patients who had reported COVID-19-like symptoms had SARS-CoV-2 antibodies. The seroprevalence of SARS-CoV-2 antibodies after reported COVID-19-like symptoms was similar in IMIDT patients with and without imed compared to controls.

PMID:35833317 | DOI:10.1080/03009742.2022.2092269

Epilepsia Open. 2022 Jul 14. doi: 10.1002/epi4.12627. Online ahead of print.

ABSTRACT

OBJECTIVE: To discuss the results of the KETASER01 trial and the reasons for its failure, particularly in view of future studies.

METHODS: KETASER01 is a multicenter, randomized, controlled, open-label, sequentially designed, non-profit Italian study that aimed to assess the efficacy of ketamine compared with conventional anesthetics in the treatment of refractory convulsive status epilepticus (RCSE) in children.

RESULTS: During the five-year recruitment phase, a total of 76 RCSEs treated with third-line therapy were observed in five of the ten participating Centers; only ten individuals (five for each study arm; five females, mean age 6.5 ± 6.3 years) were enrolled in the KETASER01 study. Two of the five patients (40%) in the experimental arm were successfully treated with ketamine and two of the five (40%) children in the control arm, where successfully treated with thiopental. In the remaining six (60%) enrolled patients, RCSE was not controlled by the randomized anesthetic(s).

SIGNIFICANCE: The KETASER01 study was prematurely halted due to low eligibility of patients and no successful recruitment. No conclusions can be drawn regarding the objectives of the study. Here we discuss the KETASER01 results and critically analyze the reasons for its failure in view of future trials.

PMID:35833327 | DOI:10.1002/epi4.12627