Tag: statistics

Drugs Aging. 2022 Aug 17. doi: 10.1007/s40266-022-00972-9. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic non-cancer pain is common among older residents of long-term care (LTC) homes and often poorly recognized and treated. With heightened concerns regarding opioid prescribing in recent years, it is important to examine the current prevalence of opioid use and its association with resident characteristics to help identify those potentially at risk of medication harms as well as suboptimal pain management.

OBJECTIVES: The aims were to estimate the prevalence and correlates of opioid use among non-palliative LTC residents and explore variation in opioid prevalence and correlates across strata defined by pain frequency and intensity.

METHODS: We conducted a population-based cross-sectional study of all older (aged > 65 years) LTC residents (excluding those with cancer or receiving palliative care) in Ontario, Canada during 2018-2019. Health administrative databases were linked with standardized clinical assessment data to ascertain residents’ health and pain characteristics and their opioid and other medication use. Modified Poisson regression models estimated unadjusted and adjusted associations between residents’ characteristics and opioid use, overall and across strata capturing pain frequency and intensity.

RESULTS: Among 75,020 eligible residents (mean age 85.1 years; 70% female), the prevalence of opioid use was 18.5% and pain was 29.4%. Opioid use ranged from 12.2% for residents with no current pain to 55.7% for those with severe pain. In adjusted models, residents newly admitted to LTC (adjusted risk ratio [aRR] = 0.60, 95% confidence interval [CI] 0.57-0.62) and with moderate to severe cognitive impairment (aRR = 0.69, 95% CI 0.66-0.72) or dementia (aRR = 0.76, 95% CI 0.74-0.79) were significantly less likely to receive an opioid, whereas residents with select conditions (e.g., arthritis, aRR = 1.37, 95% CI 1.32-1.41) and concurrently using gabapentinoids (aRR = 1.80, 95% CI 1.74-1.86), benzodiazepines (aRR = 1.33, 95% CI 1.28-1.38), or antidepressants (aRR = 1.31, 95% CI 1.27-1.35) were significantly more likely to receive an opioid. The associations observed for residents newly admitted, with dementia, and concurrently using gabapentinoids, benzodiazepines, or antidepressants were largely consistent across all pain strata.

CONCLUSIONS: Our findings describe resident sub-groups at potentially higher risk of adverse health outcomes in relation to both opioid use and non-use. LTC clinical and policy changes informed by research are required to ensure the appropriate recognition and management of non-cancer pain in this setting.

PMID:35976489 | DOI:10.1007/s40266-022-00972-9

Sleep Breath. 2022 Aug 17. doi: 10.1007/s11325-022-02691-2. Online ahead of print.

ABSTRACT

PURPOSE: The airway complex is modified by palatine expansion. Computer tomography has been used in the past to determine the change in volume, but there was a lack of a specific, reproducible method for this purpose. The present study sought to determine the accuracy, reproducibility, and repeatability of an innovative digital measurement technique for analyzing the volume of maxillary and nasal sinus airways following suture palatine expansion performed with the Hyrax disyuntor appliance.

METHODS: Patients underwent preoperative and postoperative cone-beam computed tomography (CBCT) scans. The datasets were subsequently uploaded into a digital treatment planning software to record the volume of the right and left maxillary sinus, as well as the nasal and maxillary sinus airway complex. The Gage Repeatability & Reproducibility statistical analysis methodology was used to evaluate the repeatability and reproducibility of this measurement technique when measuring the volume of maxillary and nasal sinus airways following suture palatine expansion with the Hyrax disyuntor appliance. Additionally, comparative analysis between preoperative and postoperative measures was performed using Student’s t-test for statistical analysis.

RESULTS: In 5 patients, paired t-tests found statistically significant differences before and after treatment in the volumes of the left maxillary sinus (p = 0.002), right maxillary sinus (p = 0.001), and nasal and maxillary sinus airway complex (p = 0.005) after suture palatine expansion with the Hyrax disyuntor appliance.

CONCLUSION: The proposed digital technique is an accurate, repeatable, and reproducible measurement technique for analyzing the volume of maxillary and nasal sinus airways following suture palatine expansion using the Hyrax disyuntor.

PMID:35976481 | DOI:10.1007/s11325-022-02691-2

Environ Geochem Health. 2022 Aug 17. doi: 10.1007/s10653-022-01333-6. Online ahead of print.

ABSTRACT

The water contaminations with organophosphate triesters (tri-OPEs) and diesters (di-OPEs) have recently provoked concern. However, the distributions of these compounds in natural water sources and artificial water treatment facilities are poorly characterized. A comprehensive study was therefore performed to measure their concentrations in a water source, a long-distance water pipeline, and a drinking water treatment plant (DWTP). Eight tri-OPEs and 3 di-OPEs were found to be widely distributed, with total concentrations in source water and pipelines ranging from 290.6 to 843.9 ng/L. The most abundant pollutants were tris(1-chloro-2-propyl) phosphate (TCPP), triethyl phosphate, tri-n-butyl phosphate (TnBP), and diphenyl phosphate (DPhP). Di-OPEs appeared to be removed less efficiently in the DWTP than the parent tri-OPEs, and the elimination efficiencies of tri-OPEs were structure-dependent. Long-distance pipeline transportation had no significant effect on the distributions of tri- and di-OPEs. Statistical analysis suggested that the sources of di-OPEs and the corresponding tri-OPEs differed, as did those of DPhP and di-n-butyl phosphate. A risk analysis indicated that tri-OPEs present limited ecological risks that are mainly due to TnBP and TCPP, and that the human health risks of tri-OPEs are negligible. However, di-OPEs (especially DPhP) may increase these risks. Further studies on the risks posed by di-OPEs in aquatic environments are therefore needed.

PMID:35976479 | DOI:10.1007/s10653-022-01333-6

Electrophoresis. 2022 Aug 17. doi: 10.1002/elps.202100364. Online ahead of print.

ABSTRACT

Inorganic polyphosphates have been identified in eukaryotic and prokaryotic cells alike. Various extraction methods have been optimized as a necessary step before identification and measurement of these polymers. Three commercially available sodium polyphosphate glasses were either dissolved or dissolved and extracted by two commonly used polyphosphate extraction techniques – perchloric acid or buffered phenol-chloroform. The products were separated by PAGE, stained with toluidine blue O, and the migration results quantitatively compared. Both extraction processes reduced the relative migration distances of the peak and leading edges, and the stained band lengths, suggesting reduced polyphosphate migration and dispersion. ³¹ P DOSY NMR confirmed that polyphosphate extraction by perchloric acid or phenol-chloroform processes reduced polyphosphate diffusion coefficients and suggested hydrolytic degradation with stronger end-chain signals. Reduced polyphosphate diffusivity after extraction makes possible an overestimation of synthetic polyphosphate chain length assignment when compared to unextracted polyphosphate ladders with PAGE. The mechanism(s) for reduced synthetic polyphosphate diffusion after extraction, and intracellular chemical environment effects on migration are not known. This article is protected by copyright. All rights reserved.

PMID:35975714 | DOI:10.1002/elps.202100364

New Phytol. 2022 Aug 17. doi: 10.1111/nph.18432. Online ahead of print.

ABSTRACT

All organisms emit odour, providing “open-access” olfactory information for any receiver with the right sensory apparatus. Characterising open-access information emitted by groups of organisms, such as plant species, provides the means to answer significant questions about ecological interactions and their evolution. We present a new conceptual framework defining information reliability; and a practical method to characterise and recover information from amongst olfactory noise. We quantified odour emissions from two tree species, one focal group and one outgroup, to demonstrate our approach using two new R statistical functions. We explore the consequences of relaxing or tightening criteria defining information and, from thousands of odour combinations, we identify and quantify those few likely to be informative. Our method uses core general principles characterising information while incorporating knowledge of how receivers detect and discriminate odours. We can now map information in consistency-precision reliability space; explore the concept of information; and test information-noise boundaries, and between cues and signals.

PMID:35975694 | DOI:10.1111/nph.18432

Stroke. 2022 Aug 17:STROKEAHA122038838. doi: 10.1161/STROKEAHA.122.038838. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study is to examine the associations of Life’s Simple 7 (LS7) with risks of cerebral small vessel disease (CSVD) and its magnetic resonance imaging markers.

METHODS: Community-dwelling residents in Lishui city in China from the cross-sectional survey of the PRECISE study (Polyvascular Evaluation for Cognitive Impairment and Vascular Events) were included in this study from 2017 to 2019. LS7 was analyzed as the total score, medical score (derived from the 3 metrics based on medical history and testing), and behavioral score (based on 4 metrics based on behaviors), and categorized as poor, intermediate, or ideal. A CSVD score or a modified CSVD score was derived from 4 magnetic resonance imaging markers (lacunes, microbleeds, perivascular spaces, and white matter hyperintensity) at baseline. Binary logistic regression or ordinal logistic regression model was used to estimate the relationship of LS7 scores with CSVD and magnetic resonance imaging markers.

RESULTS: A total of 3061 participants were included in this study. Compared with poor total LS7 score, ideal LS7 total score was associated with reduced adjusted odds of higher CSVD score (common odds ratio [cOR], 0.73 [95% CI, 0.58-0.90]) and higher modified CSVD score (cOR, 0.78 [95% CI, 0.64-0.95]). Compared with poor LS7 medical score, ideal LS7 medical score was associated with reduced adjusted odds of higher CSVD score (cOR, 0.65 [95% CI, 0.53-0.80]) and higher modified CSVD score (cOR, 0.67 [95% CI, 0.56-0.81]). Higher total LS7 score and LS7 medical score were associated with a lower risk of white matter hyperintensities and lacunes. Higher LS7 behavioral score was associated with lower risk of lacunes.

CONCLUSIONS: Ideal LS7 score, indicating excellent cardiovascular health, was associated with lower total CSVD burden. Optimizing the risk factors captured by LS7 may reduce the progression of CSVD.

PMID:35975667 | DOI:10.1161/STROKEAHA.122.038838

Stroke. 2022 Aug 17:101161STROKEAHA121037744. doi: 10.1161/STROKEAHA.121.037744. Online ahead of print.

ABSTRACT

BACKGROUND: Many methods have been suggested for analyzing the modified Rankin Scale (mRS). However, there lacks a unified approach to analysis and sample size determination that properly uses the ordinal nature of the data. We propose a simple method for CI estimation and corresponding sample size determination.

METHODS: We quantify treatment effect by the win probability (WinP) that a randomly selected patient in the treatment group has an equal or a better mRS score than a patient in the control group. Thus, a win probability of 0.5 means no effect, likened to a draw in competitive sports. We estimate the win probability and its SE based on the ranks of mRS scores, where tied scores are handled by average ranks. Corresponding methods for hypothesis testing, CI estimation, and sample size determination are derived. The methods are evaluated with a simulation study based on real data from 10 randomized stroke trials that used mRS as the outcome measure.

RESULTS: Simulation results demonstrated that the methods performed very well in terms of CI coverage, tail errors, and assurance to achieving the prespecified precision. Because the methods are very simple, we implemented them in an Excel spreadsheet, requiring only user inputs on frequencies of mRS scores in 2 comparison groups.

CONCLUSIONS: Sound statistical methods are important for the success of randomized stroke trials. The proposed methods and associated spreadsheet should prove useful for stroke researchers in the planning and analysis of randomized trials. Meta-analysis has also been made easy for trials with ordinal scores.

PMID:35975666 | DOI:10.1161/STROKEAHA.121.037744

Gut Liver. 2022 Aug 17. doi: 10.5009/gnl220005. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: The clinical efficacy and safety of CT-P13 are comparable to originator infliximab for Crohn’s disease in CT-P13 3.4 study (NCT02096861). We performed a multivariate logistic analysis to demonstrate the association between early infliximab trough levels and treatment outcomes of CT-P13 and originator infliximab.

METHODS: Early serum infliximab trough levels and anti-drug antibody (ADA) levels were compared between CT-P13 (n=100) and originator infliximab (n=98) groups. Receiver operating characteristic (ROC) analysis and multivariate logistic analysis were conducted to identify optimal cutoffs of serum infliximab trough levels and predictive factors for clinical outcomes.

RESULTS: The median infliximab trough levels were not different between CT-P13 and originator infliximab groups at week 6, week 14, and in median ADA levels at week 14, respectively. ROC analysis found an infliximab concentration threshold of 4.5 μg/mL at week 6 and 4.0 μg/mL at week 14 as the cutoff value with the highest accuracy for the prediction of clinical outcomes. Serum infliximab trough levels at weeks 6 and 14 predicted clinical remission at weeks 30 and 54, and endoscopic remission at week 54. The combinations of clinical remission or C-reactive protein normalization with an early infliximab trough level improved the prediction of long-term clinical or endoscopic remission.

CONCLUSIONS: A threshold in serum infliximab trough level at week 6 and week 14 was highly predictive for long-term clinical outcomes. There were no statistical differences in serum infliximab trough levels and ADA levels between CT-P13 and originator infliximab.

PMID:35975641 | DOI:10.5009/gnl220005

J Int Assoc Provid AIDS Care. 2022 Jan-Dec;21:23259582221121096. doi: 10.1177/23259582221121096.

ABSTRACT

Background: Drug adherence is the most significant in the progression of diseases. Thus, this study aimed to assess adherence and associated factors among seropositive people received treatment. Methods: Facility-based cross-sectional study was conducted in Jimma town public health facility from March to April 2019 on 385 selected participants. Systematic sampling technique was used to select study participants. The data were entered using Epi-data version 4.1 and analyzed by SPSS version 20 software. Variables with p-value of less than 0.25 in binary logistic regression were entered into the multivariable logistic regression to control cofounding A significance level of less than 0.05 was used in the final model to judge statistical significance. Results: The magnitude of adherence to antiretroviral treatment was 69.4%. Food security (AOR = 1.75 (95% CI;(1.01-3.0), substance abuse (AOR = 0.55 (95% CI;(0.32-0.96), Didn’t take other medications (AOR = 2.11(95%CI;(1.15-3.87), Good relationship with providers (AOR = 3.35(95%CI;(1.55-7.2), and irregular appointment (AOR = 0.19(95%CI; (0.11-0.34) were significantly associated. Conclusion: The magnitude of adherence to Anti-retroviral therapy was low compare to WHO. Food security, substance abuse, use of other medication, relationship with the health care providers, and irregular appointment were the factors associated. Treatment. Therefore, it is recommended that patients and health care workers enhance Antiretroviral Treatment adherence.

PMID:35975573 | DOI:10.1177/23259582221121096

Plant Genome. 2022 Aug 17:e20253. doi: 10.1002/tpg2.20253. Online ahead of print.

ABSTRACT

The growing demand for food and feed crops in the world because of growing population and more extreme weather events requires high-yielding and resilient crops. Many agriculturally important traits are polygenic, controlled by multiple regulatory layers, and with a strong interaction with the environment. In this study, 120 F₂ families of perennial ryegrass (Lolium perenne L.) were grown across a water gradient in a semifield facility with subsoil irrigation. Genomic (single-nucleotide polymorphism [SNP]), transcriptomic (gene expression [GE]), and DNA methylomic (MET) data were integrated with feed quality trait data collected from control and drought sections in the semifield facility, providing a treatment effect. Deep root length (DRL) below 110 cm was assessed with convolutional neural network image analysis. Bayesian prediction models were used to partition phenotypic variance into its components and evaluated the proportion of phenotypic variance in all traits captured by different regulatory layers (SNP, GE, and MET). The spatial effects and effects of SNP, GE, MET, the interaction between GE and MET (GE × MET) and GE × treatment (GE_Control and GE_Drought ) interaction were investigated. Gene expression explained a substantial part of the genetic and spatial variance for all the investigated phenotypes, whereas MET explained residual variance not accounted for by SNPs or GE. For DRL, MET also contributed to explaining spatial variance. The study provides a statistically elegant analytical paradigm that integrates genomic, transcriptomic, and MET information to understand the regulatory mechanisms of polygenic effects for complex traits.

PMID:35975565 | DOI:10.1002/tpg2.20253