Tag: statistics

J Intensive Care Med. 2022 May 2:8850666221098383. doi: 10.1177/08850666221098383. Online ahead of print.

ABSTRACT

Background: Shorter time spent in specific blood glucose ranges is associated with mortality benefit in critically ill patients. However, various time in range values are reported, each based on a specific blood glucose range. Objective: To evaluate relationship between percentage of time spent at various blood glucose ranges (TIR) and mortality in critically ill patients. Methods: Single-center, retrospective, cohort study that included adult patients admitted to ICU for at least one day. We evaluated the relationship between TIR at prespecified blood glucose ranges and hospital mortality in diabetic and non-diabetic patients Results: Of the 5287 patients included, 3705 (70.0%) were non-diabetic and 1582 were diabetic (29.9%). Diabetic patients had higher in-hospital mortality rate (15.8%) compared to non-diabetic patients (11.3%), p < 0.0001, and with higher incidence of hyperglycemia (77.8% vs. 39.4%) and hypoglycemia (14.3% vs. 10%) compared to non-diabetic patients, p < 0.0001. The highest median TIR for both diabetic [76% (49.1 – 97.8%)] and non-diabetic patients [100% (92.3–100%)] was at blood glucose range of 70-180 mg/dL. In non-diabetic cohort, the only optimal TIR of 40% at blood glucose range of 70-120 mg/dL was identified. Non-diabetic patients stratified into TIR 70-120 mg/dL > 40% reported significantly lower mortality (7.0%) rate compared to patients with TIR 70-120 mg/dL < 40% (15.7%), OR 0.52, 95% CI 0.27-0.97, adjusted-p = 0.03. In diabetic patients, no relationship was detected between TIR at all predefined glucose ranges and hospital mortality. Conclusion: Critically ill non-diabetic patients who spent at least 40% of time in blood glucose range of 70-120 mg/dL had improved survival. This association was not observed in diabetic patients.

PMID:35491687 | DOI:10.1177/08850666221098383

Obesity (Silver Spring). 2022 May 2. doi: 10.1002/oby.23424. Online ahead of print.

ABSTRACT

Two genomes regulate the energy metabolism of eukaryotic cells: the nuclear genome, which codes for most cellular proteins, and the mitochondrial genome, which, together with the nuclear genome, coregulates cellular bioenergetics. Therefore, mitochondrial genome variations can affect, directly or indirectly, all energy-dependent cellular processes and shape the metabolic state of the organism. This review provides a current and up-to-date overview on how codependent these two genomes are, how they appear to have coevolved, and how variations within the mitochondrial genome might be associated with the manifestation of metabolic diseases. This review summarizes and structures results obtained from epidemiological studies that identified links between mitochondrial haplogroups and individual risks for developing obesity and diabetes. This is complemented by findings on the compatibility of mitochondrial and nuclear genomes and cellular bioenergetic fitness, which have been acquired from well-controlled studies in conplastic animal models. These elucidate, more mechanistically, how single-nucleotide variants can influence cellular metabolism and physiology. Overall, it seems that certain mitochondrial genome variations negatively affect mitochondrial-nuclear compatibility and are statistically linked with the onset of metabolic diseases, whereas, for others, greater uncertainty exists, and additional research into this exciting field is required.

PMID:35491673 | DOI:10.1002/oby.23424

Prog Orthod. 2022 May 2;23(1):14. doi: 10.1186/s40510-022-00408-5.

ABSTRACT

OBJECTIVE: Prospective evaluation of the maxillary canine mobility during retraction using two different force levels over 5 months of retraction.

MATERIALS AND METHODS: Thirty patients indicated for maximum retraction of maxillary canines with age range of 14.7-18.9 years were included in the study. After complete leveling and alignment and immediately before canine retraction, the mobility of the maxillary canines was measured using the Periotest device and repeated monthly. A split-mouth design was applied where on the one side, the retraction force was 100 g, while on the other side 200 g of force. Four subgroups were investigated: A1 (R3 100 g), A2 (L3 200 g), B1 (R3 200 g) and B2 (L3 100 g). The total amount of canine retraction was measured for each side using the pre- and post-retraction dental casts.

RESULTS: The collected data were normally distributed. ANOVA test showed insignificant statistical difference in Periotest values (PTVs) among the four subgroups pre-retraction and monthly p > 0.05. However, each group showed a statistically significant difference in PTVs over the 5 months. The independent sample t test showed a statistical insignificant difference in PTVs between the 100 g and 200 g retraction force. Pearson correlation of the PTVs to the period of retraction was statistically significant p < 0.05 while being in significant to the retraction force p > 0.05.

CONCLUSION: Increasing the retraction force of maxillary canines up to 200 g of force does not significantly increase the teeth mobility during orthodontic treatment. There is a positive correlation between the PTVs and the duration of tooth movement regardless the magnitude of force.

PMID:35491412 | DOI:10.1186/s40510-022-00408-5

Andrologia. 2022 May 1:e14449. doi: 10.1111/and.14449. Online ahead of print.

ABSTRACT

This study was conducted to investigate the generalized anxiety levels and its association with semen quality in infertile men. We recruited male patients who visited the infertility outpatient departments of three teaching hospitals in North China and evaluated their generalized anxiety symptoms using the self-administered 7-item generalized anxiety disorder (GAD-7) scale. Seminal analysis was performed as per WHO guidelines. A total of 378 infertile men (average age: 31.43 ± 5.85 years) were classified into the normal group (n = 174, 46%) and the anxiety group (n = 204, 54%) according to their GAD-7 scale score. The proportion of patients with hyperlipidaemia in the normal group was significantly higher than that in the anxiety group (14.9% vs. 5.9%, p = 0.004). The other demographic characteristics were not statistically different between both groups. Patients with abnormal GAD-7 scale scores had a significantly lower sperm count (202.48 vs. 166.80 million per ejaculate, p = 0.023), sperm concentration (54.75 vs. 46.54 million/ml, p = 0.033), and progressive motility (40.25 vs. 37.16, p = 0.020) than those with normal GAD-7 scale scores. Multivariate linear regression models revealed that anxiety was significantly negatively associated with sperm concentration (percent change = -9.79, 95%CI: -12.38 to -7.12, p < 0.001), total sperm count (percent change = -13.07, 95%CI: -16.05 to -9.84, p < 0.001), progressive motility (β = -1.41, 95%CI: -1.86 to -0.96, p < 0.001), total sperm motility (β = -1.73, 95%CI: -2.38 to -1.08, p < 0.001), and normal sperm morphology (β = -0.16, 95%CI: -0.28 to -0.04, p = 0.009), respectively. Taken together, generalized anxiety disorder could significantly influence the clinical semen quality in infertile men in North China, and psychological stress management might be helpful.

PMID:35491407 | DOI:10.1111/and.14449

Actas Urol Esp (Engl Ed). 2022 Apr 28:S2173-5786(22)00040-3. doi: 10.1016/j.acuroe.2022.03.008. Online ahead of print.

ABSTRACT

OBJECTIVE: Although it was stated that supine percutaneous nephrolithotomy (PCNL) was associated with relatively shorter surgical times and comparable success and complication rates, there is no consensus in the current literature concerning the safety and efficacy of supine PCNL in patients with horseshoe kidneys. We aimed to compare supine and prone PCNL regarding safety and efficacy in patients with horseshoe kidneys.

METHODS: Data of the patients with horseshoe kidneys who underwent PCNL for renal stones larger than 2 cm between January 2010 and May 2021 were retrospectively reviewed. The study patients were categorized as Group 1 (i.e., supine PCNL-SPCNL) and Group 2 (i.e., prone PCNL-PPCNL). Both groups were compared regarding demographic, clinical, and surgical data.

RESULTS: Sixty-five patients were included. Among these patients, 31 (47.7%) were in Group 1, while 34 (52.3%) were in Group 2. Both groups were statistically similar in terms of demographic data, stone characteristics, perioperative parameters, and complication rates (p > 0.05). There was no statistical difference in terms of additional treatment rates, stone-free rates in the postoperative second-day and third-month evaluations (p > 0.05). Mean surgical time was significantly longer in Group 2 (113 ± 17.1 min) than in Group 1 (90.6 ± 11.3 min) (p = 0.000).

CONCLUSION: Although it is traditionally performed in the prone position, the supine approach is as safe and effective as the prone approach. In addition, the supine approach is associated with significantly shorter surgical times.

PMID:35491387 | DOI:10.1016/j.acuroe.2022.03.008

Stat Med. 2022 May 1. doi: 10.1002/sim.9421. Online ahead of print.

ABSTRACT

We propose an inferential framework for fixed effects in longitudinal functional models and introduce tests for the correlation structures induced by the longitudinal sampling procedure. The framework provides a natural extension of standard longitudinal correlation models for scalar observations to functional observations. Using simulation studies, we compare fixed effects estimation under correctly and incorrectly specified correlation structures and also test the longitudinal correlation structure. Finally, we apply the proposed methods to a longitudinal functional dataset on physical activity. The computer code for the proposed method is available at https://github.com/rli20ST758/FILF.

PMID:35491388 | DOI:10.1002/sim.9421

Sleep Health. 2022 Apr 28:S2352-7218(22)00009-2. doi: 10.1016/j.sleh.2022.01.004. Online ahead of print.

ABSTRACT

OBJECTIVE: Most studies in developing countries suggest that less total sleep time (TST) increases subsequent perceived stress (PS) more consistently than the inverse, but have used statistical models that are not optimal when ratings are measured in close proximity.

METHODS: We used multilevel dynamic structural equation modeling with Bayesian estimation, ideal for assessing longitudinal daily dynamic interplay between self-reported TST and PS (minimum of 30 days) in 92 Brazilian pre-university students.

RESULTS: TST showed lower inertia than PS (autoregressive effect: TST perturbations influenced subsequent TST ratings less so than corresponding PS measures) and exerted negative prospective effects on PS (cross-lagged effect).

CONCLUSION: In our developing nation sample, PS deviations from mean ratings took longer to return to baseline values than TST and PS was more sensitive to changes in prior TST than vice-versa, confirming previous findings. Future studies should confirm these findings with objective TST and stress measures.

PMID:35491382 | DOI:10.1016/j.sleh.2022.01.004

Eur Urol Oncol. 2022 Apr 28:S2588-9311(22)00060-8. doi: 10.1016/j.euo.2022.04.004. Online ahead of print.

ABSTRACT

BACKGROUND: Metastatic castration-resistant prostate cancer (mCRPC) is a heterogeneous disease in which molecular stratification is needed to improve clinical outcomes. The identification of predictive biomarkers can have a major impact on the care of these patients, but the availability of metastatic tissue samples for research in this setting is limited.

OBJECTIVE: To study the prevalence of immune biomarkers of potential clinical utility to immunotherapy in mCRPC and to determine their association with overall survival (OS).

DESIGN, SETTING, AND PARTICIPANTS: From 100 patients, mCRPC biopsies were assayed by whole exome sequencing, targeted next-generation sequencing, RNA sequencing, tumor mutational burden, T-cell-inflamed gene expression profile (TcellinfGEP) score (Nanostring), and immunohistochemistry for programmed cell death 1 ligand 1 (PD-L1), ataxia-telangiectasia mutated (ATM), phosphatase and tensin homolog (PTEN), SRY homology box 2 (SOX2), and the presence of neuroendocrine features.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The phi coefficient determined correlations between biomarkers of interest. OS was assessed using Kaplan-Meier curves and adjusted hazard ratios (aHRs) from Cox regression.

RESULTS AND LIMITATIONS: PD-L1 and SOX2 protein expression was detected by immunohistochemistry (combined positive score ≥1 and >5% cells, respectively) in 24 (33%) and 27 (27%) mCRPC biopsies, respectively; 23 (26%) mCRPC biopsies had high TcellinfGEP scores (>-0.318). PD-L1 protein expression and TcellinfGEP scores were positively correlated (phi 0.63 [0.45; 0.76]). PD-L1 protein expression (aHR: 1.90 [1.05; 3.45]), high TcellinfGEP score (aHR: 1.86 [1.04; 3.31]), and SOX2 expression (aHR: 2.09 [1.20; 3.64]) were associated with worse OS.

CONCLUSIONS: PD-L1, TcellinfGEP score, and SOX2 are prognostic of outcome from the mCRPC setting. If validated, predictive biomarker studies incorporating survival endpoints need to take these findings into consideration.

PATIENT SUMMARY: This study presents an analysis of immune biomarkers in biopsies from patients with metastatic prostate cancer. We describe tumor alterations that predict prognosis that can impact future studies.

PMID:35491356 | DOI:10.1016/j.euo.2022.04.004

J Surg Educ. 2022 Apr 28:S1931-7204(22)00057-5. doi: 10.1016/j.jsurg.2022.03.001. Online ahead of print.

ABSTRACT

INTRODUCTION: Doximity has become integrated into the residency application process without any clear merit, comparing programs based on reputation and research. Our study aims to gather program directors’ and Chiefs/Chairs’ perspectives on the Doximity ranking system and to assess what a better system might entail.

METHODS: A 16-question survey was sent to 177 program directors and Chief/Chairs of plastic surgery residency programs. The questions covered three categories: (1) demographic information; (2) Doximity ranking perceptions; (3) input on characteristics of a better tool. The responses were statistically analyzed.

RESULTS: Ninety-three questionnaires were received (53%). Twenty-nine (31%) respondents represented programs in the Northeast, 23 (25%) South, 20 (21%) Midwest, and 21 (23%) West. Seventy-three (79%) respondents were male and 16 (17%) female. 90% of respondents (n = 84) believe Doximity rankings are not accurate, all indicating their institution should be ranked higher. No significant association between program geography and ranking satisfaction was observed (p = 0.75). Only 33% (n = 31) of respondents were aware of Doximity methodology. Most respondents (95%; n = 88) do not recommend the use of Doximity to medical students. Most participants (87%; n = 81) are willing to share resident case logs to inform a future tool. “Strength of technical training/preparedness” was ranked most highly as important training program qualities.

CONCLUSIONS: The results of this program leadership survey show dissatisfaction with and a lack of understanding of the Doximity system. When considering future steps, program leadership support a strength-based categorization system and sharing case logs to guide student decision-making.

PMID:35491352 | DOI:10.1016/j.jsurg.2022.03.001

J Foot Ankle Surg. 2021 Dec 20:S1067-2516(21)00536-6. doi: 10.1053/j.jfas.2021.12.024. Online ahead of print.

ABSTRACT

The Lapidus arthrodesis is a powerful procedure for the correction of hallux valgus with metatarsus primus varus. Yet, first ray instability may persist despite correction of the primary deformity with 2 crossed screw fixation. A third screw is often utilized as the additional point of fixation for noteworthy residual transverse plane motion, but it is not without potential complications. The suture and button fixation device may be an appropriate alternative to the third screw construct. This retrospective cohort study identified clinical / radiographic outcomes and complication rates following a third point of fixation with either a screw or suture and button fixation device in patients undergoing a modified Lapidus arthrodesis. One surgeon performed all of the Lapidus procedure with a third screw while the other surgeon performed all with a suture and button fixation device. Of 136 consecutive patients who underwent a modified Lapidus arthrodesis, 83 (61%) patients required a third point of fixation for satisfactory stabilization of the first ray. Surgical technique was similar between the 2 surgeons; however, one utilized the suture and button fixation device method (n = 36), while the other used a third screw for fixation (n = 47). Many of the clinical outcomes, radiographic results, and the union rate were similar between the 2 methods. Nineteen (40%) complications occurred in the third screw group compared to 6 (17%) in the suture and button fixation device group. However, the third screw group demonstrated 100% maintenance of deformity correction at 1 year versus 95% in the suture and button fixation device group. Although fixation with a suture and button fixation device was associated with fewer complications, a larger study is necessary to determine if these variations are statistically significant.

PMID:35491340 | DOI:10.1053/j.jfas.2021.12.024