Tag: statistics

J Pediatr Surg. 2021 Jul 8:S0022-3468(21)00485-1. doi: 10.1016/j.jpedsurg.2021.06.013. Online ahead of print.

ABSTRACT

Background In congenital diaphragmatic hernia (CDH) survivors, failure to thrive is a well-known complication, ascribed to several factors. The impact of lung volume on growth of CDH survivors is poorly explored. Our aim was to evaluate if, in CDH survivors, lung volume (LV) after extubation correlates with growth at 12 and 24 months of life. Methods LV (measured as functional residual capacity-FRC) was evaluated by multibreath washout traces with an ultrasonic flowmeter and helium gas dilution technique, shortly after extubation. All CDH survivors are enrolled in a dedicated follow-up program. For the purpose of this study, we analyzed the correlation between FRC obtained shortly after extubation and anthropometric measurements at 12 and 24 months of age. We also compared growth between infants with normal lungs and those with hypoplasic lungs according to FRC values. A p < 0.05 was considered as statistically significant. Results We included in the study 22 CDH survivors who had FRC analyzed after extubation and auxological follow-up at 12 and 24 months of age. We found a significant correlation between FRC and weight Z-score at 12 months, weight Z-score at 24 months and height Z-score at 24 months. We also demonstrated that CDH infants with hypoplasic lungs had a significantly lower weight at 12 months and at 24 months and a significantly lower height at 24 months, when compared to infants with normal lungs. Conclusion We analyzed the predictive value of bedside measured lung volumes in a homogeneous cohort of CDH infants and demonstrated a significant correlation between FRC and growth at 12 and 24 months of age. An earlier identification of patients that will require an aggressive nutritional support (such as those with pulmonary hypoplasia) may help reducing the burden of failure to thrive.

PMID:34281708 | DOI:10.1016/j.jpedsurg.2021.06.013

Life Sci Space Res (Amst). 2021 Aug;30:39-44. doi: 10.1016/j.lssr.2021.05.001. Epub 2021 May 17.

ABSTRACT

Planetary Protection is applicable for missions to biologically sensitive targets of interest in the solar system. For robotic missions landing on the Martian surface, Earth-based biological contamination must be reduced, controlled, and monitored to adhere to forward planetary protection requirements. To address the overall biological load limit and microbial density requirements per spacecraft each component is tracked based on its manufacturing pedigree and/or directly assessed using a direct sampling technique with either a swab or wipe. The tracking and reporting of requirements compliance has varied from mission to mission and reporting of numbers has consistently leaned towards the conservative worst-case scenario. With an increase in the number of missions and mission complexities, the need to establish a technically sound, statistical, and biological solution that provides a single point solution which addresses the distribution of spacecraft contamination becomes critical. Select components of the InSight mission, launched in 2018, have been used as a test case to evaluate the efficacy of applying Bayesian statistics to planetary protection data sets. Eight representative components covering the various bounding cases of high and low surface area, biological count, and sampling devices were analyzed as well as an assembly level case to evaluate the rollup of directly sampled and manufacturing pedigree components. A Bayesian approach was developed leveraging different priors from the zero-inflated data sets and compared to the heritage and existing NASA bioburden assessment approaches. In addition, several non-informative priors were evaluated for use in performing bioburden calculations. The results have demonstrated a viable framework to enable a Bayesian statistical approach to be further developed and utilized for planetary protection requirements assessment.

PMID:34281663 | DOI:10.1016/j.lssr.2021.05.001

Injury. 2021 Jul 10:S0020-1383(21)00616-1. doi: 10.1016/j.injury.2021.07.011. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate changes in the Garden index and other radiological parameters during reduction of femoral neck fractures.

METHODS: Ten healthy, human femoral specimens were obtained. A 2.0 mm diameter Kirschner wire was implanted in the centre of the femoral head. A perpendicular osteotomy was made in the middle of the femoral neck. The distal osteotomy surface was used as the angle of rotation (pronation and supination up to 90° at 10° intervals). Anterior-posterior and lateral view radiographs were taken at different angles. The Garden index and other relevant data were analysed using the picture archiving and communication system. Changes in the area of the femoral head fovea at different rotation angles were measured.

RESULTS: There were no significant differences in the Garden index between 0-30° of pronation and supination (p > .05). For angles of 40-90°, there were statistically significant differences in the Garden index (p < .05). The area of femoral head fovea decreased with increasing pronation angle, and increased with increasing supination angle.

CONCLUSIONS: The Garden index does not change significantly if the angle of fracture rotation is 0-30° (in either pronation or supination) during femoral neck fracture reduction. Therefore, it is impossible to judge the rotation of fracture in this range of angles. The Garden index can detect the rotation of fracture for rotation angles of 40-90° (in either pronation or supination). Changes in the area of the femoral head fovea can help determine the rotation of femoral neck fractures.

LEVEL OF EVIDENCE: Level V.

PMID:34281692 | DOI:10.1016/j.injury.2021.07.011

Injury. 2021 Jul 10:S0020-1383(21)00619-7. doi: 10.1016/j.injury.2021.07.014. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Vertical femoral neck fractures (VFNFs) are one of the most difficult fractures to stabilize, with high non-union (17%), avascular necrosis (AVN, 21%), and femoral neck shortening (FNS, 29.0%) rates. The objective of this investigation was to directly compare the long-term clinical complication rates of VFNFs repaired by crossed (Alpha fixation) or parallel screws in non-geriatric patients.

PATIENTS AND METHODS: We conducted a retrospective comparative study of VFNFs in patients (<60 years) between January 2014 and December 2017, with at least 2 years of follow-up. VFNFs were fixed with either three parallel screws (G-TRI) or augmented with a crossed screw (G-ALP). Confounding variables included age, gender, initial displacement, ISS (Injury Severity Score), general comorbidities, combined fractures, Pauwels angle, reduction quality. Complications, including non-union, AVN of the femoral head and FNS were compared as outcome indicators. Risk factors associated with these variables were further analysed using multivariate analysis.

RESULTS: A total of 157 patients (97 G-TRI; 60 G-ALP) met inclusion criteria. G-ALP had a significantly lower rate of FNS (8.3% vs. 28.9%, p = 0.039) than that of G-TRI. non-union (3.3% vs. 11.3%), AVN (21.7% vs. 25.8%), and reoperation rates (21.7% vs. 23.7%) were lower in G-ALP than G-TRI but was not statistically significant. Multivariate analyses showed significant relationships between NU and unacceptable reduction quality (OR=7.610; 1.823-31.770, adjusted-p = 0.015); between AVN and initial displacement (Garden III and IV) (OR=7.885; 1.739-35.744, adjusted-p = 0.021); and between FNS and screw configuration (OR=5.713; 1.839-17.743, adjusted-p = 0.009).

CONCLUSION: For the treatment of VFNFs, satisfactory reduction still remains the key surgical goal that prevents NU, while the incidence of AVN strongly depends on the initial displacement at the time of injury. Crossed screws were associated with a markedly lower FNS rate than parallel screws, which promote further randomised controlled trials to establish a guideline for optimal fixation selection in VFNFs.

PMID:34281695 | DOI:10.1016/j.injury.2021.07.014

J Equine Vet Sci. 2021 Aug;103:103689. doi: 10.1016/j.jevs.2021.103689. Epub 2021 Jun 16.

ABSTRACT

Perineural anaesthesia is an essential part of lameness investigation in horses. Painful reactions to injections imply a high risk of accidents for veterinarians. To evaluate the efficacy of two topical anaesthetic creams on desensitization of the skin at two perineural injection sites and to evaluate the effects these formulations may have on pain perception distally to the application sites. Randomized, blind, prospective study. 14 healthy horses were randomly divided in two groups of 7 horses each, one treated with EMLA and one with PLIAGLIS preparations. The mechanical nociceptive threshold (MNT) was recorded via pressure algometer at the baseline and one hour after application (T1) on palmar and palmar digital nerve blocks sites. Skin sensation was also assessed on the distal limb, recording MNT on the coronary band and on both bulbs of the heels. Data were compared with a 3-way ANOVA statistical analyses. No significant difference was encountered in the MNT values between baseline records and records at T1 at the control sites. A significant difference of MNT values was detected between the two time points in the treated limbs. The significant sources of variation in our study were the time and the presence of anaesthetic cream. The type of treatment did not determine any differences. Furthermore, no significant difference of MNT values at sites distal to treatment was recorded between the two time points, both in the treated limb and control limbs. Both formulations are effective to obtain superficial skin desensitization.

PMID:34281641 | DOI:10.1016/j.jevs.2021.103689

J Equine Vet Sci. 2021 Aug;103:103644. doi: 10.1016/j.jevs.2021.103644. Epub 2021 Apr 30.

ABSTRACT

Equine asthma is a common condition in horses, for which few host-related risk factors have been identified. The objective of this study was to identify host-related risk factors for the development of equine asthma. A retrospective, case-control study was performed, utilizing horses presented to the Texas A&M University, Veterinary Medical Teaching Hospital from January 2014 December 2018. Incident cases of mild to severe equine asthma (n = 37), diagnosed clinically with cytologic support of disease were examined. For each case, two control populations were identified, including one temporal control (n = 37) and one age-matched control (n = 37). Data collected included signalment, dietary and stable management, prior medical history, metabolic status, physical examination findings, and results of cytologic evaluation via bronchoalvelolar lavage or tracheal wash. Conditional logistic regression was used to compare data on equine asthma cases with data from each set of controls. Results indicated that obesity (Body Condition Score ≥ 7) was the only statistically significant risk factor for equine asthma in this population of horses. These results may aid in identification of targets for management, prevention, and further investigation into the pathogenesis of equine asthma. Early identification and intervention of horses at risk of lower airway disease could ameliorate the impact of disease.

PMID:34281649 | DOI:10.1016/j.jevs.2021.103644

Orphanet J Rare Dis. 2021 Jul 19;16(1):319. doi: 10.1186/s13023-021-01950-x.

ABSTRACT

BACKGROUND: LAMA2-related muscular dystrophy including LAMA2-related congenital muscular dystrophy (LAMA2-CMD) and autosomal recessive limb-girdle muscular dystrophy-23 (LGMDR23) is caused by LAMA2 pathogenic variants. We aimed to describe the natural history and establish genotype-phenotype correlations in a large cohort of Chinese patients with LAMA2-related muscular dystrophy.

METHODS: Clinical and genetic data of LAMA2-related muscular dystrophy patients enrolled from ten research centers between January 2003 and March 2021 were collected and analyzed.

RESULTS: One hundred and thirty patients (116 LAMA2-CMD and 14 LGMDR23) were included. LAMA2-CMD group had earlier onset than LGMDR23 group. Head control, independent sitting and ambulation were achieved in 76.3%, 92.6% and 18.4% of LAMA2-CMD patients at median ages of 6.0 months (range 2.0-36.0 months), 11.0 months (range 6.0-36.0 months), and 27.0 months (range 18.0-84.0 months), respectively. All LGMDR23 patients achieved independent ambulation at median age of 18.0 months (range 13.0-20.0 months). Motor regression in LAMA2-CMD mainly occurred concurrently with rapid progression of contractures during 6-9 years old. Twenty-four LAMA2-related muscular dystrophy patients died, mostly due to severe pneumonia. Seizures occurred in 35.7% of LGMDR23 and 9.5% of LAMA2-CMD patients. Forty-six novel and 97 known LAMA2 disease-causing variants were identified. The top three high-frequency disease-causing variants in Han Chinese patients were c.7147C > T (p.R2383*), exon 4 deletion, and c.5156_5159del (p.K1719Rfs*5). In LAMA2-CMD, splicing variants tended to be associated with a relatively mild phenotype. Nonsense variants were more frequent in LAMA2-CMD (56.9%, 66/116) than in LGMDR23 (21.4%, 3/14), while missense disease-causing variants were more frequent in LGMDR23 (71.4%, 10/14) than in LAMA2-CMD (12.9%, 15/116). Copy number variations were identified in 26.4% of survivors and 50.0% of nonsurvivors, suggesting that copy number variations were associated with lower rate of survival (p = 0.029).

CONCLUSIONS: This study provides better understandings of natural history and genotype-phenotype correlations in LAMA2-related muscular dystrophy, and supports therapeutic targets for future researches.

PMID:34281576 | DOI:10.1186/s13023-021-01950-x

Genome Biol. 2021 Jul 19;22(1):212. doi: 10.1186/s13059-021-02426-8.

NO ABSTRACT

PMID:34281604 | DOI:10.1186/s13059-021-02426-8

J Am Assoc Lab Anim Sci. 2021 Jul 19. doi: 10.30802/AALAS-JAALAS-20-000151. Online ahead of print.

ABSTRACT

Although buprenorphine is the most frequently used opioid analgesic in common marmosets (Callithrix jacchus), thereis limited information in the literature supporting current dosing regimens used for this species. The purpose of this study was to determine the pharmacokinetic profiles of single-dose buprenorphine HCl administered intramuscularly (IM) at 0.01 mg/kg in 6 adult marmosets (1.8 to 12.8 y old; 2 males, 4 females) and subcutaneously (SQ) at 0.01 mg/kg in 6 adult marmosets(2.3-4.4 y old; 3 males, 3 females) by mass spectrometry. Blood was collected at multiple time points from 0.25 to 24 h from unsedated animals following a hybrid sparse-serial sampling design. The maximal observed plasma concentration of buprenorphine (Cmax) administered IM (2.57 ± 0.95 ng/mL) was significantly higher than administered SQ (1.47 ± 0.61 ng/mL). However, the time to Cmax (Tmax) was not statistically different between routes (17.4 ± 6 min for IM and 19.8 ±7.8 min for SQ). The time of the last quantifiable concentration of buprenorphine was 5 ± 1.67 h for IM compared with 6.33 ± 1.51 h for SQ, which was not statistically different. The mean buprenorphine plasma concentration-time curves were used to propose a dosing frequency of 4 to 6 h for buprenorphine at 0.01 mg/kg IM or SQ based on a theoretical therapeutic plasma concentration threshold of 0.1 ng/mL. Based on the mean pharmacokinetic parameters and plasma-concentration time curves, both IM and SQ routes of buprenorphine at this dose provide a rapid increase in the plasma concentration of buprenorphine above the therapeutic threshold, and may be more effective for acute rather than long-lasting analgesia. Further studies are neededto examine repeated dosing regimens and the efficacy of buprenorphine in common marmosets.

PMID:34281629 | DOI:10.30802/AALAS-JAALAS-20-000151

J Perinat Med. 2021 Jul 20. doi: 10.1515/jpm-2020-0468. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare mortality, morbidity and neurodevelopment by mode of delivery (MOD) for very preterm births with low prelabour risk of caesarean section (CS).

METHODS: The study was a population-based prospective cohort study in 19 regions in 11 European countries. Multivariable mixed effects models and weighted propensity score models were used to estimate adjusted odds ratios (aOR) by observed MOD and the unit’s policy regarding MOD. Population: Singleton vertex-presenting live births at 24 + 0 to 31 + 6 weeks of gestation without serious congenital anomalies, preeclampsia, HELLP or eclampsia, antenatal detection of growth restriction and prelabour CS for fetal or maternal indications.

RESULTS: Main outcome measures: A composite of in-hospital mortality and intraventricular haemorrhage (grade III/IV) or periventricular leukomalacia. Secondary outcomes were components of the primary outcome, 5 min Apgar score <7 and moderate to severe neurodevelopmental impairment at two years of corrected age. The rate of CS was 29.6% but varied greatly between countries (8.0-52.6%). MOD was not associated with the primary outcome (aOR for CS 0.99; 95% confidence interval [CI] 0.65-1.50) when comparing units with a systematic policy of CS or no policy of MOD to units with a policy of vaginal delivery (aOR 0.88; 95% CI 0.59-1.32). No association was observed for two-year neurodevelopment impairment for CS (aOR 1.15; 95% CI 0.66-2.01) or unit policies (aOR 1.04; 95% CI 0.63-1.70).

CONCLUSIONS: Among singleton vertex-presenting live births without medical complications requiring a CS at 24 + 0 to 31 + 6 weeks of gestation, CS was not associated with improved neonatal or long-term outcomes.

PMID:34280959 | DOI:10.1515/jpm-2020-0468