Tag: statistics

Plant Genome. 2021 Jul 29:e20118. doi: 10.1002/tpg2.20118. Online ahead of print.

ABSTRACT

Genomic selection (GS) is revolutionizing conventional ways of developing new plants and animals. However, because it is a predictive methodology, GS strongly depends on statistical and machine learning to perform these predictions. For continuous outcomes, more models are available for GS. Unfortunately, for count data outcomes, there are few efficient statistical machine learning models for large datasets or for datasets with fewer observations than independent variables. For this reason, in this paper, we applied the univariate version of the Poisson deep neural network (PDNN) proposed earlier for genomic predictions of count data. The model was implemented with (a) the negative log-likelihood of Poisson distribution as the loss function, (b) the rectified linear activation unit as the activation function in hidden layers, and (c) the exponential activation function in the output layer. The advantage of the PDNN model is that it captures complex patterns in the data by implementing many nonlinear transformations in the hidden layers. Moreover, since it was implemented in Tensorflow as the back-end, and in Keras as the front-end, the model can be applied to moderate and large datasets, which is a significant advantage over previous GS models for count data. The PDNN model was compared with deep learning models with continuous outcomes, conventional generalized Poisson regression models, and conventional Bayesian regression methods. We found that the PDNN model outperformed the Bayesian regression and generalized Poisson regression methods in terms of prediction accuracy, although it was not better than the conventional deep neural network with continuous outcomes.

PMID:34323393 | DOI:10.1002/tpg2.20118

Cytometry A. 2021 Jul 29. doi: 10.1002/cyto.a.24486. Online ahead of print.

NO ABSTRACT

PMID:34323357 | DOI:10.1002/cyto.a.24486

Int J Rheum Dis. 2021 Jul 29. doi: 10.1111/1756-185X.14195. Online ahead of print.

ABSTRACT

BACKGROUND: Fibromyalgia is a chronic pain syndrome of unknown etiology characterized by chronic widespread musculoskeletal pain and tenderness. It affects the quality of life of patients and has been associated with the human immunodeficiency virus (HIV). The study aimed to determine the prevalence of fibromyalgia in HIV-positive patients and assess the effect of fibromyalgia on their functional status.

METHODOLOGY: This was a cross-sectional study comprising 160 treatment-naive HIV-positive patients and 160 age- and sex-matched HIV-negative controls. The diagnosis of fibromyalgia was based on the 2011 modification of the 2010 American College of Rheumatology diagnostic criteria by assessing the widespread pain index and symptom severity score. The severity of fibromyalgia was assessed with the revised fibromyalgia impact questionnaire.

RESULTS: The prevalence of fibromyalgia in HIV-positive individuals was found to be 10.6%, which was significantly higher compared with controls (3.1%; P = .008). There was no significant association between fibromyalgia and age, gender, or occupation. There was a significant relationship between CD4 count levels (P < .001), WHO clinical stage (P < .001), and fibromyalgia. A statistically significant higher score on the Revised FM Impact Questionnaire was found in HIV-positive individuals with fibromyalgia (P < .001).

CONCLUSION: The study found that HIV-positive patients had a significantly higher incidence of fibromyalgia than controls and this was related to active indices of HIV disease. Fibromyalgia had a greater clinical impact on HIV patients than in controls. As a result, fibromyalgia should be identified and treated in people living with HIV.

PMID:34323376 | DOI:10.1111/1756-185X.14195

J Hum Nutr Diet. 2021 Jul 29. doi: 10.1111/jhn.12936. Online ahead of print.

ABSTRACT

OVERVIEW: This study examined the effect of a herbal supplement containing a Gynostemma pentaphyllum (Gpp) extract (ActivAMP®) on improving body composition in overweight males and females.

METHODS: One-hundred and seventeen men and women aged over 18 completed 16 weeks of daily supplementation with either Gpp or a placebo. Participants underwent dual-energy X-rays to assess body composition (fat mass, lean mass and mass distribution) as well as anthropometric measures (weight, height, hip and waist circumference) and blood tests to assess inflammatory and safety markers.

RESULTS: Following 16 weeks of treatment the Gpp group had a significant reduction in total body weight, BMI, total fat mass and gynoid fat mass compared to the placebo group. Blood measures showed plasma triglyceride, ALT and TNF-α statistically different between groups at week 16. Sub-group analysis of gender for fat distribution showed males in the Gpp group had a significant reduction in visceral fat compared to males in the placebo group and females in the Gpp group had a significant reduction in gynoid fat compared to the placebo group.

CONCLUSIONS: Gpp was capable of altering fat mass and fat distribution in overweight and obese males and females compared to a placebo. This article is protected by copyright. All rights reserved.

PMID:34323337 | DOI:10.1111/jhn.12936

Pediatr Infect Dis J. 2021 Jul 27. doi: 10.1097/INF.0000000000003179. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of the study was to identify early predictors of mortality in children with severe dengue fever admitted to pediatric intensive care unit (PICU).

MATERIALS AND METHODS: All consecutive children with laboratory-confirmed severe dengue fever were enrolled in this prospective observational study. Besides demographic data, disease severity and organ dysfunction scores, laboratory investigations and interventions are done in PICU were recorded and analyzed.

RESULTS: During the study period of 42 months, 172 patients with dengue fever were admitted to PICU. A total of 78 (45.3%) patients with severe dengue fever were included and analyzed. There were 20 (25.6%) deaths. There were significant differences in disease severity and organ dysfunction scores, transaminases, blood lactate level and serum creatinine between survivors and nonsurvivors. A significantly higher number of nonsurvivors required interventions in first 24 hours of admission. Platelet counts (P value 0.22) and hematocrit (P value 0.47) were not statistically different in 2 groups. There was a significantly high vasopressor-inotrope score (VIS) (<0.001) and positive fluid balance >10% (0.002) in nonsurvivors. Multivariate stepwise logistic regression analysis identified serum glutamic pyruvic transaminases (≥ 284 IU/L; odds ratio [OR] 1.002, 95% confidence interval [CI]: 1.001-1.003), blood lactate level (≥2.73 mmol/L; OR 2.08, 95% CI: 1.354-3.202), Pediatric Risk of Mortality score at 12 hours (≥14.5; OR 1.35, 95% CI: 1.077-1.693), VIS (≥22.5, OR 1.129, 95% CI: 1.059-1.204) and positive fluid balance >10% (OR 22.937, 95% CI: 2.393-219.84) at 24 hours of admission as independent predictors of mortality.

CONCLUSION: Disease severity, hyperlactatemia at admission, need for multiple vasoactive drugs and positive fluid balance are predictors of mortality in severe dengue infection in children admitted to PICU.

PMID:34321449 | DOI:10.1097/INF.0000000000003179

Med Sci Monit. 2021 Jul 29;27:e930000. doi: 10.12659/MSM.930000.

ABSTRACT

BACKGROUND Although percutaneous disc nucleoplasty (PDN) has been widely applied in treating lumbar disc herniation (LDH) in recent years, the efficacy of surgical levels for PDN on LDH has been reported in limited studies. This study aimed to explore and compare the efficacy of surgical levels (single level vs double level) of PDN in treating LDH. MATERIAL AND METHODS All patients diagnosed with LDH from January 2012 to December 2014 in our hospital who underwent PDN were included in this study. Patients were divided into a single-level group and double-level group based on the number of discs/surgical treatment levels. The improvement of visual analog scale (VAS) score, patient satisfaction, and reoperation occurrence were compared between the 2 groups. RESULTS Of 105 total patients, 75 patients were treated with single-level treatment and 30 patients with double-level treatment. VAS for leg pain and patient satisfaction scores in the double-level group were worse than those in the single-level group at 6 months after surgery (P<0.05). Among all 105 patients, the incidence of reoperation was 11.4%. Also, there was a marked difference in reoperation occurrence at 6 months after surgery between the single-level (6.7%) and double-level (23.3%) groups; however, the difference was not statistically significant (P=0.05). CONCLUSIONS PDN is a safe and minimal-invasive approach, which could effectively treat LDH. The number of surgical levels might be an important factor influencing the efficacy of PND. Caution should be exercised to strictly follow the clinical indications for nucleoplasty.

PMID:34321453 | DOI:10.12659/MSM.930000

J Cardiovasc Nurs. 2021 Jul 23. doi: 10.1097/JCN.0000000000000837. Online ahead of print.

ABSTRACT

BACKGROUND: For the 720 000 Americans expected to experience a new acute cardiac event this year, cardiac rehabilitation is an important part of recovery. Symptoms of depression and anxiety undermine recovery efforts, leaving recovering patients at risk for diminished functional capacity and heightened risk of mortality. Poor emotion regulation can worsen symptoms of depression and anxiety and hinder recovery efforts.

OBJECTIVE: The purpose of this randomized controlled trial was to evaluate the early efficacy testing of a theoretically based emotion regulation treatment (Regulating Emotions to Improve Self-management of Nutrition, Exercise, and Stress [RENEwS]) designed to assist survivors of an acute cardiac event in cardiac rehabilitation to optimize recovery.

METHODS: Survivors of an acute cardiac event in cardiac rehabilitation (n = 30, 83% men) were randomized to five 1-hour in-person group sessions of RENEwS or a phone-based attention-control group. Participants completed measures of depression and anxiety symptoms at 3 time points. Moderate to vigorous physical activity (MVPA) was objectively measured for 7 days at each time point using waist-worn actigraphy monitors. Between-group differences were calculated using analysis of variance with Cohen f effect sizes calculated to evaluate initial efficacy.

RESULTS: There was no statistically significant difference in depression, anxiety, or MVPA over time based on group assignment (all P > .05). Compared with attention control participants, in RENEwS participants, preliminary effects showed greater reductions in depression (Cohen f = 0.34) and anxiety (Cohen f = 0.40) symptoms but only modest improvements in MVPA from baseline to 5 months (Cohen f = 0.08).

CONCLUSIONS: Findings show that RENEwS is a promising emotion regulation intervention to enhance cardiac rehabilitation and potentially decrease symptoms of depression and anxiety.

PMID:34321436 | DOI:10.1097/JCN.0000000000000837

Pediatr Infect Dis J. 2021 Jul 27. doi: 10.1097/INF.0000000000003279. Online ahead of print.

ABSTRACT

BACKGROUND: We analyzed contagions of coronavirus disease 2019 inside school bubble groups in Catalonia, Spain, in the presence of strong nonpharmaceutical interventions from September to December 2020. More than 1 million students were organized in bubble groups and monitored and analyzed by the Health and the Educational departments.

METHODS: We had access to 2 data sources, and both were employed for the analysis, one is the Catalan school surveillance system and the other of the educational department. As soon as a positive index case is detected by the health system, isolation is required for all members of the bubble group, in addition to a mandatory proactive systematic screening of each individual. All infected cases are reported. It permits the calculation of the average reproductive number (R*), corresponding to the average number of infected individuals per index case.

RESULTS: We found that propagation inside of the bubble group was small. Among 75% index cases, there was no transmission to other members in the classroom, with an average R* across all ages inside the bubble of R* = 0.4. We found a significant age trend in the secondary attack rates, with the R* going from 0.2 in preschool to 0.6 in high school youth.

CONCLUSIONS: The secondary attack rate depends on the school level and therefore on the age. Super-spreading events (outbreaks of 5 cases or more) in childhood were rare, only occurring in 2.5% of all infections triggered from a pediatric index case.

PMID:34321438 | DOI:10.1097/INF.0000000000003279

J Pediatr Gastroenterol Nutr. 2021 Jul 27. doi: 10.1097/MPG.0000000000003251. Online ahead of print.

ABSTRACT

OBJECTIVES: Obese habitus can lead to adverse outcomes for colorectal surgeries due to technical challenges and pro-inflammatory immune mediators associated with excess adipose tissue. Surgical planning, pre-operative risk stratification, and patient counseling of pediatric Crohn’s disease (CD) patients are limited by the scarcity of data on this topic. We sought to determine the association between obesity and hospital readmission in children with CD undergoing intestinal resection.

METHODS: We used the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database to identify pediatric CD patients undergoing intestinal resection between 2012 and 2018. We calculated age- and sex-adjusted body mass index (BMI) Z-scores using CDC population statistics. We used logistic regression to evaluate the association between obesity and readmission compared to average-BMI patients adjusting for age, race, sex, steroid exposure, disease activity and surgery type.

RESULTS: We evaluated 1,258 pediatric CD intestinal resections occurring between 2012 and 2018. Patients were predominantly adolescent (91%), white (84%), and male (56%). Those with average BMI comprised 50% of the cohort, 31% were underweight, 11% overweight, and 8% obese. The overall 30-day hospital readmission rate was 8.8%. Compared to those with average BMI, obese children had a 2-fold (aOR 1.9, 95% CI, 1.0-3.8) increase in risk of hospital readmission.

CONCLUSIONS: Obese patients undergoing intestinal resection face a higher risk of 30-day hospital readmission compared to average-BMI patients. These results can inform pre-surgical risk counseling and underscore the need for long-term weight management strategies to aid in risk reduction for obese children with CD at risk of future surgery.

An infographic is available for this article at:http://links.lww.com/MPG/C451.

PMID:34321423 | DOI:10.1097/MPG.0000000000003251

J Cardiovasc Nurs. 2021 Jul 23. doi: 10.1097/JCN.0000000000000839. Online ahead of print.

ABSTRACT

BACKGROUND: ST-segment elevation myocardial infarction (STEMI) requires prompt therapy. It is recommended for door-to-balloon (DTB) times to be less than 90 minutes. In the United States, some locations have difficulty meeting this goal.

OBJECTIVE: The objective of this study was to determine whether implementation of a STEMI network decreased DTB times at a large, STEMI-receiving, metropolitan academic hospital in the southeastern United States. Furthermore, differences among presentation types, including walk-in, emergency medical services, and transfers, were explored.

METHODS: A pre-post time series study of electronic medical record data was conducted to evaluate the efficacy of a STEMI network.

RESULTS: The sample included 127 patients with a diagnosis of STEMI, collected during 3 periods (T1, T2, and T3). Patients were primarily White (78.0%) and male (67.7%), with a mean (SD) age of 58.9 (13.9) years. The 1-way analysis of variance revealed a significant difference in overall DTB times, F2 = 11.66, P < .001. Post hoc comparisons indicated longer mean DTB times for T1 compared with T3 (P < .001) and T2 (P < .001). When exploring presentation type, 1-way analysis of variance revealed a significant difference in mean DTB times in transfer patients between T1 and T2 (P < .001) and T1 to T3 (P < .001). No other statistical differences were noted; however, all DTB times with the exception of T2 for emergency medical services presentation decreased.

CONCLUSIONS: Implementation of a STEMI network was effective at decreasing overall DTB times with patients who presented to the hospital with a diagnosis of STEMI.

PMID:34321434 | DOI:10.1097/JCN.0000000000000839