The win ratio is a general method of comparing locations of distributions of two independent, ordinal random variables, and it can be estimated without distributional assumptions. In this paper we ...provide a unified theory of win ratio estimation in the presence of stratification and adjustment by a numeric variable. Building step by step on the estimate of the crude win ratio we compare corresponding tests with well known non-parametric tests of group difference (Wilcoxon rank-sum test, Fligner–Policello test, van Elteren test, test based on the regression on ranks, and the rank analysis of covariance test). We show that the win ratio gives an interpretable treatment effect measure with corresponding test to detect treatment effect difference under minimal assumptions.
Post-exertional malaise (PEM) is often considered a cardinal symptom of Chronic Fatigue Syndrome (CFS). There is no gold standard diagnostic method for CFS, however, and the Centers for Disease ...Control (CDC) Fukuda case definition does not require PEM. Research has identified differences in symptom burden between patients according to PEM, but whether it is associated with psychological distress has not been investigated.
The CDC CFS Inventory, Fatigue Symptom Inventory, Profile of Mood States, Center for Epidemiologic Studies Depression Scale, Perceived Stress Scale, and subscales of the Sickness Impact Profile were administered to 261 patients diagnosed with the Fukuda criteria. PEM status (loPEM/hiPEM) was determined via self-reported post-exertional fatigue severity. Analyses of covariance (ANCOVA), controlling for age and gender, assessed cross-sectional group differences, and cross-sectional linear regressions using the continuous PEM severity predictor paralleled these analyses.
hiPEM patients reported greater symptom intensity, frequency, and interference than loPEM counterparts (p's < .001). hiPEM patients also reported greater social disruption, depressive symptoms, and mood disturbance (p's ≤ .011). Groups did not differ in recent negative life experiences, perceived stress, or demographic variables. The results of regression analyses mirrored those of ANCOVAs.
This study replicates the association between PEM and symptom burden and additionally associates PEM with psychological distress; psychological distress could, however, be a consequence of symptom burden. Differences between hiPEM and loPEM CFS patients highlight the heterogeneity of diagnoses resulting from the Fukuda criteria. It is also possible that PEM identifies particularly distressed patients for whom psychological intervention would be most beneficial.
•Patients high in PEM endorse greater symptom burden than those low in PEM.•Patients high in PEM endorse greater psychological adversity than those low in PEM.•Results suggest the Fukuda case definition does not define a heterogeneous group.•PEM may identify patients who would most benefit from psychological intervention.
Background
Age, race, and gender differences in coagulation status of healthy volunteers have been reported in previous case series; however, rigorous multivariate analysis adjusting for these ...factors is lacking. We aimed to investigate the effects of age, race, and gender on baseline coagulation status in healthy volunteers.
Methods
Thirty healthy volunteer controls with no history of bleeding or thrombotic events and no previous anticoagulant or antiplatelet use were recruited. Citrated and heparinized blood samples were drawn, and kaolin and platelet-mapping thromboelastography (TEG) assays performed.
Results
Thirty participants had a mean age of 37, mean body mass index of 29 kg/m2, and were 47% African-American and 70% female. Women were significantly older than men (40 ± 11 y vs 28 ± 7 y, P = .002); there were no significant differences in demographics by race. Multivariate analysis of variance for the effect of age, race, and gender across TEG parameters yielded evidence for gender differences in hypercoagulability (Pillai’s trace P = .02), which appear to be driven by differences in K-time, alpha angle, maximal amplitude, and G parameter. Women were hypercoagulable compared to men, as manifested by shorter K-time, steeper alpha angle, higher maximal amplitude, and larger G parameter.
Discussion
Women at baseline have relatively hypercoagulable fibrin deposition kinetics, platelet contributions to clot formation, and overall clot strength compared to men, even when adjusted for age and race. Additional research is needed to specifically detail the key patient-level factors, clinical implications, and opportunities for tailored therapy related to gender-associated hypercoagulability.
In addition to treatment assignments and observed outcomes, covariate information is often available prior to randomization in completely randomized experiments that compare an active treatment ...versus control. The analysis of covariance (ANCOVA) method is commonly applied to adjust for baseline covariates in order to improve precision. We focus on making propensity score-based adjustment to covariates under the completely randomized design in a finite population of experimental units with two treatment groups. We study inverse probability weighting (IPW) estimation of the finite-population average treatment effect for a general class of working propensity score models, which includes generalized linear models for binary data. We provide randomization-based asymptotic analysis of the propensity score approach and explore the finite-population asymptotic behaviors of two IPW estimators of the average treatment effect. We identify a condition under which propensity score-based covariate adjustment is asymptotically equivalent to an ANCOVA-based covariate adjustment and improves precision compared with a simple unadjusted comparison between treatment and control arms. In particular, when the working propensity score is fitted by a generalized linear model for binary data with an intercept term, the asymptotic variance of the IPW estimators is the same for any link function, including identity link, logit link, probit link, and complementary log-log link. We demonstrate these methods using an HIV clinical trial and a post-traumatic stress disorder study. Finally, we present a simulation study comparing the finite-sample performance of IPW and other methods for both continuous and binary outcomes.
Supplementary materials
for this article are available online.
Quantitative polymerase chain reaction (qPCR) is the technique of choice for quantifying gene expression. While the technique itself is well established, approaches for the analysis of qPCR data ...continue to improve. Here we expand on the common base method to develop procedures for testing linear relationships between gene expression and either a measured dependent variable, independent variable, or expression of another gene. We further develop functions relating variables to a relative expression value and develop calculations for determination of associated confidence intervals. Traditional qPCR analysis methods typically rely on paired designs. The common base method does not require such pairing of samples. It is therefore applicable to other designs within the general linear model such as linear regression and analysis of covariance. The methodology presented here is also simple enough to be performed using basic spreadsheet software.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Treatment responses may differ between patients with severe versus moderate atopic dermatitis (AD).
Objectives
To assess dupilumab response by baseline AD severity in adolescent and adult ...patients with moderate‐to‐severe AD.
Methods
We assessed dupilumab response by baseline AD severity in 1719 patients aged ≥12 years with moderate‐to‐severe AD from five randomized, double‐blind, placebo‐controlled trials. Patients received subcutaneous placebo or dupilumab as monotherapy (300 mg adults, adolescents or 200 mg adolescents every 2 weeks; 16 weeks), or with concomitant topical corticosteroids (TCS) (adults; 16/52 weeks). Patients were stratified by baseline Investigator's Global Assessment (IGA) score (3 moderate/4 severe).
Results
Dupilumab‐treated patients with moderate AD had numerically higher absolute proportions of patients achieving IGA 0/1 (clear/almost clear) than those with severe AD; risk differences (dupilumab vs. placebo) were 18.9–35.5 for moderate AD and 16.4–34.2 for severe AD. For all other endpoints assessed, no meaningful differences or consistent response patterns between moderate and severe subgroups were observed.
Conclusions
Dupilumab with or without TCS demonstrated similar efficacy in patients with moderate or severe AD.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is characterized by deficits in social communication, interaction, and stereotypical behaviours. Children with ASD have not enough ...opportunities to participate in physical activity (PA), which lead to increase fitness and health problem. The aim of this study was to compare two programs on motor skills. In the current investigation, 30 high functioning autistic children were diagnosed by a psychiatrist and randomly divided into control and experimental groups. The evaluation tools included the Brininx-Oresetsky Test (BOT) and a program named "I can have physical literacy" (ICPL) and Sport, Play, and Active Recreation for Kids (SPARK). The experimental intervention groups received sixteen sessions of 60 min, while the control group did not receive any treatment. Analysis of covariance was used to determine the difference between the groups. Post-hoc test was used to compare pairs of groups. Results showed that the experimental ICPL and Spark groups had increased motor skills (MS). There were significant differences between groups on gross motor skills. There were significant differences between the control and experimental ICPL groups, and between the experimental Spark and experimental ICPL groups. Both of these programs increased MS. ICPL program that address the characteristics of children with ASD, have a positive effect on their MS.
Studies have suggested that the brain morphology and flight ability of Aves are interrelated; however, such a relationship has not been thoroughly investigated. This study aimed to examine whether ...flight ability, volant or flightless, affects brain morphology (size and shape) in the Rallidae, which has independently evolved to adapt secondary flightlessness multiple times within a single taxonomic group. Brain endocasts were extracted from computed tomography images of the crania, measured by 3D geometric morphometrics, and were analyzed using principal component analysis. The results of phylogenetic ANCOVA showed that flightless rails have brain sizes and shapes that are significantly larger than and different from those of volant rails, even after considering the effects of body mass and brain size respectively. Flightless rails tended to have a wider telencephalon and more inferiorly positioned foramen magnum than volant rails. Although the brain is an organ that requires a large amount of metabolic energy, reduced selective pressure for a lower body weight may have allowed flightless rails to have larger brains. The evolution of flightlessness may have changed the position of the foramen magnum downward, which would have allowed the support of the heavier cranium. The larger brain may have facilitated the acquisition of cognitively advanced behavior, such as tool‐using behavior, among rails.
Flightless rails have brain sizes and shapes that are significantly larger than and different from those of volant rails. Flightless rails tended to have a wider telencephalon and more inferiorly positioned foramen magnum than volant rails. The larger brain may have facilitated the acquisition of cognitively advanced behavior, such as tool‐using behavior, among rails.
Disruptions in the inter-regional connective correlation within the brain are believed to contribute to memory impairment. To detect these corresponding correlation networks in Alzheimer's disease ...(AD), we conducted three types of inter-regional correlation analysis, including structural covariance, functional connectivity and group-level independent component analysis (group-ICA). The analyzed data were obtained from the Alzheimer's Disease Neuroimaging Initiative, comprising 52 cognitively normal (CN) participants without subjective memory concerns, 52 individuals with late mild cognitive impairment (LMCI) and 52 patients with AD. We firstly performed vertex-wise cortical thickness analysis to identify brain regions with cortical thinning in AD and LMCI patients using structural MRI data. These regions served as seeds to construct both structural covariance networks and functional connectivity networks for each subject. Additionally, group-ICA was performed on the functional data to identify intrinsic brain networks at the cohort level. Through a comparison of the structural covariance and functional connectivity networks with ICA networks, we identified several inter-regional correlation networks that consistently exhibited abnormal connectivity patterns among AD and LMCI patients. Our findings suggest that reduced inter-regional connectivity is predominantly observed within a subnetwork of the default mode network, which includes the posterior cingulate and precuneus regions, in both AD and LMCI patients. This disruption of connectivity between key nodes within the default mode network provides evidence supporting the hypothesis that impairments in brain networks may contribute to memory deficits in AD and LMCI.
Introduction and Hypothesis
Venous injury may occur during exposure of the anterior longitudinal ligament at the anterior sacral promontory (SP). We aimed to quantitatively measure the extent of the ...vascular window (VW) in front of the SP in patients with internal iliac vein (IIV) variations using preoperative three-dimensional computed tomography angiography (3DCTA). We hypothesized that patients with IIV variations would have a narrow VW.
Methods
This prospective observational study included patients scheduled for laparoscopic sacrocolpopexy (LSC) between July 2022 and April 2023 who underwent preoperative 3DCTA. The primary endpoint was the VW measurement in the standard and variant IIV groups using 3DCTA before LSC. The secondary endpoint was the difference between the two IIV groups adjusted for age, body mass index, hypertension, and diabetes using an analysis of covariance (ANCOVA) model. Multiple regression analysis was performed to analyze the effect of factors on the distance from the SP to great vascular bifurcations.
Results
There were 20 cases of IIV variation (20.2%). VW was 28.8 ± 12.4 mm in the variant group and 39.6 ± 12.6 mm in the standard group (
p
= 0.001). In the ANCOVA model, IIV variations affected VW (coefficient, –11.8; 95% confidence interval CI, –18.4 to –5.08,
p
< 0.001). Multivariate analysis revealed that the aorta–SP distance decreased with age (coefficient, −0.44; 95% CI, −0.77 to −0.11,
p
= 0.009).
Conclusions
One in five women has a vascular variant at the SP that restricts the “safe” zone of fixation to < 3 cm.
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