scholarly journals Response to Pediatric Physical Therapy in Infants With Positional Preference and Skull Deformation

2014 ◽  
Vol 94 (9) ◽  
pp. 1262-1271 ◽  
Author(s):  
Renske M. van Wijk ◽  
Maaike Pelsma ◽  
Catharina G.M. Groothuis-Oudshoorn ◽  
Maarten J. IJzerman ◽  
Leo A. van Vlimmeren ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Physical Therapy ◽  
Poor Response ◽  
Parental Satisfaction ◽  
Response To Therapy ◽  
Satisfaction Score ◽  
Multiple Logistic Regression ◽  
Study Objective ◽  
Positional Preference ◽  
Skull Deformation

Background Pediatric physical therapy seems to reduce skull deformation in infants with positional preference. However, not all infants show improvement. Objective The study objective was to determine which infant and parent characteristics were related to responses to pediatric physical therapy in infants who were 2 to 4 months old and had positional preference, skull deformation, or both. Design This was a prospective cohort study. Methods Infants who were 2 to 4 months old and had positional preference, skull deformation, or both were recruited by pediatric physical therapists at the start of pediatric physical therapy. The primary outcome was a good response or a poor response (moderate or severe skull deformation) at 4.5 to 6.5 months of age. Potential predictors for responses to pediatric physical therapy were assessed at baseline with questionnaires, plagiocephalometry, and the Alberta Infant Motor Scale. Univariate and multiple logistic regression analyses with a stepwise backward elimination method were performed. Results A total of 657 infants participated in the study. At follow-up, 364 infants (55.4%) showed a good response to therapy, and 293 infants (44.6%) showed a poor response. Multiple logistic regression analysis resulted in the identification of several significant predictors for a poor response to pediatric physical therapy at baseline: starting therapy after 3 months of age (adjusted odds ratio [aOR]=1.50, 95% confidence interval [95% CI]=1.04–2.17), skull deformation (plagiocephaly [aOR=2.64, 95% CI=1.67–4.17] or brachycephaly [aOR=3.07, 95% CI=2.09–4.52]), and a low parental satisfaction score (aOR=2.64, 95% CI=1.67–4.17). A low parental satisfaction score indicates low parental satisfaction with the infant's head shape. Limitations Information about pediatric physical therapy was collected retrospectively and included general therapy characteristics. Because data were collected retrospectively, no adjustment in therapy for individual participants could be made. Conclusions Several predictors for responses to pediatric physical therapy in infants who were 2 to 4 months old and had positional preference, skull deformation, or both were identified. Health care professionals can use these predictors in daily practice to provide infants with more individualized therapy, resulting in a better chance for a good outcome.

Determining the Most Valuable Clinical Variables : a Stepwise Multiple Logistic Regression Program

1980 ◽  
Vol 19 (01) ◽  
pp. 42-49 ◽  
Author(s):  
B. W. Brown ◽  
C. Engelhard ◽  
J. Haipern ◽  
J. F. Fries ◽  
L. S. Coles
Keyword(s):  
Logistic Regression ◽  
Predictor Variable ◽  
Clinical Problem ◽  
Relevant Information ◽  
Stepwise Logistic Regression ◽  
Multiple Logistic Regression ◽  
Binary Outcome ◽  
Medical Problems ◽  
Valuable Predictor ◽  
Data Banks

In solving a clinical problem of diagnosis, prognosis, or treatment choice, a physician must select from among a large group of possible tests. In general, an ordering exists specifying which tests are most valuable in providing relevant information concerning the problem on hand. The computer program package to be described (MW) extracts appropriate data from the ARAMIS data banks and then analyzes the data by stepwise logistic regression. A binary outcome (diagnosis, prognostic event, or treatment response) is sequentially associated with possible tests, and the most powerful combination of tests is identified. For example, the most valuable predictor variable of early mortality in SLE is proteinuria, followed sequentially by anemia and absence of arthritis. Experience with these techniques suggests : 1. optimal certainty is usually reached after only three or four tests; 2. several different test sequences may lead to the same level of certainty; 3. diagnosis may usually be ascertained with greater certainty than prognosis; 4. many medical problems contain considerable non-reducible uncertainty; 5. a relatively small group of tests are typically found among the most powerful; 6. results are consistent across several patient populations; 7. results are largely independent of the particular statistic employed. These observations suggest strategies for maximizing information while minimizing risk and expense.

Experimental study on the factors affecting squeak noise occurrence in automotive suspension bushings

2021 ◽  
pp. 095440702110241
Author(s):  
Byunghyun Kang ◽  
Cheol Choi ◽  
Daeun Sung ◽  
Seongho Yoon ◽  
Byoung-Ho Choi
Keyword(s):  
Neural Network ◽  
Logistic Regression ◽  
Influencing Factors ◽  
Frictional Force ◽  
Prediction Models ◽  
Statistical Tests ◽  
Network Models ◽  
Multiple Logistic Regression ◽  
Neural Network Models ◽  
Automotive Suspension

In this study, friction tests are performed, via a custom-built friction tester, on specimens of natural rubber used in automotive suspension bushings. By analyzing the problematic suspension bushings, the eleven candidate factors that influence squeak noise are selected: surface lubrication, hardness, vulcanization condition, surface texture, additive content, sample thickness, thermal aging, temperature, surface moisture, friction speed, and normal force. Through friction tests, the changes are investigated in frictional force and squeak noise occurrence according to various levels of the influencing factors. The degree of correlation between frictional force and squeak noise occurrence with the factors is determined through statistical tests, and the relationship between frictional force and squeak noise occurrence based on the test results is discussed. Squeak noise prediction models are constructed by considering the interactions among the influencing factors through both multiple logistic regression and neural network analysis. The accuracies of the two prediction models are evaluated by comparing predicted and measured results. The accuracies of the multiple logistic regression and neural network models in predicting the occurrence of squeak noise are 88.2% and 87.2%, respectively.

Association between Procalcitonin and Acute Kidney Injury in Patients with Bacterial Septic Shock

2021 ◽  
pp. 1-10
Author(s):  
Guang Fu ◽  
Hai-chao Zhan ◽  
Hao-li Li ◽  
Jun-fu Lu ◽  
Yan-hong Chen ◽  
...  
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Piecewise Linear ◽  
Kidney Injury ◽  
Multiple Logistic Regression ◽  
Primary Analysis ◽  
Female Patients ◽  
Potential Biomarker ◽  
The Relationship

Objective: The objective of this study was to assess the relationship between serum procalcitonin (PCT) and acute kidney injury (AKI) induced by bacterial septic shock. Methods: A retrospective study was designed which included patients who were admitted to the ICU from January 2015 to October 2018. Multiple logistic regression and receiver operating characteristic (ROC) as well as smooth curve fitting analysis were used to assess the relationship between the PCT level and AKI. Results: Of the 1,631 patients screened, 157 patients were included in the primary analysis in which 84 (53.5%) patients were with AKI. Multiple logistic regression results showed that PCT (odds ratio [OR] = 1.017, 95% confidence interval [CI] 1.009–1.025, p < 0.001) was associated with AKI induced by septic shock. The ROC analysis showed that the cutoff point for PCT to predict AKI development was 14 ng/mL, with a sensitivity of 63% and specificity 67%. Specifically, in multivariate piecewise linear regression, the occurrence of AKI decreased with the elevation of PCT when PCT was between 25 ng/mL and 120 ng/mL (OR 0.963, 95% CI 0.929–0.999; p = 0.042). The AKI increased with the elevation of PCT when PCT was either <25 ng/mL (OR 1.077, 95% CI 1.022–1.136; p = 0.006) or >120 ng/mL (OR 1.042, 95% CI 1.009–1.076; p = 0.013). Moreover, the PCT level was significantly higher in the AKI group only in female patients aged ≤75 years (p = 0.001). Conclusions: Our data revealed a nonlinear relationship between PCT and AKI in septic shock patients, and PCT could be used as a potential biomarker of AKI in female patients younger than 75 years with bacterial septic shock.

Risk factors and outcomes of postoperative emergency response team activation: a matched case-control study

2020 ◽  
Vol 22 (1) ◽  
pp. 6-14
Author(s):  
Matthew I Hardman ◽  
◽  
S Chandralekha Kruthiventi ◽  
Michelle R Schmugge ◽  
Alexandre N Cavalcante ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Postoperative Complications ◽  
Emergency Response ◽  
Case Control Study ◽  
Case Control ◽  
Multiple Logistic Regression ◽  
Increased Risk ◽  
Response Team ◽  
Control Study

OBJECTIVE: To determine patient and perioperative characteristics associated with unexpected postoperative clinical deterioration as determined for the need of a postoperative emergency response team (ERT) activation. DESIGN: Retrospective case–control study. SETTING: Tertiary academic hospital. PARTICIPANTS: Patients who underwent general anaesthesia discharged to regular wards between 1 January 2013 and 31 December 2015 and required ERT activation within 48 postoperative hours. Controls were matched based on age, sex and procedure. MAIN OUTCOME MEASURES: Baseline patient and perioperative characteristics were abstracted to develop a multiple logistic regression model to assess for potential associations for increased risk for postoperative ERT. RESULTS: Among 105 345 patients, 797 had ERT calls, with a rate of 7.6 (95% CI, 7.1–8.1) calls per 1000 anaesthetics (0.76%). Multiple logistic regression analysis showed the following risk factors for postoperative ERT: cardiovascular disease (odds ratio [OR], 1.61; 95% CI, 1.18–2.18), neurological disease (OR, 1.57; 95% CI, 1.11–2.22), preoperative gabapentin (OR, 1.60; 95% CI, 1.17–2.20), longer surgical duration (OR, 1.06; 95% CI, 1.02–1.11, per 30 min), emergency procedure (OR, 1.54; 95% CI, 1.09–2.18), and intraoperative use of colloids (OR, 1.50; 95% CI, 1.17–1.92). Compared with control participants, ERT patients had a longer hospital stay, a higher rate of admissions to critical care (55.5%), increased postoperative complications, and a higher 30-day mortality rate (OR, 3.36; 95% CI, 1.73–6.54). CONCLUSION: We identified several patient and procedural characteristics associated with increased likelihood of postoperative ERT activation. ERT intervention is a marker for increased rates of postoperative complications and death.

Polymorphisms 677C > T and 1298A > C in the MTHFR gene and homocysteine levels in patients with non-alcoholic fatty liver disease as a component of the ontological model

2021 ◽  
Author(s):  
N. A. Nosko ◽  
O. M. Rud
Keyword(s):  
Logistic Regression ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Mthfr Gene ◽  
Scientific Data ◽  
Multiple Logistic Regression ◽  
Alcoholic Fatty Liver ◽  
Significant Difference ◽  
Alcoholic Fatty Liver Disease

Objective — to systematize literature data on the presence of 677C > T and 1298A > C polymorphisms in the MTHFR gene and homocysteine levels in patients with non‑alcoholic fatty liver disease (NAFLD); to calculate the frequencies 677C > T and 1298A > C polymorphisms combinations in the MTHFR gene and their impact on NAFLD development; to compare homocysteine levels in patients with and without NAFLD. Materials and methods. The analysis has been performed for the results of investigation of 49 patients, from them 17 subjects with NAFLD and 32 without it. Clinical, laboratory, statistical and ontological methods were used in the study. The MTHFR 677C > T and MTHFR 1298A > C polymorphisms in the MTHFR gene were investigated with the use of real time polymerase chain reaction (RT‑PCR) technique. Homocysteine levels were determined with chemiluminescent immunoassay with reference values 3.7 — 13.9 µmol/L. Multiple logistic regression method was used to evaluate the effects 677C > T and 1298A > C polymorphisms in the MTHFR gene on NAFLD development. Results. The variant of combination of 667С/С/1298А/А polymorphisms in the MTHFR gene (absence of mutation) was reveled in 6 (12 %) persons, that showed a widespread prevalence of variants with the presence of mutations. The correlation between variants of 677C > T and 1298A > C polymorphism in the MTHFR gene has been established (r = 0.429; p < 0.05). The results of multiple logistic regression demonstrated absence of the significant effects of 677C > T and 1298A > C polymorphisms in the MTHFR gen on NAFLD development (p > 0.05). Comparison of the homocysteine levels in patients with and without NAFLD didn’t reveal significant difference (р > 0.05), as well as comparison in the groups with combinations of 677C > T and 1298А > С polymorphisms in the MTHFR gen (р > 0.05). This can be explained by the fact that NAFLD group consisted of manly young patients without hypertension, type 2 diabetes mellitus and severe liver fibrosis. Conclusions. Ontological systematization of the scientific data on NAFLD revealed that 677C > T and 1298A > C polymorphisms in the MTHFR gen are pathogenetically associated with the significant increase in homocysteine levels as a marker of cardiovascular pathology. Giving the multifactorial nature of hyperhomocysteinemia and wide spread of 677C > T and 1298A > C polymorphisms in the MTHFR gen in population, it seems to be impractical to use genetic investigations for MTHFR gen polymorphism in NAFLD patients routinely, but only for the purpose of differential diagnosis of hyperhomocysteinemia.  

Abstract 395: State-Level CPR Education Legislation Associated With Higher Survival After Out-Of-Hospital Cardiac Arrest in Older Adults

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
David G Buckler ◽  
Megan Barnes ◽  
Tyler D Alexander ◽  
Marissa Lang ◽  
Alexis M Zebrowski ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Cardiac Arrest ◽  
State Level ◽  
Categorical Variables ◽  
Multiple Logistic Regression ◽  
Education Legislation ◽  
Chi Squared ◽  
Patient State ◽  
Hospital Cardiac Arrest

Introduction: State-level legislation requiring CPR education prior to high school graduation (CPR Legislation) is associated with an increased likelihood of community-level CPR training. CPR Legislation has also been shown to be associated with increased bystander CPR. We hypothesized that states with recent CPR Legislation would be associated with higher survival in older adults following out-of-hospital cardiac arrest (OHCA). Methods: Utilizing 2014 Medicare Claims data for emergency department (ED) visits and inpatient stays, we identified OHCA via ICD-9-CM code. CPR Legislation data was collected through online statute review. Exposure to CPR Legislation was assessed using the patient state of residence reported on the first claim. Patient dispositions were coded as home, SNF, death/hospice, rehab or other. All categories were considered survival to discharge except for death/hospice. Associations between categorical variables were assessed by chi-squared test. Multiple logistic regression was used to calculate the odds ratio associated with OHCA survival and CPR Legislation, controlling for patient age and sex. Results: In 2014, 256,277 OHCAs were identified. Mean age was 79 ±8 y, 48% were female, 23% were non-white, and survival to discharge was 22%. Prior to 2013, 4 states had passed CPR Legislation and 6 others passed legislation in 2013. These states account for 12% of OCHA for the study year. States that passed CPR Legislation in 2013 had the highest survival compared to states with earlier passage or no CPR Legislation (22.2% vs 20.6% vs. 21.8%, respectively, p < 0.001). Among those who survived to discharge, more patients were discharged home from states with 2013 CPR Legislation, than earlier or no legislation (50.8% vs. 41.3% vs. 42.8%, p <0.001). Results of the multiple logistic regression showed CPR Legislation passed in 2013 was associated with a 12% increase in the odds of survival to discharge compared to states with CPR Legislation prior to 2013 (OR: 1.12, p <0.001). Conclusion: States with CPR Legislation passed in 2013 were associated with higher survival to discharge and discharge to home, compared to earlier adopters and states with no legislation. Further work is needed to assess the mechanisms underlying this relationship.

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