Blood-to-saliva glucose time lag in sedated healthy dogs

2021 ◽  
pp. 104063872110353
Author(s):  
Antonia Ioannou ◽  
Heidi Phillips ◽  
Stephanie Keating ◽  
Anne Barger ◽  
Nicolas Lopez-Villalobos ◽  
...  
Keyword(s):  
Glucose Concentration ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Time Lag ◽  
Area Under The Curve ◽  
Oral Bacteria ◽  
Glucose Levels ◽  
Healthy Dogs ◽  
Paired Serum

The management of diabetes mellitus mandates measurement of blood glucose. Saliva offers an alternative to blood sampling, but measurement of the salivary glucose concentration is difficult, and the blood-to-saliva glucose time lag is uncertain. We aimed to determine the serum–saliva glucose time lag in the saliva of healthy dogs. The combined duct of the mandibular and sublingual salivary glands of 6 dogs was cannulated to collect saliva and prevent glucose degradation by oral bacteria. Following a 0.25 g/kg IV bolus of dextrose, paired serum–saliva samples were collected at baseline and in twelve 5-min blocks over 60 min. Serum and salivary glucose levels were analyzed with a linear mixed model for repeated measures with a compound symmetry error structure. Mean (±SD) saliva production was 10.3 ± 2.9 µL/kg/min, and the area under the curve (AUCglucose)saliva/serum ratio was 0.006, which highlights the magnitude of the large difference in glucose concentration between the 2 compartments. The serum–saliva glucose time lag was 30–40 min.

Long-term seizure outcomes after pediatric temporal lobectomy: does brain MRI lesion matter?

2019 ◽  
Vol 24 (2) ◽  
pp. 200-208
Author(s):  
Ravindra Arya ◽  
Francesco T. Mangano ◽  
Paul S. Horn ◽  
Sabrina K. Kaul ◽  
Serena K. Kaul ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Hippocampal Sclerosis ◽  
Brain Mri ◽  
Temporal Lobectomy ◽  
Seizure Freedom ◽  
Seizure Onset

OBJECTIVEThere is emerging data that adults with temporal lobe epilepsy (TLE) without a discrete lesion on brain MRI have surgical outcomes comparable to those with hippocampal sclerosis (HS). However, pediatric TLE is different from its adult counterpart. In this study, the authors investigated if the presence of a potentially epileptogenic lesion on presurgical brain MRI influences the long-term seizure outcomes after pediatric temporal lobectomy.METHODSChildren who underwent temporal lobectomy between 2007 and 2015 and had at least 1 year of seizure outcomes data were identified. These were classified into lesional and MRI-negative groups based on whether an epilepsy-protocol brain MRI showed a lesion sufficiently specific to guide surgical decisions. These patients were also categorized into pure TLE and temporal plus epilepsies based on the neurophysiological localization of the seizure-onset zone. Seizure outcomes at each follow-up visit were incorporated into a repeated-measures generalized linear mixed model (GLMM) with MRI status as a grouping variable. Clinical variables were incorporated into GLMM as covariates.RESULTSOne hundred nine patients (44 females) were included, aged 5 to 21 years, and were classified as lesional (73%), MRI negative (27%), pure TLE (56%), and temporal plus (44%). After a mean follow-up of 3.2 years (range 1.2–8.8 years), 66% of the patients were seizure free for ≥ 1 year at last follow-up. GLMM analysis revealed that lesional patients were more likely to be seizure free over the long term compared to MRI-negative patients for the overall cohort (OR 2.58, p < 0.0001) and for temporal plus epilepsies (OR 1.85, p = 0.0052). The effect of MRI lesion was not significant for pure TLE (OR 2.64, p = 0.0635). Concordance of ictal electroencephalography (OR 3.46, p < 0.0001), magnetoencephalography (OR 4.26, p < 0.0001), and later age of seizure onset (OR 1.05, p = 0.0091) were associated with a higher likelihood of seizure freedom. The most common histological findings included cortical dysplasia types 1B and 2A, HS (40% with dual pathology), and tuberous sclerosis.CONCLUSIONSA lesion on presurgical brain MRI is an important determinant of long-term seizure freedom after pediatric temporal lobectomy. Pediatric TLE is heterogeneous regarding etiologies and organization of seizure-onset zones with many patients qualifying for temporal plus nosology. The presence of an MRI lesion determined seizure outcomes in patients with temporal plus epilepsies. However, pure TLE had comparable surgical seizure outcomes for lesional and MRI-negative groups.

scholarly journals Joint modeling of multiple repeated measures and survival data using multidimensional latent trait linear mixed model

2018 ◽  
Vol 28 (10-11) ◽  
pp. 3392-3403 ◽  
Author(s):  
Jue Wang ◽  
Sheng Luo
Keyword(s):  
Survival Data ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Proportional Hazards Model ◽  
Latent Trait ◽  
Joint Modeling ◽  
Fine Motor ◽  
Terminal Event ◽  
Longitudinal Outcomes

Impairment caused by Amyotrophic lateral sclerosis (ALS) is multidimensional (e.g. bulbar, fine motor, gross motor) and progressive. Its multidimensional nature precludes a single outcome to measure disease progression. Clinical trials of ALS use multiple longitudinal outcomes to assess the treatment effects on overall improvement. A terminal event such as death or dropout can stop the follow-up process. Moreover, the time to the terminal event may be dependent on the multivariate longitudinal measurements. In this article, we develop a joint model consisting of a multidimensional latent trait linear mixed model (MLTLMM) for the multiple longitudinal outcomes, and a proportional hazards model with piecewise constant baseline hazard for the event time data. Shared random effects are used to link together two models. The model inference is conducted using a Bayesian framework via Markov chain Monte Carlo simulation implemented in Stan language. Our proposed model is evaluated by simulation studies and is applied to the Ceftriaxone study, a motivating clinical trial assessing the effect of ceftriaxone on ALS patients.

scholarly journals Changes in Income after an Industrial Accident According to Industry and Return-to-Work Status

2019 ◽  
Vol 16 (14) ◽  
pp. 2603 ◽  
Author(s):  
Suk Won Bae ◽  
Sarah Soyeon Oh ◽  
Wha Me Park ◽  
Jaehoon Roh ◽  
Jong-Uk Won
Keyword(s):  
Return To Work ◽  
Repeated Measures ◽  
Original Work ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Service Industry ◽  
Panel Study ◽  
Work Status ◽  
Industrial Accident ◽  
Industrial Accidents

Objective: To investigate changes in the incomes of workers, particularly those in the construction sector, who experienced industrial accidents according to their status of return to work. Methods: We used data from the fifth Panel Study of Workers’ Compensation Insurance. A repeated measures ANOVA was used to compare annual differential incomes before and after the industrial accident, and a linear mixed model was used to investigate the changes in income from before to after the industrial accident according to the industry and return-to-work status. Results: A comparison of the industrial categories revealed that construction industry workers exhibited the greatest incomes before the accident and the greatest decrease in income after the industrial accident. Regression analysis for assessing changes in income after the industrial accident showed that a comparison by industry revealed a significantly greater reduction in income in the construction than service industry. A comparison by work status revealed significantly greater decreases in income in the reemployment and non-return to work groups than among those who returned to their original work. Conclusions: The economic statuses of the victims of industrial accidents decreased relative to the pre-accident statuses in all industries. The ability to return to original work is important for preserving the accident victim’s economic status.

scholarly journals Endoscopic sleeve gastroplasty, laparoscopic sleeve gastrectomy, and laparoscopic greater curve plication: do they differ at 2 years?

Endoscopy ◽  
2020 ◽  
Author(s):  
Gontrand Lopez-Nava ◽  
Ravishankar Asokkumar ◽  
Inmaculada Bautista-Castaño ◽  
Janese Laster ◽  
Anuradha Negi ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Effective Treatment Option ◽  
Endoscopic Sleeve Gastroplasty ◽  
Sleeve Gastroplasty ◽  
Laparoscopic Greater Curve Plication

Abstract Background Endoscopic sleeve gastroplasty (ESG) is an effective treatment option for obesity. However, data comparing its efficacy to bariatric surgery are scarce. We aimed to compare the effectiveness and safety of ESG with laparoscopic sleeve gastrectomy (LSG) and laparoscopic greater curve plication (LGCP) at 2 years. Methods We reviewed 353 patient records and identified 296 patients who underwent ESG (n = 199), LSG (n = 61), and LGCP (n = 36) at four centers in Spain between 2014 and 2016. We compared their total body weight loss (%TBWL) and safety over 2 years. A linear mixed model (LMM) was used to analyze repeated measures of weight loss outcomes at 6, 12, 18, and 24 months to compare the three procedures. Results Among the 296 patients, 210 (ESG 135, LSG 43, LGCP 32) completed 1 year of follow-up and 102 (ESG 46, LSG 34, LGCP 22) reached 2 years. Their mean (standard deviation [SD]) body mass index (BMI) was 39.6 (4.8) kg/m2. There were no differences in age, sex, or BMI between the groups. In LMM analysis, adjusting for age, sex, and initial BMI, we found ESG had a significantly lower TBWL, %TBWL, and BMI decline compared with LSG and LGCP at all time points (P = 0.001). The adjusted mean %TBWL at 2 years for ESG, LSG, and LGCP were 18.5 %, 28.3 %, and 26.9 %, respectively. However, ESG, when compared with LSG and LGCP, had a shorter inpatient stay (1 vs. 3 vs. 3 days; P < 0.001) and lower complication rate (0.5 % vs. 4.9 % vs. 8.3 %; P = 0.006). Conclusion All three procedures induced significant weight loss in obese patients. Although the weight loss was lower with ESG compared with other techniques, it displayed a better safety profile and shorter hospital stay.

Linear mixed model better than repeated measures analysis

2019 ◽  
Vol 30 (6) ◽  
pp. NP1-NP2 ◽  
Author(s):  
Işıl Kutluturk Karagoz ◽  
Berhan Keskin ◽  
Flora Özkalaycı ◽  
Ali Karagöz
Keyword(s):  
Mixed Models ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Linear Time ◽  
Case Series ◽  
Model Fit ◽  
Repeated Measures Analysis ◽  
Technical Issues ◽  
Better Than

We have some criticism regarding some technical issues. Mixed models have begun to play a pivotal role in statistical analyses and offer many advantages over more conventional analyses regarding repeated variance analyses. First, they allow to avoid conducting multiple t-tests; second, they can accommodate for within-patient correlation; third, they allow to incorporate not only a random coefficient, but also a random slope, typically ‘linear’ time in longitudinal case series when there are enough data and patients’ trajectories vary a lot and improving model fit.

Erythropoietin Treatment Is Associated with Decreased Blood Glucose Levels: A Preliminary Study in Hematologic Patients

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4793-4793
Author(s):  
Howard S Oster ◽  
Moran Gvili ◽  
Odelia Katz ◽  
Michael Hoffman ◽  
Drorit Neumann ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Repeated Measures ◽  
Mixed Model ◽  
Conflicts Of Interest ◽  
Cell Lineage ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Organ Systems ◽  
Average Glucose

Abstract Abstract 4793 Introduction: Erythropoietin (EPO) is the major hormone which enhances proliferation and maturation of the red cell lineage, and its recombinant form (rHuEPO) is used extensively to treat various types of anemia. rHuEPO has also been found to exert effects in other organ systems, and our previous work has demonstrated an immunomodulatory role for EPO. Recently, we have also found that mice exposed to high levels of EPO (either rHuEPO injections or transgenic mice overexpressing human EPO), have significantly lower levels of blood glucose than those of their respective controls (Katz et al., J Endocrinol 2010;205:87-95). The current retrospective study was designed to determine whether rHuEPO treatment in hematologic patients, is associated with decreased blood glucose levels. Methods: Patients receiving rHuEPO were examined, comparing glucose levels (morning blood tests, assumed to be fasting) while on rHuEPO treatment to those off treatment. All patients served as their own controls. To test the association between rHuEPO treatment and blood glucose levels, we employed a mixed-model repeated-measures analysis of variance (ANOVA). Results: The charts of 19 patients were reviewed to determine the starting date of rHuEPO and the levels of blood glucose in relation to rHuEPO treatment. Mean age: 77 (range: 54–93). Thirteen patients had myelodysplastic syndrome, and six had multiple myeloma. Two patients had diabetes mellitus. Average glucose levels (mean±95%CI) without rHuEPO treatment were 116.07±4.98. Glucose measurements were available for a median of 9.23 (interquartile range: 7.90–16.80) months after the initiation of rHuEPO treatment. The average glucose level over that period of time was 101.77±4.86 (p<0.0001). The two diabetic patients also demonstrated a trend towards reduced serum blood glucose and lower HbA1C while being treated with rHuEPO. Conclusions: Treatment of hematologic patients with rHuEPO is associated with significantly lower blood glucose levels, and might serve in the future to improve glucose control in anemic patients with hyperglycemia. Further studies with both diabetic and non-diabetic patients are currently underway to clarify this association. Disclosures: No relevant conflicts of interest to declare.

Tone, Rhythm, and Timbre Perception in School-Age Children Using Cochlear Implants and Hearing Aids

2013 ◽  
Vol 24 (09) ◽  
pp. 789-806 ◽  
Author(s):  
Hamish Innes-Brown ◽  
Jeremy P. Marozeau ◽  
Christine M. Storey ◽  
Peter J. Blamey
Keyword(s):  
Hearing Loss ◽  
Hearing Aids ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
School Age Children ◽  
Impaired Hearing ◽  
School Year ◽  
Temporal Cues ◽  
Wide Range

Background: Children with hearing impairments, especially those using hearing devices such as the cochlear implant (CI) or hearing aid (HA), are sometimes not encouraged to attend music classes, as they or their parents and teachers may be unsure whether the child can perform basic musical tasks. Purpose: The objective of the current study was to provide a baseline for the performance of children using CIs and HAs on standardized tests of rhythm and pitch perception as well as an instrument timbre identification task. An additional aim was to determine the effect of structured music training on these measures during the course of a school year. Research Design: The Intermediate Measures of Music Audiation (IMMA) Tonal and Rhythmic subtests were administered four times, with 6 wk between tests. All children in the study were also enrolled in “Music Club” teaching sessions. Measures were compared between groups and across the four testing sessions. Study Sample: Twenty children from a single school in Melbourne, Australia, were recruited. Eleven (four girls) had impaired hearing, including six with a unilateral CI or CI and HA together (two girls) and five with bilateral HAs (two girls). Nine were normally hearing, selected to match the age and gender of the hearing-impaired children. Ages ranged from 9–13 yr. Intervention: All children participated in a weekly Music Club – a 45 min session of musical activities based around vocal play and the integration of aural, visual, and kinesthetic modes of learning. Data Collection and Analysis: Audiological data were collected from clinical files. IMMA scores were converted to percentile ranks using published norms. Between-group differences were tested using repeated-measures analysis of variance, and between-session differences were tested using a linear mixed model. Linear regression was used to model the effect of hearing loss on the test scores. Results: In the first session, normally hearing children had a mean percentile rank of ˜50 in both the Tonal and Rhythmic subtests of the IMMA. Children using CIs showed trends toward lower scores in the Tonal, but not the Rhythmic, subtests. No significant improvements were found between sessions. In the timbre test, children generally made fewer errors within the set of percussive compared to nonpercussive instruments. The hearing loss level partially predicted performance in the Tonal, but not the Rhythmic, task, and predictions were more significant for nonpercussive compared to percussive instruments. Conclusions: The findings highlight the importance of temporal cues in the perception of music, and indicate that temporal cues may be used by children with CIs and HAs in the perception of not only rhythm, but also of some aspects of timbre. We were not able to link participation in the Music Club with increased scores on the Tonal, Rhythmic, and Timbre tests. However, anecdotal evidence from the children and their teachers suggested a wide range of benefits from participation in the Music Club that extended from increased engagement and interest in music classes into the children's social situations.

Effects of Exercise Restriction on Patients With Anomalous Aortic Origin of a Coronary Artery

2016 ◽  
Vol 8 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Matthew D. Elias ◽  
James Meza ◽  
Brian W. McCrindle ◽  
Julie A. Brothers ◽  
Stephen Paridon ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Exercise Capacity ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Multivariable Analysis ◽  
Young Patients ◽  
Significant Difference ◽  
Exercise Restriction ◽  
Over Time

Background: Management of young patients with anomalous aortic origin of a coronary artery (AAOCA) may involve exercise restriction. We sought to identify the association of exercise restriction with changes over time in body mass index (BMI) and exercise capacity in this cohort. Methods: We performed a retrospective review of patients with AAOCA seen at The Children’s Hospital of Philadelphia between January 1, 1998, and August 31, 2014. Linear mixed model repeated-measures analysis assessed changes in BMI and exercise capacity. Results: We included 72 patients with a median age at presentation of 12.6 years (interquartile range: 10.1-15.8) and mean follow-up of 3.6 ± 3.0 years. The majority had an anomalous right coronary artery (71%) and interarterial ± intramural coronary course (90%). Surgery was performed in 54%, more often in those with interarterial/intramural course ( P < .001) and symptoms ( P = .003). Most patients (82%) were exercise-restricted on presentation, and restricted patients were older than those who were not restricted ( P = .01). There was no significant difference between restricted and nonrestricted patients in initial BMI z scores, percentage of patients with BMI over 85th percentile (26%) or exercise capacity variables. In univariable analysis, exercise restriction over time was not associated with change in BMI z score ( P = .25) or change in exercise variables. Restriction was not associated with significant change in these variables in multivariable analysis. Conclusions: Although further investigation is warranted to determine the degree of adherence to exercise restriction, the recommendation of restriction alone is not associated with increasing BMI or decreasing exercise performance in the short-term.

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