PubMed · 16186569
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Murray M Finkelstein. 2005-09-27. Modelling continuous data.. https://doi.org/10.1503/cmaj.1050102
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We propose an extension of the Harezlak and Heckman (J. Comput. Graph. Statist. 2001; 10(4): 713-729) test for detecting local extrema to the longitudinal data setting. We use penalized spline regression techniques (Statist. Sci. 1996; 11:89-102) to provide a computationally efficient method of testing for relatively large data sets. We estimate the p-values of our test, LongCriSP, with a smoothed bootstrap. Our simulation studies indicate that the test is generally conservative and has power exceeding 70 per cent at the alpha = 0.1 nominal level in most considered settings. Finally, we apply our testing procedure to the longitudinal measurements of body mass index of former prisoners of war in Vietnam and conclude that the mean population curve exhibits non-monotone behaviour.
We present a study of the pressures developed at the bony prominences (greater trochanter, iliac crest and sacrum) when a pelvic binder was applied to 10 healthy individuals. The pressures developed between the pelvic binder and the skin over the prominences were all greater than the pressure recommended at interfaces to avoid the development of pressure sores. This suggests that patients with pelvic fractures who are treated with temporary pelvic binders are at risk of developing pressure sores. This should be recognised and the skin inspected if the binder is to be in place for a prolonged period.
BACKGROUND: Gastroesophageal reflux disease (GERD) is a common cause of morbidity and health-care utilization in many countries. Obesity is a potentially modifiable risk factor, but existing studies have conflicting results, possibly due to differences in study design, definitions, or populations. METHODS: We performed a systematic review and meta-analysis of studies identified using MEDLINE, the Web of Science electronic database, manual literature review, and a review of expert bibliographies. Studies were included if they: (1) evaluated obesity, body mass index (BMI), or another measure of body size; (2) included data on reflux symptoms, esophagitis, or a GERD-related hospitalization; and (3) reported a relative risk or odds ratio (OR) with confidence intervals or provided sufficient data to permit their calculation. RESULTS: We identified 20 studies that included 18,346 patients with GERD. Studies from the United States demonstrated an association between increasing BMI and the presence of GERD (95% confidence interval [CI]= 1.36-1.80, overweight, OR = 1.57, P value homogeneity = 0.51, 95% CI = 1.89-2.45, obese, OR = 2.15, P= 0.10). Studies from Europe provided heterogeneous results despite stratification for several factors; individual studies demonstrated both positive associations and no association. CONCLUSIONS: This analysis demonstrates a positive association between increasing BMI and the presence of GERD within the United States; this relationship became apparent only after stratification by country and level of BMI. These results support the evaluation of weight reduction as a potential therapy for GERD. Further studies are needed to evaluate potential mechanisms and any differences in this relationship among different study populations.