Novel statistical approaches for censored immunological data

For several immune-mediated diseases, immunological analysis will become more complex in the future with datasets in which cytokine and gene expression data play a major role. These data have certain characteristics that require sophisticated statistical analysis such as strategies for non-normal distribution and censoring. Additionally, complex and multiple immunological relationships need to be adjusted for potential confounding and interaction effects.I aimed to introduce and apply different methods for statistical analysis of non-normal censored cytokine and gene expression data. Furthermore, I assessed the performance and accuracy of a novel regression approach in order to allow adjusting for covariates and potential confoundin

Novel statistical approaches for censored immunological data

For several immune-mediated diseases, immunological analysis will become more complex in the future with datasets in which cytokine and gene expression data play a major role. These data have certain characteristics that require sophisticated statistical analysis such as strategies for non-normal distribution and censoring. Additionally, complex and multiple immunological relationships need to be adjusted for potential confounding and interaction effects.I aimed to introduce and apply different methods for statistical analysis of non-normal censored cytokine and gene expression data. Furthermore, I assessed the performance and accuracy of a novel regression approach in order to allow adjusting for covariates and potential confoundin

A Physiotherapeutic Approach to Musicians' Health – Data From 614 Patients From a Physiotherapy Clinic for Musicians (INAP/O)

Currently, the treatment of musicians is an interprofessional approach. Playing-related health complaints may impact the performance of a musician. In Germany, a medical consulting hour for musicians exists, but those for athletes in sports medicine are not so common. The diagnosing and treatment procedure within the physiotherapy consultation for musicians follows a specific concept-b and requires knowledge of instruments and musician-specific complaints. Based on the consulting hour in a clinic in Osnabrueck, 614 case reports were part of this sample, of which 558 data sets were complete. The focus of the analysis is the instrument and the primary complaint. Also, the type of therapy is characterized, and the amount is calculated. Primary complaints of musicians, in general, are found most frequently in the spine and upper extremity. Musician complaints are different between instruments. Instrumentalists have a significantly higher chance to suffer from a primary complaint in the area of the upper extremity. Furthermore, the groups without an instrument (e.g., singing or dancing) are developing complaints in the anatomical area which they primarily use. Therefore, these types of therapy were used: physiotherapy, manual therapy, and osteopathy with an average of 5.9 treatment units. This study underpinned the importance of musician-specific physiotherapy as a profession to treat musicians. Also, an interdisciplinary approach is necessary to treat all aspects of complaints

The potential relevance of altered muscle activity and fatigue in the development of performance-related musculoskeletal injuries in high string musicians

Background: Muscle fatigue has been reported as a risk factor for the development of performance-related musculoskeletal disorders (PRMD) in musicians. However, little research exists to support this claim. The aim of this study was to investigate whether changes occur in muscle activity patterns during high string performance over a prolonged playing period, and whether this is influenced by PRMD. Methods: High string musicians were divided into a PRMD and a non-PRMD group. They played a chromatic scale pre and post and a self-chosen “hard” (Borg scale 16-17) piece of music for one hour. Electromyography data recorded from arm, shoulder and trunk muscles was analyzed: the amplitude to measure muscle activity characteristics and the lower frequency to measure muscle fatigue. Differences between and within groups and the frequency spectrum were analyzed using linear mixed models. Results: Fifteen musicians participated (7 PRMD: 22.8 years, 2 male/5 female and 8 non-PRMD: 34.3 years, 2 male/6 female). Changes in muscle activation patterns were observed between and within both groups, however changes varied significantly depending on group affiliation. Significant low frequency spectrum changes between groups were observed in overall muscles of the right arm (p=0.04) and left forearm flexors (p=0.05) following one hour of playing. Conclusions: Muscle activity and frequency spectrum shifts differ in high string musicians with and without PRMD, suggesting possible differential muscle fatigue effects between the groups

Novel statistical approaches for non-normal censored immunological data: analysis of cytokine and gene expression data

Background: For several immune-mediated diseases, immunological analysis will become more complex in the future with datasets in which cytokine and gene expression data play a major role. These data have certain characteristics that require sophisticated statistical analysis such as strategies for non-normal distribution and censoring. Additionally, complex and multiple immunological relationships need to be adjusted for potential confounding and interaction effects. Objective: We aimed to introduce and apply different methods for statistical analysis of non-normal censored cytokine and gene expression data. Furthermore, we assessed the performance and accuracy of a novel regression approach in order to allow adjusting for covariates and potential confounding. Methods: For non-normally distributed censored data traditional means such as the Kaplan-Meier method or the generalized Wilcoxon test are described. In order to adjust for covariates the novel approach named Tobit regression on ranks was introduced. Its performance and accuracy for analysis of non-normal censored cytokine/gene expression data was evaluated by a simulation study and a statistical experiment applying permutation and bootstrapping. Results: If adjustment for covariates is not necessary traditional statistical methods are adequate for non-normal censored data. Comparable with these and appropriate if additional adjustment is required, Tobit regression on ranks is a valid method. Its power, type-I error rate and accuracy were comparable to the classical Tobit regression. Conclusion: Non-normally distributed censored immunological data require appropriate statistical methods. Tobit regression on ranks meets these requirements and can be used for adjustment for covariates and potential confounding in large and complex immunological datasets

Musculoskeletal Health Complaints and Associated Risk Factors in Freshmen Music Students

Background: Evidence concerning the development of musculoskeletal health complaints (MHCs) among music students is limited due to inappropriate study designs. We aimed to assess the occurrences of MHCs and associated risk factors in freshmen music students compared to students from other disciplines. Methods: A prospective cohort study was conducted. Risk factors such as pain-related, physical, and psychosocial variables were measured at baseline. Episodes of MHCs were recorded monthly. Results: A total of 146 music students and 191 students from other disciplines were analyzed. In the cross-sectional comparison, pain-related, physical, and psychosocial variables were significantly altered in music students compared to students from other disciplines. Furthermore, music students with current MHCs differed significantly from music students without current MHCs with respect to physical health, pain, and history of MHCs. Our longitudinal analysis showed that monthly MHCs were higher in music students compared to students from other disciplines. Independent predictors for monthly MHCs in music students were current MHCs and reduced physical function. Predictors for MHCs in students from other disciplines were a history of MHCs and stress. Conclusions: We provided insight into the development of MHCs and risk factors in music students. This may help in the creation of targeted, evidence-based prevention and rehabilitation