Obesity‐Related Knowledge,Attitudes, and Behaviors in Obese and Non‐obese Urban Philadelphia Female Adolescents

Objectives: To examine relationships between knowledge, attitudinal and behavioral factors, and obesity and to determine how these factors influence obesity status in west Philadelphia female adolescents. Research Methods and Procedures: A matched‐pairs study was conducted with 32 stature‐ and age‐matched pairs of obese (body mass index and triceps skinfold ≥95th percentile of National Health and Nutrition Examination Survey I) and non‐obese (body mass index and triceps skinfold between the 15th and 85th percentiles of National Health and Nutrition Examination Survey I) female African American adolescents (aged 11 to 15 years), selected from a school‐based study sample, based on obesity status and matching criteria. Adolescents were compared on the following measures: physical activity, inactivity, dietary intake, eating attitudes, health behavior knowledge, body image, self‐esteem, and maturation status. Differences between obese and non‐obese females were tested using paired t tests and Wilcoxon matched‐pairs signed‐rank tests. Results: Physical activity, inactivity, and perception of ideal body size emerged as the most important contributory factors to obesity status. There were no statistically significant matched‐pair differences in macronutrient and micronutrient intakes, self‐esteem, eating attitudes, health behavior knowledge, or maturation status of these adolescents. Obese adolescents had significantly lower levels of physical activity, higher inactivity, and a larger perception of ideal body size than non‐obese adolescents. Discussion: Knowledge and attitudinal factors (with the exception of perception of ideal body size) had far less association with obesity than activity‐related behavioral factors. These findings suggest that future intervention strategies should pay particular attention to physical activity, inactivity, and body image attitudes.     

The Nonparametric Behrens‐Fisher Problem: Asymptotic Theory and a Small‐Sample Approximation

A generalization of the Behrens‐Fisher problem for two samples is examined in a nonparametric model. It is not assumed that the underlying distribution functions are continuous so that data with arbitrary ties can be handled. A rank test is considered where the asymptotic variance is estimated consistently by using the ranks over all observations as well as the ranks within each sample. The consistency of the estimator is derived in the appendix. For small samples (n₁, n₂ ≥ 10), a simple approximation by a central t‐distribution is suggested where the degrees of freedom are taken from the Satterthwaite‐Smith‐Welch approximation in the parametric Behrens‐Fisher problem. It is demonstrated by means of a simulation study that the Wilcoxon‐Mann‐Whitney‐test may be conservative or liberal depending on the ratio of the sample sizes and the variances of the underlying distribution functions. For the suggested approximation, however, it turns out that the nominal level is maintained rather accurately. The suggested nonparametric procedure is applied to a data set from a clinical trial. Moreover, a confidence interval for the nonparametric treatment effect is given.     

The Matched Pairs Problem with Exponential Variates

Two classes of tests for the hypothesis of bivariate symmetry are studied. For paired exponential survival times (t_1j, t_2j), the classes of tests are those based on t_1j-t_2j and those based on log t_1j–log t_2j. For each class the sign, signed ranks, t and likelihood ratio tests are compared via Pitman's criterion of asymptotic relative efficiency (ARE). For tests based on t_1j — t_2j, it is found that: (1) the efficacy of the paired t depends on the coefficient of variation (CV) of the pair means, (2) the signed rank test has the same ARE to the sign test as for the usual location problem. For tests based on log t_1j — log t_2j, the ARE comparisons reduce to the well-known results for the one-sample location problem for samples from a logistic density. Hence, the signed rank test is asymptotically efficient. Furthermore, analyses based on log t_1j — log t_2j are not complicated by the underlying pairing mechanism.     

A sampling study of the size and power of tests for paired survival data

The paired-t, sign, and signed rank tests were compared for samples from a bivariate exponential distribution. Each is a valid α-level test. One test was not uniformly more powerful than the others for all sample sizes, α levels, correlations, and alternative hypotheses considered, but the signed rank test did well consistently. It was always preferable to the sign test and never was appreciably worse than the paired-t test. The relative performance of the tests depends on α as well as the sample size.     

Host‐seeking activity and avian host preferences of mosquitoes associated with West Nile virus transmission in the northeastern U.S.A.

Mosquito host‐seeking activity was studied using a custom‐designed trap to explore: (1) at which time interval of the night adult mosquito abatement would be most effective, and (2) if there exists an avian‐specific host‐seeking preference. Overnight trials using traps baited with dry ice showed that Aedes taeniorhynchus (Wiedemann) was most active at dusk and was then captured throughout the night. In contrast, Culex spp. (Cx. pipiens (Linnaeus) and Cx. restuans (Theobald) delayed most activity until about two h after dusk and were then captured through the night. This pattern suggests that management activities directed at adult Culex spp. would be most effective if initiated well after sunset. Mosquito capture rates in traps baited with birds in net bags were significantly greater than those with empty net bags, indicating that mosquitoes were attracted to the birds and not incidentally being sucked in by the custom trap's strong fan motor (Wilcoxon matched‐pairs signed‐ranks test, n= 24, t= 30, p < 0.05). Regression analysis showed that bird weight influenced mosquito attraction (r²= 0.21, p= 0.02). Trials with paired traps that contained different native bird species showed that Gray Catbirds, Dumatella carolinensis, attracted more mosquitoes than the heavier Northern Cardinals, Cardinalis cardinalis (paired samples t‐test, t= 2.58, df= 7, p= 0.04). However, attractiveness did not differ substantially among bird species, and Gray Catbirds did not attract more mosquitoes than all other birds combined as a group. American Robins, Turdus migratorius (n = 4) were comparable in attractiveness to other bird species, but not enough American Robins were captured for a comprehensive study of mosquito avian preference.     

The Wilcoxon signed rank test for paired comparisons of clustered data

The Wilcoxon signed rank test is a frequently used nonparametric test for paired data (e.g., consisting of pre- and posttreatment measurements) based on independent units of analysis. This test cannot be used for paired comparisons arising from clustered data (e.g., if paired comparisons are available for each of two eyes of an individual). To incorporate clustering, a generalization of the randomization test formulation for the signed rank test is proposed, where the unit of randomization is at the cluster level (e.g., person), while the individual paired units of analysis are at the subunit within cluster level (e.g., eye within person). An adjusted variance estimate of the signed rank test statistic is then derived, which can be used for either balanced (same number of subunits per cluster) or unbalanced (different number of subunits per cluster) data, with an exchangeable correlation structure, with or without tied values. The resulting test statistic is shown to be asymptotically normal as the number of clusters becomes large, if the cluster size is bounded. Simulation studies are performed based on simulating correlated ranked data from a signed log-normal distribution. These studies indicate appropriate type I error for data sets with > or =20 clusters and a superior power profile compared with either the ordinary signed rank test based on the average cluster difference score or the multivariate signed rank test of Puri and Sen. Finally, the methods are illustrated with two data sets, (i) an ophthalmologic data set involving a comparison of electroretinogram (ERG) data in retinitis pigmentosa (RP) patients before and after undergoing an experimental surgical procedure, and (ii) a nutritional data set based on a randomized prospective study of nutritional supplements in RP patients where vitamin E intake outside of study capsules is compared before and after randomization to monitor compliance with nutritional protocols.     

Conditional Rejection Probabilities of Student's t‐test and Design Adaptations

For clinical trials with interim analyses conditional rejection probabilities play an important role when stochastic curtailment or design adaptations are performed. The conditional rejection probability gives the conditional probability to finally reject the null hypothesis given the interim data. It is computed either under the null or the alternative hypothesis. We investigate the properties of the conditional rejection probability for the one sided, one sample t‐test and show that it can be non monotone in the interim mean of the data and non monotone in the non‐centrality parameter for the alternative. We give several proposals how to implement design adaptations (that are based on the conditional rejection probability) for the t‐test and give a numerical example. Additionally, the conditional rejection probability given the interim t‐statistic is investigated. It does not depend on the unknown σ and can be used in stochastic curtailment procedures. (© 2004 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Assessment of changes in oral health‐related quality of life among patients with complete denture before and 1 month post‐insertion using Geriatric Oral Health Assessment Index

doi:10.1111/j.1741‐2358.2009.00323.x
Assessment of changes in oral health‐related quality of life among patients with complete denture before and 1 month post‐insertion using Geriatric Oral Health Assessment Index Objective: Geriatric Oral Health Assessment Index (GOHAI) is a 12‐item measure of “patient‐reported oral functional problems” intended for use in the assessment of the effectiveness of dental treatment. Design and Setting: As there is scanty literature available on GOHAI in the Indian population, the present study was undertaken to assess the changes in GOHAI before and 1 month after placement of dentures in completely edentulous patients reporting to a dental hospital at Indore, India. Measurements: The GOHAI questionnaire was completed by the examiner who interviewed the patients (n = 35) before placement of complete dentures and 1 month later. Mean, median values were calculated and the data were analysed using Wilcoxon signed‐rank test. Results: When overall mean was considered, the GOHAI scores increased from 27.48 to 30.19 (p = 0.002; highly significant). Conclusion: Patients reported improvement in functional changes after placement of complete dentures.     

An Adaptive Location‐Scale Test

Increasing locations are often accompanied by an increase in variability. In this case apparent heteroscedasticity can indicate that there are treatment effects and it is appropriate to consider an alternative involving differences in location as well as in scale. As a location‐scale test the sum of a location and a scale test statistic can be used. However, the power can be raised through weighting the sum. In order to select values for this weighting an adaptive design with an interim analysis is proposed: The data of the first stage are used to calculate the weights and with the second stage's data a weighted location‐scale test is carried out. The p‐values of the two stages are combined through Fisher's combination test. With a Lepage‐type location‐scale test it is illustrated that the resultant adaptive test can be more powerful than the ‘optimum’ test with no interim analysis. The principle to calculate weights, which cannot be reasonably chosen a priori, with the data of the first stage may be useful for other tests which utilize weighted statistics, too. Furthermore, the proposed test is illustrated with an example from experimental ecology.     

Optimal design of the Wilcoxon–Mann–Whitney‐test

In scientific research, many hypotheses relate to the comparison of two independent groups. Usually, it is of interest to use a design (i.e., the allocation of sample sizes m and n for fixed ) that maximizes the power of the applied statistical test. It is known that the two‐sample t‐tests for homogeneous and heterogeneous variances may lose substantial power when variances are unequal but equally large samples are used. We demonstrate that this is not the case for the nonparametric Wilcoxon–Mann–Whitney‐test, whose application in biometrical research fields is motivated by two examples from cancer research. We prove the optimality of the design in case of symmetric and identically shaped distributions using normal approximations and show that this design generally offers power only negligibly lower than the optimal design for a wide range of distributions.     

Nonparametric All‐Pairs Multiple Comparisons

Nonparametric all‐pairs multiple comparisons based on pairwise rankings can be performed in the one‐way design with the Steel‐Dwass procedure. To apply this test, Wilcoxon's rank sum statistic is calculated for all pairs of groups; the maximum of the rank sums is the test statistic. We provide exact calculations of the asymptotic critical values (and P‐values, respectively) even for unbalanced designs. We recommend this asymptotic method whenever large sample sizes are present. For small sample sizes we recommend the use of the new statistic according to Baumgartner , Weiss , and Schindler (1998, Biometrics 54 , 1129–1135) instead of Wilcoxon's rank sum for the multiple comparisons. We show that the resultant procedure can be less conservative and, according to simulation results, more powerful than the original Steel‐Dwass procedure. We illustrate the methods with a practical data set.     

Objectively Measured Physical Activity in a Representative Sample of 3‐ to 4‐Year‐Old Children

Objective: This study aimed to describe levels of physical activity in a representative sample of preschool children and to quantify tracking of activity over 1 year. Research Methods and Procedures: Physical activity (mean accelerometry counts/minute) was assessed over 3 days using the Computer Science and Applications accelerometer in 3‐ to 4‐year‐old children (n = 104; 52 boys; mean age, 3.7 ± 0.4 years). In 60 children (30 boys), measurements were repeated 1 year later. Results: Mean total activity at baseline was 777 ± 207 counts/minute in boys and 657 ± 172 counts/minute for girls; this gender difference was significant (p < 0.001). In the cross‐sectional analysis, total activity was significantly positively related to age (r = 0.37, p = 0.007). In the sample followed up for 1 year, mean total activity was 849 ± 252. The longitudinal analysis confirmed that total physical activity increased over the 1‐year period (paired Student's t test, p < 0.001). The tracking rank order correlation coefficient of total activity count over 1 year was r = 0.40 (p < 0.001). Discussion: This study suggests that total activity increases during the preschool period in Scottish children and that gender differences in total activity are present early in life. Tracking of total activity was only modest, but adequate assessment of tracking requires methodological research aimed at elucidating the biological meaning of accelerometer output.     

An omnibus consistent adaptive percentile modified Wilcoxon rank sum test with applications in gene expression studies

Summary We present an adaptive percentile modified Wilcoxon rank sum test for the two‐sample problem. The test is basically a Wilcoxon rank sum test applied on a fraction of the sample observations, and the fraction is adaptively determined by the sample observations. Most of the theory is developed under a location‐shift model, but we demonstrate that the test is also meaningful for testing against more general alternatives. The test may be particularly useful for the analysis of massive datasets in which quasi‐automatic hypothesis testing is required. We investigate the power characteristics of the new test in a simulation study, and we apply the test to a microarray experiment on colorectal cancer. These empirical studies demonstrate that the new test has good overall power and that it succeeds better in finding differentially expressed genes as compared to other popular tests. We conclude that the new nonparametric test is widely applicable and that its power is comparable to the power of the Baumgartner‐Weiß‐Schindler test.     

Adiposity‐related inflammation: Effects of pregnancy

In the nonpregnant population, there is extensive evidence of a systemic low‐grade inflammatory status in relation to excess adipose tissue. Less is known about the relation during pregnancy.

Objective:

Our main objective was therefore to explore the effect of pregnancy on adiposity‐related systemic inflammation.

Design and Methods:

This study is a longitudinal cohort study of 240 pregnant women of Scandinavian heritage at Oslo University hospital—Rikshospitalet, Norway from 2002 to 2005. The inflammatory markers (C‐reactive protein [CRP], Interleukin‐6 [IL‐6], monocyte chemoattractant protein 1 [MCP‐1], IL1‐Ra, tumor necrosis factor receptor II, and IL‐10) were measured at four timepoints during pregnancy and analyzed by enzyme immuno‐assay. The women were categorized based on BMI at inclusion (BMI <25, 25–30, and >30 kg/m²). Data were analyzed by Friedman‐test, Wilcoxon signed rank test, or Kruskal–Wallis test as appropriate.

Results:

Maternal adiposity was associated with significantly higher circulatory levels of several inflammatory markers (CRP, MCP‐1, IL‐6, and IL‐1Ra). However, this proinflammatory upregulation was not evident toward the end of pregnancy, as levels of CRP, MCP‐1, and IL‐6 were not any longer significantly different between the BMI categories.

Conclusions:

Although normal pregnancy exhibits proinflammatory features, this does not seem to have additive or synergistic effects on the inflammation associated with adiposity. On the contrary, we found that the BMI‐dependent increase in proinflammatory markers was not evident at the end of pregnancy.     

Increased mortality of growth‐enhanced transgenic common carp (Cyprinus carpio L.) under short‐term predation risk

There is strong evidence that genetic capacity for growth evolves toward an optimum rather than an absolute maximum. This implies that fast growth has a cost and that trade‐offs occur between growth and other life‐history traits. In this study, we conducted a series of predation trials with a paired‐contrast design to test the differences in anti‐predator ability between growth‐enhanced transgenic and non‐transgenic common carp (Cyprinus carpio L.). We showed that young transgenic fish suffered higher predation mortality than control carp in both small‐bodied and large‐bodied size‐matched trials, and thus possessed lower anti‐predator ability. Our results suggest that a trade‐off exists between growth rate and survival such that rapid growth entails a cost in terms of mortality.     

Testing for Homogeneity in Meta‐Analysis I. The One‐Parameter Case: Standardized Mean Difference

Summary Meta‐analysis seeks to combine the results of several experiments in order to improve the accuracy of decisions. It is common to use a test for homogeneity to determine if the results of the several experiments are sufficiently similar to warrant their combination into an overall result. Cochran’s Q statistic is frequently used for this homogeneity test. It is often assumed that Q follows a chi‐square distribution under the null hypothesis of homogeneity, but it has long been known that this asymptotic distribution for Q is not accurate for moderate sample sizes. Here, we present an expansion for the mean of Q under the null hypothesis that is valid when the effect and the weight for each study depend on a single parameter, but for which neither normality nor independence of the effect and weight estimators is needed. This expansion represents an order O(1/n) correction to the usual chi‐square moment in the one‐parameter case. We apply the result to the homogeneity test for meta‐analyses in which the effects are measured by the standardized mean difference (Cohen’s d‐statistic). In this situation, we recommend approximating the null distribution of Q by a chi‐square distribution with fractional degrees of freedom that are estimated from the data using our expansion for the mean of Q. The resulting homogeneity test is substantially more accurate than the currently used test. We provide a program available at the Paper Information link at the Biometrics website http://www.biometrics.tibs.org for making the necessary calculations.     

Trimmed Weighted Simes' Test for Two One‐Sided Hypotheses With Arbitrarily Correlated Test Statistics

The two‐sided Simes test is known to control the type I error rate with bivariate normal test statistics. For one‐sided hypotheses, control of the type I error rate requires that the correlation between the bivariate normal test statistics is non‐negative. In this article, we introduce a trimmed version of the one‐sided weighted Simes test for two hypotheses which rejects if (i) the one‐sided weighted Simes test rejects and (ii) both p‐values are below one minus the respective weighted Bonferroni adjusted level. We show that the trimmed version controls the type I error rate at nominal significance level α if (i) the common distribution of test statistics is point symmetric and (ii) the two‐sided weighted Simes test at level 2α controls the level. These assumptions apply, for instance, to bivariate normal test statistics with arbitrary correlation. In a simulation study, we compare the power of the trimmed weighted Simes test with the power of the weighted Bonferroni test and the untrimmed weighted Simes test. An additional result of this article ensures type I error rate control of the usual weighted Simes test under a weak version of the positive regression dependence condition for the case of two hypotheses. This condition is shown to apply to the two‐sided p‐values of one‐ or two‐sample t‐tests for bivariate normal endpoints with arbitrary correlation and to the corresponding one‐sided p‐values if the correlation is non‐negative. The Simes test for such types of bivariate t‐tests has not been considered before. According to our main result, the trimmed version of the weighted Simes test then also applies to the one‐sided bivariate t‐test with arbitrary correlation.     

Micro‐CT X‐rays do not fragment DNA in preserved bird skins

Most zoological systematics studies are currently based on morphological features, molecular traits or a combination of both to reconstruct animals’ phylogenetic history. Increasingly, morphological studies of museum specimens are using X‐ray computed tomography to visualize internal morphology, because of its ‘non‐destructive’ nature. However, it is not known whether CT can fragment the size of DNA extracted from museum specimens, as has been demonstrated to occur in living cells. This question is of paramount importance for collections based research because X‐rays may reduce the amount of data obtainable from specimens. In our study, we tested whether exposure of museum bird skins to typical CT X‐ray energies (for visualization of the skeleton) increased DNA strand fragmentation, a key factor for the success of downstream molecular applications. For the present study, we extracted DNA from shavings of 24 prepared and dried bird skins (100⁺ years) footpads before and after CT scanning. The pre‐ and post‐CT fragmentation profiles were assessed using a capillary electrophoresis high‐precision instrument (Agilent Bioanalyzer). Comparison of the most common strand length in each DNA sample (relative mass) revealed no significant difference unexposed and exposed tissue (paired t‐test p = 0.463). In conclusion, we found no further quantifiable degradation of DNA strand length under standard X‐ray exposure obtained from our bird skins sample. Differences in museum preservation techniques probably had a greater effect on variation of pre‐CT DNA fragmentation.     

Does Booby Egg Dumping Amount to Quasi‐Parasitism?

Quasi‐parasitism occurs when a paired male facilitates dumping in its own nest by an extra‐pair female with which it has recently copulated. Although numerous observations hint at quasi‐parasitism in diverse avian species, direct behavioral confirmation of male complicity is required to exclude the alternative adaptive explanations enumerated by Griffith et al. [Behav. Ecol. Sociobiol. 56 (2004) 191]. Our direct observations on dumping by female blue‐footed boobies (Sula nebouxii) show apparent male ambivalence: males were hostile to eggs dumped by their extra‐pair partners but half‐hearted in repelling those partners after the act of dumping. Hostility was evidenced when a host male that was present during dumping destroyed the extra‐pair partner's egg and when extra‐pair partners selectively dumped when the host male was absent or distracted rather than when it was alone on the territory. Host males appear to deter dumping by their extra‐pair partners rather than facilitating it, and their partial tolerance of females that have dumped may be a result of their general tolerance of unaccompanied females. Although paired male boobies sometimes copulate with females that dump into their nests, apparently this is not quasi‐parasitism.