Category: Nevin Manimala

Birth. 2023 Jan 25. doi: 10.1111/birt.12708. Online ahead of print.

ABSTRACT

INTRODUCTION: Infants with low birthweight (LBW, birthweight <2500 g) have increased in many high-resource countries over the past two decades. This study aimed to investigate the time trends, projections, and spatial distribution of LBW in Australia, 2009-2030.

METHODS: We used standard aggregate data on 3 346 808 births from 2009 to 2019 from Australia’s National Perinatal Data Collection. Bayesian linear regression model was used to estimate the trends in the prevalence of LBW in Australia.

RESULTS: Wefound that the prevalence of LBW was 6.18% in 2009, which has increased to 6.64% in 2019 (average annual rate of change, AARC = +0.76%). If the national trend remains the same, the projected prevalence of LBW in Australia will increase to 7.34% (95% uncertainty interval, UI = 6.99, 7.68) in 2030. Observing AARC across different subpopulations, the trend of LBW was stable among Indigenous mothers, whereas it increased among non-Indigenous mothers (AARC = +0.81%). There is also an increase among the most disadvantaged mothers (AARC = +1.08%), birthing people in either of two extreme age groups (AARC = +1.99% and +1.53% for <20 years and ≥40 years, respectively), and mothers who smoked during pregnancy (AARC = +1.52%). Spatiotemporal maps showed that some of the Statistical Area level 3 (SA3) in Northern Territory and Queensland had consistently higher prevalence for LBW than the national average from 2014 to 2019.

CONCLUSION: Overall, the prevalence of LBW has increased in Australia during 2009-2019; however, the trends vary across different subpopulations. If trends persist, Australia will not achieve the Sustainable Development Goals (SDGs) target of a 30% reduction in LBW by 2030. Centering and supporting the most vulnerable subpopulations is vital to progress the SDGs and improves perinatal and infant health in Australia.

PMID:36696404 | DOI:10.1111/birt.12708

PLoS One. 2023 Jan 25;18(1):e0280951. doi: 10.1371/journal.pone.0280951. eCollection 2023.

ABSTRACT

The use of publicly available sequencing datasets as controls (hereafter, “public controls”) in studies of rare variant disease associations has great promise but can increase the risk of false-positive discovery. The specific factors that could contribute to inflated distribution of test statistics have not been systematically examined. Here, we leveraged both public controls, gnomAD v2.1 and several datasets sequenced in our laboratory to systematically investigate factors that could contribute to the false-positive discovery, as measured by λΔ95, a measure to quantify the degree of inflation in statistical significance. Analyses of datasets in this investigation found that 1) the significantly inflated distribution of test statistics decreased substantially when the same variant caller and filtering pipelines were employed, 2) differences in library prep kits and sequencers did not affect the false-positive discovery rate and, 3) joint vs. separate variant-calling of cases and controls did not contribute to the inflation of test statistics. Currently available methods do not adequately adjust for the high false-positive discovery. These results, especially if replicated, emphasize the risks of using public controls for rare-variant association tests in which individual-level data and the computational pipeline are not readily accessible, which prevents the use of the same variant-calling and filtering pipelines on both cases and controls. A plausible solution exists with the emergence of cloud-based computing, which can make it possible to bring containerized analytical pipelines to the data (rather than the data to the pipeline) and could avert or minimize these issues. It is suggested that future reports account for this issue and provide this as a limitation in reporting new findings based on studies that cannot practically analyze all data on a single pipeline.

PMID:36696392 | DOI:10.1371/journal.pone.0280951

PLoS One. 2023 Jan 25;18(1):e0280512. doi: 10.1371/journal.pone.0280512. eCollection 2023.

ABSTRACT

In this article, an improved slime mould algorithm (SMA-CSA) is proposed for solving global optimization and the capacitated vehicle routing problem (CVRP). This improvement is based on the mixed-strategy optimization of Cauchy mutation and simulated annealing to alleviate the lack of global optimization capability of the SMA. By introducing the Cauchy mutation strategy, the optimal solution is perturbed to increase the probability of escaping from the local extreme value; in addition, the annealing strategy is introduced, and the Metropolis sampling criterion is used as the acceptance criterion to expand the global search space to enhance the exploration phase to achieve optimal solutions. The performance of the proposed SMA-CSA algorithm is evaluated using the CEC 2013 benchmark functions and the capacitated vehicle routing problem. In all experiments, SMA-CSA is compared with ten other state-of-the-art metaheuristics. The results are also analyzed by Friedman and the Wilcoxon rank-sum test. The experimental results and statistical tests demonstrate that the SMA-CSA algorithm is very competitive and often superior compared to the algorithms used in the experiments. The results of the proposed algorithm on the capacitated vehicle routing problem demonstrate its efficiency and discrete solving ability.

PMID:36696386 | DOI:10.1371/journal.pone.0280512

PLoS One. 2023 Jan 25;18(1):e0279965. doi: 10.1371/journal.pone.0279965. eCollection 2023.

ABSTRACT

OBJECTIVES: The objective of our study was to describe time trends in body height according to attained educational level in women and men in Norway.

METHODS: We used previously collected data from six repeated cross-sectional studies in the population based Tromsø Study 1979-2016. Measured body height in cm and self-reported educational level were the primary outcome measures. We included 31 466 women and men aged 30-49 years, born between 1930 and 1977. Participants were stratified by 10-year birth cohorts and allocated into four groups based on attained levels of education. Descriptive statistics was used to estimate mean body height and calculate height differences between groups with different educational levels.

RESULTS: Mean body height increased by 3.4 cm (95% confidence interval (CI) 3.0, 3.8) in women (162.5-165.9 cm) and men (175.9-179.3 cm) between 1930 and 1977. The height difference between groups with primary education compared to long tertiary education was 5.1 cm (95% CI 3.7, 6.5) in women (161.6-166.7 cm) and 4.3 cm (95% CI 3.3, 5.3) in men (175.0-179.3 cm) born in 1930-39. The height differences between these educational groups were reduced to 3.0 cm (95% CI 1.9, 4.1) in women (163.6-166.6 cm) and 2.0 cm (95% CI 0.9, 3.1) in men (178.3-180.3 cm) born in 1970-77.

CONCLUSIONS: Body height increased in women and men. Women and men with long tertiary education had the highest mean body height, which remained stable across all birth cohorts. Women and men in the three other groups had a gradual increase in height by birth cohort, reducing overall height differences between educational groups in our study population.

PMID:36696372 | DOI:10.1371/journal.pone.0279965

Birth. 2023 Jan 25. doi: 10.1111/birt.12706. Online ahead of print.

ABSTRACT

BACKGROUND: Little is known about the preconception/interconception health and behaviors of reproductive-age women in the rural Midwest of the United States. The purpose of this study was to quantify preconception/interconception health status and to identify disparities compared with statewide estimates.

METHODS: In this cross-sectional study, we collected data on 12 health conditions and behaviors that are risk factors for adverse maternal and infant health outcomes from nonpregnant women ages 18-45 years in rural northwestern Ohio. Statistical tests were used to identify associations between selected demographic characteristics and a subset of eight high-priority health measures (smoking, diabetes, heavy alcohol use, folic acid intake, normal weight, sufficient physical activity, and effective contraception use); all but physical activity could be compared with Ohio estimates derived from the Behavioral Risk Factor Surveillance System and Ohio Pregnancy Assessment Survey.

RESULTS: Three hundred-fifteen women participated, with 98.4% reporting at least one high-priority risk factor. Statistically significant differences were identified among subpopulations related to smoking, folic acid, normal weight, sufficient physical activity, and effective contraception use. In addition, the proportion of participants reporting hypertension (P < 0.001), smoking (P < 0.001), abnormal weight (P = 0.002), and lack of daily folic acid intake (P = 0.006) were statistically significantly higher than expected based on statewide estimates.

CONCLUSIONS: Women in the rural Midwest of the United States are at risk for poor health and pregnancy outcomes. Statewide estimates tracking preconception/interconception health status may obscure variation for at-risk groups, particularly in rural or underserved areas. These findings illustrate the need for interventions to advance preconception/interconception health and improve methods to capture and analyze data for rural women.

PMID:36696365 | DOI:10.1111/birt.12706

J Glaucoma. 2023 Feb 1;32(2):72-79. doi: 10.1097/IJG.0000000000002132. Epub 2022 Oct 3.

ABSTRACT

PRCIS: The manuscript evaluates cost-effectiveness of glaucoma screening with imaging devices and telemedicine based on a screening campaign performed in Spain. The screening strategy implemented in our analysis was cost-effective compared with opportunistic case finding.

INTRODUCTION: Open angle glaucoma is an asymptomatic ocular disease that represents one of the first causes of blindness. Diagnosis is currently made by opportunistic case finding, usually by community optometrists or general ophthalmologists. The aim of this study was to assess the cost-effectiveness of a screening strategy based on optical coherence tomography and fundus photographs in glaucoma detection.

MATERIALS AND METHODS: A cost-effectiveness analysis was carried out to compare 2 alternative strategies: opportunistic finding versus screening. A Markov tree model was carried out with 10 health states according to disease progression. Quality-adjusted life years (QALYs) were used as a measure of effectiveness. We included short-term and long-term direct health costs and a discount rate of 3%. We performed a probabilistic sensitivity analysis and several 1-way sensitivity analyses.

RESULTS: The cohort in the screening program entailed an increase in 0.097 QALYs and additional costs of €1187 versus opportunistic finding, with an incremental cost-effectiveness ratio of about €12.214/QALY. The 1-way sensitivity analysis showed that inputs related to age and screening program (cost and detection rate) were those most strongly influencing the results of the analysis. Probabilistic sensitivity analyses showed that the model was robust to significant changes in the main variables of the analysis.

CONCLUSIONS: The screening strategy implemented in our analysis was cost-effective compared with opportunistic finding in patients with glaucoma in this Spanish setting.

PMID:36696355 | DOI:10.1097/IJG.0000000000002132

Appl Neuropsychol Child. 2023 Jan 25:1-13. doi: 10.1080/21622965.2023.2170798. Online ahead of print.

ABSTRACT

Children with cerebral palsy (CP) are at greater risk of mathematical learning disabilities due to associated motor and cognitive limitations. However, there is currently little evidence on how to support the development of arithmetic skills within such a specific profile. The aim of this single-case study was to assess the effectiveness of a neuropsychological rehabilitation of arithmetic skills in NG, a 9-year-old boy with CP who experienced math learning disability and cumulated motor and short-term memory impairments. This issue was explored combining multiple-baseline and changing-criterion designs. The intervention consisted of training NG to solve complex additions applying calculation procedures with a tailor-made computation tool. Based on NG’s strengths, in accordance with evidence-based practice in psychology, the intervention was the result of a co-construction process involving N, his NG’s parents and professionals (therapist and researchers). Results were analyzed by combining graph visual inspections with non-parametric statistics for single-case designs (NAP-scores). Analyses showed a specific improvement in NG’s ability to solve complex additions, which maintained for up to 3 weeks after intervention. The training effect did not generalize to his ability to perform mental additions, and to process the symbolic magnitude.

PMID:36696353 | DOI:10.1080/21622965.2023.2170798

Plast Reconstr Surg. 2023 Feb 1;151(2):267-276. doi: 10.1097/PRS.0000000000009828. Epub 2022 Nov 8.

ABSTRACT

BACKGROUND: Oncoplastic breast reduction has been shown to be an effective and safe approach to breast conservation surgery in women with macromastia. However, there remains a paucity of data investigating the comparative outcomes. This study seeks to delineate the complication profiles for oncoplastic and symmetrizing breast reductions versus mammaplasty for benign macromastia.

METHODS: A retrospective review was conducted of all consecutively performed reduction mammaplasty cases at a single institution by two plastic surgeons over a 2-year period.

RESULTS: A total of 632 breasts were analyzed: 502 reduction mammaplasties, 85 symmetrizing reductions, and 45 oncoplastic reductions in 342 patients. Mean age was 43.9 ± 15.93 years, mean body mass index was 29.15 ± 5.66 kg/m2, and mean reduction weight was 610.03 ± 313.13 g. Regarding surgical technique, a medial pedicle was used in 86% of cases. There were similar postoperative complication outcomes for nipple necrosis, wound healing, scar revision, fat necrosis, seroma, hematoma, and overall complication rates for all procedures. However, the rate of postoperative revision among reduction mammaplasty (2%), oncoplastic reduction (6.7%), and symmetrizing reduction (5.9%) was significantly different (P = 0.027). In univariate analysis, diabetes (P = 0.011), smoking (P = 0.007), higher body mass index (P = 0.003), larger reduction weight (P = 0.011), longer nipple-to-inframammary fold measurement (P = 0.014), and longer sternal notch-to-nipple measurement (P = 0.039) were all significant risk factors for a surgical complication in reductions performed for any indication. Using a multivariate logistic regression model, diabetes (P = 0.047), smoking (P = 0.025), and higher body mass index (P = 0.002) were all retained as statistically significant risk factors.

CONCLUSION: The complication profiles for both oncoplastic breast reductions and breast reductions for symptomatic macromastia are similar and acceptably low.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

PMID:36696305 | DOI:10.1097/PRS.0000000000009828

BJOG. 2023 Jan 25. doi: 10.1111/1471-0528.17411. Online ahead of print.

NO ABSTRACT

PMID:36696225 | DOI:10.1111/1471-0528.17411

J Thromb Haemost. 2022 Dec 22:S1538-7836(22)07638-3. doi: 10.1016/j.jtha.2022.11.024. Online ahead of print.

ABSTRACT

BACKGROUND: Venous thromboembolism is a prominent cause of maternal death.

OBJECTIVE: As inflammation is a well-known risk factor for venous thromboembolism and several studies have found a higher grade of inflammation in pregnancies bearing a male compared with female fetuses, we investigated the risk of pregnancy-related venous thromboembolism associated with sex of the fetus.

METHODS: This cohort study linked data from national registries and compared event rates and hazard ratios of venous thrombosis for pregnancies bearing a male fetus with those bearing a female fetus during pregnancy and in the first 3 months postpartum. National data from 1995 to 2017 were used. All Danish women aged 15 to 49 years with a live or stillbirth were eligible for inclusion; 1 370 583 pregnancies were included. Women with venous thrombosis, ischemic heart disease, cerebrovascular disease, thrombophilia, or cancer before conception were excluded.

RESULTS: The event rate for a venous thrombosis was 8.0 per 10.000 pregnancy years with a male fetus compared with 6.8 for a female fetus. The adjusted hazard ratio for venous thrombosis during pregnancies bearing a male was 1.2 (95% CI, 1.1-1.4), whereas in the postpartum period, it was 0.9 (95% CI, 0.7-1.0). The risk was elevated until week 30.

CONCLUSION: These findings indicate a slightly greater risk of venous thrombosis during pregnancies bearing a male fetus than during pregnancies bearing a female fetus. There was no increased risk associated with fetal male sex in the postpartum period.

PMID:36696192 | DOI:10.1016/j.jtha.2022.11.024