Category: Statistics

Intern Emerg Med. 2024 May 28. doi: 10.1007/s11739-024-03651-2. Online ahead of print.

ABSTRACT

Patients with acute stroke often require venous access to facilitate diagnostic investigations or intravenous therapy. The primary aim of this study was to describe the rate and type of complications associated with the placement of a short peripheral catheter (SPC) in patients with acute ischemic or hemorrhagic stroke. A prospective, observational, single-cohort study was conducted at Niguarda Hospital, Italy, with enrolment in the Emergency Department. Adult patients with an ischemic or hemorrhagic stroke requiring an SPC were enrolled. Complications, such as infiltration, occlusion, phlebitis and dislodgment, were recorded daily. Descriptive statistics were used, and the incidence rate ratio (IRR) was estimated to assess the difference in complications, considering catheter calibre, dominant side, exit site, limb, and limb mobility, ictus type (ischemic/haemorrhagic), impairment deficit (language, motor, visual) and EA-DIVA score. A total of 269 participants and 755 SPC were analysed. Removal of SPC due to at least one local complication occurred in 451 (60%). Dislodgment was the major cause of SPC removal (31%), followed by infiltration (18%), occlusion (6%), and phlebitis (5%). The SPC calibre (22G), exit-site other than antecubital and forearm, visual deficit and EA-DIVA ≥ 8 were associated with a higher rate of SPC complications: IRR, 1.71 [1.31; 2.31]; 1.27 [1.01; 1.60], 1.38 [1.06; 1.80], 1.30 [1.04; 1.64], respectively. No other differences in complication rates were observed according to the insertion site, i.e. dominant side, left side, plegic/hyposthenic limb, or exit site. This study provides novel insights into the frequency and types of complications associated with SPC in patients with acute stroke. Compared to the literature, a higher dislodgment rate was observed, being the first cause of SPC removal, whereas no differences in the number of infiltrations, occlusions, and phlebitis were recorded.

PMID:38805082 | DOI:10.1007/s11739-024-03651-2

Eur J Epidemiol. 2024 May 28. doi: 10.1007/s10654-024-01126-4. Online ahead of print.

ABSTRACT

While its etiology is not fully elucidated, preterm birth represents a major public health concern as it is the leading cause of child mortality and morbidity. Stress is one of the most common perinatal conditions and may increase the risk of preterm birth. In this paper we aimed to investigate the association of maternal perceived stress and anxiety with length of gestation. We used harmonized data from five birth cohorts from Canada, France, and Norway. A total of 5297 pregnancies of singletons were included in the analysis of perceived stress and gestational duration, and 55,775 pregnancies for anxiety. Federated analyses were performed through the DataSHIELD platform using Cox regression models within intervals of gestational age. The models were fit for each cohort separately, and the cohort-specific results were combined using random effects study-level meta-analysis. Moderate and high levels of perceived stress during pregnancy were associated with a shorter length of gestation in the very/moderately preterm interval [moderate: hazard ratio (HR) 1.92 (95%CI 0.83, 4.48); high: 2.04 (95%CI 0.77, 5.37)], albeit not statistically significant. No association was found for the other intervals. Anxiety was associated with gestational duration in the very/moderately preterm interval [1.66 (95%CI 1.32, 2.08)], and in the early term interval [1.15 (95%CI 1.08, 1.23)]. Our findings suggest that perceived stress and anxiety are associated with an increased risk of earlier birth, but only in the earliest gestational ages. We also found an association in the early term period for anxiety, but the result was only driven by the largest cohort, which collected information the latest in pregnancy. This raised a potential issue of reverse causality as anxiety later in pregnancy could be due to concerns about early signs of a possible preterm birth.

PMID:38805076 | DOI:10.1007/s10654-024-01126-4

Anal Chem. 2024 May 28. doi: 10.1021/acs.analchem.4c00100. Online ahead of print.

ABSTRACT

Over the years, a number of state-of-the-art data analysis tools have been developed to provide a comprehensive analysis of data collected from gas chromatography-mass spectrometry (GC-MS). Unfortunately, the time shift problem remains unsolved in these tools. Here, we developed a novel comprehensive data analysis strategy for GC-MS-based untargeted metabolomics (AntDAS-GCMS) to perform total ion chromatogram peak detection, peak resolution, time shift correction, component registration, statistical analysis, and compound identification. Time shift correction was specifically optimized in this work. The information on mass spectra and elution profiles of compounds was used to search for inherent landmarks within analyzed samples to resolve the time shift problem across samples efficiently and accurately. The performance of our AntDAS-GCMS was comprehensively investigated by using four complex GC-MS data sets with various types of time shift problems. Meanwhile, AntDAS-GCMS was compared with advanced GC-MS data analysis tools and classic time shift correction methods. Results indicated that AntDAS-GCMS could achieve the best performance compared to the other methods.

PMID:38805056 | DOI:10.1021/acs.analchem.4c00100

Ann Hematol. 2024 May 28. doi: 10.1007/s00277-024-05811-y. Online ahead of print.

ABSTRACT

Myeloma with extramedullary plasmacytomas not adjacent to bone (EMP) is associated with an extremely poor outcome compared with paraosseous plasmacytomas (PP) as current therapeutic approaches are unsatisfactory. The role of new molecules and in particular of monoclonal antibodies is under investigation. To determine whether daratumumab-based regimens are effective for myeloma with EMP, we report herein an initial multicenter observational analysis of 102 myeloma patients with EMP (n = 10) and PP (n = 25) at diagnosis and EMP (n = 28) and PP (n = 39) at relapse, treated with daratumumab-based regimens at 11 Haematological Centers in Italy.EMP and PP at diagnosis were associated with higher biochemical (90% vs. 96%, respectively) and instrumental ORR (86% vs. 83.3%, respectively), while at relapse, biochemical (74% vs. 73%) and instrumental (53% vs. 59%) ORR were lower. Median OS was inferior in EMP patients compared with patients with PP both at diagnosis (21.0 months vs. NR) (p = 0.005) and at relapse (32.0 vs. 40.0 months) (p = 0.428), although, during relapse, there was no statistically significant difference between the two groups. Surprisingly, at diagnosis, median TTP and median TTNT were not reached either in EMP patients or PP patients and during relapse there were no statistically significant differences in terms of median TTP (20 months for two groups), and median TTNT (24 months for PP patients vs. 22 months for EMP patients) between the two groups. Median TTR was 1 month in all populations.These promising results were documented even in the absence of local radiotherapy and in transplant-ineligible patients.

PMID:38805036 | DOI:10.1007/s00277-024-05811-y

Toxicol Ind Health. 2024 May 28:7482337241257274. doi: 10.1177/07482337241257274. Online ahead of print.

ABSTRACT

Polystyrene plastic pollution poses a pressing environmental concern and represents a significant risk factor for infertility. Despite this, a comprehensive overview of the field remains scarce, with future trends largely unknown. Bibliometrics, an applied mathematical and statistical method, offers a means to analyze textual information across various levels, facilitating quantitative assessments of all knowledge carriers and unveiling the nature and developmental trajectories of a discipline. This study aimed to employ bibliometric methods to scrutinize the current status and research hotspots within the realm of polystyrene and infertility. Literature spanning from 1980 to 2023 pertaining to polystyrene and infertility was retrieved from the core database of Web of Science. Quantitative analyses were conducted utilizing CiteSpace (version 5.7.R7), VOSviewer (version 1.6.18.0), and an online literature analysis website (https://bibliometric.com/). The analysis visually represented countries, institutions, authors, journals, and keywords within the field. This study delved into the development history, knowledge structure, research hotspots, and potential trends in the field, furnishing a macro perspective for researchers. The investigation encompassed 267 articles published across 120 journals by 1,352 authors affiliated with 417 institutions in 51 countries, with these articles garnering 10,310 citations across 2,811 journals. The top three countries contributing the most articles were China, the United States, and Germany. In essence, the research hotspots primarily revolved around metabolism, endocrinology, and immunity. Despite China’s relatively recent entry into this field, its rapid development is evident. However, the low citation frequency suggests a need for improved article quality.

PMID:38805015 | DOI:10.1177/07482337241257274

J Med Virol. 2024 Jun;96(6):e29710. doi: 10.1002/jmv.29710.

ABSTRACT

Kidney transplant recipients (KTRs), like other solid organ transplant recipients display a suboptimal response to mRNA vaccines, with only about half achieving seroconversion after two doses. However, the effectiveness of a booster dose, particularly in generating neutralizing antibodies (NAbs), remains poorly understood, as most studies have mainly focused on non-neutralizing antibodies. Here, we have longitudinally assessed the humoral response to the SARS-CoV-2 mRNA vaccine in 40 KTRs over a year, examining changes in both anti-spike IgG and NAbs following a booster dose administered about 5 months post-second dose. We found a significant humoral response increase 5 months post-booster, a stark contrast to the attenuated response observed after the second dose. Of note, nearly a quarter of participants did not achieve protective plasma levels even after the booster dose. We also found that the higher estimated glomerular filtration rate (eGFR) correlated with a more robust humoral response postvaccination. Altogether, these findings underscore the effectiveness of the booster dose in enhancing durable humoral immunity in KTRs, as evidenced by the protective level of NAbs found in 65% of the patients 5 months post- booster, especially those with higher eGFR rates.

PMID:38804187 | DOI:10.1002/jmv.29710

J Med Virol. 2024 Jun;96(6):e29708. doi: 10.1002/jmv.29708.

ABSTRACT

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) persistence in COVID-19 patients could play a key role in the emergence of variants of concern. The rapid intra-host evolution of SARS-CoV-2 may result in an increased transmissibility, immune and therapeutic escape which could be a direct consequence of COVID-19 epidemic currents. In this context, a longitudinal retrospective study on eight consecutive COVID-19 patients with persistent SARS-CoV-2 infection, from January 2022 to March 2023, was conducted. To characterize the intra- and inter-host viral evolution, whole genome sequencing and phylogenetic analysis were performed on nasopharyngeal samples collected at different time points. Phylogenetic reconstruction revealed an accelerated SARS-CoV-2 intra-host evolution and emergence of antigenically divergent variants. The Bayesian inference and principal coordinate analysis analysis showed a host-based genomic structuring among antigenically divergent variants, that might reflect the positive effect of containment practices, within the critical hospital area. All longitudinal antigenically divergent isolates shared a wide range of amino acidic (aa) changes, particularly in the Spike (S) glycoprotein, that increased viral transmissibility (K417N, S477N, N501Y and Q498R), enhanced infectivity (R346T, S373P, R408S, T478K, Q498R, Y505H, D614G, H655Y, N679K and P681H), caused host immune escape (S371L, S375F, T376A, K417N, and K444T/R) and displayed partial or complete resistance to treatments (G339D, R346K/T, S371F/L, S375F, T376A, D405N, N440K, G446S, N460K, E484A, F486V, Q493R, G496S and Q498R). These results suggest that multiple novel variants which emerge in the patient during persistent infection, might spread to another individual and continue to evolve. A pro-active genomic surveillance of persistent SARS-CoV-2 infected patients is recommended to identify genetically divergent lineages before their diffusion.

PMID:38804179 | DOI:10.1002/jmv.29708

Ann Bot. 2024 May 28:mcae083. doi: 10.1093/aob/mcae083. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Lidar is a promising tool for fast and accurate measurements of trees. There are several approaches to estimate aboveground woody biomass using lidar point clouds. One of the most widely used methods involves fitting geometric primitives (e.g. cylinders) to the point cloud, thereby reconstructing both the geometry and topology of the tree. However, current algorithms are not suited for accurate estimation of the volume of finer branches, because of the unreliable point dispersions from e.g. beam footprint compared to the structure diameter.

METHODS: We propose a new method that couples point cloud-based skeletonization and multi-linear statistical modelling based on structural data to make a model (structural model) that accurately estimates the aboveground woody biomass of trees from high-quality lidar point clouds, including finer branches. The structural model was tested at segment, axis, and branch level, and compared to a cylinder fitting algorithm and to the pipe model theory.

KEY RESULTS: The model accurately predicted the biomass with 1.6% nRMSE at the segment scale from a k-fold cross-validation. It also gave satisfactory results when up-scaled to the branch level with a significantly lower error (13% nRMSE) and bias (-5%) compared to conventional cylinder fitting to the point cloud (nRMSE: 92%, bias: 82%), or using the pipe model theory (nRMSE: 31%, bias: -27%).The model was then applied to the whole-tree scale and showed that the sampled trees had more than 1.7km of structures on average and that 96% of that length was coming from the twigs (i.e. <5 cm diameter). Our results showed that neglecting twigs can lead to a significant underestimation of tree aboveground woody biomass (-21%).

CONCLUSIONS: The structural model approach is an effective method that allows a more accurate estimation of the volumes of smaller branches from lidar point clouds. This method is versatile but requires manual measurements on branches for calibration. Nevertheless, once the model is calibrated, it can provide unbiased and large-scale estimations of tree structure volumes, making it an excellent choice for accurate 3D reconstruction of trees and estimating standing biomass.

PMID:38804175 | DOI:10.1093/aob/mcae083

Scand J Occup Ther. 2024 Jan;31(1):2356548. doi: 10.1080/11038128.2024.2356548. Epub 2024 May 28.

ABSTRACT

BACKGROUND: Goal setting is an essential component of reablement programmes. At the same time it is also an important aspect in the evaluation of reablement from the perspective of clients.

OBJECTIVES: As part of the TRANS-SENIOR project, this research aims to get an in-depth insight of goal setting and goal attainment within reablement services from the perspective of the older person.

MATERIAL AND METHODS: A convergent mixed methods design was used, combining data from electronic care files, and completed Canadian Occupational Performance Measure (COPM) forms with individual interviews.

RESULTS: In total, 17 clients participated. Participants’ meaningful goals mainly focused on self-care, rather than leisure or productivity. This mattered most to them, since being independent in performing self-care tasks increased clients’ confidence and perseverance. Regarding goal attainment, a statistically significant and clinically relevant increase in self-perceived performance and satisfaction scores were observed.

CONCLUSION: Although most goals focused on self-care, it became apparent that these tasks matter to participants, especially because these often precede fundamental life goals.

SIGNIFICANCE: Reablement can positively contribute to goal setting and attainment of clients and may contribute to increased independence. However, effectiveness, and subsequently long-term effects, are not yet accomplished and should be evaluated in future research.

PMID:38804133 | DOI:10.1080/11038128.2024.2356548

Acta Odontol Scand. 2024 May 28;83:334-339. doi: 10.2340/aos.v83.40570.

ABSTRACT

OBJECTIVE: Research on reasons for malpractice claims in oral and maxillofacial surgery is scarce. The aim of this study was to investigate the causes and prevalence of permanent harm among craniofacial fracture related malpractice claims.

MATERIALS AND METHODS: A retrospective register study was designed and implemented. All patients with a complaint and a diagnosis of facial or cranial fracture were included. The main outcome was the presence of permanent harm, and the predictor variable was the cause of complaint. Chi-square test was used for estimation of statistical significance.

RESULTS: Delay in correct diagnosis was the leading cause of malpractice claims (63.2%), and permanent harm was found in 23.1% of the population. 82.4% of injuries were facial fractures in total population. 65.3% (n = 98) of facial trauma were related with delayed diagnostics (p < 0.001). Permanent harm was more frequent in patients with delayed diagnosis (71.4%) than those without (60.7%, p = 0.299).

CONCLUSIONS: Claims of craniofacial trauma are related with under-diagnostics, and un-diagnosed facial fracture can lead to a high rate of permanent harm. Systematic clinical evaluation and facial trauma specialist consultation is recommended to set early correct diagnosis for and improve treatment of craniofacial trauma patients.

PMID:38804122 | DOI:10.2340/aos.v83.40570