Category: Statistics

Am J Forensic Med Pathol. 2023 Jul 31. doi: 10.1097/PAF.0000000000000859. Online ahead of print.

ABSTRACT

Collecting and reporting accurate disaster mortality data are critical to informing disaster response and recovery efforts. The National Association of Medical Examiners convened an ad hoc committee to provide recommendations for the documentation and certification of disaster-related deaths. This article provides definitions for disasters and direct, indirect, and partially attributable disaster-related deaths; discusses jurisdiction for disaster-related deaths; offers recommendations for medical examiners/coroners (ME/Cs) for indicating the involvement of the disaster on the death certificate; discusses the role of the ME/C and non-ME/C in documenting and certifying disaster-related deaths; identifies existing systems for helping to identify the role of disaster on the death certificate; and describes disaster-related deaths that may require amendments of death certificates. The recommendations provided in this article seek to increase ME/C’s understanding of disaster-related deaths and promote uniformity in how to document these deaths on the death certificate.

PMID:37527356 | DOI:10.1097/PAF.0000000000000859

IEEE Trans Neural Netw Learn Syst. 2023 Aug 1;PP. doi: 10.1109/TNNLS.2023.3293888. Online ahead of print.

ABSTRACT

Traditional support vector machines (SVMs) are fragile in the presence of outliers; even a single corrupt data point can arbitrarily alter the quality of the approximation. If even a small fraction of columns is corrupted, then classification performance will inevitably deteriorate. This article considers the problem of high-dimensional data classification, where a number of the columns are arbitrarily corrupted. An efficient Support Matrix Machine that simultaneously performs matrix Recovery (SSMRe) is proposed, i.e. feature selection and classification through joint minimization of l_2,1 (the nuclear norm of L ). The data are assumed to consist of a low-rank clean matrix plus a sparse noisy matrix. SSMRe works under incoherence and ambiguity conditions and is able to recover an intrinsic matrix of higher rank in the presence of data densely corrupted. The objective function is a spectral extension of the conventional elastic net; it combines the property of matrix recovery along with low rank and joint sparsity to deal with complex high-dimensional noisy data. Furthermore, SSMRe leverages structural information, as well as the intrinsic structure of data, avoiding the inevitable upper bound. Experimental results on different real-time applications, supported by the theoretical analysis and statistical testing, show significant gain for BCI, face recognition, and person identification datasets, especially in the presence of outliers, while preserving a reasonable number of support vectors.

PMID:37527325 | DOI:10.1109/TNNLS.2023.3293888

IEEE Trans Neural Netw Learn Syst. 2023 Aug 1;PP. doi: 10.1109/TNNLS.2023.3282785. Online ahead of print.

ABSTRACT

Canonical correlation analysis (CCA) is a correlation analysis technique that is widely used in statistics and the machine-learning community. However, the high complexity involved in the training process lays a heavy burden on the processing units and memory system, making CCA nearly impractical in large-scale data. To overcome this issue, a novel CCA method that tries to carry out analysis on the dataset in the Fourier domain is developed in this article. Appling Fourier transform on the data, we can convert the traditional eigenvector computation of CCA into finding some predefined discriminative Fourier bases that can be learned with only element-wise dot product and sum operations, without complex time-consuming calculations. As the eigenvalues come from the sum of individual sample products, they can be estimated in parallel. Besides, thanks to the data characteristic of pattern repeatability, the eigenvalues can be well estimated with partial samples. Accordingly, a progressive estimate scheme is proposed, in which the eigenvalues are estimated through feeding data batch by batch until the eigenvalues sequence is stable in order. As a result, the proposed method shows its characteristics of extraordinarily fast and memory efficiencies. Furthermore, we extend this idea to the nonlinear kernel and deep models and obtained satisfactory accuracy and extremely fast training time consumption as expected. An extensive discussion on the fast Fourier transform (FFT)-CCA is made in terms of time and memory efficiencies. Experimental results on several large-scale correlation datasets, such as MNIST8M, X-RAY MICROBEAM SPEECH, and Twitter Users Data, demonstrate the superiority of the proposed algorithm over state-of-the-art (SOTA) large-scale CCA methods, as our proposed method achieves almost same accuracy with the training time of our proposed method being 1000 times faster. This makes our proposed models best practice models for dealing with large-scale correlation datasets. The source code is available at https://github.com/Mrxuzhao/FFTCCA.

PMID:37527324 | DOI:10.1109/TNNLS.2023.3282785

IEEE Trans Med Imaging. 2023 Aug 1;PP. doi: 10.1109/TMI.2023.3300656. Online ahead of print.

ABSTRACT

The segmentation of blurred cell boundaries in cornea endothelium microscope images is challenging, which affects the clinical parameter estimation accuracy. Existing deep learning methods only consider pixel-wise classification accuracy and lack of utilization of cell structure knowledge. Therefore, the segmentation of the blurred cell boundary is discontinuous. This paper proposes a structural prior guided network (SPG-Net) for corneal endothelium cell segmentation. We first employ a hybrid transformer convolution backbone to capture more global context. Then, we use Feature Enhancement (FE) module to improve the representation ability of features and Local Affinity-based Feature Fusion (LAFF) module to propagate structural information among hierarchical features. Finally, we introduce the joint loss based on cross entropy and structure similarity index measure (SSIM) to supervise the training process under pixel and structure levels. We compare the SPG-Net with various state-of-the-art methods on four corneal endothelial datasets. The experiment results suggest that the SPG-Net can alleviate the problem of discontinuous cell boundary segmentation and balance the pixel-wise accuracy and structure preservation. We also evaluate the agreement of parameter estimation between ground truth and the prediction of SPG-Net. The statistical analysis results show a good agreement and correlation.

PMID:37527299 | DOI:10.1109/TMI.2023.3300656

PLoS One. 2023 Aug 1;18(8):e0289366. doi: 10.1371/journal.pone.0289366. eCollection 2023.

ABSTRACT

Evolutionary models are used to study the self-organisation of collective action, often incorporating population structure due to its ubiquitous presence and long-known impact on emerging phenomena. We investigate the evolution of multiplayer cooperation in mobile structured populations, where individuals move strategically on networks and interact with those they meet in groups of variable size. We find that the evolution of multiplayer cooperation primarily depends on the network topology and movement cost while using different stochastic update rules seldom influences evolutionary outcomes. Cooperation robustly co-evolves with movement on complete networks and structure has a partially detrimental effect on it. These findings contrast an established principle from evolutionary graph theory that cooperation can only emerge under some update rules and if the average degree is lower than the reward-to-cost ratio and the network far from complete. We find that group-dependent movement erases the locality of interactions, suppresses the impact of evolutionary structural viscosity on the fitness of individuals, and leads to assortative behaviour that is much more powerful than viscosity in promoting cooperation. We analyse the differences remaining between update rules through a comparison of evolutionary outcomes and fixation probabilities.

PMID:37527254 | DOI:10.1371/journal.pone.0289366

PLoS One. 2023 Aug 1;18(8):e0288744. doi: 10.1371/journal.pone.0288744. eCollection 2023.

ABSTRACT

PURPOSE: The purpose of this study is to evaluate the influences of gadolinium-based contrast agents, field-strength and different sequences on perfusion quantification in Phase-Resolved Functional Lung (PREFUL) MRI.

MATERIALS AND METHODS: Four cohorts of different subjects were imaged to analyze influences on the quantified perfusion maps: 1) at baseline and after 2 weeks to obtain the reproducibility (26 COPD patients), 2) before and after the administration of gadobutrol (11 COPD, 2 PAH and 1 asthma), 3) at 1.5T and 3T (12 healthy, 4 CF), and 4) with different acquisition sequences spoiled gradient echo (SPGR) and balanced steady-state free precession (bSSFP) (11 COPD, 7 healthy). Wilcoxon-signed rank test, Bland-Altman plots, voxelwise Pearson correlations, normalized histogram analyses with skewness and kurtosis and two-sample Kolmogorov-Smirnov tests were performed. P value ≤ 0.05 was considered statistically significant.

RESULTS: In all cohorts, linear correlations of the perfusion values were significant with correlation coefficients of at least 0.7 considering the entire lung (P<0.01). The reproducibility cohort revealed stable results with a similar distribution. In the gadolinium cohort, the quantified perfusion increased significantly (P<0.01), and no significant change was detected in the histogram analysis. In the field-strength cohort, no significant change of the quantified perfusion was shown, but a significant increase of skewness and kurtosis at 3T (P = 0.01). In the sequence cohort, the quantified perfusion decreased significantly in the bSSFP sequence (P<0.01) together with a significant decrease of skewness and kurtosis (P = 0.02). The field-strength and sequence cohorts had differing probability distribution in the two-sample Kolmogorov-Smirnov tests.

CONCLUSION: We observed a high susceptibility of perfusion quantification to gadolinium, field-strength or MRI sequence leading to distortion and deviation of the perfusion values. Future multicenter studies should strictly adhere to the identical study protocols to generate comparable results.

PMID:37527251 | DOI:10.1371/journal.pone.0288744

PLoS One. 2023 Aug 1;18(8):e0289021. doi: 10.1371/journal.pone.0289021. eCollection 2023.

ABSTRACT

BACKGROUND: Ulcerative colitis (UC) is a manifestation of inflammatory bowel disease (IBD), which can cause inflammation of the intestinal tract. Ankylosing spondylitis (AS) is an inflammatory disease of the sacroiliac joints. Many studies have found that some UC patients progress to AS. In this study, we conducted a literature search and meta-analysis to investigate the prevalence of AS among UC patients during follow-up.

METHODS: The studies related to the AS among patients with UC were obtained from PubMed, Web of Science, Embase, and Cochrane Library databases since its inception-December 2022. The literature was screened strictly according to inclusion and exclusion criteria. Forest plots were used to detect the overall incidence of AS in UC and to compare the risk ratios for the development of AS in the UC. The heterogeneity of studies was assessed using I2 statistical methods.

RESULTS: 1) 17 studies with 98704 UC patients were included. 2)700 UC patients developed AS during follow-up (1.66%, 95% CI: 0.89-2.62%). Human leukocyte antigen B27 (HLA-B27) was reported in 3 studies. HLA-B27 positivity was significantly higher than the incidence of HLA-B27 negativity in AS patients (68.29% vs 31.71%, P < 0.0001). There was significantly increased risk of AS development in HLA-B27 positive IBD patients (RR: 22.17, 95% CI: 11.79-41.66, P < 0.0001). 3)The definite follow-up time was reported in 12 studies (range: 0.3-40 years). After follow-up for ≥5 years, the incidence of AS among patients with UC was 1.75% (95% CI: 0.62-3.37%). Meanwhile, after follow-up for <5 years, the incidence of AS among patients with UC was 1.41% (95% CI: 0.65-2.37%) which was significant.

CONCLUSION: Patients with UC are more likely to develop AS in the future. Furthermore, the IBD patients are at a higher risk of AS who have positive HLA-B27. The incidence of AS increased with longer follow-up time.

PMID:37527250 | DOI:10.1371/journal.pone.0289021

JMIR Public Health Surveill. 2023 Aug 1;9:e44822. doi: 10.2196/44822.

ABSTRACT

BACKGROUND: COVID-19 vaccine hesitancy reduces vaccination rates, which is detrimental to building herd immunity and halting the spread of COVID-19 and its variations. Most researches have simply identified the reasons affecting COVID-19 vaccination reluctance without delving into its dynamics, which makes forecasting future trends difficult.

OBJECTIVE: This study aimed to examine the current COVID-19 vaccine booster hesitancy rate in Chinese adults as well as the dynamics of vaccine hesitancy and its influencing factors. The results of this study will have practical implications for policy responses in mainland China, and effective COVID-19 booster vaccination in specific populations.

METHODS: The web-based survey was completed by creating questionnaires and using a stratified random sampling method to collect information from adults (≥18 years old) among 2556 households in 4 geographical regions of China. We collected sociodemographic information, health status, awareness of COVID-19 and its vaccine, self-perceptions, trust in medical staff and vaccine developers, and so on. The odds ratios and 95% CI for the statistical associations were estimated using logistic regression models.

RESULTS: Overall, 6659 participants (females: n=3540, 53.2%; males: n=3119, 46.8%) responded. In total, 533 (8%; 95% CI 7.4%-8.7%) participants presented a clear hesitancy in receiving the COVID-19 booster vaccination, while 736 (11.1%; 95% CI 10.3%-11.8%) expressed hesitancy in regular booster vaccination. A higher prevalence of vaccine hesitancy in both booster vaccination and regular booster vaccination was observed among participants with a history of allergies, experiencing chronic disease, lower levels of public health prevention measures or susceptibility or benefits or self-efficiency, higher levels of severity or barriers, and lower trust in both medical staff and vaccine developers (P<.05). The females and participants with higher education levels, higher levels of barriers, lower levels of susceptibility, and lower trust in vaccine developers preferred to have attitudinal changes from acceptance to hesitancy, while people with higher education levels, lower self-report health conditions, experiencing chronic disease, history of allergies, and lower trust in medical staff and developers were all positively associated with constant COVID-19 booster hesitancy.

CONCLUSIONS: The prevalence of COVID-19 vaccine booster hesitancy is not high in mainland China. However, there is a slight increment in hesitancy on regular booster vaccination. Conducting targeted information guidance for people with higher education levels and chronic diseases, as well as improving accessibility to booster vaccination and increasing trust in medical staff and vaccine producers may be highly effective in reducing vaccine hesitancy.

PMID:37526963 | DOI:10.2196/44822

JAMA Netw Open. 2023 Aug 1;6(8):e2326546. doi: 10.1001/jamanetworkopen.2023.26546.

ABSTRACT

IMPORTANCE: Black patients present with more aggressive disease and experience higher mortality than White patients with prostate cancer. Race and social determinants of health influence prostate cancer-specific mortality and overall survival (OS); however, in a previous trial, Black patients did not have inferior outcomes compared with White patients, possibly because of equitable access to care available in a clinical trial setting.

OBJECTIVE: To compare differences in survival outcomes of patients with metastatic castration-sensitive prostate cancer (mCSPC) by race in a phase 3 trial with a large proportion of Black patients.

DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of patient-level data of a prospective phase 3 randomized clinical trial included patients with newly diagnosed mCSPC enrolled between March 1, 2013, and July 15, 2017. Analysis was conducted between December 2022 and February 2023.

INTERVENTIONS: Patients receiving androgen deprivation therapy were randomized (1:1) to receive either orteronel 300 mg orally twice daily (experimental group) or bicalutamide 50 mg orally daily (control group).

MAIN OUTCOMES AND MEASURES: OS, with progression-free survival (PFS) as a secondary end point.

RESULTS: Among 1313 participants, 135 (10%) identified as Black and 1077 (82%) as White, with an equal racial distribution between groups. Black patients were younger (median [IQR] age, 65.8 [60-70] vs 68.4 [62.5-74.1] years; P = .001) and had a higher median (IQR) baseline prostate-specific antigen response rate than White patients (54.7 [19.8-222.0] vs 26.7 [9.2-96.0] ng/mL; P < .001). At a median follow-up of 4.9 years, Black and White patients had similar median PFS (2.3 years; 95% CI, 1.8-1.4 years vs 2.9 years; 95% CI, 2.5-3.3 years; P = .71) and OS (5.5 years; 95% CI, 4.8-NR vs 6.3 years; 95% CI, 5.7-NR; P = .65). The multivariable analysis confirmed similar PFS and OS after adjusting for known prognostic factors. No interaction between race and treatment was observed.

CONCLUSIONS AND RELEVANCE: In this secondary analysis of a randomized clinical trial studying androgen deprivation therapy with first- or second-generation androgen receptor pathway inhibitors, both Black and White patients demonstrated similar OS and PFS. Equitable access to care may reduce historical differences in outcomes between Black and White patients with advanced prostate cancer.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01809691.

PMID:37526936 | DOI:10.1001/jamanetworkopen.2023.26546

JAMA Netw Open. 2023 Aug 1;6(8):e2326654. doi: 10.1001/jamanetworkopen.2023.26654.

ABSTRACT

IMPORTANCE: Patients with head and neck squamous cell carcinoma (HNSCC) have a significant risk of locoregional recurrence within the first 2 years, with approximately two-thirds of patients experiencing such recurrence. While early recurrence detection may be associated with improved patient outcomes, the association of such detection with survival remains uncertain.

OBJECTIVE: To investigate the association of an intensive posttreatment follow-up strategy using 18F-fludeoxyglucose-positron emission tomography with computed tomography (18FDG-PET/CT) with survival among patients with HNSCC.

DESIGN, SETTING, AND PARTICIPANTS: This case-control study was conducted among patients treated at 1 of 3 locations in Brest, France (University Hospital, Military Hospital, or Pasteur Clinic). The statistical analysis was conducted from January to June 2023. All adults with histologically proven HNSCC who were treated with curative intent between January 1, 2006, and December 31, 2019, and achieved a complete response on imaging at 3 to 6 months were included. They had a minimum of 3 years of follow-up.

EXPOSURES: Patients undergoing an intensive posttreatment follow-up strategy had 18FDG-PET/CT (PET/CT group) at months 12, 24, and 36, chosen at the discretion of ear, nose, and throat surgeons.

MAIN OUTCOMES AND MEASURES: Overall survival (OS) at 3 years.

RESULTS: Among 782 patients with HNSCC (642 males [82.1%]; median [IQR] age, 61 [56-68] years), 497 patients had 18FDG-PET/CT during follow-up and 285 patients had conventional follow-up (CFU group). Cox regression analysis showed an association between undergoing 18FDG-PET/CT and lower risk of death (odds ratio, 0.71; 95% CI, 0.57-0.88; P = .002) after adjustment for covariates (age, sex, comorbidities, primary location, stage, surgeon, year of treatment, and treatment). The mean (SD) 3-year OS was significantly better in the PET/CT vs CFU group (72.5% [2.0%] vs 64.3% [2.9%]; P = .002). Analysis based on American Joint Committee on Cancer stage showed significantly better mean (SD) 3-year OS for advanced stages III and IV in the PET/CT group (373 patients) vs CFU group (180 patients; 68.5% [2.4%] vs 55.4% [3.8%]; P < .001), while no significant difference was observed between patients with stage I or II HNSCC. Analysis based on primary tumor site revealed significantly longer mean (SD) 3-year OS for oropharyngeal tumor in the PET/CT group (176 patients) than the CFU group (100 patients; 69.9% [3.5%] vs 60.5% [5.0%]; P = .04).

CONCLUSIONS AND RELEVANCE: This case-control study found that use of 18FDG-PET/CT in the standard annual CFU of HNSCC was associated with a 3-year survival benefit, with a larger benefit for patients with advanced initial tumor stage (III-IV) and oropharyngeal disease.

PMID:37526935 | DOI:10.1001/jamanetworkopen.2023.26654