Category: Statistics

BMC Musculoskelet Disord. 2023 Jun 17;24(1):497. doi: 10.1186/s12891-023-06569-6.

ABSTRACT

BACKGROUND: Isthmic spondylolisthesis (IS) is a common clinical disease with a high incidence rate. However, most current researches explain the clear pathogenesis from a single perspective. The aim of our study was to explore the relationships between multiple parameters in patients and find the potential risk factors of this disease.

METHODS: Our study retrospectively included 115 patients who were diagnosed with isthmic spondylolisthesis and the same number of individuals without spondylolisthesis. The following parameters were measured or collected: age, pelvic incidence (PI), facet joint angle (FJA) and pedicle-facet angle (P-F angle). The radiographic files were imported into Mimics Medical 20.0 and all collected data were analyzed using SPSS, version 26.0, statistical software.

RESULTS: The age was higher in IS group than in control group. PI was also higher in the IS group (50.99 ± 7.67) than in the control group (43.77 ± 9.30) significantly (P = 0.009). There was significant difference in cranial and average FJA tropism in L3-L4 level (P = 0.002, P = 0.006, respectively) and in L4-L5 level (P < 0.001). P-F angle of L4-L5 level showed significantly larger in IS group than in control group (P = 0.007).The logistic regression analysis showed a larger age, a greater L3-L4 cranial FJA tropism, and a greater L4-L5 cranial FJA tropism were potential predictors of IS, with an OR of 1.07, 1.28, and 1.39 respectively. The thresholds of the predictors were 60 years, 5.67°, and 8.97° according to the ROC curve. The linear regression equation was established: degree of slippage (%) = 0.220*age – 0.327* L3-4 cranial FJA tropism – 0.346* L4-5 average FJA tropism (F = 3.460, P = 0.011, r = 0.659).

CONCLUSIONS: Our study revealed that isthmic spondylolisthesis may be related to multiple factors rather than a single factor. Age, PI, PJA and P-F angle are potentially associated with spondylolisthesis.

PMID:37330503 | DOI:10.1186/s12891-023-06569-6

BMC Oral Health. 2023 Jun 17;23(1):402. doi: 10.1186/s12903-023-03102-y.

ABSTRACT

BACKGROUND: Open gingival embrasures form complex aesthetic and functional problems. This clinical trial assessed the bioclear matrix using injection molding technique against conventional celluloid matrix technique in management of black triangle.

METHODS: A total of 26 participants were randomly divided into two groups (13 participants each) according to the technique used. In group (A) celluloid conventional matrix method was used, while in group (B) bioclear matrix with injection molding technique was used. The different outcomes (Esthetic evaluation, marginal integrity and patient satisfaction) were evaluated following the FDI criteria by two blinded examiners. The evaluation was done at (T0) (immediate after restoration); (T6) after 6 months; and (T12) after 12 months. Statistical analysis was done as categorical and ordinal data were presented as frequency and percentage values. Categorical data were compared using fisher’s exact test. Intergroup comparisons for ordinal data were analyzed utilizing the Mann-Whitney U test, while intragroup comparisons were analyzed using Friedman’s test followed by the Nemenyi post hoc test. The significance level was set at p ≤ 0.05 within all tests.

RESULTS: Regarding radiographic marginal integrity and marginal adaptation, the bioclear matrix group revealed superior results when compared to celluloid matrix group with a significant difference between both groups at all intervals (p < 0.05); however no significant difference was detected at different intervals. While for proximal anatomical form and esthetic anatomical form, as well as phonetics and food impaction, all cases in both groups were successful with no statistical significant difference between groups. For the periodontal response, there was no significant difference between groups. However, there was a significant difference between scores measured at different intervals, with T0 being significantly different from other intervals (p < 0.001). Marginal staining revealed that there was no significant difference between groups. While, a significant difference between scores measured at different intervals.

CONCLUSIONS: The restorative management of the black triangle with both protocols was able to deliver superior aesthetic and good marginal adaptation; suitable biological properties; with adequate survival time. Both techniques were almost equally successful, however they are depending on the operator skills.

TRIAL REGISTRATION: The clinical trial was registered in the ( www.

CLINICALTRIALS: gov/ ) database in 23/07/2020; with the unique identification number NCT04482790.

PMID:37330484 | DOI:10.1186/s12903-023-03102-y

BMC Health Serv Res. 2023 Jun 17;23(1):650. doi: 10.1186/s12913-023-09665-4.

ABSTRACT

BACKGROUND: Compassion is the first ethical principle of health care to provide high- quality care that influences patient satisfaction and treatment outcome. However, there is limited data on the level of compassionate mental health care practice in low-resource countries like Ethiopia.

OBJECTIVES: This study aimed to assess the level of perceived compassionate care and associated factors among patients with mental illness at Tibebe Ghion specialized and Felege Hiwot comprehensive specialized hospital, North West, Ethiopia, 2022.

METHODS: An institutional-based cross-sectional study design was conducted from June 18 to July 16, 2022, at Tibebe Ghion Specialized and Felege Hiwot Comprehensive Specialized Hospital. A systematic random sampling technique was used. The level of perceived compassionate care was assessed by the validated 12-item Schwartz Center Compassionate Care Scale among 423 patients with mental illness. Epicollect-5 was used to collect data, which was then exported to the Statistical Product and Service solution version 25 for analysis. Variables with a P-value < 0.05, and 95% confidence interval (CI) were used to declare significant variables at the multivariate logistic regression analysis.

RESULT: The level of perceived good compassionate care was 47.5% (95% CI 42.6%-52.4%). Factors including urban residence (AOR = 1.90; 95%CI 1.08-3.36), duration of illness < 24 months (AOR = 2.68; 95% CI 1.27-5.65), strong social support (AOR = 4.43; 95%CI 2.16-9.10), shared decision making (AOR = 3.93; 95% CI 2.27-6.81), low perceived stigma(AOR = 2.97; 95% CI 1.54-5.72) and low patient anticipated stigma (AOR = 2.92; 95% CI 1.56-5.48) were positively associated with good compassionate care.

CONCLUSION AND RECOMMENDATION: Less than half of the patients had received good compassionate care. Compassionate mental health care needs public health attention. Policymakers should emphasize on compassionate care continuity by including it in the health care curriculum and design appropriate policies to strengthen compassionate care.

PMID:37330472 | DOI:10.1186/s12913-023-09665-4

BMC Bioinformatics. 2023 Jun 17;24(1):256. doi: 10.1186/s12859-023-05349-2.

ABSTRACT

BACKGROUND: Modeling of single cell RNA-sequencing (scRNA-seq) data remains challenging due to a high percentage of zeros and data heterogeneity, so improved modeling has strong potential to benefit many downstream data analyses. The existing zero-inflated or over-dispersed models are based on aggregations at either the gene or the cell level. However, they typically lose accuracy due to a too crude aggregation at those two levels.

RESULTS: We avoid the crude approximations entailed by such aggregation through proposing an independent Poisson distribution (IPD) particularly at each individual entry in the scRNA-seq data matrix. This approach naturally and intuitively models the large number of zeros as matrix entries with a very small Poisson parameter. The critical challenge of cell clustering is approached via a novel data representation as Departures from a simple homogeneous IPD (DIPD) to capture the per-gene-per-cell intrinsic heterogeneity generated by cell clusters. Our experiments using real data and crafted experiments show that using DIPD as a data representation for scRNA-seq data can uncover novel cell subtypes that are missed or can only be found by careful parameter tuning using conventional methods.

CONCLUSIONS: This new method has multiple advantages, including (1) no need for prior feature selection or manual optimization of hyperparameters; (2) flexibility to combine with and improve upon other methods, such as Seurat. Another novel contribution is the use of crafted experiments as part of the validation of our newly developed DIPD-based clustering pipeline. This new clustering pipeline is implemented in the R (CRAN) package scpoisson.

PMID:37330471 | DOI:10.1186/s12859-023-05349-2

BMC Med Res Methodol. 2023 Jun 17;23(1):143. doi: 10.1186/s12874-023-01972-y.

ABSTRACT

BACKGROUND: Up to 8% of the general population have a rare disease, however, for lack of ICD-10 codes for many rare diseases, this population cannot be generically identified in large medical datasets. We aimed to explore frequency-based rare diagnoses (FB-RDx) as a novel method exploring rare diseases by comparing characteristics and outcomes of inpatient populations with FB-RDx to those with rare diseases based on a previously published reference list.

METHODS: Retrospective, cross-sectional, nationwide, multicenter study including 830,114 adult inpatients. We used the national inpatient cohort dataset of the year 2018 provided by the Swiss Federal Statistical Office, which routinely collects data from all inpatients treated in any Swiss hospital. Exposure: FB-RDx, according to 10% of inpatients with the least frequent diagnoses (i.e.1.decile) vs. those with more frequent diagnoses (deciles 2-10). Results were compared to patients having 1 of 628 ICD-10 coded rare diseases.

PRIMARY OUTCOME: In-hospital death.

SECONDARY OUTCOMES: 30-day readmission, admission to intensive care unit (ICU), length of stay, and ICU length of stay. Multivariable regression analyzed associations of FB-RDx and rare diseases with these outcomes.

RESULTS: 464,968 (56%) of patients were female, median age was 59 years (IQR: 40-74). Compared with patients in deciles 2-10, patients in the 1. were at increased risk of in-hospital death (OR 1.44; 95% CI: 1.38, 1.50), 30-day readmission (OR 1.29; 95% CI 1.25, 1.34), ICU admission (OR 1.50; 95% CI 1.46, 1.54), increased length of stay (Exp(B) 1.03; 95% CI 1.03, 1.04) and ICU length of stay (1.15; 95% CI 1.12, 1.18). ICD-10 based rare diseases groups showed similar results: in-hospital death (OR 1.82; 95% CI 1.75, 1.89), 30-day readmission (OR 1.37; 95% CI 1.32, 1.42), ICU admission (OR 1.40; 95% CI 1.36, 1.44) and increased length of stay (OR 1.07; 95% CI 1.07, 1.08) and ICU length of stay (OR 1.19; 95% CI 1.16, 1.22).

CONCLUSION(S): This study suggests that FB-RDx may not only act as a surrogate for rare diseases but may also help to identify patients with rare disease more comprehensively. FB-RDx associate with in-hospital death, 30-day readmission, intensive care unit admission, and increased length of stay and intensive care unit length of stay, as has been reported for rare diseases.

PMID:37330464 | DOI:10.1186/s12874-023-01972-y

J Environ Manage. 2023 Jun 15;344:118398. doi: 10.1016/j.jenvman.2023.118398. Online ahead of print.

ABSTRACT

Surface water pollution has always posed a serious challenge to water quality management. Improving water quality management requires figuring out how to comprehend water quality conditions scientifically and effectively as well as quantitatively identify regional pollution sources. In this study, Xianghai Lake, a typical lake-type wetland on the Northeast China Plain, was taken as the research area. Based on a geographic information system (GIS) method and 11 water quality parameters, the single-factor evaluation and comprehensive water quality index (WQI) methods were used to comprehensively evaluate the water quality of the lake-type wetland in the level period. Four key water quality parameters were determined by the principal component analysis (PCA) method, and more convenient comprehensive water quality evaluation models, the minimum WQI considering weights (WQI_min-w) and the minimum WQI without considering weights (WQI_min-nw) were established. The multiple statistical method and the absolute principal component score-multiple liner regression (APCS-MLR) model were combined to analyse the lake pollution sources based on the spatial changes in pollutants. The findings demonstrated that the WQI_min-nw model’s water quality evaluation outcome was more accurate when weights were not taken into account. The WQI_min-nw model can be used as a simple and convenient way to comprehend the variations in water quality in wetlands of lakes and reservoirs. It was concluded that the comprehensive water quality in the study area was at a “medium” level, and COD_Mn was the main limiting factor. Nonpoint source pollution (such as agricultural planting and livestock breeding) was the most important factor affecting the water quality of Xianghai Lake (with a comprehensive contribution rate of 31.65%). The comprehensive contribution rates of sediment endogenous and geological sources, phytoplankton and other plants, and water diversion and other hydrodynamic impacts accounted for 25.12%, 19.65%, and 23.58% of the total impact, respectively. This study can provide a scientific method for water quality assessment and management of lake wetlands, and an effective support for migration of migratory birds, habitat protection and grain production security.

PMID:37329587 | DOI:10.1016/j.jenvman.2023.118398

J Environ Manage. 2023 Jun 15;344:118379. doi: 10.1016/j.jenvman.2023.118379. Online ahead of print.

ABSTRACT

The Azo dyes are primarily utilized in textile industries. Treatment of textile wastewater because of the presence of recalcitrant dyes using conventional processes is greatly challenging and ineffective. So far, no experimental work has been conducted on the decolorization of Acid Red 182 (AR182) in aqueous media. Hence, in this novel experimental work, the treatment of AR182 from the Azo dyes family was explored using the electro-Peroxone (EP) process. For the optimization of operating factors, including AR182 concentration, pH, applied current, and O₃ flowrate in the decolorization of AR182, Central Composite Design (CCD) was utilized. The statistical optimization presented a highly satisfactory determination coefficient value and a satisfactory second-order model. The expected optimum conditions by the experimental design were as the following: AR182 concentration at 483.12 mg.L^-1, applied current at 0.627,113 A, pH at 8.18284 and O₃ flowrate at 1.13548 L min^-1. The current density is directly proportional to dye removal. However, increasing the amount of applied current beyond a critical value has a contradictory impact on dye removal performance. The dye removal performance in both acidic and highly alkaline environments was negligible. Hence, ascertaining the optimum pH value and conduction of the experiment at that point is critical. At optimum points, the decolorization performance in predicted and experimental conditions for AR182 were 99 and 98.5%, respectively. The outcomes of this work clearly substantiated that the EP can be successfully utilized for the decolorization of AR182 in textile wastewater.

PMID:37329582 | DOI:10.1016/j.jenvman.2023.118379

Cell Mol Biol (Noisy-le-grand). 2023 Apr 30;69(4):16-23. doi: 10.14715/cmb/2023.69.4.3.

ABSTRACT

Today, using elastography and ultrasound images is the best method for diagnosing breast cancer for dense tissues, especially for women under 30 years old, which is used to detect the exact border of masses. Besides, using quantitative microscopic criteria that are less tasteful seems to be useful in predicting the behavior of the tumor and its prognosis. Ki-67 is an antigen corresponding to a nuclear non-histone protein produced by cells in proliferative phases. In this article, ultrasound and elastography images of patients were collected, and breast masses were identified. The proposed algorithm includes pre-processing, feature extraction, and classification. To remove the speckle noise, two pre-processing steps are used, and after segmenting each data with its appropriate color channel, statistical features and features based on the morphology of suspicious areas are extracted. Also, sections of paraffin blocks of samples fixed in formalin were prepared and stained by immunohistochemical staining with Ki-67 monoclonal antibody, and the cell proliferation index was determined in the prepared slides. The relationship between Ki-67 positivity and microscopic grade was studied. The feature extraction results show that elastography is chosen as a more appropriate method than ultrasound due to the separation in terms of color channels. The most appropriate proposed combined methods, namely RBF-Kmeans, MLP-SCG, and RBF-SOM, have been used to classify features. The combined MLP-SCG classifier with an average accuracy of 96% and an average of 98% has improved significantly compared to other methods.

PMID:37329553 | DOI:10.14715/cmb/2023.69.4.3

Ultrasound Obstet Gynecol. 2023 Jun 17. doi: 10.1002/uog.26292. Online ahead of print.

ABSTRACT

OBJECTIVES: The primary objective was to perform a systematic review on predictive factors for Obstetric Anal Sphincter Injury (OASI) occurrence at a first vaginal delivery, where the diagnosis was made by ultrasound (US-OASI). The secondary objective was to report on incidence rates of sonographic AS trauma, including trauma that was not clinically reported on at childbirth, among the studies providing data for our primary endpoint.

METHODS: We conducted a systematic search of MEDLINE, Embase, Web of Science, Cinahl, Cochrane library and Clinicaltrials.gov databases. Both observational cohort studies and interventional trials were eligible for inclusion. Study eligibility was assessed independently by two authors. Random-effect meta-analyses were performed to pool effect estimates from studies reporting on similar predictive factors. Summary Odds Ratios (ORs) or Mean Differences (MDs) were reported with 95% CI. Heterogeneity was assessed using the I² statistic. Methodological quality was assessed using the Quality in Prognosis Studies tool.

RESULTS: 2805 records were screened and 21 met the inclusion criteria (16 prospective cohort, three retrospective cohort and two interventional non-randomized trials). Increasing gestational age at delivery (MD 0.34w [0.04, 0.64]), shorter antepartum perineal body length (MD -0.60cm [-1.09, -0.11]), labor augmentation (OR 1.81 [1.21-2.71]), instrumental delivery (OR 2.13 [1.13-4.01]), in particular forceps extraction (OR 3.56 [1.31-9.67]), shoulder dystocia (OR 12.07 [1.06-137.6]), episiotomy use (OR 1.85 [1.11-3.06]) and shorter episiotomy length (MD -0.40cm [-0.75, -0.05]) were associated with US-OASI. When pooling incidence rates, 26% of women who first delivered vaginally, had sonographic evidence of AS trauma (95%CI 20-32%, 20 studies, I² =88%). In studies reporting on both clinical and ultrasound OASI rates, 20% of women had AS trauma on ultrasound, that was not reported on at childbirth (95%CI 14-28%, 16 studies, I² =90%). No differences were found in maternal age, BMI, weight, subpubic arch angle, induction of labor, epidural analgesia, duration of first/second/active second stage, vacuum extraction, neonatal birthweight or head circumference. Also, antenatal perineal massage and use of an intrapartum pelvic floor muscle dilator did not affect the odds of US-OASI. Most studies (81%) were judged at high risk of bias on at least one domain, and only four studies (19%) had an overall low risk of bias.

CONCLUSION: Given there was ultrasound evidence of structural damage to the AS in 26% of women who first delivered vaginally, clinicians should have a low threshold of suspicion. Our systematic review identified several predictive factors for this. This article is protected by copyright. All rights reserved.

PMID:37329513 | DOI:10.1002/uog.26292

Ultrasound Obstet Gynecol. 2023 Jun 17. doi: 10.1002/uog.26291. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the performance at 35+0 to 36+6 weeks’ gestation of screening for delivery with pre-eclampsia (PE) at various time points, using one of three approaches: placental growth factor (PlGF) concentration, the soluble fms-like tyrosine kinase-1 (sFLT-1) to PlGF concentration ratio, or the competing risks model, which combines maternal risk factors with biomarkers to estimate patient-specific risk.

METHODS: This was a prospective observational study in women attending for a routine hospital visit at 35+0 to 36+6 weeks’ gestation in two maternity hospitals in England (2016-22). The visits included recording of maternal demographic characteristics and medical history, and measurement of serum PlGF, serum sFLT-1, and mean arterial pressure (MAP). The detection rates (DRs) were evaluated for delivery with PE (by 2019 American College of Obstetricians and Gynecologists criteria), within 1 week, within 2 weeks, or at any time after screening, using either: (i) low PlGF (<10^th percentile), (ii) high sFLT-1/PlGF ratio (>90^th percentile), or (iii) the competing risks model, using a combination of maternal factors and multiple of the median (MoM) values of PlGF (‘single’ test), PlGF and sFLT-1 (‘double’ test), or PlGF, sFLT-1 and MAP (‘triple’ test). Risk cut-offs corresponded to a screen-positive rate of 10%. DRs were compared between tests by McNemar’s test, with p<0.05 considered statistically significant.

RESULTS: Of 34,782 pregnancies, 831 (2.4%) developed PE. In screening for delivery with PE at any time from assessment, the DR at 10% screen-positive rate was 47% by low PlGF alone, 54% by the ‘single test’, 55% by high sFLT-1/PlGF, 61% by the ‘double test’, and 68% by the ‘triple test’. In screening for delivery with PE within 2 weeks, the respective values were 67%, 74%, 74%, 80%, and 87%. In screening for delivery with PE within 1 week, the respective values were 77%, 81%, 85%, 88% and 91%. For prediction of PE at any time, the DR difference [95% confidence interval] was significantly higher with the ‘triple test’, compared with PlGF alone (20.1 [16.7-23.0]) or the sFLT-1/PlGF ratio (12.4 [9.7-15.3]). Similar results were seen for prediction of PE within 2 weeks (20.6 [14.9-26.8] and 12.9 [7.7-17.5], respectively) and prediction of PE within 1 week (13.5 [5.4-21.6]) and (5.4 [0.0-10.8]). The double test was superior to the sFLT-1/PlGF ratio and the single test was superior to PlGF alone in the prediction of PE within 2 weeks and at any time from assessment, but not within 1 week of assessment.

CONCLUSION: At 35+0 to 36+6 weeks’ gestation, the performance of screening for PE by the competing risks model ‘triple test’ is superior to that of PlGF alone or the sFLT-1/PlGF ratio for PE within 1 week, within 2 weeks and at any time from screening. This article is protected by copyright. All rights reserved.

PMID:37329494 | DOI:10.1002/uog.26291