Category: Statistics

Osong Public Health Res Perspect. 2022 Dec;13(6):424-434. doi: 10.24171/j.phrp.2022.0212. Epub 2022 Nov 28.

ABSTRACT

OBJECTIVES: Although it is widely used as a measure for mortality, the case fatality rate (CFR) ofcoronavirus disease 2019 (COVID-19) can vary over time and fluctuate for many reasons otherthan viral characteristics. To compare the CFRs of different countries in equal measure, weestimated comparable CFRs after adjusting for multiple covariates and examined the mainfactors that contributed to variability in the CFRs among 21 countries.

METHODS: For statistical analysis, time-series cross-sectional data were collected from OurWorld in Data, CoVariants.org, and GISAID. Biweekly CFRs of COVID-19 were estimated bypooled generalized linear squares regression models for the panel data. Covariates includedthe predominant virus variant, reproduction rate, vaccination, national economic status,hospital beds, diabetes prevalence, and population share of individuals older than age 65. Intotal, 21 countries were eligible for analysis.

RESULTS: Adjustment for covariates reduced variation in the CFRs of COVID-19 across countriesand over time. Regression results showed that the dominant spread of the Omicron variant,reproduction rate, and vaccination were associated with lower country-level CFRs, whereasage, the extreme poverty rate, and diabetes prevalence were associated with higher countrylevel CFRs.

CONCLUSION: A direct comparison of crude CFRs among countries may be fallacious, especiallyin a cross-sectional analysis. Our study presents an adjusted comparison of CFRs over timefor a more proper comparison. In addition, our findings suggest that comparing CFRs amongdifferent countries without considering their context, such as the epidemic phase, medicalcapacity, surveillance strategy, and socio-demographic traits, should be avoided.

PMID:36617548 | DOI:10.24171/j.phrp.2022.0212

Eur J Neurol. 2023 Jan 8. doi: 10.1111/ene.15676. Online ahead of print.

ABSTRACT

OBJECTIVE: To elucidate the clinical profile of sporadic fatal insomnia (sFI), assess the similarities and differences between sFI and fatal familial insomnia (FFI), and evaluate the influence of ethnicity on the phenotype of sFI patients.

METHODS: The data of sFI and FFI patients was retrieved from our case series and through literature review. The clinical and diagnostic features of sFI and FFI were compared, as were the phenotypes of Asian and Caucasian sFI patients.

RESULTS: We identified 44 sFI and 157 FFI cases. The prevalence of sleep-related, neuropsychiatric and autonomic symptoms among the sFI patients were 65.9%, 100.0% and 43.2% respectively. Compared to FFI, sFI exhibited longer disease duration and a higher proportion of neuropsychiatric symptoms, while FFI was characterized by a higher incidence of sleep-related and autonomic symptoms in the early stages of the disease or throughout its course. In addition, a higher proportion of the sFI patients showed hyperintensity on MRI and PSWCs on EEG compared to the FFI patients, especially those presenting with pathological changes associated with MM2-cortical type sCJD. The Asian sFI patients had a higher proportion of males and positivity for CSF 14-3-3 protein, and fewer sleep-related symptoms compared to Caucasian sFI patients. The age of onset and duration of sFI differed between ethnic groups, but failed to reach statistical significance.

CONCLUSIONS: Despite its similarities to FFI, sFI is characterized by longer disease duration, higher proportion of neuropsychiatric symptoms and hyperintensity on MRI, along with differences in the clinical characteristics based on ethnicity.

PMID:36617541 | DOI:10.1111/ene.15676

J Dent Educ. 2023 Jan 8. doi: 10.1002/jdd.13169. Online ahead of print.

ABSTRACT

PURPOSE: This cross-sectional study assessed the perceptions of pediatric dental residency program directors (PDs) regarding policies and attitudes on pregnancy and parenthood during residency training.

METHODS: A 28-item electronic survey was administered to PDs of pediatric dental residencies in the United States. Statistical tests were performed. Variables were reported as counts (percentages) and compared using Fischer’s exact test and chi-squared tests at a significance level of 0.05.

RESULTS: Forty-two of the 97 PDs completed the survey for 43% response rate. Almost all programs had a formal maternal leave policy, but perceptions and policies varied regarding the effects of both pregnancy and parenthood on residents during training. Chi-square results compared if parenthood had a negative impact on the well-being a female trainee versus a male trainee had a p-value < .05.

CONCLUSIONS: There appeared to be a lack of national uniformity regarding program policies on parental leave. Most PDs perceived having a child during residency had at least one negative effect on their female residents. Finally, PDs were likely to perceive parenthood to adversely impact the well-being and work of female trainees more so than their male counterparts.

PMID:36617504 | DOI:10.1002/jdd.13169

Pediatr Pulmonol. 2023 Jan 8. doi: 10.1002/ppul.26309. Online ahead of print.

ABSTRACT

INTRODUCTION: The submaximal tests are used to measure aerobic capacity and correlate with activities of daily living in chronic patients. The 6-minute handbike cycle test (6mhct) was created for non-ambulatory subjects, but there are no reference values to quantify and classify the cardiorespiratory fitness of children in this condition.

OBJECTIVE (S): Generate 6mhct reference values and determine predictive variables in a population of Chilean children between 8 and 13 years old.

MATERIALS AND METHODS: Cross-section study. Sampling for convenience, stratified by age. Evaluation of anthropometric variables, handgrip strength, heart rate (HR), effort perception, and blood pressure were performed, then the 6mhct was applied. Descriptive statistics, Student’s t-test and Mann-Whitney U test, correlation coefficient, and regression equation were used to estimate the total revolutions by age, being significant p <0.05.

RESULTS: Were evaluated 120 children homogeneously distributed by age. The total revolutions performed by boys and girls were 861.4 ± 102.9 and 771.8 ± 90.2 respectively (p<0.001). There was a significant correlation between total revolutions and age (r = 0.52), weight (r=0.29), height (r=0.46), average UULL length (r=0.44), average handgrip strength (r=0.53), peak HR (r=0.67), recovery HR (r=0.44) and HR reserve (r=0.72). The regression equation was established.

CONCLUSIONS: These results can be used as preliminary reference values for the 6mhct in Chilean children from 8 to 13 years old. Handgrip strength, age, peak HR, and HR reserve influenced the performance of the 6mhct. This article is protected by copyright. All rights reserved.

PMID:36617493 | DOI:10.1002/ppul.26309

Korean J Women Health Nurs. 2022 Dec;28(4):348-357. doi: 10.4069/kjwhn.2022.12.23. Epub 2022 Dec 29.

ABSTRACT

PURPOSE: This study aimed to identify maternal, infant, and perinatal mortality using the nationalpopulation data of South Korea between 2018 and 2020, and to analyze mortality rates according tocharacteristics such as age, date of death, and cause of death in each group. This study updates themost recent study using 2009 to 2017 data.

METHODS: Analyses of maternal, infant, and perinatal mortality were done with data identifiedthrough the supplementary investigation system for cases of death from the Census of PopulationDynamics data provided by Statistics Korea from 2018 to 2020.

RESULTS: Between 2018 and 2020, a total of 99 maternal deaths, 2,427 infant deaths, and 2,408 perinatal deaths were identified from 901,835 live births. The maternal mortality ratio was 11.3 deathsper 100,000 live births in 2018; it decreased to 9.9 in 2019 but increased again to 11.8 in 2020. Thematernal mortality ratio increased steeply in women over the age of 40 years. An increasing trend inthe maternal mortality ratio was found for complications related to the puerperium and hypertensive disorders. Both infant and perinatal mortality continued to decrease, from 2.8 deaths per 1,000live births in 2018 to 2.5 in 2020 and from 2.8 in 2018 to 2.5 in 2020, respectively.

CONCLUSION: Overall, the maternal, infant, and perinatal mortality statistics showed improvements.However, more attention should be paid to women over 40 years of age and specific causes of maternal deaths, which should be taken into account in Korea’s maternal and child health policies.

PMID:36617486 | DOI:10.4069/kjwhn.2022.12.23

Korean J Women Health Nurs. 2022 Dec;28(4):338-347. doi: 10.4069/kjwhn.2022.12.16. Epub 2022 Dec 29.

ABSTRACT

PURPOSE: The incidence of high-risk pregnancies is increasing in Korea as the birth age increasesdue to late marriage. Maternal-fetal attachment is an important factor that affects children even afterchildbirth, but it is difficult for high-risk pregnant women to form maternal-fetal attachment. Thecurrent study aimed to explore whether taegyo practice (i.e., pregnant women’s efforts for fetal goodgrowth and development), self-esteem, and social support influenced the degree of maternal-fetalattachment in women with high-risk pregnancies.

METHODS: The participants included 226 pregnant Korean women at ≥20 gestational weeks, hospitalized with 15 high-risk pregnancy conditions as defined by the Ministry of Health and Welfare.Recruitment via convenience sampling was done at four sites in Busan, Korea. Surveys were distributed and collected from February 1 to 28, 2022. Data analysis was conducted using descriptive statistics, the t-test, one-factor analysis of variance, Pearson correlation coefficients, and hierarchicalmultiple regression.

RESULTS: On average, participants were 33.97±4.23 years of age and at 31.65±6.23 gestational weeks.Preterm labor (35.4%) and gestational diabetes (21.0%) were the most common high-risk conditions. Maternal-fetal attachment was positively correlated with taegyo practice (r=.70, p&lt;.001),self-esteem (r=.53, p&lt;.001), and social support (r=.53, p&lt;.001), all with statistical significance. Taegyo practice (β=.50, p&lt;.001) and social support (β=.17, p=.030) explained 53% of variance in maternal-fetal attachment in women with high-risk pregnancies.

CONCLUSION: Nurses caring for women with high-risk pregnancies during hospitalization can usethese findings by promoting taegyo practice and enhancing social support to increase maternal-fetalattachment.

PMID:36617485 | DOI:10.4069/kjwhn.2022.12.16

Korean J Women Health Nurs. 2022 Dec;28(4):296-306. doi: 10.4069/kjwhn.2022.11.21. Epub 2022 Dec 29.

ABSTRACT

PURPOSE: This study investigated the effects of peripheral neuropathy symptoms, self-care ability,and disturbances to daily life on quality of life (QoL) among gynecological cancer patients undergoing chemotherapy.

METHODS: The participants included 144 patients with gynecological cancer undergoing anticancerchemotherapy at a tertiary hospital in Seoul, South Korea, from December 1, 2021 to January 28,2022. Convenience sampling was used to recruit patients who had received 4 or more cycles of chemotherapy using a paclitaxel-platinum regimen, and a self-reported questionnaire was used to collect data. Descriptive statistics, the t-test, analysis of variance, Scheffé test, Pearson correlation coefficients, and multiple regression analysis were performed.

RESULTS: Most of the participants had ovarian cancer (70.1%) or endometrial cancer (14.6%), andthe most common number of treatment cycles was 6 to 10 (29.2%). The mean QoL (60.83±19.89)was greater than the midpoint. The regression model analyzing the patients’ QoL was statisticallysignificant (F=15.38, p&lt;.001) with an explanatory power of 56.7%. Self-care ability (β=.39, p&lt;.001),disturbances to daily life (β=-.38, p&lt;.001), the duration of peripheral neuropathy symptoms(β=2.14, p=.034), and regular exercise (β=-2.12, p=.036) were found to significantly affect QoL.

CONCLUSION: Efforts to improve the self-care ability of gynecological cancer patients who have experienced peripheral neuropathy after receiving chemotherapy and mitigate disturbances to their dailylife can improve their QoL. Healthcare professionals should identify peripheral neuropathy symptoms and examine the effects of the symptoms on patients’ daily lives. Improving the self-care abilityof patients and alleviating their limitations in daily life may improve QoL.

PMID:36617481 | DOI:10.4069/kjwhn.2022.11.21

Zhongguo Fei Ai Za Zhi. 2022 Dec 20;25(12):852-861. doi: 10.3779/j.issn.1009-3419.2022.101.55.

ABSTRACT

BACKGROUND: The prognosis of stage I non-small cell lung cancer (NSCLC) is generally good. However, some of the stage I NSCLC patients still may have early recurrence and metastasis, and there is no standard method to screen this part of the population. The aim of this study is to investigate the relationship between Ki67 expression as well as epidermal growth factor receptor (EGFR) mutation and the risk of recurrence in postoperative patients with stage I lung adenocarcinoma.

METHODS: We retrospectively enrolled 118 postoperative patients with stage I lung adenocarcinoma. EGFR mutation was tested using amplification refractory mutation system polymerase chain reaction (ARMS-PCR) , and Ki67 level was detected by immunohistochemistry (IHC), followed by the collection of the patients’ clinical characteristics. Kaplan-Meier method, Log-rank test, and Cox proportional hazards regression model were used for the prognostic statistical analysis.

RESULTS: Among the 118 patients, the rate of high Ki67 expression was 43.22% (51/118), which is related to gender, smoking status, surgical method, differentiation degree, and postoperative stage (P<0.05). Meanwhile, EGFR mutation rate was 61.02% (72/118), of which EGFR exon 19 deletion mutation rate was 19.49% (23/118), and the EGFR exon 21 L858R mutation rate was 41.53% (49/118). However, Ki67 expression was not associated with EGFR mutation status (χ2=1.412, P=0.235). Survival analysis showed that high Ki67 expression was inversely associated with disease-free survival (DFS) and overall survival (OS) in stage I lung adenocarcinoma (P<0.05), but EGFR mutation status was not significantly associated with DFS and OS (P>0.05). In the subgroup analysis, the DFS of the EGFR exon 19 deletion group was significantly decreased compared with the EGFR exon 21 L858R mutation group (P=0.031), but there was no significant difference in OS (P=0.308). Multivariate analysis showed that there was statistical significance between Ki67 expression (P=0.001) and DFS in stage I lung adenocarcinoma; Ki67 expression (P=0.03) and gender (P=0.015) were associated with OS in stage I lung adenocarcinoma.

CONCLUSIONS: Ki67 expression is an independent influencing factor for postoperative recurrence and OS of stage I lung adenocarcinoma and it is not significantly associated with EGFR mutation. There is no significant difference between EGFR mutation status and the prognostis of stage I lung adenocarcinoma. However, the prognosis differed in EGFR mutation types; the patients with EGFR exon 19 deletion are at higher risk of recurrence than EGFR exon 21 L858R mutation.

PMID:36617471 | DOI:10.3779/j.issn.1009-3419.2022.101.55

Zhongguo Fei Ai Za Zhi. 2022 Dec 20;25(12):843-851. doi: 10.3779/j.issn.1009-3419.2022.101.56.

ABSTRACT

BACKGROUND: Osimertinib is a third-generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) capable of overcoming non-small cell lung cancer (NSCLC) with EGFR T790M mutation. Although the addition of bevacizumab to 1st generation EGFR-TKIs confers a significant improvement in progression-free survival (PFS) in treatment-naive EGFR mutant NSCLC patients, osimertinib plus bevacizumab combination failed to show prolongation in the phase 2 study WJOG8715L. Data of such combination in Chinese patients are still lacking. This study aimed to explore the efficacy of the addition of bevacizumab to osimertinib as second-line therapy in real-world data, and to evaluate the role of anti-angiogenesis plus osimertinib combination therapeutic strategies in pretreated Chinese NSCLC patients with acquired EGFR T790M mutation.

METHODS: A total of 42 advanced NSCLC patients with acquired EGFR T790M mutation after prior EGFR-TKIs treatment were collected between January 2020 to August 2021, with 16 cases treated with osimertinib plus bevacizumab and 26 cases treated with osimertinib. The treatment effect of patients were analyzed.

RESULTS: The objective response rate (ORR) in combination group and osimertinib group were 43.8% and 50.0% respectively (P=0.694). No statistically significant difference in median PFS (14.0 mon vs 13.0 mon, P=0.797) and overall survival (OS) (29.0 mon vs 26.0 mon, P=0.544) between the combination group and osimertinib group were observed. Prior history of bevacizumab was identified as an independent predictor of PFS (P=0.045) and OS (P=0.023).

CONCLUSIONS: Our study demonstrated that adding bevacizumab to osimertinib could not show advantages in PFS and OS in pretreated NSCLC patients harboring EGFR T790M-mutation.

PMID:36617470 | DOI:10.3779/j.issn.1009-3419.2022.101.56

Hum Reprod. 2023 Jan 9:deac264. doi: 10.1093/humrep/deac264. Online ahead of print.

ABSTRACT

STUDY QUESTION: Is the outcome of donor recruitment influenced by the country in which recruitment took place or the initial identity (ID)-release choice of applicants?

SUMMARY ANSWER: More applicants are accepted as donors in Denmark than in the USA and those who choose ID release are more frequently accepted than those who do not.

WHAT IS KNOWN ALREADY: The successful recruitment of sperm donors is essential to provide a range of medically assisted reproduction (MAR) procedures, which rely upon donor sperm. However, while much has been written about the medical screening and assessment of sperm donors from a safety perspective, relatively little has been written about the process of recruiting donors and how it works in practice. There are differences in demographic characteristics between donors who choose to allow their identity to be released to their donor offspring (ID release) compared to those who do not (non-ID release). These characteristics may also influence the likelihood of them being recruited.

STUDY DESIGN, SIZE, DURATION: A total of 11 712 men applied to be sperm donors at a sperm bank in Denmark and the USA during 2018 and 2019.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Anonymized records of all donor applicants were examined to assess the number passing through (or lost) at each stage of the recruitment process. Statistical analysis was carried out to examine differences between location (Denmark or USA) and/or donor type (ID release versus non-ID release).

MAIN RESULTS AND THE ROLE OF CHANCE: Few applicants (3.79%) were accepted as donors and had samples frozen and released for use; this was higher in Denmark (6.53%) than in the USA (1.03%) (χ2 = 243.2; 1 degree of freedom (df); z = 15.60; P < 0.0001) and was higher in donors who opted at the outset to be ID release (4.70%) compared to those who did not (3.15%) (χ2 = 18.51; 1 df; z = 4.303; P < 0.0001). Most candidate donors were lost during recruitment because they: withdrew, failed to respond, did not attend an appointment, or did not return a questionnaire (54.91%); reported a disqualifying health issue or failed a screening test (17.41%); did not meet the eligibility criteria at the outset (11.71%); or did not have >5 × 106 motile sperm/ml in their post-thaw samples (11.20%). At each stage, there were statistically significant differences between countries and the donor’s initial ID choice. During recruitment, some donors decided to change ID type. There were no country differences in the frequency in which this occurred (χ2 = 0.2852; 1 df; z = 0.5340; P = 0.5933), but it was more common for donors to change from non-ID release to ID release (27.19%) than the other way around (11.45%) (χ2 = 17.75; 1 df; z = 4.213; P < 0.0001), although movements in both directions did occur in both countries.

LIMITATIONS, REASONS FOR CAUTION: No information was available about the demographic characteristics of the applicants, which may also have influenced their chances of being accepted as a donor (e.g. ethnicity and age). Donor recruitment procedures may differ in other locations according to local laws or guidelines.

WIDER IMPLICATIONS OF THE FINDINGS: A better understanding of when and why candidate donors are lost in the recruitment process may help develop leaner and more efficient pathways for interested donors and sperm banks. This could ultimately increase the number of donors recruited (through enhanced information, support, and reassurance during the recruitment process) or it may reduce the financial cost to the recipients of donor sperm, thus making it more affordable to those who are ineligible for state-funded treatment.

STUDY FUNDING/COMPETING INTEREST(S): The study received no funding from external sources. All authors are Cryos employees or members of the Cryos External Scientific Advisory Committee.

TRIAL REGISTRATION NUMBER: N/A.

PMID:36617425 | DOI:10.1093/humrep/deac264