Category: Statistics

Orv Hetil. 2023 Jan 8;164(1):29-37. doi: 10.1556/650.2023.32658. Print 2023 Jan 8.

ABSTRACT

INTRODUCTION: Osteoporosis affects one in three women and one in five men over the age of 50. We do not have an osteoporosis-related knowledge questionnaire over the age of 50, which is considered strong evidence in the prevention and treatment of the disease.

OBJECTIVE: Aim of the study was to validate the Hungarian form of the Osteoporosis Questionnaire in Hungarian-speaking women over the age of 50.

METHOD: The questionnaire was validated into Hungarian according to Beaton’s six-step method. Our sample consisted of 326 women. During our statistical analysis, we calculated descriptive statistics, difference tests, Cronbach’s alpha value, and Spearman’s correlation coefficient for test-retest and for external validity. Quality of life and physical activity were examined to support the external validity.

RESULTS: Our sample (63.08 ± 9.36 years) scored 8.76 ± 6.94 points on the questionnaire. Cronbach’s alpha value was 0.89. For the test-retest, Spearman’s correlation coefficient showed a value of p≥0.25 for all the questions. Significant correlations were found between knowledge and age (R = 0.37; p<0.001) and years of using hormone replacement therapy (R = 0.34; p = 0.02). The correlation analysis showed significant (p<0.001) correlation between knowledge and all sub-dimensions of quality of life. Significant correlation was found between transport movement (p<0.001; R = 0.21), intensive (p<0.001; R = 0.354), moderate recreational activity (p<0.001; R = 0.348), total moderate (p = 0.041; R = 0.125) total intense movements (p = 0.018; R = 0.145) and knowledge.

DISCUSSION: The Hungarian questionnaire was validated in accordance with international practice.

CONCLUSION: The Hungarian version of the Osteoporosis Questionnaire is a reliable, adaptable questionnaire for measuring the osteoporosis-related knowledge of the Hungarian female population over 50. Orv Hetil. 2022; 163(51): 29-37.

PMID:36617349 | DOI:10.1556/650.2023.32658

Am J Epidemiol. 2023 Jan 6:kwad006. doi: 10.1093/aje/kwad006. Online ahead of print.

ABSTRACT

Comparing parasite genotypes to inform parasitic disease outbreak investigations involves computation of genetic distances that are typically analyzed by hierarchical clustering to identify related isolates, indicating a common source. A limitation of hierarchical clustering is that hierarchical clusters are not discrete, they are nested. Consequently, small groups of similar isolates exist within larger groups that get progressively larger as relationships become increasingly distant. Investigators must dissect hierarchical trees at a partition number ensuring grouped isolates belong to the same strain; a process typically performed subjectively, introducing bias into resultant groupings. We describe an unbiased, probabilistic framework for partition number selection that ensures partitions comprise isolates that are statistically likely to belong to the same strain. We compute distances and establish a normalized distribution of background distances that is used to demarcate a threshold below which the closeness of relationships is unlikely to be random. Distances are hierarchically clustered and the dendrogram dissected at a partition number where most within-partition distances fall below the threshold. We evaluated this framework by partitioning 1,137 clustered Cyclospora cayetanensis genotypes including 552 isolates epidemiologically linked to various outbreaks. The framework was 91% sensitive and 100% specific in assigning epidemiologically-linked isolates to the same partition.

PMID:36617302 | DOI:10.1093/aje/kwad006

Health Promot Int. 2023 Feb 1;38(1):daac180. doi: 10.1093/heapro/daac180.

ABSTRACT

There is a gap in understanding specific features of health literacy that might be associated with adherence to influenza immunization. The aim of this study was to examine the association of health literacy with avoidance of influenza immunization and beliefs about the influenza vaccine among people with chronic diseases. Selection of study participants was based on a case-control study design in a population of people with chronic illnesses living in the Foča region (Republic of Srpska, Bosnia and Herzegovina) and who were entitled to receive a free influenza shot in season 2017/2018. The cases represented all non-vaccinated people (a total of 146) and the controls were vaccinated people (a total of 149) matched according to town of residence. Participants were interviewed in person from April to December 2018 using a socio-demographic questionnaire, Health Literacy Questionnaire (HLQ) and Health Belief Model Applied to Influenza (HBMAI). Better score on ‘Feeling understood and supported by healthcare providers’, ‘Social support for health’ and ‘Ability to actively engage with healthcare providers’ was associated with more perceived benefits of influenza immunization in men, but not in women. Perceiving more Barriers to influenza immunization was associated with lower scores on ‘Feeling understood and supported by healthcare providers’, ‘Have sufficient information to manage health’, ‘Social support for health’ and ‘Ability to actively engage with healthcare providers’ in both men and women. Health literacy may be associated with the perception of susceptibility to influenza, benefits and barriers to influenza immunization and motivations to receive influenza vaccine.

PMID:36617290 | DOI:10.1093/heapro/daac180

Ann Ital Chir. 2022;93:716-719.

ABSTRACT

BACKGROUND: The aim of this study is to evaluate long-term results of hybrid seton on anal continence and quality of life in transsphincteric fistulas.

METHODS: Between 2011-2013 eighty patients who completed 7-year follow-up among 154 patients who were operated for perianal fistula were included. Of the 50 patients participating, 42 (84%); 31 men, 11 women) returned all questionnaraires. The proctological findings of the patients were compared with the newly obtained ones retrospectively. Demographic characteristics of the patients, preoperative and postoperative 3rd month and 7th year Cleveland Clinic Incontinence Score, preoperative and postoperative 3rd month and 7th year Fecal Incontinence Quality of Life and seton fall times were assessed.

RESULTS: Thirty (73.8%) of 42 patients were male and 11 (26.2%) were female. The mean age of male patients was 36.3 ± 10.3 (18-57), and the mean age of female patients was 41.2 ± 12.1 (25-64) years. The mean time drop off the elastic seton was 19 ± 2.40 days (range 12-30 days). The preoperative and postoperative 3rd month Fecal Incontinence Quality of Life values™ were compared and improvement in lifestyle quality at the postoperative 3rd month was found to be statistically significant (p <0.01). When the preoperative and postoperative 7th year were compared in terms of Fecal Incontinence Quality of Life, behavior, life style and depression improved positively (p <0.01).

CONCLUSION: Hybrid seton in transsphincteric perianal fistula surgery is an effective and reliable method for preserving anal continence and improving quality of life.

KEY WORDS: Anal fistula, Fecal incontinence, Quality of life.

PMID:36617281

Eur J Orthod. 2023 Jan 7:cjac073. doi: 10.1093/ejo/cjac073. Online ahead of print.

ABSTRACT

BACKGROUND/OBJECTIVES: The aim of this study was to explore the effect of palatally displaced canines on maxillary dimensions and arch shape.

METHODS: Occlusal and skeletal landmarks were plotted on cone beam computed tomography (CBCT) images of 156 orthodontic patients: 78 with palatally displaced canines (PDC) (27 left, 28 right, and 23 bilateral) and 78 controls using Mimics™ (Materialise, Belgium). Arch forms were created, and arch width, depth, and skeletal dimensions were measured. T-test (P < 0.05) was used to compare the groups. Geometric Morphometrics (GM) analysis was used to compare the groups and to explore the pattern of covariation between two sets of landmarks.

RESULTS: The unilateral PDC group showed an increased first premolar, second premolar, molar widths, and an increased molar depth. No significant difference was found in arch form. The skeletal measurements were generally larger in the PDC group, but the transverse measurements were the most significant. Discriminant Function Analysis (DFA) with cross-validation allowed an accurate classification of 85.9% of the control group and 66.7% of the PDC group. The Mahalanobis distance displayed significant differences among three combinations of groups. Strong covariance was found between the second premolar and all other landmarks.

LIMITATIONS: The small sample sizes of the stratified groups precluded recognition of statistical significance.

CONCLUSIONS: Patients with unilateral PDC displayed significantly wider first, second premolar, and first molar widths, and increased first molar depths. There were no significant differences in arch form; however, GM showed significant differences between the groups and a prominent covariance function for the 2nd premolars.

PMID:36617278 | DOI:10.1093/ejo/cjac073

Neuro Oncol. 2023 Jan 7:noad002. doi: 10.1093/neuonc/noad002. Online ahead of print.

ABSTRACT

Durable objective response rate (ORR) remains a meaningful endpoint in recurrent cancer; however, the target ORR for single arm recurrent glioblastoma trials has not been based on historic information or tied to patient outcomes. The current study reviewed 68 treatment arms comprising 4,793 patients in past trials in recurrent glioblastoma in order to judiciously define target ORRs for use in recurrent glioblastoma trials. ORR was estimated at 6.1%[95% CI 4.23; 8.76%] for cytotoxic chemotherapies (ORR=7.59% for CCNU, 7.57% for TMZ, 0.64% for CPT-11, and 5.32% for other agents), 3.37% for biologic agents, 7.97% for (select) immunotherapies, and 26.8% for anti-angiogenic agents. ORRs were significantly correlated with median overall survival (mOS) across chemotherapy (R2=0.4078,P<0.0001), biologics (R2=0.4003,P=0.0003), and immunotherapy trials (R2=0.8994,P<0.0001), but not anti-angiogenic agents (R2=0, P=0.8937). Pooling data from chemotherapy, biologics, and immunotherapy trials, a meta-analysis indicated a strong correlation between ORR and mOS (R2=0.3900, P<0.0001; mOS[weeks]=1.4xORR+24.8). Assuming an ineffective cytotoxic (control) therapy has ORR=7.6%, the average ORR for lomustine and temozolomide trials, a sample size of ≥40 patients with target ORR>25% is needed to demonstrate statistical significance compared to control with a high level of confidence (P<0.01) and adequate power (>80%). Given this historic data and potential biases in patient selection, we recommend that well-controlled, single-arm phase II studies in recurrent glioblastoma should have a target ORR >25% (which translates to a median OS of approximately 15 months) and a sample size of ≥40 patients, in order to convincingly demonstrate antitumor activity. Crucially, this response needs to have sufficient durability, which was not addressed in the current study.

PMID:36617262 | DOI:10.1093/neuonc/noad002

J Anim Sci. 2023 Jan 7:skad008. doi: 10.1093/jas/skad008. Online ahead of print.

ABSTRACT

Reducing age at first calving has been a challenge in beef herds. There is anecdotal evidence that herd owners choose to calve heifers older because of the perceived consequences of calving heifers at 24 mo of age compare to 36 mo on performance traits in beef herds. The objective of this study was to estimate the association of calving heifers at younger ages on subsequent performance traits, calving interval, longevity, cow weight, dystocia and progeny weaning weight for parities 1 to 5. Available to the study after data edits were 219,818 calving interval records, 219,818 longevity records, 118,504 cow live-weight records, 230,998 dystocia records and 230,998 weaning weight records. Linear mixed models were used to quantify performance of each trait in age at first calving (AFC) groups for each parity. As parity increased, there was a favorable reduction in calving interval and dystocia (P<0.001), while the likelihood of cows surviving reduced (P<0.001). Both cow live-weight and progeny weaning weight increased as parity increased. Age at first calving only had a significant association with dystocia within parity one (P<0.001), where older heifers at first calving subsequently had lower risk of calving. Calving interval for parity 1 cows was observed to be longer by 6 days in cows that calved for the first time at 33 to 36 months compared to cows calved for the first time at 22 to 24 months (P<0.001). No statistical difference was observed for longevity between cows with an AFC of 22 to 24 mo compared to cows with an AFC of 33 to 36 mo (P>0.05). Cows that calved at a younger age did wean lighter calves for their first 3 lactations (P<0.01) but had no association with weaning weight for parity 4 and 5 cows (P>0.05). Cows with a lower AFC were lighter for parity 1, 2, 3 and 4 (P<0.001); at parity 5, AFC had no association with cow live-weight (P>0.05). The performance of mature cows for calving interval, longevity, calving difficulty, cow live-weight and weaning weight was not impacted by AFC. In conclusion, calving cows for the first time at younger ages does pose risks and associated performance loss but this risk and loss should be minimized by good management.

PMID:36617256 | DOI:10.1093/jas/skad008

Arch Clin Neuropsychol. 2023 Jan 6:acac110. doi: 10.1093/arclin/acac110. Online ahead of print.

ABSTRACT

OBJECTIVE: It is essential to interpret performance validity tests (PVTs) that are well-established and have strong psychometrics. This study evaluated the Child and Adolescent Memory Profile (ChAMP) Validity Indicator (VI) using a pediatric sample with traumatic brain injury (TBI).

METHOD: A cross-sectional sample of N = 110 youth (mean age = 15.1 years, standard deviation [SD] = 2.4 range = 8-18) on average 32.7 weeks (SD = 40.9) post TBI (71.8% mild/concussion; 3.6% complicated mild; 24.6% moderate-to-severe) were administered the ChAMP and two stand-alone PVTs. Criterion for valid performance was scores above cutoffs on both PVTs; criterion for invalid performance was scores below cutoffs on both PVTs. Classification statistics were used to evaluate the existing ChAMP VI and establish a new VI cutoff score if needed.

RESULTS: There were no significant differences in demographics or time since injury between those deemed valid (n = 96) or invalid (n = 14), but all ChAMP scores were significantly lower in those deemed invalid. The original ChAMP VI cutoff score was highly specific (no false positives) but also highly insensitive (sensitivity [SN] = .07, specificity [SP] = 1.0). Based on area under the curve (AUC) analysis (0.94), a new cutoff score was established using the sum of scaled scores (VI-SS). A ChAMP VI-SS score of 32 or lower achieved strong SN (86%) and SP (92%). Using a 15% base rate, positive predictive value was 64% and negative predictive value was 97%.

CONCLUSIONS: The originally proposed ChAMP VI has insufficient SN in pediatric TBI. However, this study yields a promising new ChAMP VI-SS, with classification metrics that exceed any other current embedded PVT in pediatrics.

PMID:36617240 | DOI:10.1093/arclin/acac110

Mol Biol Evol. 2023 Jan 7:msad001. doi: 10.1093/molbev/msad001. Online ahead of print.

ABSTRACT

Adaptive introgression (AI) facilitates local adaptation in a wide range of species. Many state-of-the-art methods detect AI with ad-hoc approaches that identify summary statistic outliers or intersect scans for positive selection with scans for introgressed genomic regions. Although widely used, approaches intersecting outliers are vulnerable to a high false-negative rate as the power of different methods varies, especially for complex introgression events. Moreover, population genetic processes unrelated to AI, such as background selection or heterosis, may create similar genomic signals to AI, compromising the reliability of methods that rely on neutral null distributions. In recent years, machine learning (ML) methods have been increasingly applied to population genetic questions. Here, we present a ML-based method called MaLAdapt for identifying AI loci from genome-wide sequencing data. Using an Extra-Trees Classifier algorithm, our method combines information from a large number of biologically meaningful summary statistics to capture a powerful composite signature of AI across the genome. In contrast to existing methods, MaLAdapt is especially well-powered to detect AI with mild beneficial effects, including selection on standing archaic variation, and is robust to non-AI selective sweeps, heterosis from deleterious mutations, and demographic misspecification. Further, MaLAdapt outperforms existing methods for detecting AI based on the analysis of simulated data and on a validation of empirical signals through visual inspection of haplotype patterns. We apply MaLAdapt to the 1000 Genomes Project human genomic data, and discover novel AI candidate regions in non-African populations, including genes that are enriched in functionally important biological pathways regulating metabolism and immune responses.

PMID:36617238 | DOI:10.1093/molbev/msad001

Dis Esophagus. 2023 Jan 6:doac100. doi: 10.1093/dote/doac100. Online ahead of print.

ABSTRACT

It is unknown whether Ivor Lewis (IL) or McKeown (McK) esophagectomy is preferred in patients with potentially curable esophageal or gastro-esophageal junction (GEJ) cancer. Patients with mid- and distal esophageal and GEJ cancer without distant metastases who underwent IL or McK esophagectomy in the Netherlands between 2015 and 2017, were selected from the Netherlands Cancer Registry. Patients were propensity score matched for sex, age, American Society of Anesthesiologist classification, comorbidity, tumor type, tumor location, clinical stage, neoadjuvant treatment and year of diagnosis. The primary outcome was a 3-year relative survival (RS). Secondary outcome parameters were number of lymph nodes examined, number of positive lymph nodes, radical resection rate, tumor regression grade, post-operative complications and mortality. A total of 1627 patients who underwent IL (n = 1094) or McK (n = 533) esophagectomy were included. Patient and tumor characteristics were balanced after propensity score matching, leaving 658 patients to be compared. The 3-year RS was 54% after IL and 50% after McK esophagectomy, P = 0.140. The median number of lymph nodes examined, median number of positive lymph nodes, radical resection rate and tumor regression grade were comparable between both groups. Recurrent laryngeal nerve palsy (2 vs. 5%, P = 0.006) occurred less frequently after IL esophagectomy. No differences were observed in post-operative anastomotic leakage rate, pulmonary complication rate and mortality rates. There was no statistically significant difference in the 3-year RS between IL and McK esophagectomy. Based on these results, both IL and McK esophagectomy can be performed in patients with mid to distal esophageal and GEJ cancer.

PMID:36617230 | DOI:10.1093/dote/doac100