Category: Statistics

J Clin Res Pediatr Endocrinol. 2023 Jan 26. doi: 10.4274/jcrpe.galenos.2023.2022-11-16. Online ahead of print.

ABSTRACT

BACKGROUND: Menarche is the endpoint of a sequence of maturational events of female puberty. The timing of menarche is a strongly heritable trait. However, secular trends suggest that lifestyle and environmental factors are important.

OBJECTIVE: To assess the trend in age at menarche (AAM), and its associated factors in Istanbul over the last 12 years.

METHOD: A cross-sectional study was carried out between March and April 2022 on schoolgirls aged 9-18 years. A predesigned and self-administered questionnaire was filled out anonymously by the students. The data of AAM was included in the statistical analysis if the time of AAM is remembered for months and years. A probit model was used to calculate the median AAM. The findings were compared with those from the study performed 12 years ago in the same region of Istanbul.

RESULTS: Among 9000 girls to whom the questionnaire was distributed, 1749 (19.5%) responded. The median AAM of 1374 girls whose AAM information was considered valid was 12.04 years (95% CI 12.01-12.13), 0.7 years lower than was reported 12 years ago (p<0.0001). AAM was correlated positively with maternal AAM, and negatively with body mass index (BMI) SDS and maternal educational status (p<0.0001, <0.0001, 0.002), respectively. There was no correlation between the AAM and birth weight. Girls with BMI percentile ≥85% (n=251) had earlier menarche than the ones with BMI percentile <85% (n=1072) (11.5 vs. 12.1 years, p<0.0001). Among the mother-daughter pairs (n=1162), AAM of girls was 0.91 years (median 0.94 years) earlier than their mothers.

CONCLUSION: The present study demonstrates a significant downward trend in the menarcheal age in Istanbul over the last decade. Our findings support a strong contribution of genetic factors and BMI on AAM.

PMID:36700465 | DOI:10.4274/jcrpe.galenos.2023.2022-11-16

Med Phys. 2023 Jan 26. doi: 10.1002/mp.16242. Online ahead of print.

ABSTRACT

BACKGROUND: The machine-specific reference correction factors ( $k_{Q_{msr},Q_0}^{f_{msr},f_{ref}}$ ) were introduced in International Atomic Energy Agency (IAEA) Technical Report Series 483 (TRS-483) for reference dosimetry of small fields. Several correction factor sets exist for a Leksell Gamma Knife® (GK) Perfexion^TM or Icon^TM . Nevertheless, experiments have not rigorously validated the correction factors from different studies.

PURPOSE: This study aimed to assess the role and accuracy of $k_{Q_{msr},Q_0}^{f_{msr},f_{ref}}$ values in determining the absorbed dose rates to water in the reference dosimetry of Gamma Knife.

METHODS: The dose rates in the 16 mm collimator field of a GK were determined following the international code of practices with three ionization chambers: PTW T31010, PTW T31016 (PTW Freiberg GmbH, New York, NY, USA), and Exradin A16 (Standard Imaging, Inc., Middleton, WI, USA). A chamber was placed at the center of a solid water phantom (Elekta AB, Stockholm, Sweden) using a detector-specific insert. The reference point of the ionization chamber was confirmed using cone-beam CT images. Consistency checks were repeated five times at a GK site and performed once at seven GK sites. Correction factors from six simulations reported in previous studies were employed. Variations in the dose rates and relative dose rates before and after applying the $k_{Q_{msr},Q_0}^{f_{msr},f_{ref}}$ were statistically compared.

RESULTS: The standard deviation of the dose rates measured by the three chambers decreased significantly after any correction method was applied (p = 0.000). When the correction factors of all studies were averaged, the standard deviation was reduced significantly more than when any single correction method was applied (p ≤ 0.030), except for the IAEA TRS-483 correction factors (p = 0.148). Before any correction was applied, there were statistically significant differences among the relative dose rates measured by the three chambers (p = 0.000). None of the single correction methods could remove the differences among the ionization chambers (p ≤ 0.038). After TRS-483 correction, the dose rate of Exradin A16 differed from those of the other two chambers (p ≤ 0.025). After the averaged factors were applied, there were no statistically significant differences between any pairs of chambers according to Scheffe’s post hoc analyses (p ≥ 0.051); however, PTW T31010 differed from PTW 31016 according to Tukey’s HSD analyses (p = 0.040).

CONCLUSION: The $k_{Q_{msr},Q_0}^{f_{msr},f_{ref}}$ significantly reduced variations in the dose rates measured by the three ionization chambers. The mean correction factors of the six simulations produced the most consistent results, but this finding was not explicitly proven in the statistical analyses. This article is protected by copyright. All rights reserved.

PMID:36700450 | DOI:10.1002/mp.16242

Geriatr Psychol Neuropsychiatr Vieil. 2022 Dec 1;20(4):439-456. doi: 10.1684/pnv.2022.1065.

ABSTRACT

CONTEXTE: La population d’octogénaires est hétérogène, avec des sujets robustes et d’autres à risque d’événements indésirables. Dans notre étude, nous comparons la valeur prédictive de deux instruments visant à identifier les sujets à haut risque : le phénotype de fragilité selon Fried et un test de performance physique standardisé.

MÉTHODES: La base de données de l’étude BELFRAIL nous fournit un échantillon représentatif de la population belge d’octogénaires, composé de 567 sujets. Des données sur l’hospitalisation ont été recueillies jusqu’à 3,0 ± 0,25 ans et sur la mortalité jusqu’à 5,1 ± 0,25 ans. Nous avons réalisé et calculé des analyses de survie, des indices de reclassification et des courbes décisionnelles.

RÉSULTATS: Les participants fragiles (phénotype de Fried) ou dans le quartile inférieur (Short Physical Performance Battery – SPPB) ont un risque de mortalité et d’hospitalisation plus élevé. Le C de Harrell et l’aire sous la courbe sont semblables (< 0,70). Les courbes de décision illustrent un bénéfice net supérieur aux stratégies par défaut pour les deux outils. Les indices de reclassification et les courbes décisionnelles ne montrent aucune différence significative entre les instruments.

CONCLUSION: In a cohort of community-dwelling adults 80 years and older a standardized physical performance test was as good as the Fried frailty phenotype in identifying higher risk for adverse outcomes.

BACKGROUND: The population of adults aged 80 years and older is heterogenous with some being robust and others having a higher risk for adverse events. This study compares the predictive value of two tools used to identify older adults who are at higher risk for adverse outcomes: frailty phenotype according to Fried and a standardized physical performance test.

METHODS: The BELFRAIL population-based cohort of 567 community-dwelling adults aged 80 years and older living in Belgium. Fried frailty phenotype and physical performance test (gait, chair stand, standing balance tests and putting on and off a cardigan). The predictive value of the two tools in predicting mortality (up to 5.1 ± 0.25 years), hospitalization (3.0 ± 0.25 years) and decline in activities of daily living (after 1.7 ± 0.21 years) was compared using reclassification statistics and decision curve analysis.

RESULTS: Frail participants according to Fried phenotype and those in the lowest quartile of the physical performance test score had higher risk for mortality and hospitalization. Harrell C and area under operator curve were similar (< 0.70). Reclassification statistics and net benefit in decision curve analysis showed no significant difference between the two tools in identifying higher risk for mortality, hospitalization and functional decline.

PMID:36700437 | DOI:10.1684/pnv.2022.1065

J Exp Biol. 2023 Jan 26:jeb.244676. doi: 10.1242/jeb.244676. Online ahead of print.

ABSTRACT

The standard paradigm of organismal biology views lower-level traits (e.g., aspects of physiology) as determining organismal performance abilities (e.g., maximal sprint speed), which in turn constrain behavior (e.g., social interactions). However, few studies have simultaneously examined all three levels of organization. We used focal observations to record movement behaviors and push-up displays in the field for adult male Sceloporus occidentalis lizards during the breeding season. We then captured animals, measured aspects of physiology, morphology, performance, and counted ecto- and endoparasites as potential predictors of sprint speed and maximal oxygen consumption (VO2max). Field behaviors were statistically repeatable, but not strongly so. Sprint speed and VO2max were repeatable using residuals from regressions on body mass (speed: r=0.70; VO2max: r=0.88). Both calf (standardized partial regression [path] coefficient B=0.53) and thigh (B=-0.37) muscle masses (as residuals from regressions on body mass) were significant predictors of sprint speed; hemoglobin concentration (B=0.42) was a predictor of VO2max. In turn, VO2max predicted the maximum number of 4-legged push-ups per bout (B=0.39). In path analysis, log likelihood ratio tests indicated no direct paths from lower-level traits to behavior, supporting the idea that morphology, in the broad sense, only affects behavior indirectly through measures of performance. Our results show that inter-individual variation in field behaviors can be related to performance abilities, which in turn reflect differences in morphology and physiology, although not parasite load. Given the low repeatability of field behaviors, some of the relationships between behavior and performance may be stronger than suggested by our results.

PMID:36700411 | DOI:10.1242/jeb.244676

Paediatr Anaesth. 2023 Jan 26. doi: 10.1111/pan.14639. Online ahead of print.

ABSTRACT

BACKGROUND: There is a high incidence of perioperative anxiety in the pediatric population, with adverse side effects, such as emergency delirium and maladaptive postoperative behaviors.

AIMS: The study’s objective was to compare the level of preoperative anxiety in children after standard preparation plus a virtual tour of the operating room vs. standard preparation alone.

PATIENTS/METHODS: This was a prospective single-center, randomized, controlled, blinded trial with parallel assignment, registered as NCT04043663. Eligible subjects were healthy children (ASA I-II) aged 4 to 12, scheduled for outpatient surgery. Five visits were conducted during the study, two at the hospital and three over the phone. Variables assessed were: Child’s anxiety through the modified Yale Perioperative Anxiety Scale, demographic data, cooperation with induction through the Induction Compliance Checklist, preoperative parental anxiety through the State-Trait Anxiety Inventory and Anxiety Visual Analog Scale, the postoperative delirium degree through the Pediatric Anesthesia Emergence Delirium Scale, the presence of behavioral changes through the Post Hospitalization Behavior Questionnaire for Ambulatory Surgery, and the overall parental satisfaction.

RESULTS: 125 participants were included; 61 (48.8%) of them were randomized to the Virtual Tour Group (VT+) and 64 (51.2%) to the Non-virtual Tour Group (VT-). Yale Preoperative Anxiety Scale results in VT+ vs. VT- were mean 27.26 vs. 32.57, and median 23.4 (CI 95% 23.4-23.4) vs. 23.4 (CI 95% 23.4-33.4), (p=0.0086). In the VT+ group, satisfaction was higher for questions one (p=0.0213), three (p=<0.0001), and four (p=0.0130). Throughout the study, we observed a significant reduction in perioperative anxiety in the VT+ group, facilitating anesthetic induction in perfect (p=0.018) and moderate compliance (p=0.0428). The other variables did not show statistically significant differences.

CONCLUSION: Our study confirms previous studies that found virtual tours for perioperative patients may reduce perioperative anxiety and improve satisfaction. We found no impact on longer-term outcomes.

PMID:36700361 | DOI:10.1111/pan.14639

J Anim Ecol. 2023 Jan 26. doi: 10.1111/1365-2656.13889. Online ahead of print.

ABSTRACT

Ecological processes leave distinct structural imprints on the species interactions that shape the topology of animal-plant mutualistic networks. Detecting how direct and indirect interactions between animals and plants are organised is not trivial since they go beyond pairwise interactions, but may get blurred when considering global network descriptors. Recent work has shown that the meso-scale, the intermediate level of network complexity between the species and the global network, can capture this important information. The meso-scale describes network subgraphs representing patterns of direct and indirect interactions between a small number of species, and when these network subgraphs differ statistically from a benchmark, they are often referred to as “network motifs”. Although motifs can capture relevant ecological information of species interactions, they remain overlooked in natural plant-pollinator networks. By exploring 60 empirical plant-pollinator networks from 18 different studies with wide geographical coverage, we show that some network subgraphs are consistently under- or over-represented, suggesting the presence of worldwide network motifs in plant-pollinator networks. In addition, we found a higher proportion of densely connected network subgraphs that, based on previous findings, could reflect that species relative abundances are the main driver shaping the structure of the meso-scale on plant-pollinator communities. Moreover, we found that distinct subgraph positions describing species ecological roles (e.g., generalisation and number of indirect interactions) are occupied by different groups of animal and plant species representing their main life-history strategies (i.e., functional groups). For instance, we found that the functional group of ‘bees’ was over-represented in subgraph positions with a lower number of indirect interactions in contrast to the rest of floral visitors groups. Finally, we show that the observed functional group combinations within a subgraph can not be retrieved from their expected probabilities (i.e., joint probability distributions), indicating that plant and floral visitor associations within subgraphs are not random either. Our results highlight the presence of common network motifs in plant-pollinator communities that are formed by a non-random association of plants and floral visitors functional groups.

PMID:36700304 | DOI:10.1111/1365-2656.13889

Rev Esp Salud Publica. 2023 Jan 23;97:e202301005.

ABSTRACT

OBJECTIVE: Health personnel are at greater risk of contracting infections related to their work within the group of workers with biological risk, and these mishaps can affect their physical and mental health. therefore, the objective of this paper was to understand the experience of health professionals in an intensive care unit (ICU) in Cali (Colombia) who suffered biological accidents.

METHODS: Explanatory sequential mixed design, it was developed in two phases, the first of a descriptive quantitative type and the second of a qualitative type with a phenomenological approach. Initially the knowledge about biosafety in 40 workers was characterized through a survey and a in the first contact, five participants were chosen who shared their experiences with biological accidents, through in-depth interviews. The statistical analysis was descriptive, the quantitative variables were presented through measures of central tendency and the qualitative variables through frequency and percentage.

RESULTS: 39% of the professionals knew the biosafety barriers, 35% identified the pathogenic pathways, 34% were right about the protection measures, 51% answered correctly about hand washing, 70% answered adequately about biological waste, and only 38% recognized the procedure for reporting an accident.

CONCLUSIONS: A low level of knowledge is identified on issues related to biosafety principles, transmission routes, hand sanitizing agents, and procedures to follow in the event of a biohazard accident. In addition, ICUs are identified as high-risk places. biological that cause feelings of fear, anguish, and stress that are added to the long working hours.

PMID:36700293

Jt Dis Relat Surg. 2023;34(1):144-150. doi: 10.52312/jdrs.2023.879. Epub 2022 Dec 27.

ABSTRACT

OBJECTIVES: This study aims to compare three glenohumeral dislocation (GHD) reduction techniques in terms of pain and reduction time and to offer clinicians an idea of the selection of the most appropriate technique.

PATIENTS AND METHODS: This multi-center, prospective, randomized clinical study included a total of 90 patients (55 males, 35 females; median age: 29 years; range, 22 to 41 years) who had isolated anterior GHD without complication between December 2019 and December 2021. The patients were divided into three equal groups (traction-countertraction [TCT], external rotation [ExR], and Cunningham) using the block randomization method, and reductions were performed. Pre-reduction, intra-reduction, and post-reduction Visual Analog Scale (VAS) scores, reduction times, success rates, and complication rates were analyzed.

RESULTS: There was no statistically significant difference among the groups in terms of age (p=0.414), sex (p=0.954), pre-reduction VAS (p=0.175), and post-reduction VAS (p=0.204). The median intra-reduction VAS values in the TCT, the external rotation, and the Cunningham groups were 8 (range, 7 to 9), 5 (range, 4 to 7), and 4 (range, 2.75 to 5), respectively (p<0.001). The median reduction time and IQR were 105 (range, 82.5 to 120) sec for TCT, 270 (range, 232.5 to 300) sec for ExR, and 630 (range, 540 to 780) sec for Cunningham (p=0.001).

CONCLUSION: The fastest, but most painful technique is TCT, while the longest and the least painful technique is Cunningham. An inverse relationship is found between time and pain. Based on these findings, it seems to be reasonable to leave the choice of the ideal reduction technique to the clinician. The clinician should choose the technique to be used according to the conditions in the emergency department.

PMID:36700276 | DOI:10.52312/jdrs.2023.879

Jt Dis Relat Surg. 2023;34(1):138-143. doi: 10.52312/jdrs.2023.784. Epub 2022 Dec 27.

ABSTRACT

OBJECTIVES: This study aims to investigate the impact of anterior cruciate ligament (ACL) injury and its reconstruction on men’s sexual functions.

PATIENTS AND METHODS: Between February 2016 and November 2019, a total of 27 sexually active male patients (mean age: 33.7±4.3 years; range, 26 to 40 years) who were operated for ACL injury at least six months after trauma were retrospectively analyzed. Erectile function was assessed using the International Index of Erectile Function questionnaire (IIEF) and knee function was evaluated by using the International Knee Documentation Committee (IKDC) Scoring System, Lysholm Knee Scoring Scale, and Tegner Activity Score. Sexual and functional questionnaires were applied to evaluate three different periods retrospectively. These periods were as follows: the period before an ACL injury (Period I); the period in which the patient suffered from an ACL injury, but not operated (Period II), and the period after the ACL reconstruction (Period III).

RESULTS: There was a statistically significant difference in the comparison of knee function scores according to three different periods. Sexual function scores were significantly different between Periods I and II, and between Periods I and III. However, although the IIEF value was higher in Period III than in Period II, no statistically significant difference was observed. A moderate correlation was found between the sexual functional scores of IIEF and IKDC scores.

CONCLUSION: Our study results suggest that ACL injury affects sexual functions adversely. The change in sexual functions after ACL surgery depends on the success of surgery. While deciding on the treatment of ACL injury, the patient’s sexual life should be questioned along with his expectations.

PMID:36700275 | DOI:10.52312/jdrs.2023.784

Jt Dis Relat Surg. 2023;34(1):121-129. doi: 10.52312/jdrs.2023.788. Epub 2023 Jan 14.

ABSTRACT

OBJECTIVES: This study aims to evaluate the success of plate augmentation over a retained intramedullary nail (IMN) against exchange nailing performed with autologous bone grafting in oligotrophic and atrophic pseudoarthrosis of the femoral shaft.

PATIENTS AND METHODS: Between May 2005 and October 2020, a total of 42 of 56 patients (28 males, 14 females; mean age: 47.3±17.2 years; range, 19 to 84 years) with aseptic atrophic or oligotrophic femoral nonunion were retrospectively analyzed. The patients, 20 were operated with plate over a retained IMN, and the rest (n=22) by exchange nailing. Data including demographic and clinical characteristics of the patients, treatment success, duration of surgery, blood loss during surgery, infection rates, length of hospital stay, time to bridging of the nonunion site, and time to obliteration of the fracture line (solid union) were recorded.

RESULTS: The mean follow-up was 23.8±20.4 (range, 12 to 96) months in the plate over an IMN group and 34.7±27.4 (range, 12 to 90) months in the exchange nailing group. At the final follow-up, solid union occurred in all of the patients in the plate augmentation over a retained IMN group, and 21 of 22 (95.45%) patients in the exchange nailing group. Blood loss during surgery was significantly less in the plate augmentation over IMN group (p=0.027). There was no statistically significant difference in the other variables between the two groups (p>0.05).

CONCLUSION: Our study results demonstrate that plate over a retained IMN is effective as exchange nailing in the surgical treatment of oligotrophic and atrophic pseudoarthrosis of the femoral shaft. However, it can be speculated that plate application over IMN is more advantageous in terms of blood loss during surgery.

PMID:36700273 | DOI:10.52312/jdrs.2023.788