Category: Statistics

Hist Philos Life Sci. 2022 Aug 2;44(3):34. doi: 10.1007/s40656-022-00514-x.

ABSTRACT

This is the story, told in the light of a new analysis of historical data, of a mathematical biology problem that was explored in the 1930s in Thomas Morgan’s laboratory at the California Institute of Technology. It is one of the early developments of evolutionary genetics and quantitative phylogeny, and deals with the identification and counting of chromosomal inversions in Drosophila species from comparisons of genetic maps. A re-analysis of the data produced in the 1930s using current mathematics and computational technologies reveals how a team of biologists, with the help of a renowned mathematician and against their first intuition, came to an erroneous conclusion regarding the presence of phylogenetic signals in gene arrangements. This example illustrates two different aspects of a same piece: (1) the appearance of a mathematical in biology problem solved with the development of a combinatorial algorithm, which was unusual at the time, and (2) the role of errors in scientific activity. Also underlying is the possible influence of computational complexity in understanding the directions of research in biology.

PMID:35918616 | DOI:10.1007/s40656-022-00514-x

Clin Exp Optom. 2022 Aug 2:1-7. doi: 10.1080/08164622.2022.2102410. Online ahead of print.

ABSTRACT

CLINICAL RELEVANCE: Efforts to provide accessible eye care must consider the extent to which travel-distance may be a barrier for some communities.

BACKGROUND: This study aimed to determine the distribution of – and geographic access to – eye health services in Aotearoa New Zealand. We further sought to identify communities who might benefit from provision of eye health services that were more geographically accessible.

METHODS: We obtained addresses of optometry and ophthalmology clinics from regulatory bodies and augmented this with online searches. Address locators were created using a Land Information dataset and geocoded using ArcGIS 10.6. A national population was derived using Statistics New Zealand’s Integrated Data Infrastructure. We generated population-weighted centroids of each of New Zealand’s 50,938 meshblocks and calculated the travel distance along the road network between each clinic and population (meshblock centroid). The proportion of the population living >50 km from each clinic type was calculated; as was the median, inter-quartile range and maximum distance across area-level deprivation quintiles in each district.

RESULTS: A national population of 4.88 million was identified, as were addresses for 344 optometry, 46 public ophthalmology and 90 private ophthalmology clinics. Nationally and within each district, travel distance to optometry was shorter than to either type of ophthalmology clinic. The region of Northland – with a high proportion of the population Māori and in the highest quintile of area-level deprivation – had the furthest average distance to travel to optometry and public ophthalmology, while the West Coast region on the South Island had the farthest to travel to private ophthalmology. Several communities were identified where longer distances intersected with higher area-level deprivation.

CONCLUSION: Most New Zealanders live within 10 km of eye health services. However, to achieve equitable eye health, strategies are required that make affordable eye health services accessible to communities for whom large travel distances intersect with high deprivation.

PMID:35917587 | DOI:10.1080/08164622.2022.2102410

Appl Neuropsychol Adult. 2022 Aug 2:1-8. doi: 10.1080/23279095.2022.2106571. Online ahead of print.

ABSTRACT

The Response Bias Scale (RBS) was developed to predict non-credible cognitive presentations among disability claimants without head injury. Developers used empirical keying, which is independent of apparent content, to select items from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) item pool that distinguished between individuals passing or failing performance validity tests (PVTs). No study has examined which of these items would have psychometric value when used in clinical neuropsychological evaluations. This study reexamined items comprising RBS with reference to manifest item content, internal consistency, PVTs, and a symptom validity test (SVT) in a sample of 173 predominately White male veterans (M_AGE = 50.70, M_EDU = 13.73) in a VA outpatient neuropsychology clinic. Participants completed the MMPI-2 Restructured Form (MMPI-2-RF), PVTs, and an SVT. The 28-item RBS appears to contain three types of items: those that manifestly address cognitive functioning, those that are supported but do not appear to address cognitive functioning, and nine items that were unrelated to cognition and not statistically supported. The 19 empirically supported items, or RBS-19, predicted PVT and SVT failures marginally better than the RBS. Both the RBS and RBS-19 had stronger relationships with SVTs relative to PVTs. Although the removal of the nine problematic items improved the diagnostic accuracy of the scale, it still did not reach the level that is generally considered to be clinically optimal. The RBS-19 offers a measure with improved internal consistency and predictive validity compared to the RBS and warrants additional research.

PMID:35917583 | DOI:10.1080/23279095.2022.2106571

Appl Neuropsychol Child. 2022 Aug 2:1-9. doi: 10.1080/21622965.2022.2105146. Online ahead of print.

ABSTRACT

Dyscalculia is a specific difficulty in learning mathematics that strongly influences activities of daily living that require skills such as counting and simple mathematical operations. The aim of this study is to investigate the effect of negative emotions on mathematical performance in children with and without developmental dyscalculia using psychosocial tests, a quality of life test, an anxiety test and the Zareki-R mathematical performance test. This pilot study was realized on a sample of 20 children in the first year of secondary school (a group of 10 dyscalculic children and another group of 10 control children with an average age of 12.65 years). Descriptive statistics showed that dyscalculic children had low scores on all Zareki-R subtests. The Mann Whitney analysis revealed a significant difference between dyscalculic children and typically developing children on the Zareki-R subtests and the quality of life test, but no significance was found for the anxiety test. Analysis of the ANOVA by gender revealed no significant differences for the three tests, and the opposite for the ANOVA by age (F = 3.86, dll = 2, p ˂ 0.05). Using multiple linear regression, the subtests of physical quality of life, emotional quality of life and academic quality of life were significantly different for the two groups. In conclusion, the psychosocial quality of life and the high level of anxiety in dyscalculic children strongly influence their performance in mathematics.

PMID:35917565 | DOI:10.1080/21622965.2022.2105146

Menopause. 2022 Aug 2. doi: 10.1097/GME.0000000000002019. Online ahead of print.

ABSTRACT

IMPORTANCE: The increasing trend of delaying childbirth means that more women are being diagnosed with breast cancer before having given birth to their desired number of children. Although chemotherapy can significantly improve the prognosis of this population, it also causes ovarian damage, including premature ovarian insufficiency and infertility. Gonadotropin-releasing hormone agonists (GnRHa) have shown promising fertility protective activity in premenopausal women, but their clinical usage remains controversial.

OBJECTIVE: Here, we conducted a meta-analysis to assess the efficacy of GnRHa when administered concurrently with chemotherapy that included cyclophosphamide in the prevention of chemotherapy-induced ovarian damage in premenopausal women.

EVIDENCE REVIEW: An extensive literature search was performed using the PubMed, Embase, and Cochrane databases. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were determined.

FINDINGS: Eleven randomized controlled trials with a total of 1,219 participants were included in the analyses. A significantly higher number of women treated with GnRHa experienced the resumption of ovarian function after chemotherapy than those who did not receive this treatment (OR, 3.04; 95% CI, 1.87-4.94; P < 0.001). Regarding spontaneous pregnancy, a statistically significant difference was observed only in hormone receptor-negative participants (OR, 2.06; 95% CI, 1.03-4.11; P = 0.04).

CONCLUSIONS AND RELEVANCE: When treating premenopausal women with breast cancer, the administration of GnRHa concurrently with chemotherapy appeared to improve the resumption rate of ovarian function; however, the spontaneous pregnancy rate only improved in hormone receptor-negative patients. Thus, the use of GnRHa during chemotherapy may represent a feasible strategy for preserving ovarian function in women with breast cancer.

PMID:35917530 | DOI:10.1097/GME.0000000000002019

J Urol. 2022 Aug 2:101097JU0000000000002831. doi: 10.1097/JU.0000000000002831. Online ahead of print.

ABSTRACT

BACKGROUND: Alcohol intoxication is a known risk factor for Motor Vehicle Collisions (MVCs). We hypothesize ethanol intoxication increases the risk of bladder injury and surgical repair, especially at higher Blood Alcohol Content (BAC) levels.

METHODS: We identified all patients involved in MVCs from the National Trauma Data Bank from 2017-2019. Patients were categorized into an intoxication and intoxication negative group. Variables collected included age, sex, BAC level, driver status, seat belt restraint use, non-alcoholic intoxication, pelvic fracture and Injury Severity Scale (ISS). Primary outcome measures of bladder injury and bladder surgical repair were assessed and interaction with pelvic fracture and restraint use were measured.

RESULTS: We identified 594,484 patients and 97,831 (16.5%) had a positive alcohol screen. Patients in the intoxication group were more likely to be intoxicated with other substances (32.8% vs 14.6%,p<0.001), have a bladder injury (1%vs0.4%,p<0.001) and receive bladder surgical repair (0.7% vs 0.15%,p<0.001). ISS and pelvic fracture were statistically significant predictors of bladder injury. In adjusted analysis, higher BAC was associated with both outcomes. Above the legal limit, alcohol intoxication was more predictive of bladder surgical repair than pelvic fracture. The association of alcohol intoxication with both outcomes did not differ by pelvic fracture, but strengthened with seat belt use at higher intoxication levels.

CONCLUSIONS: Alcohol intoxication is independently associated with increased risk of bladder injury and subsequent bladder surgical repair following MVCs. Trauma providers should have a high index of suspicion for bladder injuries in alcohol intoxicated patients, particularly those using seat belt restraints.

PMID:35917522 | DOI:10.1097/JU.0000000000002831

Photobiomodul Photomed Laser Surg. 2022 Aug 2. doi: 10.1089/photob.2021.0027. Online ahead of print.

ABSTRACT

Objective: To carry out a histological and morphometric analysis of the antimicrobial effect of Er:YAG laser irradiation combined with photodynamic therapy (PDT) on root canals infected with Enterococcus faecalis. Background: PDT and Er:YAG laser irradiation may be alternatives for effective endodontic disinfection but there are no data on the combination of these therapies. Materials and methods: Forty single-rooted bovine teeth had their roots contaminated with E. faecalis for 72 h. The teeth were randomly divided into four groups (n = 10): group 1, irrigation with 2.5% sodium hypochlorite (NaOCl); group 2, Er:YAG laser (λ2940 nm, 15 Hz, 100 mJ); group 3, PDT with 0.07% methylene blue as photosensitizer and laser irradiation (λ660 nm, power 40 mW, 5 min); and group 4, Er:YAG laser + PDT. After treatment, the teeth were examined by confocal laser scanning microscopy to verify bacterial viability, and morphometric analysis of the images was performed. Results: The PDT and Er:YAG + PDT treatments promoted the greatest reduction in bacteria among the proposed therapies, whereas 2.5% NaOCl was the least effective in bacterial elimination. A statistically significant difference (p < 0.05) was observed among the groups studied, except between the group combining Er:YAG and PDT and the group treated with PDT alone. Conclusions: PDT combined or not with Er:YAG laser was found to be more effective in root canal disinfection when compared with the other groups.

PMID:35917508 | DOI:10.1089/photob.2021.0027

J Physician Assist Educ. 2022 Aug 1. doi: 10.1097/JPA.0000000000000451. Online ahead of print.

ABSTRACT

INTRODUCTION: Many physician assistant (PA) students experience mistreatment in clinical learning environments, and accredited PA programs are required to define, publish, and make readily available policies and procedures for student reports of mistreatment. The purpose of this study is to describe the prevalence, content, and dissemination of program policies to address students’ reports of mistreatment involving preceptors during supervised clinical experiences.

METHODS: To conduct a national policy analysis, the investigators included 10 new survey items in the 2019 Physician Assistant Education Association annual program survey. Deidentified data were analyzed by using descriptive statistics.

RESULTS: The program response rate to the survey items was 99% (232). Approximately 76% of PA programs reported having a learner mistreatment policy. Policy content across programs varied widely, and several student reporting mechanisms were available. Program directors, clinical faculty, and institutional leadership were most likely to be involved in the management of reports. A majority programs actively assessed for mistreatment and most did so through clinical course evaluations and at the end of each clinical phase course. Most programs disseminated information about policy to faculty, students, and preceptors at least once a year.

DISCUSSION: The descriptions of policy content, procedures, and dissemination increase educators’ understanding of current policies across PA programs in the context of renewed efforts to write or revise policy that is specific to mistreatment. The authors discuss key policy priorities to define mistreatment, offer a range of confidential reporting mechanisms, review the management of reports, and consider how to optimize dissemination strategies.

PMID:35917472 | DOI:10.1097/JPA.0000000000000451

Clin Infect Dis. 2022 Aug 3:ciac613. doi: 10.1093/cid/ciac613. Online ahead of print.

ABSTRACT

BACKGROUND: The SARS-CoV-2 Delta variant has been replaced by the highly transmissible Omicron BA.1 variant, and subsequently by Omicron BA.2. It is important to understand how these changes in dominant variants affect reported symptoms, while also accounting for symptoms arising from other co-circulating respiratory viruses.

METHODS: In a nationally representative UK community study, the COVID-19 Infection Survey, we investigated symptoms in PCR-positive infection episodes vs. PCR-negative study visits over calendar time, by age and vaccination status, comparing periods when the Delta, Omicron BA.1 and BA.2 variants were dominant.

RESULTS: Between October-2020 and April-2022, 120,995 SARS-CoV-2 PCR-positive episodes occurred in 115,886 participants, with 70,683 (58%) reporting symptoms. The comparator comprised 4,766,366 PCR-negative study visits (483,894 participants); 203,422 (4%) reporting symptoms. Symptom reporting in PCR-positives varied over time, with a marked reduction in loss of taste/smell as Omicron BA.1 dominated, maintained with BA.2 (44%/45% 17 October 2021, 16%/13% 2 January 2022, 15%/12% 27 March 2022). Cough, fever, shortness of breath, myalgia, fatigue/weakness and headache also decreased after Omicron BA.1 dominated, but sore throat increased, the latter to a greater degree than concurrent increases in PCR-negatives. Fatigue/weakness increased again after BA.2 dominated, although to a similar degree to concurrent increases in PCR-negatives. Symptoms were consistently more common in adults aged 18-65 years than in children or older adults.

CONCLUSIONS: Increases in sore throat (also common in the general community), and a marked reduction in loss of taste/smell, make Omicron harder to detect with symptom-based testing algorithms, with implications for institutional and national testing policies.

PMID:35917440 | DOI:10.1093/cid/ciac613

Surg Infect (Larchmt). 2022 Aug;23(6):597-603. doi: 10.1089/sur.2022.126.

ABSTRACT

Background: Ventilator-associated pneumonia (VAP) is a frequently occurring nosocomial infection in critically ill trauma patients. When bronchoalveolar lavage (BAL) returns with indigenous oral flora (IOF), de-escalating antimicrobial therapy is challenging. Patients and Methods: This is a retrospective review of trauma patients who received broad-spectrum empiric antimicrobial therapy for clinical VAP, and whose BAL culture resulted with >100,000 CFU/mL of IOF from September 1, 2017 to September 1, 2020. Patients were identified using the trauma database and microbiology reports of BALs with IOF. This review evaluated the effect of antibiotic de-escalation on recurrent or persistent pneumonia. Results: Of 51 trauma patients with clinical VAP and IOF, 18 patients (35.3%) had antimicrobial agents de-escalated. De-escalation was driven primarily by the discontinuation of vancomycin, with the continuation of a β-lactam antibiotic as monotherapy for the remainder of the treatment course (n = 15; 86.7%). The overall rate of either persistent or recurrent VAP in the cohort was 10%, and this did not differ statistically between those who received de-escalation therapy after isolation of IOF and those who did not (16.7% vs. 6.1%; p = 0.224), however, the incidence of acute kidney injury (AKI) was higher in the non-de-escalation group (39.4% vs. 11.1%; p = 0.034). There was no statistical difference in ventilator days, intensive care unit (ICU) length of stay, or hospital length of stay between treatment groups. Conclusions: Trauma patients who develop VAP with isolated BAL cultures of IOF or mixed flora can safely have anti-methicilllin-resistant Staphylococcus aureus (MRSA) antimicrobial agents discontinued, and this may result in decreased rates of AKI.

PMID:35917387 | DOI:10.1089/sur.2022.126