Category: Statistics

Rev Bras Ginecol Obstet. 2022 Feb 17. doi: 10.1055/s-0041-1741450. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study aimed to evaluate the antenatal care adequacy for women who gave birth at the University Hospital of Santa Catarina in Florianopolis (Brazil) during the COVID-19 pandemic, and to evaluate the association of adequacy with sociodemographic, clinical, and access characteristics.

METHODS: Data were collected between October and December 2020, including 254 patients who delivered in the University Hospital from Federal University of Santa Catarina and answered our questionnaires. Additional data were obtained from patients’ antenatal booklets. Antenatal care was classified as adequate, intermediate, or inadequate according to the number of appointments, gestational age at the beginning of follow-up, and tests results. We carried out a descriptive statistical analysis and a bivariate/with odds ratio analysis on maternal sociodemographic, clinical and health access variables that were compared with antenatal adequacy.

RESULTS: Antenatal care was considered adequate in 35.8% of cases, intermediate in 46.8%, and inadequate in 17.4%. The following maternal variables were associated with inadequate prenatal care (intermediate or inadequate prenatal care): having black or brown skin colour, having two or more children, being of foreign nationality, not being fluent in Portuguese, and using illicit drugs during pregnancy; the clinical variables were more than 6 weeks between appointments, and not attending high-risk antenatal care; as for access, the variables were difficulties in attending or scheduling appointments, and attending virtual appointments only.

CONCLUSION: In a sample of pregnant women from a teaching hospital in Florianópolis during the COVID-19 pandemic, antenatal care was considered adequate in 35.8%, intermediate in 46.8%, and inadequate in 17.4% of cases.

PMID:35176779 | DOI:10.1055/s-0041-1741450

Cerebrovasc Dis. 2022 Feb 17:1-4. doi: 10.1159/000521794. Online ahead of print.

ABSTRACT

BACKGROUND: Globally, stroke remains an important cause of death and long-term disability, and the impact of coronavirus disease (COVID-19) on the health system may have impaired stroke care. Previous studies suggest significant reduction in hospital admissions for stroke after COVID-19 onset as patients may hesitate seeking medical help due to fear of exposure.

METHODS: This cross-sectional study included cases of hospital admissions for stroke, identified from the Hospital Information System of the Unified Health System (Sistema Único de Saúde), which contains official and public data in Brazil. Data were collected in duplicate, then categorized according to the International Classification of Diseases, tenth revision (ICD-10), considering codes I60-I69. Linear regression was used to estimate the variation in hospital admissions for stroke in the city of São Paulo (SP) – the largest and most populous city in Brazil and Latin America, between January and June of each analyzed year (2017-2020). The percentage variation between June and January 2020 was also compared. The level of significance was set at 5%, and the statistical program used was Stata, version 14.0.

RESULTS: In the city of SP, during the first wave of COVID-19, from January to June 2020, there were registered decreases in absolute numbers and mean monthly admissions for stroke. Compared to January 2020, data from June 2020 showed 17% reduction in hospitalizations for intracerebral hemorrhage, 32% for cerebral infarction, 26% for stroke unspecified, and 47% for other cerebrovascular diseases.

CONCLUSION: We argue for policies aimed at improving stroke care and developing awareness campaigns regarding the importance of early diagnosis and treatment, as even in less severe presentations, stroke can trigger an increase in mortality, cost, and long-term disability.

PMID:35176738 | DOI:10.1159/000521794

Phys Med. 2022 Feb 14;95:133-139. doi: 10.1016/j.ejmp.2022.02.005. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the accuracy of dose delivery during stereotactic radiotherapy of the lung (SBRT) and brain (SRT) tumours by registered CT (rCT) images obtained from CT used for planning (pCT) and cone-beam CT (CBCT).

METHODS: The study is based on two groups of patients (10 patients each) undergoing SBRT and SRT. To assess the correctness of the propagation of the GTV (brain group) and ITV (lung group) contours, the volumes calculated on the pCT and rCT studies were analysed. The Dice-Sørensen similarity coefficient (DSC) was used to check the variability in the position of GTV/ITV observed between pCT and rCT. The dose recalculated on rCT was compared with the dose from pCT.

RESULT: GTV and ITV determined on pCT and rCT studies did not differ statistically (p = 0.770 for ITV and p = 0.086 for GTV). DSC obtained for the lung group was statistically smaller than that for the brain group (p < 0.001). Differences between doses obtained for 99% of the ITV/GTV on pCT and rCT studies were within ±10% and did not exceed the clinically acceptable tolerance.

CONCLUSION: The observed changes in the volume (ITV/GTV) were within the area of the original PTV volume. The differences between the planned and delivered doses in the ITV/GTV were not clinically significant.

PMID:35176719 | DOI:10.1016/j.ejmp.2022.02.005

Res Dev Disabil. 2022 Feb 14;124:104199. doi: 10.1016/j.ridd.2022.104199. Online ahead of print.

ABSTRACT

BACKGROUND: Family-centered service is recognized as a recommended approach to help families of children with disabilities. However, the Israeli family-centered program does not explicitly propose intervention strategies for fathers of children with disabilities.

AIMS: This study explored fathers’ perspectives on family-centered services for families of children with disabilities and focused on their use of the services and experiences with them.

METHODS AND PROCEDURES: We employed a mixed-methods design using an online survey completed by 33 fathers of children with disabilities who participated in the Israeli family-centered program for families of children with disabilities. Data analyses included descriptive statistics and conventional content analysis.

OUTCOMES AND RESULTS: The majority of fathers said the Israeli family-centered program fit their needs. Participation in the program yielded psychological, familial, and social benefits. Psychologically, the program allowed fathers to mentally recharge and grow. In addition, more than three-quarters of the fathers thought their participation strengthened their family, as evidenced in more shared experiences, more effective family communication, and positive feelings. They also appreciated society’s recognition of their unique life circumstances.

CONCLUSIONS AND IMPLICATIONS: Family-centered services should make special efforts to reach out to fathers and create father-friendly services.

PMID:35176723 | DOI:10.1016/j.ridd.2022.104199

Aquat Toxicol. 2022 Feb 11;245:106118. doi: 10.1016/j.aquatox.2022.106118. Online ahead of print.

ABSTRACT

Tralopyril is an emerging marine antifouling agent with potential toxic effects on non-target aquatic organisms. To evaluate the toxicity of tralopyril, to turbot (Scophthalmus maximus), we assessed biomarkers, including oxidative stress, neurotoxicity, and osmotic homeostasis regulation enzymes, after a 7-day exposure to tralopyril (5 μg/L, 15 μg/L, 30 μg/L). Superoxide dismutase activity was significantly decreased at 30 μg/L, and Ca²⁺-Mg²⁺-ATPase activity in the gills was significantly increased at 15 μg/L and 30 μg/L. No statistically significant differences in the responses of acetylcholinesterase and nitric oxide were detected. In addition, 15 μg/L and 30 μg/L tralopyril induced hyperthyroidism, reflected by significantly increased of T3 levels. The expression levels of hypothalamus-pituitary-thyroid axis-related genes were also upregulated. The molecular docking results showed that the thyroid system disruption was not caused by competitive binding to the receptor. In addition, the integrated biomarker response index showed that 15 μg/L tralopyril had the greatest effect on turbot. In general, tralopyril caused oxidative damage, affected energy metabolism, and interfered with the endocrine system. These findings could provide reference data for assessing the ecological risk of tralopyril in marine environments.

PMID:35176693 | DOI:10.1016/j.aquatox.2022.106118

Epilepsy Behav. 2022 Feb 14;129:108602. doi: 10.1016/j.yebeh.2022.108602. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate possible factors that influenced whether pregnancy in women with epilepsy resulted in the desirable outcome of a live-born non-malformed infant and a mother whose pregnancy had been seizure free.

RESULTS: The desirable outcome, as defined, occurred in 46.3% of unselected pregnancies in the database of the Australian Register of Antiepileptic Drugs in Pregnancy (APR). The only factor investigated that had a statistically significant (P < 0.05) effect, increasing the chance of such a desirable outcome, was freedom from seizures in the pre-pregnancy year. However, anti-seizure medication (ASM) doses, particularly valproate doses, had been reduced prior to 15.6% of the pregnancies, and this may have concealed factors that otherwise may have adversely affected the desirable outcome rate. Analysis of data for monotherapy with the more commonly used ASMs appears to suggest that employing levetiracetam at the outset of antiseizure therapy may offer a better chance of a desirable outcome to future pregnancies than monotherapy with other ASMs, but this finding is not confirmed statistically.

CONCLUSIONS: In pregnancies where valproate use has already been minimized, seizure control throughout the pre-pregnancy year was associated with the best chance of a desirable outcome, as defined above. In most Australian women starting therapy for epilepsy initiating treatment with levetiracetam monotherapy may offer the best chance of such a desirable outcome to a future pregnancy, yet to be confirmed.

PMID:35176651 | DOI:10.1016/j.yebeh.2022.108602

Eur J Radiol. 2022 Feb 9;149:110203. doi: 10.1016/j.ejrad.2022.110203. Online ahead of print.

ABSTRACT

PURPOSE: To compare the accuracy of placental MRI in reporting placental adhesive disease in readers with different expertise and to identify the most reliable MRI features that predict placental pathology regardless of reader expertise.

METHODS: Retrospective analysis of 27 placental MRI studies by six radiologists with different expertise levels; specificity, sensitivity, and accuracy were used to quantify the predictive performance of eight radiological features previously described in the literature. Histopathological evaluation was used as a diagnostic gold standard when available and the presence of the radiological features was decided by consensus. Features with higher sensitivity and specificity were identified and the optimal cut-off was calculated to obtain the resulting accuracy.

RESULTS: The accuracy for seniors with expertise was non-statistically higher (0.83) compared to senior with no expertise (SWE) (0.65) and juniors (0.74) with SWE having tendency to over-estimate the severity of abnormality (26% vs 17%), whilst junior underestimated the degree of placental infiltration when compared to seniors with expertise (18.5% vs 0%, p = 0.006). Dark bands was the criteria with the highest sensitivity (95%) and high specificity (74%), followed by myometrial thinning (89%-76%) and uterine bulging (86%-81%). These three features demonstrated substantial (K) agreement. Using these features with optimal diagnostic cut-off, the accuracy increased to 0.91 for both the seniors and SWE and to 0.93 for the juniors.

CONCLUSION: Placental MRI is most accurately interpreted by experienced radiologists; however, less experienced readers can obtain an accurate diagnosis relying on set criteria that are easier to be identified.

PMID:35176669 | DOI:10.1016/j.ejrad.2022.110203

Clin Nutr. 2022 Feb 5;41(3):737-745. doi: 10.1016/j.clnu.2022.01.033. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: The current criteria for defining sarcopenic obesity (SOB) combines the threshold criteria for sarcopenia and obesity, but no consensus has been reached on the criteria. Given the variations among ethnic groups and in the prevalence of sarcopenia, the study aim was to establish sex-specific cutoff points for Chinese cancer patients and investigate the effect of SOB on clinical consequences.

METHODS: A prospective study of 2480 cancer patients was conducted. Clinical materials, bioelectrical impedance analysis measurements, and follow-up data were analyzed. The survival receiver operating characteristic curve was used to determine threshold values. The odds ratios for nutrition risk, severe malnutrition, and quality of life were calculated. The global and sex-specific survival statistics were extracted from the Kaplan-Meier curve and Cox proportional hazard regression models.

RESULTS: The cutoff points of visceral fat area to best classify patients regarding time to death were >75.6 cm² for males and >61.2 cm² for females. And the cutoff points of percent of body fat were 15% in males and 25% in females. Among all participants, the prevalence of SOB was 3.03% in males and 4.46% in females. SOB significantly increased the nutrition risk and severe malnutrition probability and worsened quality of life. Finally, SOB was significantly associated with overall cancer mortality [hazard ratio 2.772, 95% confidence interval 2.080-3.694, P < 0.001].

CONCLUSIONS: On the basis of sex-specific cutoff values, SOB was strongly associated with unfavorable clinical consequences and mortality in cancer patients. These results indicate the importance of SOB detection in routine clinical practice for improving patient assessments, cancer prognosis, and intervention.

PMID:35176638 | DOI:10.1016/j.clnu.2022.01.033

Comput Methods Programs Biomed. 2022 Feb 1;217:106668. doi: 10.1016/j.cmpb.2022.106668. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: The Spline Reconstruction Technique (SRT) is a fast algorithm based on a novel numerical implementation of an analytic representation of the inverse Radon transform. The purpose of this study is to provide a comparison between SRT, Filtered Back-Projection (FBP), Ordered Subset Expectation Maximization 2D (2D-OSEM), and the Tera-Tomo 3D algorithm, using phantom data at various acquisition durations as well as small-animal data obtained from the Mediso nanoScan® PET/CT scanner.

METHODS: For this purpose, the “NEMA NU 4-2008 standards” protocol was employed at five different realizations and acquisition durations. In addition to the image quality metrics described by the NEMA protocol, Cold Region Contrast was also considered as a figure-of-merit. Furthermore, Cold Region Contrast was measured in the myocardial infarction region of six male Wistar rats. The volumetric defect quantification was assessed with dedicated computer software. Lastly, plots of Recovery Coefficient and Spill-Over Ratio as a function of the Percentage Standard Deviation were generated, after smoothing the phantom reconstructions with four different Gaussian filters. Statistical significance was determined by employing the Kruskal-Wallis test or One-way Analysis of Variance depending on the normality of the variable’s distribution.

RESULTS: The present study revealed that, at the expense of slightly increased noise in the reconstructed images, SRT resulted in higher Recovery Coefficient values for small hot regions of interest, when compared with FBP and 2D-OSEM at all acquisition durations. Furthermore, SRT reconstructed images exhibit higher Recovery Coefficient values, for all hot regions of interest, when compared to the other 2D algorithms at short acquisition durations. In both phantom and animal studies, SRT achieved a significant improvement over 2D-OSEM for the Spill-Over Ratio and the Cold Region Contrast. These advantages were maintained even after comparing the algorithms at equal noise levels. The Tera-Tomo 3D algorithm (4 subsets, iterations≥ 13) performed significantly better compared to the other algorithms for all figures-of-merit. No statistically significant differences regarding the myocardial defect size were observed between the algorithms investigated.

CONCLUSIONS: Overall, SRT appears that could be useful for the quantification of small hot regions of interest, cold regions of interest, as well as in low-count imaging applications.

PMID:35176596 | DOI:10.1016/j.cmpb.2022.106668

Stud Hist Philos Sci. 2022 Feb 14;92:144-151. doi: 10.1016/j.shpsa.2022.01.017. Online ahead of print.

ABSTRACT

Bayesian approaches have long been a small minority group in scientific practice, but quickly acquired a high level of popularity since the 1990s. This paper shall describe and analyze this turn. I argue that the success of Bayesian approaches hinges on computational methods that make a class of models predictive that would otherwise lack practical relevance. Philosophically, however, this orientation toward prediction comes at a price. The new computational approaches change Bayesian rationality in an important way. Namely, they undercut the interpretation of priors, turning them from an expression of beliefs held prior to new evidence into an adjustable parameter that can be manipulated flexibly by computational machinery. Thus, in the case of Bayes, one can see a coevolution of computing technology, an exploratory-iterative mode of prediction, and the conception of rationality.

PMID:35176618 | DOI:10.1016/j.shpsa.2022.01.017