Category: Statistics

Int J Gynaecol Obstet. 2022 Jan 19. doi: 10.1002/ijgo.14102. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe the epidemiology of early gestational diabetes mellitus (GDM) based on the International Association of Diabetes and Pregnancy Study Groups (IADPSG) defined fasting glycemia MATERIALS AND METHODS: A prospective multicenter study testing fasting venous plasma glucose (FPG) in women aged 18 – 45 years between 6 – 23 6/7 weeks gestation in secondary health facilities in Ondo State, Nigeria. Early GDM was defined using the IADPSG threshold for fasting hyperglycemia, and its severity was examined. Potential risk factors for early GDM were assessed using logistic regression analysis.

RESULTS: Of the 8915 women who underwent FPG testing, the prevalence of early GDM was 12.5% (11.9 – 13.3). Multivariable analysis identified a dose-response association between body mass index (BMI) (kg/m² ) and early GDM, with a BMI ≥35kg/m² (aOR 1.92, 95% CI 1.03-3.55) associated with early GDM. Primiparity (aOR 1.49, 95%CI 1.25-1.76), multiparity (aOR 1.73, 95%CI 1.47-2.04) and a first-degree family history of diabetes (aOR 1.60, 95%CI 1.27-2.02) were associated with significantly higher odds of early GDM.

CONCLUSION: This study established the prevalence, severity and risk factors for early GDM in a specific country that potentially represents a global region with no previous relevant data.

PMID:35044685 | DOI:10.1002/ijgo.14102

Biofactors. 2022 Jan 19. doi: 10.1002/biof.1816. Online ahead of print.

ABSTRACT

The triglyceride glucose (TyG) index and triglyceride/high lipoprotein density cholesterol (TG/HDL-C) are two important risk markers to evaluate the insulin resistance and cardiovascular diseases (CVDs). To assess the association between TG/HDL-C and TyG index and CVDs. The Mashhad stroke and heart association disorder cohort study started in 2010 and has been continued until 2020. During 6-year follow-up of 9704 participants, 235 events including 118 acute coronary syndrome (ACS), 83 chronic coronary syndrome, 27 myocardial infarction, and 27 cardiac death were confirmed. SPSS software (version 21) was used for statistical analysis and figures were drawn by GraphPad Prism 6 software. The prevalence of ACS and cardiac death were higher in the fourth quartile of serum TG/HDL-C (>4.43) and higher prevalence of ACS was considered in subjects classified in the fourth quartile of TyG index (>8.98). A high TyG index was associated with an increased risk of ACS and cardiac death [1.362 (95% confidence interval [CI]: [1.013-1.831]) and 2.3 (95% CI: [1.247-4.241])] respectively; based on Cox regression analysis elevated TyG and TG/HDL-C increased the chance of CVD by [1.634 (95% CI: 1.304-2.047) and 1.068 (95% CI: 1.031-1.105)], respectively. Our results strongly showed that TyG index and TG/HDL-C are independent risk factors for incident CVD, suggesting that TyG index and TG/HDL-C may be as an important unique biomarker for predicting CVD outcomes and progression.

PMID:35044705 | DOI:10.1002/biof.1816

Int J Gynaecol Obstet. 2022 Jan 19. doi: 10.1002/ijgo.14103. Online ahead of print.

ABSTRACT

OBJECTIVE: to explore the role of transportation in seeking emergency obstetric care among women with obstetric complications.

METHODS: A mixed-methods design. The population for the study were women aged 15-49 years who had experience direct obstetric complications and were attending the health facility for care at the time of this study. Three-hundred and eighteen (318) women completed the questionnaires, whilst in-depth interviews were held for six women who were conveniently selected from a large (318) quantitative respondent. Both questionnaire and semi-structured interviews were used in collecting data for this study. Quantitative data were analysed using Statistical Package for Social Sciences (SPSS) using both inferential and bivariate analysis, whilst a qualitative content analysis was carried out on the qualitative data.

RESULTS: Of the 318 respondents, 91.2% accessed health facilities by motorised transport with 8.8% on-foot. Mode of transportation was (p=0.003) related to regularity at antenatal care, with those who came on-foot being regular at ANC than those that came on motorised transport.

CONCLUSIONS: The study concludes that efficient and suitable transport system as well as distance are key factors influencing women role in decision-making to seek care.

PMID:35044678 | DOI:10.1002/ijgo.14103

Biometrics. 2022 Jan 19. doi: 10.1111/biom.13624. Online ahead of print.

ABSTRACT

Partial correlation is a common tool in studying conditional dependence for Gaussian distributed data. However, partial correlation being zero may not be equivalent to conditional independence under non-Gaussian distributions. In this paper, we propose a statistical inference procedure for partial correlations under the high-dimensional nonparanormal (NPN) model where the observed data are normally distributed after certain monotone transformations. The nonparanormal partial correlation is the partial correlation of the normal transformed data under the NPN model, which is a more general measure of conditional dependence. We estimate the NPN partial correlations by regularized nodewise regression based on the empirical ranks of the original data. A multiple testing procedure is proposed to identify the nonzero NPN partial correlations. The proposed method can be carried out by a simple coordinate descent algorithm for lasso optimization. It is easy-to-implement and computationally more efficient compared to the existing methods for estimating NPN graphical models. Theoretical results are developed to show the asymptotic normality of the proposed estimator and to justify the proposed multiple testing procedure. Numerical simulations and a case study on brain imaging data demonstrate the utility of the proposed procedure and evaluate its performance compared to the existing methods. Data used in preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database.

PMID:35044681 | DOI:10.1111/biom.13624

J Robot Surg. 2022 Jan 19. doi: 10.1007/s11701-022-01367-z. Online ahead of print.

ABSTRACT

Minimally invasive esophagectomy for esophageal cancer decreases overall complication rate and leads to faster postoperative recovery. Robot-assisted minimally invasive esophagectomy is becoming more common. Its three-dimensional view and wristed instruments may provide advantages over traditional thoraco-laparoscopic techniques. There are limited studies comparing robotic and conventional thoraco-laparoscopic esophagectomy. This study aimed to evaluate short-term outcomes of robot-assisted McKeown esophagectomy (RAME) and video-assisted McKeown esophagectomy (VAME). All consecutive patients undergoing minimally invasive McKeown esophagectomy for middle and distal third esophageal cancer between January 2016 and December 2018 at our center were included in this study. Data on baseline characteristics, pathological data and short-term outcomes were collected in a dedicated database. Postoperative complications were defined as per recommendations of Esophagectomy Complications Consensus Group. Histopathologic assessment was performed as per College of American Pathologists guidelines. Propensity score matching was performed for comparison between RAME and VAME groups using age, gender, performance status, American Society of Anesthesiologists grade, body mass index, Charlson Index, tumor location, clinical tumor stage, and neoadjuvant treatment as covariates. A total of 74 patients were included, 25 of whom underwent RAME and 49 underwent VAME. Propensity score matching on 1:1 basis produced 25 pairs of patients, comparable in terms of baseline characteristics. Total operative time and estimated blood loss was similar between the two groups. Length of hospital stay was significantly lower in RAME group. Major postoperative complications (Clavien-Dindo grade ≥ 3A) were more common in VAME group, but not statistically significant. Median number of harvested lymph nodes and R0 resection rate did not differ in between the two groups. In our experience, robot-assisted McKeown esophagectomy was comparable to video-assisted McKeown esophagectomy in terms of safety, feasibility and oncologic adequacy. Use of the robot was associated with reduced hospital stay. Further randomized controlled studies with larger patient samples are needed to compare the two.

PMID:35044671 | DOI:10.1007/s11701-022-01367-z

Hum Cell. 2022 Jan 19. doi: 10.1007/s13577-022-00673-w. Online ahead of print.

ABSTRACT

As one of important components of tumor microenvironment, CAFs (cancer-associated fibroblasts) play a vital role in the development and metastasis of bladder cancer. The present study aimed to develop a CAFs-related gene signature to predict the prognosis of patients and the response to chemotherapy and immunotherapy based on research of multidatabase. Expression data and clinical information were obtained from TCGA and GEO databases. Different bioinformatic and statistical methods were combined to construct the robust CAFs-related gene signature for prognosis. The model was explored from four aspects: single-cell source, immune infiltration, correlation with cancer-related genes and pathways, and prediction of drug response. After screening, five genes (BNC2, LAMA2, MFAP5, NID1, and OLFML1) related to CAFs were used for constructing the signature to divide patients into high- and low-risk groups. Patients in low-risk group had better prognosis and multidatabase analysis confirmed the predictive value. The five genes were mainly expressed by fibroblasts and involved in regulation of pathways related with glycolysis, hypoxia, and epithelial-mesenchymal transition (EMT). BNC2, LAMA2, and NID1 were strongly associated with drug sensitivity. Moreover, the immunological status was different between high- and low-risk groups. High-risk patients had poor response to chemotherapy or immunotherapy. The CAFs-related gene signature might help to optimize risk stratification and provide a new insight in individual treatment for bladder cancer.

PMID:35044630 | DOI:10.1007/s13577-022-00673-w

J Neurovirol. 2022 Jan 19. doi: 10.1007/s13365-021-01047-y. Online ahead of print.

ABSTRACT

HIV-associated neurocognitive disorders (HAND) are highly prevalent in people living with HIV (PLWH) despite successful treatment with combination antiretroviral therapy (cART). HAND pathogenesis is complex and definitive surrogate biomarkers are not clearly defined. Brain function has been assessed through the evaluation of cortical source rhythms with delta waves associated with neurological impairment. The aim of this study was to assess the correlation between EEG cortical sources, cerebrospinal fluid (CSF) biomarkers, and neurocognitive tests in PLWH with HAND. PLWH with HAND without significant comorbidities were enrolled. Baseline rsEEG-LORETA waves, CSF biomarkers (t-tau, p-tau, β-amiloid₄₂, neopterin, S100β), and neurocognitive tests were correlated and compared through non-parametric tests (Spearman’s rho and Mann-Whitney); data are presented as medians (interquartile ranges). Fifty-four patients were enrolled. Median time of suppressed HIV-RNA and CD4⁺ T-lymphocyte were 10 years (5.5-15) and 691/uL (477-929). Thirty-nine participants (72%) underwent CSF collection: abnormal biomarkers were found in a small percentage. Only neopterin showed a statistically significant correlation with delta activity [parietal (rho 0.579; p < 0.001), occipital (rho 0.493; p = 0.007), and global sources (rho 0.464 p = 0.011)]. Seven patients (12.9%) showed an abnormal neopterin level (> 1.5 ng/mL) with significantly higher delta source activity compared to the ones with in-range concentrations. We observed a statistically significant correlation between working memory test Trail Making B with both CSF neopterin levels and delta waves (p values < 0.05). In a small sample of PLWH with HAND, we observed that higher CSF neopterin levels were associated with higher EEG delta waves and worse working memory tests.

PMID:35044644 | DOI:10.1007/s13365-021-01047-y

Indian J Pediatr. 2022 Jan 19. doi: 10.1007/s12098-022-04081-8. Online ahead of print.

ABSTRACT

OBJECTIVE: To systematically identify and critically appraise the methodological quality of pediatric guidelines applicable to management of COVID-19 in India.

METHODS: Pediatric COVID-19 guidelines applicable to India, published until 30 April 2021, were identified through a systematic search across ten databases. Each was critically appraised for methodological quality using the AGREE-II tool, by at least two appraisers. Median (interquartile range) of the total score and domain-wise scores were calculated, and compared for Indian vs. foreign guidelines, updated vs. original versions of guidelines, and those developed earlier vs. later in the pandemic.

RESULTS: A total of 62 guidelines was identified. Only 8 (12.9%) were published in India. The overall AGREE-II score ranged from 4.7% to 72.8%; with median (IQR) 37.9% (29.4, 48.6). This suggested overall low(er) methodological quality. The median (IQR) domain-wise scores were as follows: Scope and Purpose 66.7% (58.3, 83.3), Stakeholder Involvement 41.7% (30.6, 83.3), Rigor of Development 23.4% (14.8, 37.5), Clarity of Presentation 59.7% (50.0, 75.0), Applicability 27.1% (18.8, 33.3), and Editorial Independence 8.3% (0.0, 45.8). This suggested diversity in quality of different aspects of the guidelines, with very low quality in the critical domain of methodological rigor. There were no statistically significant differences in the overall scores of Indian vs. foreign guidelines, updated versions vs. original versions, and those developed earlier vs. later in the pandemic.

CONCLUSION: The currently available pediatric COVID-19 guidelines have low methodological quality, adversely affecting their credibility, validity, and applicability. Urgent corrective strategies are presented for consideration.

PMID:35044617 | DOI:10.1007/s12098-022-04081-8

Int J Cardiovasc Imaging. 2022 Jan 19. doi: 10.1007/s10554-022-02523-0. Online ahead of print.

ABSTRACT

Mitral valve area (MVA) measurement by three-dimensional transesophageal echocardiography (3D-TEE) has a crucial role in the evaluation of mitral stenosis (MS) severity. Three-dimensional direct (3D-direct) planimetry has been proposed as a new technique to measure mitral valve area. This study aimed to compare the 3D-direct mitral valve planimetry to conventional three-dimensional multiplanar reconstruction (3D-MPR) in severe MS using 3D-TEE. In this cross-sectional, prospective study; 149 patients with severe MS who were referred for transesophageal echocardiography in Shahid Madani Hospital (Tabriz Iran), just before percutaneous transmitral commissurotomy (PTMC), recruited consecutively. All patients underwent 2D transthoracic echocardiography (2D-TTE) and 3D-TEE in a single session before PTMC. During 2D-TTE planimetry, pressure half time (PHT), and proximal isovelocity surface area (PISA) were applied to measure the MVA. Transmitral mean pressure gradient (MPG) was measured. During 3D-TEE, MVA planimetry was carried out with both 3D-direct and 3D-MPR methods. 3D-direct was applied from both atrial and ventricular views. The consistency of MVA measurements with 3D-direct, 3D-MPR, and 2D-TTE methods was statistically investigated. Our sample consisted of 109 (73.2%) women and 40 (26.8%) men. The mean age was 51.75 ± 9.81 years. The agreement between 3D-direct and 3D-MPR planimetry was significant and moderate (0.99 ± 0.29 cm² vs. 1.12 ± 0.26 cm², intraclass correlation = 0.716, p value = 0.001).The accuracy of the 3D-direct method reduced significantly compared to the MPR method at MVA > 1.5 cm². The maximum difference between two methods was observed in cases with MVAs larger than 1.5 cm². MVA measured with the 3D-MPR method was significantly correlated with a 2D-TTE method, with a moderate agreement (intraclass correlation = 0.644, p value = 0.001). Also, 2D-TTE and 3D-direct TEE techniques yielded significantly consistent measurements of the MVA (1.06 ± 0.026 cm² vs. 0.99 ± 0.29 cm², intraclass correlation = 0.787, p value = 0.001); however, with a slight overestimation of the MVA by the former with a net difference of 0.06 ± 0.013 cm². Mitral valve pressure gradient (MPG) had no significant correlation with planimetry results. A significant inverse correlation was seen between the MVA and pulmonary arterial systolic pressure. 3D-direct planimetry has an acceptable agreement with 3D-MPR planimetry at MVA less than 1.5 cm², but their correlation decreases significantly at MVA above 1.5 cm². 3D-direct planimetry underestimates MVA compared to 3D-MPR, especially at MVA above 1.5 cm². It seems that the saddle shape of mitral valve, interferes with 3D-direct measurement of commissures at moderate MS. The 2D-TTE planimetry has generally acceptable accuracy, but its correlation to the 3D-TEE methods is significantly reduced in cases with moderate to severe MS (i.e. MVA > 1.0 cm²).

PMID:35044628 | DOI:10.1007/s10554-022-02523-0

J Gambl Stud. 2022 Jan 19. doi: 10.1007/s10899-021-10103-5. Online ahead of print.

ABSTRACT

Past work has demonstrated that presenting statistical information in a foreground-background icon array can improve risk understanding, reduce decision-making biases, and decrease the salience of low-probability risks. In the present study, we assess whether presenting readily available gambling information within a foreground-background icon array influences individuals’ gambling-related judgments (e.g., their perceived likelihood of winning a prize). Across two experiments (N = 1151), we find that using icon arrays to present gambling information reduces the appeal of scratch card games. That is, participants presented with gambling information in a foreground-background icon array, as opposed to a non-graphical numerical format, reported feeling less likely to win a prize, less excitement to play, and less urge to gamble on a scratch card game presented in a hypothetical gambling task. Overall, we conclude that presenting gambling information in an icon array format represents a simple yet promising tool for correcting gamblers’ often overly-optimistic perceptions and reducing the appeal of negative expected value scratch card games.

PMID:35044578 | DOI:10.1007/s10899-021-10103-5