Category: Statistics

Eur J Radiol. 2021 Dec 29;147:110136. doi: 10.1016/j.ejrad.2021.110136. Online ahead of print.

ABSTRACT

PURPOSE: Understanding how mechanical properties relate to functional changes in glioblastomas may help explain different treatment response between patients. The aim of this study was to map differences in biomechanical and functional properties between tumor and healthy tissue, to assess any relationship between them and to study their spatial distribution.

METHODS: Ten patients with glioblastoma and 17 healthy subjects were scanned using MR Elastography, perfusion and diffusion MRI. Stiffness and viscosity measurements G’ and G”, cerebral blood flow (CBF), apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were measured in patients’ contrast-enhancing tumor, necrosis, edema, and gray and white matter, and in gray and white matter for healthy subjects. A regression analysis was used to predict CBF as a function of ADC, FA, G’ and G”.

RESULTS: Median G’ and G” in contrast-enhancing tumor were 13% and 37% lower than in normal-appearing white matter (P < 0.01), and 8% and 6% lower in necrosis than in contrast-enhancing tumor, respectively (P < 0.05). Tumors showed both inter-patient and intra-patient heterogeneity. Measurements approached values in normal-appearing tissue when moving outward from the tumor core, but abnormal tissue properties were still present in regions of normal-appearing tissue. Using both a linear and a random-forest model, prediction of CBF was improved by adding MRE measurements to the model (P < 0.01).

CONCLUSIONS: The inclusion of MRE measurements in statistical models helped predict perfusion, with stiffer tissue associated with lower perfusion values.

PMID:35007982 | DOI:10.1016/j.ejrad.2021.110136

Child Abuse Negl. 2022 Jan 7;124:105481. doi: 10.1016/j.chiabu.2021.105481. Online ahead of print.

ABSTRACT

BACKGROUND: To prevent abusive head trauma (AHT), many studies focus on understanding the risk factors. Few studies assess the role of household composition.

OBJECTIVE: To describe the household composition of children diagnosed with AHT and assess the relationships between patient and household characteristics, perpetration, and fatality.

PARTICIPANTS AND SETTING: Children admitted to a large pediatric hospital with AHT between January 1, 2010 and December 31, 2019.

METHODS: The diagnosis of AHT was made at initial hospitalization by a child abuse pediatrician with a multidisciplinary team review. The electronic medical records of identified patients were reviewed to identify demographic information, the number and ages of all of their siblings and the number and relationship to patients of all adults who were reported as being present at the time of AHT and therefore considered to be possible perpetrators. Descriptive statistics were used to characterize the sample. Comparisons were made using Fisher exact tests and Mann-Whitney tests.

RESULTS: Children with AHT who were under 12 months of age and had siblings in the home, particularly siblings under age 5, had greater odds of being injured by a biological parent. Children 12 months or older and children without siblings had greater odds of being injured by a boyfriend or girlfriend of their parent or guardian.

CONCLUSIONS: In cases of AHT, the possible perpetrator differed based on the presence of young siblings living in the home, which has important implications for AHT prevention.

PMID:35007972 | DOI:10.1016/j.chiabu.2021.105481

Accid Anal Prev. 2022 Jan 7;166:106548. doi: 10.1016/j.aap.2021.106548. Online ahead of print.

ABSTRACT

In recent years, pedestrian safety has emerged to be of major concern to selected States in the US and at the national level. With the transition to the mobility of people, pedestrian safety has become more prevalent for governmental agencies to address and prioritize for strategic implementation. It was crucial to address the pedestrian-vehicular conflict within Florida as it was reported as having the highest four pedestrian incident locations in the country. Many pedestrian sidewalks in Florida are not continuous and there is a concern among planners and engineers in the Florida Department of Transportation (FDOT) that these gaps constitute discontinuity of flow and are potentially posing threats to pedestrian safety. This paper investigates the correlation between pedestrian safety and sidewalk gaps within the Central Florida region. A sidewalk gap is defined as a length of a roadway segment with missing or absent sidewalk between existing sidewalks (before and after) along the same segment. “Missing” sidewalks are locations where the sidewalk is not only absent, but there is a desire to have one constructed or it would be used if it were constructed. The missing sidewalk can be on one side of the road or both sides. A wide array of Geographic Information Systems (GIS) information associated with the sidewalk gaps and the safety data were secured by FDOT. The data included all the Roadway Characteristics Inventory (RCI) within the district. Crash data combined with other geometric design data, traffic data, and census data were used to develop a statistical model. The results showed that presence of sidewalk along roadway segments is one of the main factors that have significant impact on the expected number of pedestrian crashes at a specific location. Other factors included daily traffic volumes, roadway category, specifically along urban two-way divided and undivided arterials with four to six lanes as well as the population within half-mile radius surrounding the crash location. The model results revealed that the Incident Risk Ratio (IRR) of a pedestrian crash along roadways with no sidewalk is 1.67 times greater than the likelihood of a crash with the presence of a sidewalk at 95% Confidence Interval (C.I.). The analysis also concluded that the likelihood of a pedestrian crash per mile along roadways with no sidewalk is three times greater than the likelihood of a crash per mile with the presence of a sidewalk.

PMID:35007964 | DOI:10.1016/j.aap.2021.106548

Child Abuse Negl. 2022 Jan 7;124:105459. doi: 10.1016/j.chiabu.2021.105459. Online ahead of print.

ABSTRACT

BACKGROUND: Adverse Childhood Experiences (ACEs) have been associated with a greater risk of later criminal offending. However, existing research in this area has been primarily conducted in Western developed countries and cross-cultural studies are rare.

OBJECTIVES: This study examined the relationship between ACEs and criminal behaviors in young adults living in 10 countries located across five continents, after accounting for sex, age, and cross-national differences.

PARTICIPANTS AND SETTING: In total, 3797 young adults aged between 18 and 20 years (M = 18.97; DP = 0.81) were assessed locally in community settings within the 10 countries.

METHOD: The ACE Questionnaire was used to assess maltreatment and household dysfunction during childhood and a subset of questions derived from the Deviant Behavior Variety Scale (DBVS) was used to determine past-year criminal variety pertaining to 10 acts considered crime across participating countries.

RESULTS: Physical and sexual abuse, physical neglect, and household substance abuse were related to criminal variety, globally, and independently across sexes and countries ranked differently in the United Nations Human Development Index (HDI). In addition, three out of five experiences of household dysfunction were related to criminal variety, but subsequent analyses indicate that some forms of household dysfunction only hold statistical significance among males or females, or in countries ranking lower in the HDI.

CONCLUSIONS: This research strengthens the finding that there are cross-cultural mechanisms perpetuating the cycle of violence. It also indicates that forms of household dysfunction have an impact on criminal behavior that is shaped by gender and the country’s levels of social well-being.

PMID:35007971 | DOI:10.1016/j.chiabu.2021.105459

Waste Manag. 2022 Jan 7;139:330-340. doi: 10.1016/j.wasman.2021.11.036. Online ahead of print.

ABSTRACT

The environmental risk assessment and the factors influencing heavy metals (HM) in the soil at the municipal solid waste landfill sites (MSWLs) were studied by literature review, field survey, and statistical methods. The results indicated that the dominant HM contamination in the soil at the MSWLs was caused by chromium (Cr) with the Nemero index values (PI) from 22.7 to 44.3 and zinc (Zn) with the PI from 0.7 to 9.8. There were significant differences in the Cr, mercury (Hg), lead (Pb), Zn, and arsenic (As) concentrations between soil samples from sanitary and non-sanitary landfills (NSLs) where HM contamination (PI = 10.9) was more obvious. As (CRA_As = 2.35 × 10^-4) and cadmium (Cd) (CRA_Cd = 1.45 × 10^-4) posed potential carcinogenic health effects. The soil Cd concentration had a significant negative correlation (r = -0.476^**) with the landfill age. The soil As concentration had a significant positive correlation (r = 0.472^**) with rainfall in NSLs. There were significant differences in the As (P = 0.042) and copper (Cu) (P = 0.042) concentrations between soil samples from the surrounding areas of MSWLs and the base where soil had higher HM concentrations. For the efficient prevention of HM ecological risk, a scientific site selection, undamaged coverage and anti-seepage systems, standardized management, and ongoing monitoring are required.

PMID:35007953 | DOI:10.1016/j.wasman.2021.11.036

Thromb Res. 2021 Dec 31;210:53-62. doi: 10.1016/j.thromres.2021.12.024. Online ahead of print.

ABSTRACT

BACKGROUND: Anticoagulation is important for extracorporeal membrane oxygenation (ECMO). Heparin is widely used; however, in some cases, it is not suitable for patients. Bivalirudin has been recently proposed for ECMO patients, and there is no evidence regarding its effectiveness and safety.

OBJECTIVE: We aimed to systematically review the effectiveness and safety of bivalirudin in ECMO patients.

STUDY DESIGN AND METHODS: PubMed, Web of Science, Cochrane Library, and EMBASE were searched to find relevant research on the use of bivalirudin versus heparin for anticoagulation in ECMO patients. Outcomes included in-hospital mortality, ECMO duration, major bleeding events, thrombosis events and circuit intervention events. Types of studies included randomized control trials (RCTs), cohort studies, and case-control studies. Case reports, studies lacking comparison with heparin, and where patients transitioned between heparin and bivalirudin, were excluded. Publication bias was evaluated when the number of included studies was more than ten. Sensitivity analysis was performed to examine the stability of the results.

RESULTS: Ten articles were selected, and nine articles were included in the meta-analysis. The results of the meta-analysis showed hospital mortality [OR = 0.65, 95%CI (0.44, 0.95), P = 0.03] and thrombosis events decreased (OR = 0.55, 95%CI [0.37, 0.83], P = 0.004) in bivalirudin group compared with heparin in adult patients. Major bleeding events (OR = 0.66, 95%CI [0.17, 2.55], P = 0.55), ECMO duration (MD = 18.92, 95%CI [-29.33, 67.17], P = 0.44) and circuit intervention events (OR = 1.67, 95%CI [0.54, 5.18], P = 0.37) in the bivalirudin group was not statistically significant compared with the heparin group.

CONCLUSION: Bivalirudin may provide survival benefits and reduce thrombosis in adult patients on ECMO compared with heparin. There is no difference in treating major bleeding events between bivalirudin and heparin group. However, because all included studies were retrospective observational studies, the evidence level of this systematic review is low and heterogeneity could not be avoided. More high-quality clinical studies are urgently needed to confirm these benefits.

PMID:35007937 | DOI:10.1016/j.thromres.2021.12.024

J Stroke Cerebrovasc Dis. 2022 Jan 7;31(3):106284. doi: 10.1016/j.jstrokecerebrovasdis.2021.106284. Online ahead of print.

ABSTRACT

OBJECTIVE: Flow diversion is becoming an increasingly established practice for the treatment of acutely ruptured intracranial aneurysms. In this study the authors present a literature review and meta-analysis, adding a retrospective review of institutional registry on emergency treatment of aRIA with flow diverter stent.

MATERIALS AND METHODS: A systematic search of PubMed, SCOPUS, Ovid MEDLINE, and Ovid EMBASE was performed on April 20^th, 2021, extrapolating 35 articles. R language ‘meta’ and ‘metafor’ packages were used for data pooling. The DerSimonian-Laird model was used to calculate the pooled effect. The I² value and Q statistic evaluated study heterogeneity. Additionally, the authors retrospectively reviewed their institutional database for the treatment and outcomes of all patients with acutely ruptured intracranial aneurysms treated with flow diverter stent placement from May 2010 to November 2020 was performed.

RESULTS: From the systematic literature review and meta-analysis, the pooled proportion of complete aneurysm occlusion was 78%, with a pooled rate of 79%, 71%, 80%, and 50% for dissecting, saccular, fusiform, and mycotic aneurysms, respectively. The pooled proportion of aneurysm rebleeding and intrastent stenosis was 12% and 15% respectively, for a total of 27% rate. The analysis of authors retrospective register showed an overall mortality rate of 16.7% (3/18), with a low but not negligible postprocedural rebleeding and intrastent thrombosis rates (5.6% and 11.1% respectively).

CONCLUSION: Although increasingly utilized in the management of selected patients with acutely ruptured intracranial aneurysms, flow diversion for acutely ruptured intracranial aneurysms treatment presents rebleeding and intrastent stenosis rates not negligible.

PMID:35007933 | DOI:10.1016/j.jstrokecerebrovasdis.2021.106284

Placenta. 2021 Dec 28;118:32-37. doi: 10.1016/j.placenta.2021.12.022. Online ahead of print.

ABSTRACT

INTRODUCTION: Gestational diabetes mellitus (GDM) is associated with many adverse outcomes of pregnancy, especially macrosomia. The aim of our study was to verify whether high glucose concentrations change the methylation levels of the insulin-like growth factor-2 (IGF-2)/H19 gene promoters to increase the expression of IGF-2, a key gene in fetal growth regulation.

METHODS: HTR8/SVneo cells were used to establish a cell model of intrauterine hyperglycemia in pregnant women with GDM. The RNA expression levels of the IGF-2/H19 genes and the methylation levels of the IGF-2/H19 gene promoter regions were measured. Methylated and unmethylated IGF-2/H19 gene promoter plasmids were transfected into HTR8/SVneo cells.

RESULTS: Among the five groups of cells, the RNA levels of IGF-2 and H19 were lowest in the 5-mM (physiological blood glucose level) group, which was statistically significant (all P < 0.05). Compared with those in the 5-mM group, two cytosine-phosphate-guanine (CpG) sites in the promoter region of the IGF-2 gene and twelve CpG sites in the promoter region of the H19 gene had statistically significant changes in methylation levels (all P < 0.05). Additionally, luciferase activity was significantly higher in cells transfected with the methylated H19 gene promoter plasmid than in control cells transfected with the unmethylated plasmid (P < 0.01), while the methylated IGF-2 gene promoter plasmid produced lower luciferase activity than the unmethylated plasmid (P < 0.01).

DISCUSSION: High glucose concentrations may increase IGF-2/H19 expression by changing the methylation levels of the IGF-2 and H19 gene promoters.

PMID:35007927 | DOI:10.1016/j.placenta.2021.12.022

Int J Med Inform. 2021 Dec 29;159:104677. doi: 10.1016/j.ijmedinf.2021.104677. Online ahead of print.

ABSTRACT

BACKGROUND: Covid-19 pandemic has boosted digitalization in healthcare, as mobility restrictions and social distancing rules have made healthcare providers to adopt digital tools to replace or complement face-to-face interactions.

PURPOSE: We discuss the effects of Covid-19 pandemic on physicians’ use of digital media. We examine whether Covid-19 conditions have changed how physicians use internet resources for information search, how they engage in social media, and their attitude towards online events.

BASIC PROCEDURES: The study was done as a longitudinal panel survey in four waves. The sample was a panel including active physicians in Finland. The panel was updated annually. Identical surveys were administered in 2018, 2019, 2020 and 2021. Spring 2020 was the time when Finland executed mobility restrictions and re-organization of healthcare because of pandemic. Comparing results of the survey before and after Covid-19 restrictions gives us a unique opportunity to do comparative analysis of Covid-19 effects.

MAIN FINDINGS: Our results show that the use of digital media for information search stayed relatively stable without statistically significant change during the four-year period covered in the study. The use of social media rose steadily from 2018 to 2021 with no significant difference in the trend. However, there was a significant change in the attitude of Finnish physicians on online events. Year 2021, the attitude remained in this more positive level.

PRINCIPAL CONCLUSIONS: As use of digital media including social media was already high prior Covid-19 in Finland, our results do not show significant change because of special circumstances introduced in 2020. However, our results show that the attitudes towards online events turned more positive during Covid-19 related restrictions. This could indicate that Covid-19 era has triggered a change that might continue also when pandemic related restrictions will be removed.

PMID:35007925 | DOI:10.1016/j.ijmedinf.2021.104677

Int J Dent Hyg. 2022 Jan 10. doi: 10.1111/idh.12577. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate infection control knowledge and its practice of clinical dental hygienists in response to Coronavirus Disease 2019 (COVID-19) in South Korea.

METHODS: 9 questions (Q9-K) on the degree of knowledge acquisition of dental hygienists in response to COVID-19, and another 9 questions (Q9-P) on the practices for COVID-19 infection and spread prevention were prepared. From 500 clinical dental hygienists in South Korea, answers about their general characteristics, Q9-K, and Q9-P were collected. 1 point was given to each question based on the ‘yes’ answers from Q9-K and Q9-P, and Score-K and Score-P were calculated, respectively. To identify factors affecting Score-P, multiple linear regression analysis was performed. In all analyses, p-values lower than 0.05 were considered statistically significant.

RESULTS: Average scores of Score-K and Score-P were 7.36±1.35 and 6.26±2.07, respectively. The regression model of Score-P was significant (F=20.788, p<0.001). With respect to Score-P, Score-K (β=0.385), age (β=0.275), dental hospital (β=0.158), monthly income of $2,360∼$2,730 (β=0.104) had a significantly positive correlation, and the total years of career (β=-0.293) are found to have a significantly negative correlation.

CONCLUSIONS: Infection control knowledge and practice of clinical dental hygienists in South Korea was found to be vulnerable in the group of hygienists who are younger than 27 years old, working in dental clinics, and whose monthly income is less than under $2000. Also, the factor that influences infection control practice the most was the degree of knowledge. Therefore, continuous infection control education and supplement targeting these vulnerable groups are necessary.

PMID:35007394 | DOI:10.1111/idh.12577