Category: Statistics

J Clin Apher. 2022 Feb 26. doi: 10.1002/jca.21976. Online ahead of print.

ABSTRACT

BACKGROUND: Autologous stem cell transplantation (ASCT) is a standard consolidation treatment for eligible patients with multiple myeloma (MM). There is no standardized mobilization regimen for collection of CD34+ stem cells, which is crucial to the success of ASCT. Cyclophosphamide/GCSF is an effective regimen, although reported associated toxicities include risk of febrile neutropenia (FN). Since plerixafor was introduced in Canada, this mobilization agent has been increasingly used as needed with GCSF at Kingston Health Science Centre (KHSC), with elimination of cyclophosphamide. This single center, retrospective, quality improvement study evaluates mobilization and ASCT outcomes of MM patients who had undergone stem cell mobilization at KHSC with cyclophosphamide/GCSF+/-plerixafor without antibiotics, cyclophosphamide/GCSF+/-plerixafor with antibiotics, and GCSF+/-plerixafor without antibiotics.

METHODS: A retrospective chart review was conducted evaluating 137 patients. The primary outcome measure was FN rates with mobilization. Balancing measures include CD34+ cell collected, plerixafor usage, days of apheresis and transplant outcomes. Chi-square, ANOVA, or Kruskal-Wallis methods were used to test statistical significance where appropriate.

RESULTS: Our study noted a higher total and day one CD34+ count in the two groups utilizing cyclophosphamide in mobilization. All nine cases of FN occurred in these two groups (P < .05). Addition of antibiotics decreased, but did not eliminate risk of FN. There were no significant differences in the rate of plerixafor usage and number of apheresis days. Difference in transplant outcomes, including engraftment and transfusion support, were statistically but not clinically significant. A larger sample size may be needed to explore this fully. There was no significant difference in length of transplant hospital stay.

CONCLUSION: The elimination of cyclophosphamide from mobilization regimens for MM appears to significantly reduce FN rates, without increasing balancing measures such as total number of apheresis days, plerixafor usage, duration of transplant hospitalization or mortality outcomes.

PMID:35218068 | DOI:10.1002/jca.21976

Birth. 2022 Feb 25. doi: 10.1111/birt.12627. Online ahead of print.

ABSTRACT

BACKGROUND: Anecdotal and emerging evidence suggested that the 2020 COVID-19 pandemic may have influenced women’s attitudes toward community birth. Our purpose was to examine trends in community births from 2019 to 2020, and the risk profile of these births.

METHODS: Recently released 2020 birth certificate data were compared with prior years’ data to analyze trends in community births by socio-demographic and medical characteristics.

RESULTS: In 2020, there were 71 870 community births in the United States, including 45 646 home births and 21 884 birth center births. Community births increased by 19.5% from 2019 to 2020. Planned home births increased by 23.3%, while birth center births increased by 13.2%. Increases occurred in every US state, and for all racial and ethnic groups, particularly non-Hispanic Black mothers (29.7%), although not all increases were statistically significant. In 2020, 1 of every 50 births in the United States was a community birth (2.0%). Women with planned home and birth center births were less likely than women with hospital births to have several characteristics associated with poor pregnancy outcomes, including teen births, smoking during pregnancy, obesity, and preterm, low birthweight, and multiple births. More than two-thirds of planned home births were self-paid, compared with one-third of birth center and just 3% of hospital births.

CONCLUSIONS: It is to the great credit of United States midwives working in home and birth center settings that they were able to substantially expand their services during a worldwide pandemic without compromising standards in triaging women to optimal settings for safe birth.

PMID:35218065 | DOI:10.1111/birt.12627

J Community Psychol. 2022 Feb 25. doi: 10.1002/jcop.22830. Online ahead of print.

ABSTRACT

In this article, the several factors have been investigated relating to the poor mental health of the children in Punjab, Pakistan. Using the data of the survey conducted by the Punjab Bureau of Statistics, different determinants of child malnutrition and poverty were diagnosed based upon sufficient information of the children under 5 year of age. Logistic regression analysis methodology has been applied for screening the most influential factors of the study. It has been observed that the rise in poverty has prejudiced the nutritional position of the children, the mother’s education, and the fitness of the youth. It has also been observed that male children are more at risk to poor mental health than female children. A number of policy issues came to light from the findings of the study. The wealth index of all three anthropometric measures, the child malnutrition status of uneducated mothers, and the child diarrhea menace are the significant areas.

PMID:35218036 | DOI:10.1002/jcop.22830

J Sci Food Agric. 2022 Feb 26. doi: 10.1002/jsfa.11837. Online ahead of print.

NO ABSTRACT

PMID:35218014 | DOI:10.1002/jsfa.11837

Laryngoscope. 2022 Feb 25. doi: 10.1002/lary.30072. Online ahead of print.

ABSTRACT

OBJECTIVES: Acute vocal fold edema (VFE) is often a consequence of illness, allergy, or voice overuse, causing dysphonia. Although VFE typically resolves with voice rest and treatment of predisposing causes, oral glucocorticoids are often considered for performers with imminent performance demands. There are limited data about performers’ perceptions of vocal change during treatment and how this relates to their ability to perform. This study aims to examine performers’ self-perceptions of vocal function with steroid treatment.

METHODS: Fifty-five performers (34 F; 21 M) diagnosed with VFE who chose treatment with a 6-day methylprednisolone taper were prospectively assessed. They completed the Evaluation of the Ability to Sing Easily (EASE) and reported on their voice use, regimen, performance obligations, and ability to perform. Findings were compared between Day 1 and Day 6 using paired t-tests and nonparametric Wilcoxon signed-rank tests.

RESULTS: Nearly all subjects completed scheduled performances without interruption. Following treatment, all subscales of the EASE were decreased at Day 6 (Vocal Function 29.78-20.59; Pathologic Risk Indicator 26.60-17.33; Vocal Concerns 6.10-4.20). These differences were statistically significant (p < 0.0001) and greater in subjects with performances scheduled and subjects who consistently completed vocal warmups. These findings demonstrate significant improvement in several facets of performers’ self-perception of function.

CONCLUSION: Subjects reported significant improvement in vocal function with oral steroid treatment and were able to meet performance obligations. It remains important that steroids are not prescribed without laryngeal examination. Examination should be repeated when dysphonia persists, recurs swiftly, or when patients seek repeated treatment, as there may be increased risk of adverse outcomes, and continued steroid use may mask underlying chronic pathology that is best treated by other means.

LEVEL OF EVIDENCE: 4 Laryngoscope, 2022.

PMID:35218020 | DOI:10.1002/lary.30072

J Behav Health Serv Res. 2022 Feb 25. doi: 10.1007/s11414-021-09776-y. Online ahead of print.

ABSTRACT

Statistical reliability of the Treatment Perceptions Survey (TPS) questionnaire was examined using data from 19 California counties. The 14-item TPS was designed for clients receiving substance use disorder services at publicly funded community-based programs. The TPS is being used for evaluation of the State’s 1115 Medicaid Waiver, external quality review of county-based systems of care, and quality improvement efforts. The survey addresses four domains of access to care, quality of care, care coordination, and general satisfaction that each include multiple items, plus a single item focused on self-reported outcome. Reliability test results of the four domains as composite measures were statistically significant. General satisfaction ratings were the best predictor of self-reported outcome in a path analysis model, followed by ratings of care coordination and quality of care. Separate analyses of TPS data from clients receiving specialty mental health services suggest the questionnaire can also be used reliably in mental health settings.

PMID:35217967 | DOI:10.1007/s11414-021-09776-y

Eur Geriatr Med. 2022 Feb 26. doi: 10.1007/s41999-022-00621-9. Online ahead of print.

ABSTRACT

PURPOSE: Day-care services contribute to maintaining the daily living ability of older people cared for at home. This study aimed to detect factors that could impede the continuation of day-care services.

METHODS: We collected clinical data of 132 older users (age = 82.8 ± 7.5 years; male:female = 49:83) utilizing our day-care center from April 2019 to March 2020. We evaluated age, sex, underlying disease, medication, family background, care level, food texture, physical ability, reasons for frequenting day-care centers, and combined medical/nursing care plans. Participants were divided into two groups: continuation (n = 51) and suspension (n = 81). The collected items were evaluated statistically using the chi-square test, Mann-Whitney test, and unpaired t test. Multivariate logistic analysis (forward-backward stepwise selection method) was added to the statistically significant items. Statistical significance was defined as p < 0.05.

RESULTS: The comparison test detected statistical significance in Parkinson disease/Parkinsonism, pain complaints, day-service use, short-stay service use, day-care center use to reduce care burden, physical ability including ambulation, and availability of the major caregiver (p < 0.05). Day-care service use to reduce care burden (odds ratio 5.646, p < 0.05), use of short-stay and day-care services (odds ratio 4.798, p < 0.05), and low independent ambulation (odds ratio 0.585, p < 0.05) were the likely factors for suspended use (percentage of correct classification = 68.5%).

CONCLUSION: An unreplaceable and effective program for day-service and short-stay services to improve the activities of daily living of older users and reduce care burden is required in day-care centers.

PMID:35217981 | DOI:10.1007/s41999-022-00621-9

Environ Sci Pollut Res Int. 2022 Feb 25. doi: 10.1007/s11356-022-19430-5. Online ahead of print.

ABSTRACT

Edible amaranth (Amaranthus tricolor L.) is used as a food-medicine or ornamental plant, and despite its importance, there are few reports associated with cadmium (Cd) stress. This study aimed to appraise the crosstalk between sodium nitroprusside (SNP), as a source of nitric oxide (NO), and cadmium toxicity on growth and physiological traits in edible amaranth by using different multivariate statistical methods. The results showed that growth-related traits of A. tricolor were significantly reduced under Cd stress. Contrarily, Cd treatments increased lipid peroxidation and reduced total protein content. Delving on the results of SNP application showed the suitability of its medium level (100 µM) on increasing the growth-related traits and also plant tolerance to Cd stress via lowering the lipid peroxidation and radical molecules production due to the higher activities of superoxide dismutase and catalase. Increasing the amount of Cd in roots and shoots, as the result of Cd treatment, reduced the growth and production of A. tricolor plants by high rates (over 50% in 60 mg kg^-1 Cd level), indicating its susceptibility to high Cd toxicity. Contrarily, treating plants with SNP showed no effect on shoot Cd content, while it significantly increased Cd allocation in the root, which might be attributable to the protective effect of NO on Cd toxicity by trapping Cd in the root. Subsequently, the application of a medium level of SNP (around 100 µM) is recommendable for A. tricolor plant to overcome the negative impacts of Cd toxicity. Moreover, according to the results of heatmap and biplot, under no application of Cd, the application of 100 µM SNP showed a great association with growth-related traits indicating the effectiveness of SNP on the productivity of this species even under no stress situations.

PMID:35217955 | DOI:10.1007/s11356-022-19430-5

Environ Sci Pollut Res Int. 2022 Feb 25. doi: 10.1007/s11356-022-19401-w. Online ahead of print.

ABSTRACT

To better understand Africa’s banks and the environment, this study investigates the impact of financial performance on environmental performance in Africa. We examined financial performance, environmental performance, and some control indicators dated from 2000 to 2016 by applying panel quantile regression and panel vector autoregressive techniques. Our results indicate that (i) in North African countries, carbon emission had a significant negative impact on financial performance on the 25th quantile and (ii) in the South, carbon emission had a statistically positive impact on financial performance on the 25th and 50th quantiles with the marginal effect increases from the lower quantile to the highest quantile. Also, bank deposits statistically negatively impacted financial performance on the 25th and 50th quantiles for both North and South economies. The dynamic panel quantile results show dissimilar effects at different quantiles. Also, the panel vector autoregressive results show that in North Africa carbon emission had a positive impact. Our results validate the stability test of the panel vector autoregressive model. The granger causality results in the North show a bilateral causal link between carbon emission and bank credit, carbon emission, and bank deposit. Since sustainability has become one of our era’s most thorny issues, this paper provides extensive policy directives to assist African nations in boosting a greener future.

PMID:35217950 | DOI:10.1007/s11356-022-19401-w

J Assist Reprod Genet. 2022 Feb 26. doi: 10.1007/s10815-022-02440-0. Online ahead of print.

ABSTRACT

PURPOSE: To compare reproductive outcomes following a euploid embryo transfer, between those embryos vitrified-warmed twice to those vitrified-warmed once.

METHODS: We retrospectively analysed 694 single euploid frozen embryo transfer cycles following preimplantation genetic testing for aneuploidy (PGT-A). For cycles in group 1 (N = 451), embryos were biopsied for PGT-A at blastocyst stage and vitrified. For cycles in group 2 (N = 146), embryos were vitrified at blastocyst stage, before being warmed and biopsied for PGT-A and vitrified again. For cycles in group 3 (N = 97), embryos were vitrified on day-3, before being warmed, cultured to day-5 and biopsied for PGT-A and re-vitrified.

RESULTS: The pregnancy, clinical pregnancy and livebirth rate in group 2 were not statistically different to group 1 (pregnancy rate, adjusted OR 1.09, 95% CI 0.62-1.91; clinical pregnancy, aOR 0.89, 95% CI 0.58-1.37; live birth rate, aOR 0.85, 95% CI 0.56-1.28). There was also no significant difference between group 3 and group 1, with similar pregnancy rate (aOR 1.22, 95% CI 0.74-1.99), clinical pregnancy rate (aOR 1.21, 95% CI 0.75-1.96) and live birth rate (aOR 1.15, 95% CI, 0.73-1.80). There was no significant difference in miscarriage rates between all three groups. The age at the oocyte collection, embryo quality and day of biopsy were associated with pregnancy, clinical pregnancy and live birth rate.

CONCLUSION: This study suggests that vitrifying and warming embryos twice at blastocyst or at cleavage and then blastocyst stage, can lead to similar reproductive outcomes to embryos vitrified-warmed once, after a single euploid embryo transfer.

PMID:35217947 | DOI:10.1007/s10815-022-02440-0