Category: Statistics

Brain Struct Funct. 2021 Apr 7. doi: 10.1007/s00429-020-02200-9. Online ahead of print.

ABSTRACT

While previous structural-covariance studies have an advanced understanding of brain alterations in Parkinson’s disease (PD), brain-behavior relationships have not been examined at the individual level. This study investigated the topological organization of grey matter (GM) networks, their relation to disease severity, and their potential imaging diagnostic value in PD. Fifty-four early-stage PD patients and 54 healthy controls (HC) underwent structural T1-weighted magnetic resonance imaging. GM networks were constructed by estimating interregional similarity in the distributions of regional GM volume using the Kullback-Leibler divergence measure. Results were analyzed using graph theory and network-based statistics (NBS), and the relationship to disease severity was assessed. Exploratory support vector machine analyses were conducted to discriminate PD patients from HC and different motor subtypes. Compared with HC, GM networks in PD showed a higher clustering coefficient (P = 0.014) and local efficiency (P = 0.014). Locally, nodal centralities in PD were lower in postcentral gyrus and temporal-occipital regions, and higher in right superior frontal gyrus and left putamen. NBS analysis revealed decreased morphological connections in the sensorimotor and default mode networks and increased connections in the salience and frontoparietal networks in PD. Connection matrices and graph-based metrics allowed single-subject classification of PD and HC with significant accuracy of 73.1 and 72.7%, respectively, while graph-based metrics allowed single-subject classification of tremor-dominant and akinetic-rigid motor subtypes with significant accuracy of 67.0%. The topological organization of GM networks was disrupted in early-stage PD in a way that suggests greater segregation of information processing. There is potential for application to early imaging diagnosis.

PMID:33825053 | DOI:10.1007/s00429-020-02200-9

Cogn Res Princ Implic. 2021 Apr 6;6(1):27. doi: 10.1186/s41235-021-00290-5.

ABSTRACT

Camouflage-breaking is a special case of visual search where an object of interest, or target, can be hard to distinguish from the background even when in plain view. We have previously shown that naive, non-professional subjects can be trained using a deep learning paradigm to accurately perform a camouflage-breaking task in which they report whether or not a given camouflage scene contains a target. But it remains unclear whether such expert subjects can actually detect the target in this task, or just vaguely sense that the two classes of images are somehow different, without being able to find the target per se. Here, we show that when subjects break camouflage, they can also localize the camouflaged target accurately, even though they had received no specific training in localizing the target. The localization was significantly accurate when the subjects viewed the scene as briefly as 50 ms, but more so when the subjects were able to freely view the scenes. The accuracy and precision of target localization by expert subjects in the camouflage-breaking task were statistically indistinguishable from the accuracy and precision of target localization by naive subjects during a conventional visual search where the target ‘pops out’, i.e., is readily visible to the untrained eye. Together, these results indicate that when expert camouflage-breakers detect a camouflaged target, they can also localize it accurately.

PMID:33825054 | DOI:10.1186/s41235-021-00290-5

Cardiovasc Intervent Radiol. 2021 Apr 6. doi: 10.1007/s00270-021-02824-2. Online ahead of print.

ABSTRACT

PURPOSE: To determine 30-day-mortality rates and identify predictors for survival in patients undergoing endovascular revascularization for acute mesenteric ischemia (AMI) due to occlusion of the celiac (CA) or superior mesenteric artery (SMA) from arterial thrombosis in the setting of atherosclerosis at the vessel origin.

MATERIALS AND METHODS: A retrospective analysis on patients who underwent acute endovascular revascularization to treat AMI caused by thrombotic occlusion of the CA and/or SMA between January 2011 and December 2019 was conducted. 30-day-mortality rates were calculated. Univariate binomial logistic regression analyses (p < 0.05) were performed to assess whether the following factors were associated with 30-day mortality: sex, age, history of smoking, history of abdominal angina, signs of bowel necrosis on pre-interventional CT, one- vs. two-vessel disease, patency of the inferior mesenteric artery, outpatient or inpatient occurrence of ischemia, onset of AMI during ITU stay, elevated pre-interventional serum lactate levels, total leukocyte count, platelet/lymphocyte ratio and neutrophil/lymphocyte ratio.

RESULTS: 40 patients were included in this analysis. 30-day-mortality rate was 25/40 (62.5%). Median overall survival of patients who survived the first 30 days was 36 ± 18 months. None of the analyzed factors was statistically significantly associated with 30-day mortality.

CONCLUSION: Although mortality of patients with AMI due to acute arterial thrombosis remains high, almost 40% of patient who underwent emergent endovascular revascularization survived longer than one month. Since no predictors for the outcome in these patients were identified, all patients with AMI should be offered an immediate revascularization effort.

PMID:33825061 | DOI:10.1007/s00270-021-02824-2

Arch Orthop Trauma Surg. 2021 Apr 6. doi: 10.1007/s00402-021-03871-7. Online ahead of print.

ABSTRACT

INTRODUCTION: The incidence of patella fracture is statistically low (0.5-1.5%) compared to other fractures of the extremities [Patella fractures 76(10):987-997, 2005]. In the latter research, patella fractures if treated surgically present an overall inferior functional outcome. Little is known about the influence of the postoperative patella height on the clinical outcome. Therefore, the aim of our study was to analyse the influence of the patella height on the patients’ functional outcome after surgery.

METHODS: In this retrospective study the in-house trauma register of our level I University trauma center was screened for patients suffering patella fractures treated surgically. Patella height of the same patients was evaluated on lateral X-rays using the Insall-Salvati Ratio (ISR). The patients’ X-rays were analyzed at two time points for the ISR, whereas group A presents ISR data right after surgery and group B data at the latest follow up (minimum 6 weeks). The change of mean ISR at both time points was tested for significance. The functional outcome was measured by the “Munich Knee Questionaire” (MKQ). These MKQ results of different patella heights and fracture types were compared.

RESULTS: The screening of our in-house trauma register revealed 375 patients between the years 2003 and 2016. Out of these 54 patients (34f, 20 m) were enrolled. In detail the follow-up time for ISR between group A and B accounted for a mean of 503.8 ± 655.7 days. The MKQ was assessed at a mean of 1367.0 ± 1042.8 days after surgery. According to the AO-classification 10% AO.34 type B and 90% AO.34 type C fractures were found. Group A showed in 9.1% a patella baja and in 27.3% a patella alta compared to group B presenting 20.0% patella baja and 14.5% patella alta. There was no significant difference in functional outcome referring to the MKQ in patella alta (MKQ 69.0% ± 18.2) or baja (MKQ 67.1% ± 17.9) (p = 0.9). No significant functional difference between AO34.type B (MKQ 74.5% ± 11.0) and AO34.type C fractures (MKQ 64.0% ± 15.0) resulted (p = 0.1).

CONCLUSION: Our results demonstrate that different postoperative patella heights apparently do not influence the functional outcome in the short follow-up.

PMID:33825039 | DOI:10.1007/s00402-021-03871-7

Langenbecks Arch Surg. 2021 Apr 7. doi: 10.1007/s00423-021-02168-y. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aims to evaluate the risk of postoperative mortality in octogenarians undergoing emergency laparotomy.

METHODS: In compliance with STROCSS guideline for observational studies, we conducted a multicentre retrospective cohort study. All consecutive patients aged over 80 with acute abdominal pathology requiring emergency laparotomy between April 2014 and August 2019 were considered eligible for inclusion. The primary outcome measure was 30-day postoperative mortality, and the secondary outcome measures were in-hospital mortality and 1-year mortality. Statistical analyses included simple descriptive statistics, binary logistic regression analyses, and Kaplan-Meier survival statistics.

RESULTS: A total of 523 octogenarians were eligible for inclusion. Emergency laparotomy in octogenarians was associated with 21.8% (95% CI 18.3-25.6%) 30-day postoperative mortality, 22.6% (95% CI 19.0-26.4%) in-hospital mortality, and 40.2% (95% CI 35.9-44.5%) 1-year mortality. Binary logistic regression analysis identified ASA status (OR, 2.49; 95% CI 1.82-3.38, P < 0.0001) and peritoneal contamination (OR, 2.00; 95% CI 1.30-3.08, P = 0.002) as predictors of 30-day postoperative mortality. The ASA status (OR, 1.92; 95% CI 1.50-2.46, P < 0.0001), peritoneal contamination (OR, 1.57; 95% CI 1.07-2.48, P = 0.020), and presence of malignancy (OR, 2.06; 95% CI 1.36-3.10, P = 0.001) were predictors of 1-year mortality. Log-rank test showed significant difference in postoperative survival rates among patients with different ASA status (P < 0.0001) and between patients with and without peritoneal contamination (P = 0.0011).

CONCLUSIONS: Emergency laparotomies in patients older than 80 years with ASA status more than 3 in the presence of peritoneal contamination carry a high risk of immediate postoperative and 1-year mortality. This should be taken into account in communications with patients and their relatives, consent process, and multidisciplinary decision-making process for operative or non-operative management of such patients.

PMID:33825046 | DOI:10.1007/s00423-021-02168-y

Eur Radiol. 2021 Mar 30. doi: 10.1007/s00330-021-07846-5. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the safety and efficacy of CT-guided IRE of clinical T1a (cT1a) renal tumours close to vital structures and to assess factors that may influence the technical success and early oncological durability.

METHODS: CT-guided IRE (2015-2020) was prospectively evaluated. Patients’ demographics, technical details/success, Clavien-Dindo (CD) classification of complications (I-V) and oncological outcome were collated. Statistical analysis was performed to determine variables associated with complications. The overall 2- and 3-year cancer-specific (CS), local recurrence-free (LRF) and metastasis-free (MF) survival rates are presented using the Kaplan-Meier curves.

RESULTS: Thirty cT1a RCCs (biopsy-proven/known VHL disease) in 26 patients (age 32-81 years) were treated with IRE. The mean tumour size was 2.5 cm and the median follow-up was 37 months. The primary technical success rate was 73.3%, where 22 RCCs were completely IRE ablated. Seven residual diseases were successfully ablated with cryoablation, achieving an overall technical success rate of 97%. One patient did not have repeat treatment as he died from unexpected stroke at 4-month post-IRE. One patient had CD-III complication with a proximal ureteric injury. Five patients developed > 25% reduction of eGFR immediately post-IRE. All patients have preservation of renal function without the requirement for renal dialysis. The overall 2- and 3-year CS, LRF and MF survival rates are 89%, 96%, 91% and 87%.

CONCLUSION: CT-guided IRE in cT1a RCC is safe with acceptable complications. The primary technical success rate was suboptimal due to the early operator’s learning curve, and long-term follow-up is required to validate the IRE oncological durability.

KEY POINTS: • Irreversible electroporation should only be considered when surgery or image-guided thermal ablation is not an option for small renal cancer. • This non-thermal technique is safe in the treatment of small renal cancer and the primary technical success rate was 73.3%. • This can be used when renal cancer is close to important structure.

PMID:33825033 | DOI:10.1007/s00330-021-07846-5

Graefes Arch Clin Exp Ophthalmol. 2021 Apr 6. doi: 10.1007/s00417-021-05159-3. Online ahead of print.

ABSTRACT

PURPOSE: The use of face mask is globally recommended as a preventive measure against COVID-19. However, the intraocular pressure (IOP) changes caused by face masks remain unknown. The objective of this study was to assess the impact of wearing surgical and FFP2/N95 face masks during a 400-m walking protocol on IOP in primary open-angle glaucoma (POAG) patients.

METHODS: Thirteen subjects diagnosed of POAG (21 eyes) were enrolled in this study. IOP was measured at baseline, during the 400-m walking protocol and after 5 min of passive recovery while POAG patients wore a surgical mask, FFP2/N95 mask and no mask in randomized order. From the 21 POAG eyes, we analyzed the IOP changes caused by physical exercise with two face masks and without wearing any face mask.

RESULTS: At rest (baseline and recovery measurements), the use of the different face masks did not affect IOP levels (mean differences ranging from 0.1 to 0.6 mmHg). During physical activity, wearing an FFP2/N95 mask caused a small (mean differences ranging from 1 to 2 mmHg), but statistically significant, IOP rise in comparison to both the surgical mask and control conditions (Cohen’s d = 0.63 and 0.83, respectively).

CONCLUSION: Face masks must be used to minimize the risk of SARS-CoV-2 transmission, and POAG patients can safely use FFP2/N95 and surgical masks at rest. However, due to the IOP rise observed while walking with the FFP2/N95 mask, when possible, POAG patients should prioritized the use of surgical masks during physical activity.

PMID:33825030 | DOI:10.1007/s00417-021-05159-3

Biomed Res Int. 2021 Mar 22;2021:8847107. doi: 10.1155/2021/8847107. eCollection 2021.

ABSTRACT

BACKGROUND: Active lifestyle is a determining factor for functional and clinical health that protects and maintains both physical and mental health of an individual, whereas sedentary lifestyle is a contrary vital cause for higher premature mortality, heart disease, diabetics, and poorer quality of life. This study is aimed at determining the amount of time spent on sedentary activity and identifying sedentary behaviours frequently practiced by civil servants in Southern Ethiopia in 2015.

METHODS: It was a cross-sectional study which employed both qualitative and quantitative approach. A stratified cluster sampling method was used to select 375 office workers (222 men and 153 women) from Hawassa, Wolayta Soddo, and Dilla ranging from 18-65 years old. Data were collected using harmonized self-reporting LASSA (Longitudinal Aging Study Amsterdam) questionnaires and prevalence estimates of mean sedentary time in each 12 activities per day were determined. Descriptive and inferential statistics such as Independent t-test, Uni-variate ANOVA, and Person’s correlation were used to analyze association and predictability of IV on DV variables.

RESULT: The total mean time spent sitting per day was 13.39 h which was 81.5% of weak time. Collectively, screen time was dominant (6.08). About 70.7%, 23.7%, 4.8%, and 0.8% of respondents were levelled very high, high, moderate, and less sedentary, respectively. In general, women accounted higher sedentary level (96.1%) than men (93.3%) in sedentary activity. There is a weak positive correlation between age and time spent in an administrative task. Income and mealtime were statistically significant (r < 0.2, n = 375, p < 0.05).

CONCLUSION: The high level of self-reported sedentary time record suggests the need for public health policies targeted at increasing physical activity and decreasing sitting time through systemic intervention in and out of work.

PMID:33824879 | PMC:PMC8007353 | DOI:10.1155/2021/8847107

GMS J Med Educ. 2021 Mar 15;38(3):Doc50. doi: 10.3205/zma001446. eCollection 2021.

ABSTRACT

Aim: Recent developments measured using statistics and surveys among veterinarians show that integrating key competence training into veterinary education is becoming increasingly important. This article describes the collaborative development process of the first work package within the SOFTVETS project. The SOFTVETS project aims to create a competence model and an ideal version of a soft skills curriculum that can be implemented in veterinary higher education throughout Europe. Method: In the course of a desk research phase, a literature review and an inventory of the current practice of key competence training within veterinary education was carried out. An initial set of recommendations for three competence areas was developed using the Handbook for Internal Quality Management in Competence-Based Higher Education. Finally, an alternating sequence of individual and collaborative expert reviews was carried out. Result: Experts from five European countries participated in the process. The derived competence model consisted of the following three competence areas with the corresponding number of defined competences: ten communication, nine entrepreneurial and eight digital competences. Conclusion: In the next work packages, learning objectives, teaching and assessment methods will be collected. Training concepts for facilitators to provide professional competence training will be established. In addition, an evaluation toolkit will be developed to standardise the implementation, evaluation and assessment of competence training events. The SOFTVETS competence model should help educators to be able to integrate the training of key competence training into the veterinary curriculum. This detailed list of competences can also be used as a tool to identify existing deficiencies and thus enable further curricular changes.

PMID:33824886 | PMC:PMC7994872 | DOI:10.3205/zma001446

S Afr J Physiother. 2021 Mar 9;77(1):1515. doi: 10.4102/sajp.v77i1.1515. eCollection 2021.

ABSTRACT

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) are a global public concern for health and social-care systems, as well as individuals. They are the second-most prevalent cause of disability globally.

OBJECTIVES: The primary objective was to determine the prevalence of WMSDs amongst flower farm workers. The secondary objective was to determine the association between the socio-demographic characteristics and the presence of WMSDs in the previous 12-month period.

METHOD: A cross-sectional descriptive study was conducted. A sample of 270 participants was drawn from 897 farm workers. Quantitative data related to musculoskeletal disorders were collected using the Nordic Musculoskeletal Questionnaire (NMQ). Descriptive statistics were undertaken using frequencies and percentages. Inferential statistics were analysed using a chi-squared test (X²) based on an alpha level of p < 0.05.

RESULTS: A total of 184 (68.1%) respondents reported musculoskeletal discomfort. Amongst the 184 respondents, 178 were performing general farm work. Most 103 (38.1%) of the WMSDs were reported in the lower back. There was a strong association between job designation as a general worker (p = 0.016), an older age (p = 0.027) and having worked for a long time as a farm worker (p = 0.041) and WMSDs.

CONCLUSION: Flower farm workers in Kenya were found to be heavily burdened by WMSDs. Furthermore, the job designation, older age, as well as having worked for a long time, predisposes workers to the risk of developing WMSDs.

CLINICAL IMPLICATIONS: The high prevalence of WMSDs necessitates policy reform in the flower farm industry.

PMID:33824920 | PMC:PMC8008086 | DOI:10.4102/sajp.v77i1.1515