Category: Statistics

Diabetes Care. 2022 Feb 22:dc211597. doi: 10.2337/dc21-1597. Online ahead of print.

ABSTRACT

OBJECTIVE: We investigated the association between interval changes in physical activity (PA) and dementia risk among patients with new-onset type 2 diabetes.

RESEARCH DESIGN AND METHODS: We identified 133,751 participants newly diagnosed with type 2 diabetes in a health screening (2009-2012), with a follow-up health screening within 2 years (2010-2015). PA level changes were categorized into continuous lack of PA, decreaser, increaser, and continuous PA groups. Dementia was determined using dementia diagnosis codes and antidementia drug prescriptions.

RESULTS: During the median follow-up of 4.8 years, 3,240 new cases of all-cause dementia developed. Regular PA was associated with lower risks of all-cause dementia (adjusted hazard ratio [aHR] 0.82; 95% CI 0.75-0.90), Alzheimer disease (AD) (aHR 0.85; 95% CI 0.77-0.95), and vascular dementia (VaD) (aHR 0.78; 95% CI 0.61-0.99). Increasers who started to engage in regular PA had a lower risk of all-cause dementia (aHR 0.86; 95% CI 0.77-0.96). Moreover, the risk was further reduced among those with continuous regular PA: all-cause dementia (aHR 0.73; 95% CI 0.62-0.85), AD (aHR 0.74; 95% CI 0.62-0.88), and VaD (aHR 0.62; 95% CI 0.40-0.94). Consistent results were noted in various subgroup analyses.

CONCLUSIONS: Regular PA was independently associated with lower risks of all-cause dementia, AD, and VaD among individuals with new-onset type 2 diabetes. Those with continuous regular PA and, to a lesser extent, those who started to engage in regular PA had a lower risk of dementia. Regular PA should be encouraged to prevent dementia in high-risk populations and those with new-onset type 2 diabetes.

PMID:35192690 | DOI:10.2337/dc21-1597

J Gerontol B Psychol Sci Soc Sci. 2022 Feb 22:gbac030. doi: 10.1093/geronb/gbac030. Online ahead of print.

ABSTRACT

OBJECTIVES: The paper seeks to examine the contribution of internal socioeconomic disparities in mortality to the United States international disadvantage in life expectancy at birth.

METHODS: Using individual death records from the US national vital statistics system for years 1982 to 2019 and data for other countries from the Human Mortality Database, we compare age-specific death rates and life expectancy between counties classified into ten socioeconomic categories and 20 high-income countries. We also calculate the number of years of life lost in each socioeconomic decile in relation to the comparison set.

RESULTS: There is a clear and increasing socioeconomic gradient of mortality in the United States but the growing divergence in internal mortality trends does not explain the rising gap between the country and its peers. In 2019, even American women in the most socioeconomically advantaged decile lived shorter lives while only the 10% men in the most affluent decile fared better than their peers. The long-standing US disadvantage in young adult mortality has been growing and the country previous advantage in mortality at ages 75 years and above has virtually disappeared for all but for Americans in the most affluent counties.

DISCUSSION: The similar age-pattern of differences in mortality rates between socioeconomic deciles and the comparison group suggests that the underlying factors might be the same. The roles of external causes (including drug overdoses) for middle-age adults and a slowing down in progress to control cardiovascular diseases at older ages at the national level are consistent with this pattern.

PMID:35192708 | DOI:10.1093/geronb/gbac030

Age Ageing. 2022 Feb 2;51(2):afac012. doi: 10.1093/ageing/afac012.

ABSTRACT

OBJECTIVE: to evaluate the sensitivity, specificity and test-retest reliability of the Delirium Early Monitoring System-Delirium Observation Screening Scale (DEMS-DOSS).

DESIGN: prospective diagnostic accuracy study of a convenience sample of admitted older adults with DEMS-DOSS and reference standard assessments.

SETTING: 60-bed aged care precinct at a metropolitan hospital in Sydney, Australia.

PARTICIPANTS: 156 patients (aged ≥65 years old) were recruited to participate between April 2018 and March 2020. One hundred participants were included in the analysis.

MEASUREMENTS: Participants were scored on the DEMS-DOSS. Trained senior aged care nurses conducted a standardised clinical interview based on the Diagnostic and Statistical Manual of Mental Disorder (DSM)-IV delirium criteria, within two hours of DEMS-DOSS completion. The senior aged care nurse undertaking the DSM-IV interview was blinded to the results of the DEMS-DOSS.

RESULTS: Participants’ mean age was 84 (SD ±7.3) years and 39% (n = 39) had a documented diagnosis of dementia. Delirium was detected in 38% (n = 38) according to the reference standard. The DEMS-DOSS had a sensitivity of 76.3% and a specificity of 75.8% for delirium. The area under the receiver operating characteristics curve for delirium was 0.76. The test-retest reliability of the DEMS-DOSS was found to be high (r = 0.915).

CONCLUSION: DEMS-DOSS is a sensitive and specific tool to assist with monitoring new onset and established delirium in hospitalised older adults. Further studies are required to evaluate the impact of the monitoring tool on health outcomes.

PMID:35192683 | DOI:10.1093/ageing/afac012

PLoS One. 2022 Feb 22;17(2):e0264290. doi: 10.1371/journal.pone.0264290. eCollection 2022.

ABSTRACT

BACKGROUND: In times of the global corona pandemic health care workers (HCWs) fight the disease at the frontline of healthcare services and are confronted with an exacerbated load of pandemic burden. Psychosocial resources are thought to buffer adverse effects of pandemic stressors on mental health. This rapid review summarizes evidence on the specific interplay of pandemic burden and psychosocial resources with regard to the mental health of HCWs during the COVID-19 pandemic. The goal was to derive potential starting points for supportive interventions.

METHODS: We conducted a rapid systematic review following the recommendations of the Cochrane Rapid Reviews Methods Group. We searched 7 databases in February 2021 and included peer-reviewed quantitative studies, that reported related data on pandemic stressors, psychosocial resources, and mental health of HCWs.

RESULTS: 46 reports were finally included in the review and reported data on all three outcomes at hand. Most studies (n = 41) applied a cross-sectional design. Our results suggest that there are several statistically significant pandemic risk factors for mental health problems in HCWs such as high risk and fear of infection, while resilience, active and emotion-focused coping strategies as well as social support can be considered beneficial when protecting different aspects of mental health in HCWs during the COVID-19 pandemic. Evidence for patterns of interaction between outcomes were found in the context of coping style when facing specific pandemic stressors.

CONCLUSIONS: Our results indicate that several psychosocial resources may play an important role in buffering adverse effects of pandemic burden on the mental health of HCWs in the context of the COVID-19 pandemic. Nevertheless, causal interpretations of mentioned associations are inadequate due to the overall low study quality and the dominance of cross-sectional study designs. Prospective longitudinal studies are required to elucidate the missing links.

PMID:35192662 | DOI:10.1371/journal.pone.0264290

PLoS One. 2022 Feb 22;17(2):e0263664. doi: 10.1371/journal.pone.0263664. eCollection 2022.

ABSTRACT

Given challenges with adherence to existing HIV prevention products, the development of an extended duration vaginal ring could improve adherence while reducing patient and provider burden. Additionally, women have other interlinked sexual health concerns such as unintended pregnancy. We evaluated acceptability of a 90-day ring to prevent HIV and hypothetical preferences for a dual (HIV and contraceptive) indication. This was a secondary analysis of a Phase 1, two-arm, multi-site, placebo-controlled randomized trial evaluating safety and pharmacokinetics of a 90-day vaginal ring containing tenofovir for HIV prevention (N = 49). We used a mixed methods approach to assess quantitative data on acceptability (n = 49) and used qualitative data from a random subset to explain the quantitative findings (N = 25). The 3-month extended duration tenofovir ring was highly acceptable. Participants perceived the ring to be easy to use, comfortable and reported liking it more over time. About half felt the ring during sex but most of those participants said it bothered them only a little. Concerns about hygiene increased over the study period but were often outweighed by the benefits of an extended duration ring. Interest in a multi-purpose ring was high (77%) and even higher among those who were sexually active and had male partners. The 3-month extended duration tenofovir ring for HIV prevention was highly acceptable among women and interest in an MPT was high.

PMID:35192655 | DOI:10.1371/journal.pone.0263664

PLoS One. 2022 Feb 22;17(2):e0264323. doi: 10.1371/journal.pone.0264323. eCollection 2022.

ABSTRACT

OBJECTIVES: The purpose of this study was to evaluate the COVID-19 vaccination experience among United States-based dental professionals and students: to understand their beliefs, concerns, safety and confidence levels, and side effects experienced after vaccination; striving to boost vaccination acceptability to curtail the pandemic.

METHODS: An observational survey study approved by The University of Texas Health San Antonio Institutional Review Board was distributed to members of the School of Dentistry community using Qualtrics XM software. The survey was completed anonymously. Data were analyzed using R statistical computing software, χ2 test and Fisher’s Exact test.

RESULTS: Over 80% of all participants felt moderately to very safe working after the COVID-19 vaccine was made available, and more than 75% were moderately to very confident that the vaccine can protect them during the pandemic. At least 35% were moderately to very concerned about immediate and long-term side effects of the vaccine; despite the concerns, 94% received the vaccine. Side effects were more common after the second dose of the vaccine. Most common side effects were injection site pain, and general side effects of fatigue/tiredness, headache, muscle/body ache, and chills/fever. 74% reported no effect of the vaccine on daily activities, and the severity of side effects no worse than mild (about 60%).

CONCLUSIONS: Majority of the participants felt safe and confident that the vaccine would protect them against COVID-19 infection. Sharing these findings and reliable information that the vaccine is safe and effective is paramount to fostering the vaccine uptake and curtailing the pandemic.

PRACTICAL IMPLICATIONS: Findings of this study demonstrated the confidence of the UT Health San Antonio, School of Dentistry community that the benefits of the vaccines greatly outweigh the risks; boosting the vaccination acceptance while creating a COVID-19 free environment both for the academic dental setting and the community it serves.

PMID:35192657 | DOI:10.1371/journal.pone.0264323

PLoS One. 2022 Feb 22;17(2):e0264181. doi: 10.1371/journal.pone.0264181. eCollection 2022.

ABSTRACT

Low-power consumption has been always a crucial design constraint for an efficient intellectual property based three-dimensional multi-core system that cannot be ignored easily. As the complexity increases due to the number of cores/stacks/ layers in 3D digital systems, the challenges to handle power can be more difficult at a high abstraction level. Therefore, the low-power approach gives designers an opportunity to estimate and optimize the power consumption in the early stages of design phases. The accurate power estimation through the macro-modeling approach at high-level reduces the risk of redesign cycle and turn-around time. In this research, we have presented an improved statistical macro-modeling approach that estimates power through statistical characteristics of randomly generated input patterns by using Biogeography Based Optimization. These input patterns propagate signals into an IP-based 3D digital test system. In experiments, the test system is based on four 8 to 32- bits heterogeneous cores. The response of the power is monitored by applying the well-known Monte Carlo Simulation technique. The entire power estimation method is performed in two major steps. First, the average power is estimated for an IP-based individual core. Second, the average power for bus-based Through-Silicon-Via is estimated. Finally, the cores and B-TSVs are integrated together to construct a 3D system. Then the average power for complete test systems is estimated. The experimental results of the statistical power macro-model are compared with the commercial Electronic Design Automation power simulator at the operating frequency of 100 MHz. The average percentage error of the test system is calculated as 8.65%. For the validation of these results, the statistical error analysis is additionally performed and reveals that our proposed macro-model is accurate in terms of percentage of error with a feasible amount of time.

PMID:35192654 | DOI:10.1371/journal.pone.0264181

PLoS Negl Trop Dis. 2022 Feb 22;16(2):e0010183. doi: 10.1371/journal.pntd.0010183. Online ahead of print.

ABSTRACT

BACKGROUND: Snakebite is a neglected problem with a high mortality in India. There are no simple clinical prognostic tools which can predict mortality in viper envenomings. We aimed to develop and validate a mortality-risk prediction score for patients of viper envenoming from Southern India.

METHODS: We used clinical predictors from a prospective cohort of 248 patients with syndromic diagnosis of viper envenoming and had a positive 20-minute whole blood clotting test (WBCT 20) from a tertiary-care hospital in Puducherry, India. We applied multivariable logistic regression with backward elimination approach. External validation of this score was done among 140 patients from the same centre and its performance was assessed with concordance statistic and calibration plots.

FINDINGS: The final model termed VENOMS from the term “Viper ENvenOming Mortality Score included 7 admission clinical parameters (recorded in the first 48 hours after bite): presence of overt bleeding manifestations, presence of capillary leak syndrome, haemoglobin <10 g/dL, bite to antivenom administration time > 6.5 h, systolic blood pressure < 100 mm Hg, urine output <20 mL/h in 24 h and female gender. The lowest possible VENOMS score of 0 predicted an in-hospital mortality risk of 0.06% while highest score of 12 predicted a mortality of 99.1%. The model had a concordance statistic of 0·86 (95% CI 0·79-0·94) in the validation cohort. Calibration plots indicated good agreement of predicted and observed outcomes.

CONCLUSIONS: The VENOMS score is a good predictor of the mortality in viper envenoming in southern India where Russell’s viper envenoming burden is high. The score may have potential applications in triaging patients and guiding management after further validation.

PMID:35192642 | DOI:10.1371/journal.pntd.0010183

PLoS One. 2022 Feb 22;17(2):e0263333. doi: 10.1371/journal.pone.0263333. eCollection 2022.

ABSTRACT

Obesity, associated with having excess body fat, is a critical public health problem that can cause serious diseases. Although a range of techniques for body fat estimation have been developed to assess obesity, these typically involve high-cost tests requiring special equipment. Thus, the accurate prediction of body fat percentage based on easily accessed body measurements is important for assessing obesity and its related diseases. By considering the characteristics of different features (e.g. body measurements), this study investigates the effectiveness of feature extraction for body fat prediction. It evaluates the performance of three feature extraction approaches by comparing four well-known prediction models. Experimental results based on two real-world body fat datasets show that the prediction models perform better on incorporating feature extraction for body fat prediction, in terms of the mean absolute error, standard deviation, root mean square error and robustness. These results confirm that feature extraction is an effective pre-processing step for predicting body fat. In addition, statistical analysis confirms that feature extraction significantly improves the performance of prediction methods. Moreover, the increase in the number of extracted features results in further, albeit slight, improvements to the prediction models. The findings of this study provide a baseline for future research in related areas.

PMID:35192644 | DOI:10.1371/journal.pone.0263333

PLoS One. 2022 Feb 22;17(2):e0263431. doi: 10.1371/journal.pone.0263431. eCollection 2022.

ABSTRACT

BACKGROUND: Adolescents are currently becoming sexually active before their 18th birthday during which they have to battle with unsafe sexual behaviours, teenage pregnancies, sexually transmitted infections (STIs), and school dropouts. The trend is linked with low soft skills (self-esteem and assertiveness skills) for them to make informed, reasoned, and responsible decisions over sexual activities. This study designed and tested the effect of integrated reproductive health (RH) lesson materials in a problem-based pedagogy (PBP) to enhance soft skills for safe sexual behaviour among adolescents in Tanzania.

METHODS: A double-blinded clustered randomized controlled trial was conducted between September 2019 and September 2020 among 660 randomly selected adolescents. A Sexual-risk Behaviour Beliefs and Self-esteem Scale adopted from previous studies measured soft skills for safe sexual behaviour. A descriptive statistical analysis was performed by using the statistical analysis software programme version 9.4. The effect of the intervention was determined using Linear Mixed Model set at α error probability = 5% significance level (95% confidence interval) and a β error probability = 0.80.

FINDINGS: Adolescents’ mean age was 15±1.869 with 57.5% females. The end-line findings indicated that the coefficient of soft skills was significantly higher among adolescents in the hybrid PBP (β=9.0986, p<0.01; 95%CI: 4.7772, 14.2311) and pure PBP (β =8.7114, p<0.01; 95%CI: 3.9990, 10.1208) than in the control group. The retention rate of soft skills was still significantly higher at 3-months follow-up (β=2.0044; p<0.01; 95%CI: 1.0234, 4.1182) and at 6-months follow-up (β=1.9803; p<0.01; 95%CI: 0.8399, 3.1099) compared to the baseline and immediate post-intervention assessments.

CONCLUSION: The intervention substantially enhanced soft skills for safe sexual behaviour among adolescents of both sex. Despite the fact that scores for soft skills varied across the study timelines, adolescents demonstrated significant intentions to abstain from sexual intercourse, delay sexual relationships, negotiate condom use, and withstand sexual coercions. The PBP may need to be incorporated in ordinary level secondary school curricula as a formal guide to teachers and or health workers to optimally prepare adolescents for their healthy adulthood.

PMID:35192640 | DOI:10.1371/journal.pone.0263431