Category: Statistics

Arq Neuropsiquiatr. 2021 Aug;79(8):676-681. doi: 10.1590/0004-282X-ANP-2020-0053.

ABSTRACT

BACKGROUND: Parkinson’s disease (PD) is a neurodegenerative disease that affects food intake as the disease progresses. The assessment of nutritional status is essential to identify early nutritional deficits.

OBJECTIVE: To investigate the nutritional status and food intake of patients diagnosed with PD.

METHODS: This was a descriptive, cross-sectional, and quantitative study. A structured questionnaire with restricted questions was applied to identify the sociodemographic profile and anthropometric measurements were taken. To evaluate the disease stage, the modified Hoehn & Yahr scale was used. Food intake was evaluated using the Food Frequency Questionnaire (FFQ). The acquired information was organized in the Microsoft Office Excel 2010 program and statistical analysis was performed using the BioEstat 5.3 program.

RESULTS: The research was carried out with 40 patients; the majority was male (60%), over 60 years old (52.5%), single (55%), with a high school degree (42.5%), retirees (80%), and receiving one minimum salary (42.5%). Most were classified with eutrophic (42.5%) and overweight (42.5%). About food consumption, the most common foods were banana (60%), fish (52.5%), acerola (45%), and orange (32%). Among the high-risk foods, red meat (82.5%), fried foods (30%), heavy cream (25%), and filled sandwich cookies (25%) were the most common.

CONCLUSIONS: Most patients had a high consumption of red meat and processed foods, with relevant consumption of some fruits and low consumption of grains and oilseeds. The disease stage was not associated with nutritional status.

PMID:34550185 | DOI:10.1590/0004-282X-ANP-2020-0053

Arq Neuropsiquiatr. 2021 Aug;79(8):716-723. doi: 10.1590/0004-282X-ANP-2020-0032.

ABSTRACT

BACKGROUND: Peripheral neural surgical decompression (PNSD) is used as a complementary therapy to the clinical treatment of neuritis to preserve neural function.

OBJECTIVE: To evaluate the long-term (≥ 1 year) clinical and functional results for PNSD in leprosy neuritis.

METHODS: This cross-sectional study included leprosy patients who were in late postoperative period (LPO) of surgical decompression of ulnar, median, tibial, and fibular nerves. Socioeconomic, epidemiological, and clinical data were collected. The following instruments were used in this evaluation: visual analogue pain scale (VAS), Douleur Neuropathique en 4 Questions (DN4), SALSA scale, and simplified neurological assessment protocol. The preoperative (PrO) and 180-day postoperative (PO180) results were compared.

RESULTS: We evaluated 246 nerves from 90 patients: 56.6% were on multidrug therapy (MDT) and 43.3% discharged from MDT. Motor scores and pain intensity showed statistically significant improvement (p<0.01). There was an increase in sensory scores only for bilateral ulnar nerves (p<0.05). Of the operated cases, 26.0% of patients were referred for surgery of ulnar neuritis and 23.6% of tibial neuritis. Neuropathic pain was reported in 41% of cases. Daily dose of prednisone reduced from 39.6 mg (±3.0) in PrO, 16.3 mg (±5.2) in PO180, to 1.7 mg (±0.8) in LPO. The SALSA scale results showed mild activity limitation in 51% and moderate in 34% of patients. Eighty percent of individuals reported that the results reached their expectations.

CONCLUSIONS: PNSD in leprosy was effective in the long term to decrease the prevalence and intensity of pain, improve motor function, and reduce the dose of corticosteroids, which is reflected in the patients’ satisfaction.

PMID:34550184 | DOI:10.1590/0004-282X-ANP-2020-0032

Arq Bras Cardiol. 2021 Sep 20:S0066-782X2021005015201. doi: 10.36660/abc.20200186. Online ahead of print.

ABSTRACT

BACKGROUND: Recent epidemiological studies have shown that alterations in microbiota and its metabolites are associated with systemic arterial hypertension. Helicobacter pylori (H. pylori) is one of the most common bacterial pathogens, and the potential association between H. pylori infection and hypertension are controversial.

OBJECTIVE: This study aimed to clarify their association and provide a new theoretical basis for uncovering the pathogenesis of hypertension.

METHODS: Case-control and cross-sectional studies on the association between H. pylori and hypertension published from 1996 to 2019 indexed in PubMed, Google Scholar, Chinese Wan Fang Data, and Chinese National Knowledge Infrastructure (CNKI). The pooled odds ratios (OR) and 95% confidence interval (CI) were estimated. I2 was performed to evaluate the statistical heterogeneity. Publication bias was evaluated using Begg’s and Egger’s test. The extracted data was analyzed in Stata 12.0. Statistical significance was defined as p-value < 0.05.

RESULTS: A total of 17 studies involving 6,376 cases of hypertension and 10,850 controls were enrolled. H. pylori infection rate in hypertension patients and controls were 64.9% and 56.3%, respectively. A significantly positive association was shown between H. pylori infection and hypertension with an overall OR of 2.07 (95% CI: 1.46-2.94; p < 0.05). Subgroup analysis revealed that the prevalence of H. pylori infection was associated with hypertension in the region of Asia and the case-control group, ORs (95% CI) were 2.26 (1.51-3.38) and 2.53 (1.72-3.72), respectively. After stratifying by detection methods, differences still existed in subgroups (all p < 0.05).

CONCLUSION: This meta-analysis indicated that H. pylori infection is positively associated with hypertension.

PMID:34550168 | DOI:10.36660/abc.20200186

Arq Bras Cardiol. 2021 Sep 20:S0066-782X2021005015203. doi: 10.36660/abc.20200963. Online ahead of print.

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) is associated with cardiovascular clinical manifestations, including cardiac arrhythmias.

OBJECTIVE: To assess the incidence of cardiac arrhythmias (atrial tachyarrhythmia, bradyarrhythmia, and sustained ventricular tachycardia) and cardiac arrest (CA) in a cohort of patients hospitalized with COVID-19 in a tertiary university-affiliated hospital.

METHODS: Cohort study with retrospective analysis of electronic medical records. For comparison between groups, a value of p <0.05 was considered statistically significant.

RESULTS: We included 241 consecutive patients diagnosed with COVID-19 (mean age, 57.8 ± 15.0 years; 51.5% men; 80.5% white), 35.3% of whom received invasive mechanical ventilation (MV). The overall mortality was 26.6%, being 58.8% among those on MV. Cardiac arrhythmias were identified in 8.7% of the patients, the most common being atrial tachyarrhythmia (76.2%). Patients with arrhythmias had higher mortality (52.4% versus 24.1%, p = 0.005). On multivariate analysis, only the presence of heart failure (HF) was associated with a higher risk of arrhythmias (hazard ratio, 11.9; 95% CI: 3.6-39.5; p <0.001). During hospitalization, 3.3% of the patients experienced CA, with a predominance of non-shockable rhythms. All patients experiencing CA died during hospitalization.

CONCLUSIONS: The incidence of cardiac arrhythmias in patients admitted with COVID-19 to a Brazilian tertiary hospital was 8.7%, and atrial tachyarrhythmia was the most common. Presence of HF was associated with an increased risk of arrhythmias. Patients with COVID-19 experiencing CA have high mortality.

PMID:34550170 | DOI:10.36660/abc.20200963

An Acad Bras Cienc. 2021 Sep 17;93(4):e20190316. doi: 10.1590/0001-3765202120190316. eCollection 2021.

ABSTRACT

The interpretation of odds ratios (OR) as prevalence ratios (PR) in cross-sectional studies have been criticized since this equivalence is not true unless under specific circumstances. The logistic regression model is a very well known statistical tool for analysis of binary outcomes and frequently used to obtain adjusted OR. Here, we introduce the prLogistic for the R statistical computing environment which can be obtained from The Comprehensive R Archive Network, https://cran.r-project.org/package=prLogistic. The package prLogistic was built to assist the estimation of PR via logistic regression models adjusted by delta method and bootstrap for analysis of independent and correlated binary data. Two applications are presented to illustrate its use for analysis of independent observations and data from clustered studies.

PMID:34550162 | DOI:10.1590/0001-3765202120190316

An Acad Bras Cienc. 2021 Sep 17;93(4):e20190586. doi: 10.1590/0001-3765202120190586. eCollection 2021.

ABSTRACT

In this paper, a new three-parameter lifetime model called the Topp-Leone odd log-logistic exponential distribution is proposed. Its density function can be expressed as a linear mixture of exponentiated exponential densities and can be reversed-J shaped, skewed to the left and to the right. Further, the hazard rate function of the new model can be monotone, unimodal, constant, J-shaped, constant-increasing-decreasing and decreasing-increasing-decreasing and bathtub-shaped. Our main focus is on estimation from a frequentist point of view, yet, some statistical and reliability characteristics for the proposed model are derived. We briefly describe different estimators namely, the maximum likelihood estimators, ordinary least-squares estimators, weighted least-squares estimators, percentile estimators, maximum product of spacings estimators, Cramér-von-Mises minimum distance estimators, Anderson-Darling estimators and right-tail Anderson-Darling estimators. Monte Carlo simulations are performed to compare the performance of the proposed methods of estimation for both small and large samples. We illustrate the performance of the proposed distribution by means of two real data sets and both the data sets show the new distribution is more appropriate as compared to some other well-known distributions.

PMID:34550163 | DOI:10.1590/0001-3765202120190586

Soft Matter. 2021 Sep 22;17(36):8343-8353. doi: 10.1039/d1sm00891a.

ABSTRACT

Dissipative Particle Dynamics (DPD) is a powerful mesoscopic modelling technique that is routinely used to predict complex fluid morphology and structural properties. While its ability to quickly scan the conformational space is well known, it is unclear if DPD can correctly calculate the viscosity of complex fluids. In this work, we estimate the viscosity of several unentangled polymer solutions using both the Einstein and Green-Kubo formulas. For this purpose, an Einstein relation is derived analogous to the revised Green-Kubo formula suggested by Jung and Schmid, J. Chem. Phys., 2016, 144, 204104. We show that the DPD simulations reproduce the dynamical behaviour predicted by the theory irrespectively of the values of the conservative and friction parameters used and estimate a Schmidt number compatible to that of a fluid system. Moreover, we observe that the Einstein method requires shorter trajectories to achieve the same statistical accuracy as the Green-Kubo formula. This work shows that DPD can confidently be used to calculate the viscosity of complex fluids and that the statistical accuracy of short trajectories can be improved by using our revised Einstein formula.

PMID:34550156 | DOI:10.1039/d1sm00891a

Eur Urol Focus. 2021 Sep 18:S2405-4569(21)00235-2. doi: 10.1016/j.euf.2021.09.006. Online ahead of print.

ABSTRACT

BACKGROUND: Artificial urinary sphincter (AUS) is the gold standard for the management of moderate to severe stress urinary incontinence (SUI) in the male population. While outcomes of this device in postprostatectomy incontinence (PPI) are widely described, those obtained for incontinence after benign prostatic obstruction (BPO) surgery remains poorly explored.

OBJECTIVE: To compare continence outcomes after AUS implantation in a PPI population with those obtained in men incontinent after BPO surgery.

DESIGN, SETTING, AND PARTICIPANTS: A retrospective review of all cases of AUS implantation between 2005 and 2020 in 16 different French centers was conducted. Only patients with primary implantation whose indication was moderate to severe SUI after prostatectomy or BPO surgery were included (excluding those with a history of radiation therapy, brachytherapy, cystectomy, high-intensity focused ultrasound therapy, or neurogenic disease).

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoint was the rate of social continence (zero or one pad per day) at 3 mo. Complications were also noted within 90 d of implantation.

RESULTS AND LIMITATIONS: A total of 417 patients were included in the PPI group and 50 in the BPO surgery group. Social continence rates at 3 mo were similar between the groups (79% vs 72%, p = 0.701). Complication rate was significantly higher in the BPO group (8% vs 18%, p = 0.044). The same was found for the Clavien-Dindo type 2 complication rate (20.6% vs 44.4%, p = 0.026). The retrospective nature and lack of precise definition of incontinence are the main limitations of this study.

CONCLUSIONS: This multicentric study strengthens the position of AUS as gold standard for SUI after radical prostatectomy. Comparable efficacy results were found for incontinence after BPO surgery, with nevertheless a higher rate of complications.

PATIENT SUMMARY: Artificial urinary sphincter represents the gold standard for the treatment of moderate to severe stress urinary incontinence. Efficacy results are comparable between postprostatectomy incontinence and incontinence after benign prostatic obstruction surgery.

PMID:34548254 | DOI:10.1016/j.euf.2021.09.006

J Emerg Med. 2021 Sep 18:S0736-4679(21)00640-5. doi: 10.1016/j.jemermed.2021.07.058. Online ahead of print.

ABSTRACT

BACKGROUND: Prediction of early outcomes of nontraumatic out-of-hospital cardiac arrest (OHCA) by emergency physicians is inaccurate.

OBJECTIVE: Our aim was to develop and validate practical machine learning (ML)-based models to predict early outcomes of nontraumatic OHCA for use in the emergency department (ED). We compared their discrimination and calibration performances with the traditional logistic regression (LR) approach.

METHODS: Between October 1, 2017 and March 31, 2020, prehospital resuscitation was performed on 17,166 OHCA patients. There were 8157 patients 18 years or older with nontraumatic OHCA who received continued resuscitation in the ED included for analysis. Eleven demographic and resuscitation predictor variables were extracted to predict survived events, defined as any sustained return of spontaneous circulation until in-hospital transfer of care. Prediction models based on random forest (RF), multilayer perceptron (MLP), and LR were created with hyperparameter optimization. Model performances on internal and external validation were compared using discrimination and calibration statistics.

RESULTS: The three models showed similar discrimination performances with c-statistics values of 0.712 (95% confidence interval [CI] 0.711-0.713) for LR, 0.714 (95% CI 0.712-0.717) for RF, and 0.712 (95% CI 0.710-0.713) for MLP models on external validation. For calibration, MLP model had a better performance (slope of calibration regression line = 1.10, intercept = -0.09) than LR (slope = 1.17, intercept = -0.11) and RF (slope = 1.16, intercept= -0.10).

CONCLUSIONS: Two practical ML-based and one regression-based clinical prediction models of nontraumatic OHCA for survived events were developed and validated. The ML-based models did not outperform LR in discrimination, but the MLP model showed a better calibration performance.

PMID:34548227 | DOI:10.1016/j.jemermed.2021.07.058

J Craniomaxillofac Surg. 2021 Sep 9:S1010-5182(21)00199-2. doi: 10.1016/j.jcms.2021.09.003. Online ahead of print.

ABSTRACT

The objective of this study was to assess the efficacy of tissue engineered (TE) constructs compared to the standard autogenous anterior iliac crest (AIC) bone graft in secondary maxillary alveolar cleft reconstruction. This clinical trial was registered on (clinical trials.gov); the trial registry number is: NCT03563495. Patients with unilateral alveolar clefts were allocated on the basis of simple randomization. Selected patients were randomly divided into two equal groups: the AIC group (control) received autogenous particulate bone graft from anterior iliac crest, whereas the TE group received tissue engineered construct. Assessment included the newly formed bone volume and density at the grafted cleft sites, which were measured immediately, 6 and 12 months postoperatively on axial computed tomograms. The study population included 10 patients; each group comprised 5 patients. There was no statistically significant difference between the 2 groups regarding the mean volume of the newly formed bone (p = 0.91 at 6 months, p = 0.994 at 1 year) and the mean density of the newly formed bone (p = 0.364 at 6 months, p = 0.073 at 1 year). However, there was a significant increase of TE graft density from 6 months to 1 year (p = 0.048). Within the limitations of the study it seems that the tissue engineered construct (collagen/osteogenically differentiated bone marrow-derived mesenchymal stem cells) might be an alternative to autogenous bone for unilateral secondary alveolar cleftgrafting.

PMID:34548195 | DOI:10.1016/j.jcms.2021.09.003