Category: Statistics

PLoS One. 2022 Apr 6;17(4):e0266612. doi: 10.1371/journal.pone.0266612. eCollection 2022.

ABSTRACT

INTRODUCTION: University students’ psychological health is linked to their academic satisfaction. This study aimed to investigate students’ psychological health and academic satisfaction in the context of COVID-19 and academic year-end stress.

MATERIALS AND METHODS: Standardized self-filled scales for anxiety, depression, stress, psychological well-being, academic satisfaction (subjective assessment of students’ quality of life in their educational setting), and an ad-hoc scale for stress on the learning experience due to COVID-19 were used in this cross-sectional study. Participants were first- to third-year students of eight different health-related tracks in Geneva, Switzerland. Descriptive statistics and hierarchical regression analyses were applied.

RESULTS: In June 2020, out of 2835 invited students, 433 (15%) completed the survey. Academic satisfaction was a stronger mental health predictor than COVID-19 stress on the learning experience, which mainly predicted stress and anxiety. Lower academic satisfaction scores were significantly associated with stress (β = -0.53, p < 0.001), depression (β = -0.26, p < 0.001), anxiety (β = -0.20, p < 0.001), while higher scores with psychological well-being (β = 0.48, p < 0.001). Identifying as female was strongly associated with anxiety and stress but not with depression or psychological well-being. Lower age was associated with stress only. The nature of the academic training had a lesser impact on mental health and the academic year had no impact.

CONCLUSIONS: Academic satisfaction plays a more substantial role than COVID-19 stress on the learning experience in predicting students’ overall mental health status. Training institutions should address the underlying factors that can enhance students’ academic satisfaction, especially during the COVID-19 period, in addition to ensuring that they have a continuous and adequate learning experience, as well as access to psychosocial services that help them cope with mental distress and enhance their psychological well-being.

PMID:35385555 | DOI:10.1371/journal.pone.0266612

PLoS One. 2022 Apr 6;17(4):e0266541. doi: 10.1371/journal.pone.0266541. eCollection 2022.

ABSTRACT

Thermal remote sensing is an important tool for monitoring regional climate and environment, including urban heat islands. However, it suffers from a relatively lower spatial resolution compared to optical remote sensing. To improve the spatial resolution, various “data-driven” image processing techniques (pan-sharpening, kernel-driven methods, and machine learning) have been developed in the previous decades. Such empirical super-resolution methods create visually appealing thermal images; however, they may sacrifice radiometric consistency because they are not necessarily sensitive to specific sensor features. In this paper, we evaluated a “sensor-driven” super-resolution approach that explicitly considers the sensor blurring process, to ensure radiometric consistency with the original thermal image during high-resolution thermal image retrieval. The sensor-driven algorithm was applied to a cloud-free Moderate Resolution Imaging Spectroradiometer (MODIS) scene of heterogeneous urban and suburban landscape that included built-up areas, low mountains with a forest, a lake, croplands, and river channels. Validation against the reference high-resolution thermal image obtained by the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) shows that the sensor-driven algorithm can downscale the MODIS image to 250-m resolution, while maintaining a high statistical consistency with the original MODIS and ASTER images. Part of our algorithm, such as radiometric offset correction based on the Mahalanobis distance, may be integrated with other existing approaches in the future.

PMID:35385560 | DOI:10.1371/journal.pone.0266541

PLoS One. 2022 Apr 6;17(4):e0265754. doi: 10.1371/journal.pone.0265754. eCollection 2022.

ABSTRACT

Sex determination of the human pelvis has traditionally been done through visual analyses of morphoscopic traits and there are limited metric methods available to forensic anthropologists to add metric credibility to these analyses. The goal of this research was to create an improved metric method using three-dimensional geometric morphometrics to determine sex from both whole and modeled fragmented human pubic bones. The sample consisted of n = 378 pubic bones from the University of New Mexico’s Maxwell Museum Documented Skeletal Collection and eight landmarks were collected from each bone. Statistical analyses and machine learning algorithms were used to predict the accuracy of the method’s ability to classify a bone as male or female on both whole and simulated fragmented remains; this included tests run on each possible landmark combination of three or more landmarks to simulate fragmented bones (218 combinations). The results of the whole bone analysis resulted in 95.35% testing accuracy. The results of the modeled fragmentary analysis consisted of 164 combinations which exhibit a 90% or higher accuracy in sex prediction; and twelve combinations which exhibit 96% or higher accuracy in sex prediction. In particular, two landmarks clustered around the ventral arc of the pubic bone performed the best, indicating this is the most sexually dimorphic portion of the bone. These results indicate that three-dimensional geometric morphometrics is a valid method to be applied to sex determination in forensic anthropology.

PMID:35385554 | DOI:10.1371/journal.pone.0265754

PLoS One. 2022 Apr 6;17(4):e0265549. doi: 10.1371/journal.pone.0265549. eCollection 2022.

ABSTRACT

The Covid-19 global pandemic that began in March 2020 was not fully mitigated through governmental Non-Pharmaceutical Interventions (NPIs) and continued to infect people and take lives through 2021. Since many countries were affected by the second, third, and fourth waves of Covid-19, governments extended and strengthened NPIs, but these actions led to citizen protests and fatigue. In this study, we investigate the effect of a lockdown policy on Covid-19 third wave implemented by the province of Ontario, Canada, on April 3rd 2021, followed by a stay-at-home order on April 7th 2021 while free Covid-19 testing and vaccination were in progress. Herein, the effect of both NPIs and vaccination are considered simultaneously. We used the prevalence of Covid-19 cases, tests, and administered vaccines data reported publicly by the Government of Ontario on their website. Because mobility changes can reflect the behaviors and adherence of residents with a stay-at-home order, Covid-19 community mobility data for Ontario provided by Google was also considered. A statistical method called interrupted time series was used to analyze the data. The results indicated that, although vaccinations helped to control the Covid-19 infection rate during this time, the stay-at-home order caused a rate reduction by decreasing the trend of the Covid-19 prevalence by 13 (±0.8962) persons per million daily and the level by 33 (±7.6854) persons per million. Furthermore, the stay-at-home order resulted in approximately a 37% reduction in Covid-19 prevalence one week after the intervention’s effective date. Therefore, Ontario’s strict lockdown policy, including several NPIs, mitigated the Covid-19 surge during the third wave. The results show that even when vaccination is in progress, strict NPIs such as lockdown is required to control Covid-19 waves, and early re-openings should be avoided. These results may also be useful for other countries that have implemented delayed vaccination schedules.

PMID:35385547 | DOI:10.1371/journal.pone.0265549

PLoS One. 2022 Apr 6;17(4):e0266607. doi: 10.1371/journal.pone.0266607. eCollection 2022.

ABSTRACT

OBJECTIVE: This study aimed to compare the peripapillary retinal nerve fiber layer (pRNFL) thickness and macular thickness (MT) between patients with non-diabetic chronic kidney disease (NDCKD) and controls, as well as between different stages of NDCKD. We also evaluated the correlation between pRNFL thickness and MT with duration of NDCKD.

METHODS: This was a comparative cross-sectional study. Subjects were divided into NDCKD and control groups. Both pRNFL thickness and MT, including center subfield thickness (CST), average MT as well as average ganglion cell-inner plexiform layer (GC-IPL) were measured using spectral-domain optical coherence tomography. One-way ANCOVA test was used to compare the differences in pRNFL and MT between NDCKD and controls, as well as between the different stages of NDCKD. Spearman rank-order correlation coefficients were employed to determine the effects of NDCKD duration on pRNFL thickness and MT.

RESULTS: A total of 132 subjects were recruited, 66 with NDCKD and 66 controls. There was a statistically significant difference in superior (110.74 ± 23.35 vs 117.36 ± 16.17 μm, p = 0.022), nasal (65.97 ± 12.90 vs 69.35 ± 10.17 μm, p = 0.006), inferior quadrant (117.44 ± 23.98 vs 126.15 ± 14.75 μm, p = 0.006), average pRNFL (90.36 ± 14.93 vs 95.42 ± 9.87 μm, p = 0.005), CST (231.89 ± 26.72 vs 243.30 ± 21.05 μm, p = 0.006), average MT (268.88 ± 20.21 vs 274.92 ± 12.79 μm, p = 0.020) and average GC-IPL (75.48 ± 12.44 vs 81.56 ± 6.48, p = 0.001) values between the NDCKD group and controls. The superior quadrant (p = 0.007), nasal quadrant (p = 0.030), inferior quadrant (p = 0.047), average pRNFL (p = 0.006), average MT (p = 0.001) and average GC-IPL (p = 0.001) differed significantly between different stages of NDCKD. There was no correlation between pRNFL thickness and MT with duration of NDCKD.

CONCLUSION: CST, average MT, average GC-IPL thickness, average pRNFL and all quadrants of pRNFL except the temporal quadrant were significantly thinner in NDCKD patients compared to controls. These changes were associated with the severity of CKD, but not its duration.

PMID:35385541 | DOI:10.1371/journal.pone.0266607

PLoS One. 2022 Apr 6;17(4):e0265951. doi: 10.1371/journal.pone.0265951. eCollection 2022.

ABSTRACT

BACKGROUND: Estimating the clinical demand for blood and components arising in a health facility is crucial to ensure timely availability of blood. This study aims to estimate disease-specific clinical demand, supply and utilization of whole blood and components in India.

METHODS: We conducted a national level cross-sectional study in five randomly selected states from five regions of the country. We included 251 public and private facilities representing primary, secondary and tertiary care facilities. We collected annual disease-specific demand, supply and utilization of blood and components using a structured tool. We estimated the national demand by extrapolating the study data (demand and beds) to the total number of estimated beds in the country.

FINDINGS: According to the study, the total clinical demand of 251 health facilities with 51,562 beds was 474,627 whole blood units. Based on this, the clinical demand for India was estimated at 14·6 million whole blood units (95 CI: 14·59-14·62), an equivalent of 36·3 donations per 1,000 eligible populations, which will address whole blood and component requirement. The medicine specialty accounted for 6·0 million units (41·2%), followed by surgery 4·1 million (27·9%), obstetrics and gynecology 3·3 million (22·4%) and pediatrics 1·2 million (8·5%) units. The supply was 93% which is equivalent to 33·8 donations against the demand.

CONCLUSION: The study indicated a demand and supply gap of 2.5 donations per 1,000 eligible persons which is around one million units. The gap emphasises the need for sustained and concerted efforts from all stakeholders and for increasing the awareness about repeat voluntary non-remunerated blood donation (VNRBD); optimizing the availability of blood components through efficient blood component separation units; promoting modern principles of patient blood management and strengthening capacities of human resources in the blood transfusion system in India.

PMID:35385543 | DOI:10.1371/journal.pone.0265951

PLoS One. 2022 Apr 6;17(4):e0266505. doi: 10.1371/journal.pone.0266505. eCollection 2022.

ABSTRACT

BACKGROUND: There is limited knowledge about the risk of non-alcoholic fatty liver disease (NAFLD) associated with cardiometabolic disorders in lean persons. This study examines the contribution of cardiometabolic disorders to NAFLD risk among lean individuals and compares to non-lean individuals.

METHODS: We analyzed longitudinal data from 6,513 participants of a yearly voluntary routine health testing conducted at the Hospital Israelita Albert Einstein, Brazil. NAFLD was defined as hepatic ultrasound diagnosed fatty liver in individuals scoring below 8 on the alcohol use disorders identification test. Our main exposure variables were elevated blood glucose, elevated blood pressure (BP), presence of atherogenic dyslipidemia (AD, defined as the combination of elevated triglycerides and low HDL cholesterol) and physical inactivity (<150 minutes/week of moderate activity). We further assessed the risk of NAFLD with elevations in waist circumference and high sensitivity C-reactive protein (HsCRP).

RESULTS: Over 15,580 person-years (PY) of follow-up, the incidence rate of NAFLD was 7.7 per 100 PY. In multivariate analysis adjusting for likely confounders, AD was associated with a 72% greater risk of NAFLD (IRR: 1.72 [95% CI:1.32-2.23]). Elevated blood glucose (IRR: 1.71 [95%CI: 1.29-2.28]) and physical inactivity (IRR: 1.46 [95%CI: 1.28-1.66]) were also independently associated with increased risk of NAFLD. In lean individuals, AD, elevated blood glucose and elevated BP were significantly associated with NAFLD although for elevated blood glucose, statistical significance was lost after adjusting for possible confounders. Physical inactivity and elevations in HsCRP were not associated with the risk of NAFLD in lean individuals only. Among lean (and non-lean) individuals, there was an independent association between progressively increasing waist circumference and NAFLD.

CONCLUSION: Cardiometabolic risk factors are independently associated with NAFLD. However, there are significant differences in the metabolic risk predictors of NAFLD between lean and non-lean individuals. Personalized cardiovascular disease risk stratification and appropriate preventive measures should be considered in both lean and non-lean individuals to prevent the development of NAFLD.

PMID:35385529 | DOI:10.1371/journal.pone.0266505

PLoS One. 2022 Apr 6;17(4):e0266479. doi: 10.1371/journal.pone.0266479. eCollection 2022.

ABSTRACT

INTRODUCTION: Worldwide, the estimated prevalence of urinary incontinence is 8.7%. Urinary incontinence is more frequent in women than in men. Posing the right questions is crucial, when diagnosing urinary incontinence, but also to evaluate the need of treatment and treatment effect. Therefore, reliable and validated questionnaires within this area are needed. Even though the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) has been used on a daily basis in the Danish Urogynaecological Database since 2006, it has not yet been validated in a Danish population of both men and women.

OBJECTIVE: To test the reliability and validity of the Danish version of the ICIQ-UI SF in a Danish speaking population of men and women among municipal employees.

METHODS: Content validity was evaluated with semi-structured interviews. A quantitative field test was performed, in which the questionnaire was distributed electronically to municipal workers by E-mail. Statistical methods included item characteristics (missings, kurtosis and skewness), internal consistency (Chronbach’s alfa), test-retest (ICC), construct validity (known group validation), and floor and ceiling effect.

RESULTS: A number of 1814 Danish municipal workers completed the questionnaire. Of the total number of responders, 426 were invited to complete the questionnaire twice (for test-retest) and 215 (50.5%) of these completed the questions again two weeks later. Statistical analyses of the ICIQ-UI SF demonstrated no floor and ceiling effects, skewness was zero and kurtosis 0.00-0.49. Cronbach’s alfa was 0.87 and intraclass correlation coefficient 0.73. Two out of three hypotheses were accepted in the known-groups validation.

CONCLUSION: This study offers an adaptation of the ICIQ-UI SF to a Danish setting. The Danish ICIQ-UI SF demonstrated acceptable reliability and validity. However, clinicians should consider the relatively high measurement error.

PMID:35385519 | DOI:10.1371/journal.pone.0266479

PLoS One. 2022 Apr 6;17(4):e0265497. doi: 10.1371/journal.pone.0265497. eCollection 2022.

ABSTRACT

BACKGROUND: Blood pressure (BP) elevations are commonly treated in hospitalized patients; however, treatment is not guideline directed. Our objective was to assess BP response to commonly prescribed antihypertensives after the development of severe inpatient hypertension (HTN).

METHODS: This is a cohort study of adults, excluding intensive care unit patients, within a single healthcare system admitted for reasons other than HTN who developed severe HTN (systolic BP>180 or diastolic BP >110 mmHg at least 1 hour after admission). We identified the most commonly administered antihypertensives given within 6 hours of severe HTN (given to >10% of treated patients). We studied the association of treatment with each antihypertensive vs. no treatment on BP change in the 6 hours following severe HTN development using mixed-effects model after adjusting for demographics and clinical characteristics.

RESULTS: Among 23,147 patients who developed severe HTN, 9,166 received antihypertensive treatment. The most common antihypertensives given were oral metoprolol (n = 1991), oral amlodipine (n = 1812), oral carvedilol (n = 1116), IV hydralazine (n = 1069) and oral hydralazine (n = 953). In the fully adjusted model, treatment with IV hydralazine led to 13 [-15.9, -10.1], 18 [-22.2, -14] and 11 [-14.1, -8.3] mmHg lower MAP, SBP, and DBP in the 6 hours following severe HTN development compared to no treatment. Treatment with oral hydralazine and oral carvedilol also resulted in significantly lower BPs in the 6 hours following severe HTN development (6 [-9.1, -2.1 and -7 [-9.1, -4.2] lower MAP, respectively) compared to no treatment. Receiving metoprolol and amlodipine did not result in a drop in BP compared to no treatment.

CONCLUSION: Among commonly used antihypertensives, IV hydralazine resulted in the most significant drop in BP following severe HTN, while metoprolol and amlodipine did not lower BP. Further research to assess the effect of treatment on clinical outcomes and if needed which antihypertensives to administer are necessary.

PMID:35385506 | DOI:10.1371/journal.pone.0265497

PLoS One. 2022 Apr 6;17(4):e0265153. doi: 10.1371/journal.pone.0265153. eCollection 2022.

ABSTRACT

BACKGROUND AND AIMS: Stigmatization is a well-documented problem of some diseases. Perceived stigma is common in alcohol-related liver disease and hepatitis C, but little information exists on stigma in patients with non-alcoholic fatty liver disease (NAFLD). Aim of the study was to investigate frequency and characteristics of perceived stigma among patients with NAFLD.

METHODS: One-hundred and ninety-seven patients seen at the liver clinic were included: a study group of 144 patients with NAFLD, 50 with cirrhosis (34 compensated, 16 decompensated), and a control group of 53 patients with alcohol-related cirrhosis. Demographic, clinical, and laboratory data were collected. Quality-of-life was assessed by chronic liver disease questionnaire (CLDQ). Perceived stigma was assessed using a specific questionnaire for patients with liver diseases categorized in 4 domains: stereotypes, discrimination, shame, and social isolation.

RESULTS: Perceived stigma was common in patients with NAFLD (99 patients, 69%) and affected all 4 domains assessed. The frequency was slightly higher, yet not significant, in patients with NAFLD cirrhosis vs those without (72% vs 67%, respectively; p = 0.576). In patients without cirrhosis perceived stigma was unrelated to stage of disease, since frequency was similar in patients with no or mild fibrosis compared to those with moderate/severe fibrosis (66% vs 68%, respectively). There were no differences in perceived stigma between patients with compensated cirrhosis and these with decompensated cirrhosis. Among patients with cirrhosis, stigmatization was more common in alcohol-related vs NAFLD-cirrhosis, yet differences were only significant in two domains. In patients with NAFLD, perceived stigma correlated with poor quality-of-life, but not with demographic or clinical variables.

CONCLUSIONS: Perceived stigmatization is common among patients with NAFLD independently of disease stage, is associated with impaired quality-of-life, and may be responsible for stereotypes, discrimination, shame, and social isolation, which may affect human and social rights of affected patients.

PMID:35385510 | DOI:10.1371/journal.pone.0265153