Category: Statistics

PLoS One. 2022 Apr 6;17(4):e0265673. doi: 10.1371/journal.pone.0265673. eCollection 2022.

ABSTRACT

PURPOSE: Research on the novel coronavirus diseases 2019 (COVID-19) mainly relies on cross-sectional data, but this approach fails to consider the temporal dimension of the pandemic. This study assesses three temporal dimensions of the COVID-19 infection risk in US counties, namely probability of occurrence, duration of the pandemic, and intensity of transmission, and investigate local patterns of the factors associated with these risks.

METHODS: Analyzing daily data between January 22 and September 11, 2020, we categorize the contiguous US counties into four risk groups-High-Risk, Moderate-Risk, Mild-Risk, and Low-Risk-and then apply both conventional (i.e., non-spatial) and geographically weighted (i.e., spatial) ordinal logistic regression model to understand the county-level factors raising the COVID-19 infection risk. The comparisons of various model fit diagnostics indicate that the spatial models better capture the associations between COVID-19 risk and other factors.

RESULTS: The key findings include (1) High- and Moderate-Risk counties are clustered in the Black Belt, the coastal areas, and Great Lakes regions. (2) Fragile labor markets (e.g., high percentages of unemployed and essential workers) and high housing inequality are associated with higher risks. (3) The Monte Carlo tests suggest that the associations between covariates and COVID-19 risk are spatially non-stationary. For example, counties in the northeastern region and Mississippi Valley experience a stronger impact of essential workers on COVID-19 risk than those in other regions, whereas the association between income ratio and COVID-19 risk is stronger in Texas and Louisiana.

CONCLUSIONS: The COVID-19 infection risk levels differ greatly across the US and their associations with structural inequality and sociodemographic composition are spatially non-stationary, suggesting that the same stimulus may not lead to the same change in COVID-19 risk. Potential interventions to lower COVID-19 risk should adopt a place-based perspective.

PMID:35385491 | DOI:10.1371/journal.pone.0265673

Pediatr Phys Ther. 2022 Apr 1;34(2):212-219. doi: 10.1097/PEP.0000000000000881.

ABSTRACT

PURPOSE: This pilot study assesses the feasibility of using PedBotHome to promote adherence to a home exercise program, the ability of the device to withstand frequent use, and changes in participant ankle mobility.PedBotHome is a robotic ankle device with integrated video game software designed to improve ankle mobility in children with cerebral palsy.

METHODS: Eight participants enrolled in a 28-day trial of PedBotHome. Ankle strength, range of motion, and plantar flexor spasticity were measured pre- and posttrial. Performance was monitored remotely, and game settings were modified weekly by physical therapists.

RESULTS: Four participants met the study goal of 20 days of use. There were statistically significant improvements in ankle strength, spasticity, and range of motion.

CONCLUSIONS: PedBotHome is a feasible device to engage children with static neurological injuries in ankle home exercise. This pilot study expands the paradigm for future innovative home-based robotic rehabilitation.

PMID:35385456 | DOI:10.1097/PEP.0000000000000881

PLoS One. 2022 Apr 6;17(4):e0265506. doi: 10.1371/journal.pone.0265506. eCollection 2022.

ABSTRACT

Review, promotion, and tenure (RPT) processes at universities typically assess candidates along three dimensions: research, teaching, and service. In recent years, some have argued for the inclusion of a controversial fourth criterion: collegiality. While collegiality plays a role in the morale and effectiveness of academic departments, it is amorphic and difficult to assess, and could be misused to stifle dissent or enforce homogeneity. Despite this, some institutions have opted to include this additional element in their RPT documents and processes, but it is unknown the extent of this practice and how it varies across institution type and disciplinary units. This study is based on two sets of data: survey data collected as part of a project that explored the publishing decisions of faculty and how these related to perceived importance in RPT processes, and 864 RPT documents collected from 129 universities from the United States and Canada. We analysed these RPT documents to determine the degree to which collegiality and related terms are mentioned, if they are defined, and if and how they may be assessed during the RPT process. Results show that when collegiality and related terms appear in these documents they are most often just briefly mentioned. It is less common for collegiality and related terms to be defined or assessed in RPT documents. Although the terms are mentioned across all types of institutions, there is a statistically significant difference in how prevalent they are at each. Collegiality is more commonly mentioned in the documents of doctoral research-focused universities (60%), than of master’s universities and colleges (31%) or baccalaureate colleges (15%). Results from the accompanying survey of faculty also support this finding: individuals from R-Types were more likely to perceive collegiality to be a factor in their RPT processes. We conclude that collegiality likely plays an important role in RPT processes, whether it is explicitly acknowledged in policies and guidelines or not, and point to several strategies in how it might be best incorporated in the assessment of academic careers.

PMID:35385489 | DOI:10.1371/journal.pone.0265506

J Clin Lab Anal. 2022 Apr 6:e24403. doi: 10.1002/jcla.24403. Online ahead of print.

ABSTRACT

INTRODUCTION: The intensification of coronavirus disease 2019 (COVID-19) complications, severe symptoms, and high mortality rate has led researchers to focus on this significant issue. While respiratory and cardiac complications have been described as high-risk manifestations in patients with COVID-19, neurological complications can also enhance mortality. This study aimed to evaluate the prevalence of neurological complications arises from SARS-CoV-2 and assess the mortality rate from neurological complications.

MATERIAL AND METHODS: Literature review was conducted by searching in PubMed/Medline, Web of Sciences, and Embase. After performing search strategies with relevant terms, a number of articles were excluded, including review articles, systematic review or meta-analysis, duplicate publication of same researchers, congress abstracts, animal studies, case reports, case series, and articles reporting a history of neurological features prior to COVID-19 infection. After retrieving the data, statistical analysis was performed using the STATA Version 14 software.

RESULTS: From 4455 retrieved publications, 20 articles were selected for further analysis. Among 18,258 included patients, 2791 showed neurological symptoms, which were classified into different groups. Headache, confusion, and fatigue were reported as the most non-specific neurological features in confirmed COVID-19 patients. Psychiatric symptoms, CNS disorders, cerebrovascular disorders, CNS inflammatory disorders, PNS disorders, neuromuscular disorders, etc., were defined as specific neurological manifestations. The pooled prevalence of neurological manifestations and mortality rate of COVID-19 patients with neurological features were estimated to be 23.0% (95% CI: 17.8-29.2) and 29.1% (95% CI: 20.3-39.8), respectively.

CONCLUSION: Neurological manifestations may commonly happen in patients with COVID-19. This study reported a high prevalence of neurological complications and mortality rates in COVID-19 patients. Therefore, patients with COVID-19 who indicated neurological symptoms should be taken seriously and should receive early treatment to prevent undesirable events.

PMID:35385200 | DOI:10.1002/jcla.24403

J Eval Clin Pract. 2022 Apr 6. doi: 10.1111/jep.13685. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: Clinical guidelines produced by cardiology societies (henceforth referred to simply as ‘clinical guidelines’) recommend thromboprophylaxis with oral anticoagulants (OACs) in patients with atrial fibrillation (AF) who have moderate-to-high stroke risk. However, deviations from these recommendations are observed, especially in the primary healthcare setting. The primary aims of this study were to evaluate the self-reported use of AF clinical guidelines and risk stratification tools among Australian general practitioners (GPs), and their perceptions regarding the available resources.

METHOD: We conducted an online survey of Australian GPs. Descriptive statistics were used to summarise the findings.

RESULTS: Responses from 115 GPs were included for analysis. Respondents reported various ways of accessing thromboprophylaxis-related information (n = 113), including clinical guidelines (13.3%), ‘Therapeutic Guidelines^© ‘ (37.2%) and Royal Australian College of General Practitioners websites (16.8%). Of those who reported reasons against accessing information from clinical guidelines (n = 97), the most frequent issues were: too many AF guidelines to choose from (34.0%; 33/97), different guidelines for different diseases (32.0%; 31/97), time-consuming to read guidelines (21.6%; 21/97), disagreements between different guideline recommendations (20.0%; 19/97), conflict with criteria for government subsidy (17.5%; 17/97) and GPs’ busy schedules (15.5%; 15/97). When assessing patients’ risk of stroke (n = 112) and bleeding (n = 111), the majority of the respondents reported primarily relying on a formal stroke risk (67.0%) and bleeding risk (55.0%) assessment tools, respectively. Respondents reported using formal stroke and bleeding risk assessment tools mainly when newly initiating patients on therapy (72.4%; 76/105 and 65.3%; 65/101, respectively).

CONCLUSION: Among our small sample of Australian GPs, most did not access thromboprophylaxis-related information directly from AF-specific clinical guidelines developed by cardiology societies. Although the majority reported using formal stroke and bleeding assessment tools, these were typically used on OAC initiation only. More focus is needed on formal risk reassessment as clinically indicated and at regular review.

PMID:35385183 | DOI:10.1111/jep.13685

J Obstet Gynaecol Res. 2022 Apr 6. doi: 10.1111/jog.15247. Online ahead of print.

ABSTRACT

INTRODUCTION: To assess the rate of disease control and survival after adjuvant treatment in patients with uterine papillary serous (PSC) and clear cell carcinoma (CCC) and compare the results between these two subtypes.

METHODS: The medical charts of 199 patients with de novo uterine PSC or CCC who underwent radiotherapy (RT) following surgery between 2001 and 2019 in three radiation oncology departments were retrospectively evaluated. Adjuvant treatment was decided by a multidisciplinary tumor board. All patients were planned to undergo adjuvant 4-6 cycles of chemotherapy with external beam RT (EBRT) and/or vaginal brachytherapy (VBT).

RESULTS: Median age was 63 years for all, 64 years for PSC, and 59 years for CCC, respectively. Complete surgical staging was applied in 98% of patients. Histopathologic subtype was PSC in 142 (71%) and pure CCC in 57 (29%) patients, respectively. FIGO stage was I in 107 (54%), II in 35 (18%), and III in 57 (28%) patients, respectively. Lympho-vascular space invasion and positive peritoneal cytology (PPC) were present in 42% and 10% of patients, respectively. All patients but 23 (12%) underwent adjuvant chemotherapy. Median follow-up was 49.5 months for all patients, 43.9 months for patients with PSC, and 90.4 months for patients with CCC, respectively. During follow-up, 20 (10%) patients developed pelvic recurrence (PR) and 37 (19%) developed distant metastasis (DM). PSC subtype increased the PR and DM rates, although the latter not statistically significant. The 5-year overall survival and disease-free survival rate was 73% and 69% for all patients, 71% and 66% for patients with PSC, and 77% and 75% for patients with CCC, respectively. The difference was more prominent in patients with stage ≥ IB disease. In multivariate analysis, advanced age and PPC significantly decreased all survival rates.

CONCLUSION: PSC has a worse prognosis than CCC with regard to pelvic and distant recurrence with a trend for decreased survival rates. Therefore, a more aggressive therapy is needed for patients with uterine PSC, particularly in patients with stage ≥ IB disease.

PMID:35385171 | DOI:10.1111/jog.15247

Cytopathology. 2022 Apr 6. doi: 10.1111/cyt.13124. Online ahead of print.

ABSTRACT

CONTEXT: The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) is a standardized six tier-reporting format aimed at ensuring better communication and improved patient management.

AIMS: The main objectives of our study were to classify salivary gland fine needle aspirates into 6 categories of the MSRSGC and assess Risk of malignancy (ROM), specificity, sensitivity, Positive Predictive Value and Negative Predictive Value.

SETTINGS AND DESIGN: It was a retrospective study done over a period of three years from January 2017 to December 2020.

MATERIALS AND METHODS: All salivary gland FNAs performed in the above period were retrieved and classified into six categories based on the Milan system. Histopathological diagnosis was also retrieved wherever available.

STATISTICAL ANALYSIS: Using histopathological diagnosis as gold standard, ROM was calculated. Specificity, sensitivity, PPV, NPV and diagnostic accuracy were also assessed.

RESULTS: Out of the 202 salivary gland FNAs, histopathological diagnosis was available in 102 cases. ROM for Non Diagnostic, Non Neoplastic, Atypia of Undetermined Significance (AUS), Benign, Salivary Gland Neoplasm of Uncertain Malignant Potential (SUMP), Suspicious for Malignancy (SM) and Malignant categories was 30%, 8.3%, 25%, 3.9%, 33.3%, 71.4% and 93.3% respectively. Highest specificity and diagnostic accuracy were achieved when only malignant and SM were considered as positive results. Maximum sensitivity was observed when AUS, SUMP, SM and malignant were included in positive test results.

CONCLUSION: The MSRSGC is an excellent system for accurately classifying salivary gland FNAs with better reproducibility of reports and enhanced communication between pathologist and surgeon.

PMID:35385174 | DOI:10.1111/cyt.13124

Muscle Nerve. 2022 Apr 6. doi: 10.1002/mus.27556. Online ahead of print.

ABSTRACT

INTRODUCTION/AIMS: Data regarding weight, height/length, and growth status of patients with spinal muscular atrophy (SMA) who have received only supportive care are limited. This cross-sectional study describes these measurements in patients with Type 1 and Types 2/3 SMA and compares them with reference values from typically developing children.

METHODS: Retrospective baseline data from three sites in the Pediatric Neuromuscular Clinical Research Network (Boston, New York, Philadelphia) were used. Descriptive statistics for weight, height/length, body mass index-for-age, as well as weight-for-length and absolute and relative deviations from references values (i.e. 50th percentile from World Health Organization/Centers for Disease Control growth charts) were calculated. Further, growth status was reported.

RESULTS: A total of 91 genetically confirmed patients with SMA receiving optimal supportive care and without any disease-modifying treatment were stratified into Types 1 (n=28) and 2/3 SMA (n=63). Patients with Type 1 SMA weighed significantly less (median = -7.5%) compared with reference values and patients with Types 2/3 SMA were significantly shorter (mean = -3.0%) compared with reference values. The median weight was considerably below the 50th percentile in both groups of patients, even if they received high standard of care and proactive feeding support.

DISCUSSION: More research is needed to understand which factors influence growth longitudinally, and how to accurately capture growth in patients with SMA. Further research should investigate the best time to provide feeding support to avoid underweight, especially in patients with Type 1, and how to avoid the risk of overfeeding, especially in patients with Types 2/3 SMA.

PMID:35385150 | DOI:10.1002/mus.27556

J Periodontal Res. 2022 Apr 6. doi: 10.1111/jre.12991. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study was to examine the potential influence of antithrombotics on leukocyte- and platelet-rich fibrin (L-PRF) membranes.

METHODS: Tensile tests and cell counts were performed with L-PRF membranes originating from patients on anticoagulants and antiplatelets versus patients not taking antithrombotics.

RESULTS: For the tensile tests, 13 control patients, 12 on anticoagulants, and 10 on antiplatelets donated blood. Compared to controls, membranes from anticoagulated donors were weaker (strength 0.57 ± 0.24 MPa vs. 0.80 ± 0.27 MPa, p = .03) and could not be stretched as far (1.8 ± 0.3 vs. 2.1 ± 0.3 times the initial length, p = .01). For the cell counting, 23 control patients, 16 on anticoagulants, and 16 on antiplatelets donated blood. The percentage of platelets was ±50% in the three groups. The percentage of leukocytes was lower in the anticoagulant group compared with controls (69 ± 10% vs. 78 ± 8%, p = .04). However, because of the unknown error of method, it is questionable whether the statistical significance is meaningful. There was no difference between membranes from the control group and the group on antiplatelets.

CONCLUSION: Our results indicate that L-PRF membranes originating from patients on anticoagulants are weaker, stretch less far, and contain less leukocytes than L-PRF membranes of patients not taking these drugs.

PMID:35385142 | DOI:10.1111/jre.12991

Cancer. 2022 Apr 6. doi: 10.1002/cncr.34217. Online ahead of print.

ABSTRACT

BACKGROUND: Sarcomas are rare, heterogeneous, ubiquitously localized malignancies with many histologic subtypes and genomic patterns. The survival of patients with sarcoma has rarely been described based on this heterogeneity; therefore, the authors’ objective was to estimate survival outcomes in patients who had sarcomas using the 2020 version of the World Health Organization classification of soft tissue and bone tumors.

METHODS: Patients older than 15 years who had incident sarcoma diagnosed between 2005 and 2010 were extracted from 14 French population-based cancer registries covering 18% of the French metropolitan population. Vital status for each patient was actively followed up to June 30, 2013. Net survival (NS) was estimated using the unbiased Pohar-Perme method.

RESULTS: Overall, 4202 patients were included. NS declined with increasing age at diagnosis. According to topographic groups, large 5-year NS disparities were observed, ranging from 47% among women with gynecologic sarcomas to 89% among patients with skin sarcomas. Patients with soft tissue, bone, and gastrointestinal sarcomas had 5-year NS rates of 53%, 61%, and 70%, respectively. Similar heterogeneity was observed according to histologic subtypes, with 5-year NS ranging from 19% for patients with angiosarcomas to 96% for patients with dermatofibrosarcomas. Patients with sarcoma who displayed missense mutations had a better 5-year NS (74%); those with MDM2-amplified sarcomas had the worst NS (45%).

CONCLUSIONS: NS rates in patients with sarcoma are presented here for the first time based on the 2020 World Health Organization classification applied to population-based registry data. Large prognostic heterogeneity was observed based on age, topographic and histologic groups, and genomic alteration profiles, constituting a benchmark for future studies and clinical trials.

PMID:35385134 | DOI:10.1002/cncr.34217