Category: Statistics

PLoS One. 2022 Jan 21;17(1):e0262760. doi: 10.1371/journal.pone.0262760. eCollection 2022.

ABSTRACT

BACKGROUND: Fetal growth restriction is a major complication of pregnancy and is associated with stillbirth, infant death and child morbidity. Ultrasound monitoring of pregnancy is becoming more common in Africa for fetal growth monitoring in clinical care and research, but many countries have no national growth charts. We evaluated the new international fetal growth standards from INTERGROWTH-21st and WHO in a cohort from southern Benin.

METHODS: Repeated ultrasound and clinical data were collected in women from the preconceptional RECIPAL cohort (241 women with singleton pregnancies, 964 ultrasounds). We modelled fetal biometric parameters including abdominal circumference (AC) and estimated fetal weight (EFW) and compared centiles to INTERGROWTH-21st and WHO standards, using the Bland and Altman method to assess agreement. For EFW, we used INTERGROWTH-21st standards based on their EFW formula (IG21st) as well as a recent update using Hadlock’s EFW formula (IG21hl). Proportions of fetuses with measurements under the 10th percentile were compared.

RESULTS: Maternal malaria and anaemia prevalence was 43% and 69% respectively and 11% of women were primigravid. Overall, the centiles in the RECIPAL cohort were higher than that of INTERGROWTH-21st and closer to that of WHO. Consequently, the proportion of fetuses under 10th percentile thresholds was systematically lower when applying IG21st compared to WHO standards. At 27-31 weeks and 33-38 weeks, respectively, 7.4% and 5.6% of fetuses had EFW <10th percentile using IG21hl standards versus 10.7% and 11.6% using WHO standards.

CONCLUSION: Despite high anemia and malaria prevalence in the cohort, IG21st and WHO standards did not identify higher than expected proportions of fetuses under the 10th percentiles of ultrasound parameters or EFW. The proportions of fetuses under the 10th percentile threshold for IG21st charts were particularly low, raising questions about its use to identify growth-restricted fetuses in Africa.

PMID:35061819 | DOI:10.1371/journal.pone.0262760

PLoS One. 2022 Jan 21;17(1):e0262664. doi: 10.1371/journal.pone.0262664. eCollection 2022.

ABSTRACT

BACKGROUND: Diabetic retinopathy is the most common microvascular complication of diabetes mellitus on eye and it is the leading cause of visual impairment among productive segment of the population. Globally, the prevalence of diabetic retinopathy is reported to be 27%. In Ethiopia, sufficient data is lacking on the prevalence of diabetic retinopathy as well as information on its predisposing factors. The study was required to assess the prevalence of diabetic retinopathy and its predisposing factors in diabetic patients attending at a General Hospital in Ethiopia.

METHODS: An institution based cross sectional study was employed on 331 diabetic patients recruited with a systematic random sampling technique. Data were collected through structured questionnaire, tracing patients’ medical folder and ocular health examination. Data were analyzed with Statistical Package for Social Science Version 20. Logistic regression methods of analysis were used to figure out predisposing factors of diabetic retinopathy. Adjusted odds ratio with 95% confidence interval was used to determine the strength of association.

RESULT: A total of 331 diabetic patients completed the study with a response rate of 99.10%. The median duration of diabetes was 5 years. The prevalence of diabetic retinopathy was 34.1% (95%Confidence Interval (CI): 28.7%-39.3%). Low family monthly income (Adjusted Odds Ratio (AOR) = 7.43, 95% CI: 2.44-22.57), longer duration of diabetes (AOR = 1.44, 95% CI: 1.30-1.58), poor glycemic control (AOR = 4.76, 95%CI: 2.26-10.00), and being on insulin treatment alone (AOR = 3.85, 95%CI: 1.16-12.74) were independently associated with diabetic retinopathy.

CONCLUSION AND RECOMMENDATION: The prevalence of diabetic retinopathy was 34.1%, higher than national and global figures. Low family monthly income, longer duration of diabetes, poor glucose control and being on insulin treatment alone were important risk factors of diabetic retinopathy. Proper diabetes self management and early screening of diabetic retinopathy in all diabetic patients were recommended.

PMID:35061820 | DOI:10.1371/journal.pone.0262664

PLoS One. 2022 Jan 21;17(1):e0262466. doi: 10.1371/journal.pone.0262466. eCollection 2022.

ABSTRACT

OBJECTIVE: Pakistan was one of the first South-Asian countries to introduce the ten-valent pneumococcal conjugate vaccine (PCV10) at the national level, using a 3+0 schedule without catchup, in 2013.

METHODS: From 2014-18, fifteen children <2 years old were recruited every week in Matiari, Sindh, and nasopharyngeal swabs were collected. The samples were cultured, and pneumococcus was further serotyped through multiplex PCR at the Aga Khan University Hospital as per the method described by the Centers for Disease Control and Prevention, USA.

RESULTS: Pneumococcus was detected in 2370/3140 (75%) children. Vaccine type (VT) and non-vaccine type (NVT) serotypes were carried by 379 and 1990 children. There was a significant decline in VT carriage (by 40.3%, p-value <0.001), whereas overall NVT carriage remained the same. The prevalence of VT serotypes 6B, 9V/9A, and 19F showed a significant decline by 58.8%, 79.3%, and 56%, respectively. The prevalence of NVT serotypes 19A, 21, and 10A increased by 70%, 33.3%, and 65.6%, respectively, whereas serotypes 13 and 9N/9L decreased by 53.4% and 51.8%, respectively. Serotype-specific vaccine effectiveness estimates that reached statistical significance were for 9V/9A (VE = 65.0, 95% CI 26.0-83.5%), 19F (VE = 55.3, 95% CI 15.5-76.4%) and for the vaccine related serotype 6A (VE = 28.4, 95% CI 0.9-48.2%).

CONCLUSION: The emergence of NVT serotypes, primarily 19A replacing VT serotypes in this rural community, necessitates continuous monitoring of serotypes in the carriage and invasive disease to evaluate the utility of existing vaccine formulations.

PMID:35061793 | DOI:10.1371/journal.pone.0262466

PLoS One. 2022 Jan 21;17(1):e0262280. doi: 10.1371/journal.pone.0262280. eCollection 2022.

ABSTRACT

School anxiety and psychopathological symptoms tend to co-occur across development and persist in adulthood. The present study aimed to determine school anxiety profiles based on Lang’s model of the triple response system (cognitive anxiety, psychophysiological anxiety, and behavioral anxiety) and to identify possible differences between these profiles in psychopathological symptoms (depression, hostility, interpersonal sensitivity, somatization, anxiety, psychoticism, obsessive-compulsive, phobic anxiety, and paranoid ideation). The School Anxiety Inventory (SAI) and the Symptom Assessment-45 Questionnaire (SA-45) were administered to 1525 Spanish students (49% girls) between 15 and 18 years old (M = 16.36, SD = 1.04). Latent Profile Analysis identified four school anxiety profiles: Low School Anxiety, Average School Anxiety, High School Anxiety, and Excessive School Anxiety. A multivariate analysis of variance revealed statistically significant differences among the school anxiety profiles in all the psychopathological symptoms examined. Specifically, adolescents with Excessive School Anxiety showed significantly higher levels of the nine psychopathological symptoms than their peers with Average School Anxiety and Low School Anxiety. In addition, the Excessive School Anxiety profile scored significantly higher in phobic anxiety than the High School Anxiety group. These findings allow to conclude that it is necessary enhance well-being and reduce psychopathology of those adolescents who manifest high and very high reactivity in cognitive, psychophysiological, and behavioral anxiety.

PMID:35061775 | DOI:10.1371/journal.pone.0262280

PLoS One. 2022 Jan 21;17(1):e0262161. doi: 10.1371/journal.pone.0262161. eCollection 2022.

ABSTRACT

This study aimed to assess the mediating roles of positive and negative emotions on the relationship between COVID-19-related risk perception and coping behaviours adopted by Chinese college students in response to the COVID-19 pandemic. We conducted an internet-based questionnaire survey from mid February-late October 2020, among 1038 college students, from six Chinese universities (females = 73.41%), ranging within 17-26 years. The survey questionnaire included three major components-the COVID-19-Related Risk Perception Scale (CRPS), the Positive and Negative Affect Scale (PANAS-Revision), and Coping Response of COVID-19 Scale (CRCS). Descriptive statistics and a mediated model were used to analyse the collected data. A partial mediation relationship was found between COVID-19-related risk perception and 1) active-response behaviour (β = 0.05, 95% Confidence Interval [CI: 0.03, 0.08]), 2) self-protection behaviour through positive emotions (β = 0.03, CI [0.01, 0.04]), and 3) risk-taking behaviour through negative emotions (β = -0.04, CI [-0.07, -0.02]). This study’s double-mediation model has been shown to detect the effect coping mechanisms to COVID-19. Furthermore, it implies that public health managers should consider the differences in coping mechanisms and the diverse mediating roles of positive and negative emotions for coping with public health emergencies.

PMID:35061777 | DOI:10.1371/journal.pone.0262161

PLoS One. 2022 Jan 21;17(1):e0261920. doi: 10.1371/journal.pone.0261920. eCollection 2022.

ABSTRACT

To validate the Computerized Adaptive Test Suicide Scale (CAT-SS), Veterans completed measures at baseline (n = 305), and 6- (n = 249), and 12-months (n = 185), including the CAT-SS (median items 11, duration of administration 107 seconds) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Logistic regression was used to relate CAT-SS scores (baseline) to C-SSRS assessed outcomes (active ideation with plan and intent; attempt; interrupted, aborted or self-interrupted attempt, or preparatory acts or behaviors; all outcomes combined). A mixed-effects logistic regression model was used to evaluate the relationship between the lagged CAT-SS scores and outcomes (6- and 12-months). The baseline CAT-SS demonstrated predictive accuracy for all outcomes at 6-months, and similar results were found for baseline and all outcomes at and through 12-months. Longitudinal analysis revealed for every 10-point change in the CAT-SS there was a 50-77% increase in the likelihood of suicide-related outcomes. The CAT-SS demonstrated added value when compared to current suicide risk prediction practices.

PMID:35061760 | DOI:10.1371/journal.pone.0261920

J Magn Reson Imaging. 2022 Jan 21. doi: 10.1002/jmri.28072. Online ahead of print.

ABSTRACT

BACKGROUND: Long-distance running is a common cause of Achilles tendinopathy. A reliable magnetic resonance imaging (MRI) technique to track early changes in the tendon caused by running could facilitate more effective interventions to combat progression.

PURPOSE: To evaluate an ultrashort echo time sequence with magnetization transfer preparation (UTE-MT) in the detection of changes in Achilles tendons of amateur marathon runners before and after long-distance running.

STUDY TYPE: Prospective.

POPULATION: Thirty-two runners (19 enrolled for full marathons and 13 enrolled for half-marathons) and 5 healthy non-runners.

FIELD STRENGTH/SEQUENCE: 3.0 T; UTE-MT and dual-echo UTE for T2* assessment (UTE-T2*).

ASSESSMENT: MRI was performed 1-week pre-race, 2-days post-race, and 4-weeks post-race. UTE-MT ratio (UTE-MTR) and UTE-T2* of tendon were measured by two independent radiologists who were blinded to the scan time point and participant data. The Achilles tendon was divided into six regions of interest (ROIs) for data analysis, namely the insertion part (INS), middle part (MID), muscle-tendon junction (MTJ), tendon-bone insertion (TBI), tendon-muscle insertion (TMI), and whole tendon (bulk).

STATISTICAL TESTS: Analysis of variance and Friedman’s rank tests were used to evaluate changes in UTE-MTR and UTE-T2* between time points. Tukey test and Bonferroni method were used for further comparisons. P < 0.05 was considered significant.

RESULTS: The UTE-MTR values of most tendon ROIs changed significantly between the measured time points, except for the INS region (P = 0.1977). Conversely, the UTE-T2* values only showed significant changes in the MID and TBI regions. Paired comparisons showed that the UTE-MTR decreases in the MTJ, MID, TMI, and bulk regions at 2-days post-race were significant compared to measures taken pre-race and 4-weeks post-race. For UTE-T2* measurements, significant differences were observed only for the MID region between pre-race and 2-days post-race (P = 0.0408, 95% CI: 0.0061, 0.1973), and for the TBI region between pre-race and 4-weeks post-race (P = 0.0473, 95% CI: 0.0013, 0.1766).

DATA CONCLUSION: The UTE-MT sequence is able to detect biochemical changes in the Achilles tendon after long-distance running.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 1.

PMID:35060638 | DOI:10.1002/jmri.28072

Pain Med. 2022 Jan 21:pnac009. doi: 10.1093/pm/pnac009. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examines Patient-Reported Outcome Measurement Information System (PROMIS®)-29 v1.0 outcomes of chiropractic care in a multi-site, pragmatic clinical trial and compares the PROMIS measures to: 1) worst pain intensity from a numerical pain rating 0-10 scale, 2) 24-item Roland-Morris Disability Questionnaire (RMDQ); and 3) global improvement (modified visual analog scale).

DESIGN: A pragmatic, prospective, multisite, parallel-group comparative effectiveness clinical trial comparing usual medical care (UMC) with UMC plus chiropractic care (UMC+CC).

SETTING: 3 military treatment facilities.

SUBJECTS: 750 active-duty military personnel with low back pain.

METHODS: Linear mixed effects regression models estimated the treatment group differences. Coefficient of repeatability to estimate significant individual change.

RESULTS: We found statistically significant mean group differences favoring UMC+CC for all PROMIS®-29 scales and the RMDQ score. Area under the curve estimates for global improvement for the PROMIS®-29 scales and the RMDQ, ranged from 0.79 to 0.83.

CONCLUSIONS: Findings from this pre-planned secondary analysis demonstrate that chiropractic care impacts health-related quality of life beyond pain and pain-related disability. Further, comparable findings were found between the 24-item RMDQ and the PROMIS®-29 v1.0 briefer scales.

PMID:35060609 | DOI:10.1093/pm/pnac009

Health Promot Int. 2022 Jan 21:daab213. doi: 10.1093/heapro/daab213. Online ahead of print.

ABSTRACT

The health promoting sports club describes the development of the settings-based approach in sports clubs. Based on this model, a questionnaire was developed to measure health promotion perceptions in sports clubs (e-PROSCeSS). The objective of this study was to assess the psychometric properties of a French version of the e-PROSCeSS measurement tool. The questionnaire includes three scales measuring stakeholder’s perceptions of club (macro), managers (meso) and coaches (micro) activities toward promoting health. Five steps were undertaken to assess perceptions. First, scales were translated into French. Second, each item’s content clarity was tested in three populations: managers, coaches, sports participants. Third, descriptive statistics were analyzed for each scale. Fourth, confirmatory factorial analysis was used to select items for each level. Predictive validity found positive relationships between health promotion perceptions and managing/coaching positions, and negative relationships with drop-out intentions. Positive relationships were found between sports participants’ perceptions of health promotion and their self-rated performance and quality of life, while negative relationships were detected with drop-out intentions. The French e-PROSCeSS subscales showed good psychometric properties in measuring health determinants at multiple levels. However, the tool did not measure health promotion as an overarching concept that questions its applicability in the sports club setting.

PMID:35060597 | DOI:10.1093/heapro/daab213

Europace. 2022 Jan 21:euab320. doi: 10.1093/europace/euab320. Online ahead of print.

ABSTRACT

AIMS: School-based routine screenings of electrocardiograms (ECGs) have been performed upon admission to primary school (PS), junior high school (JHS), and high school (HS) in Japan. Though ECGs with prolonged QT intervals are occasionally found, the role of regular ECG screening tests in identifying long QT syndrome (LQTS) remains to be determined. We investigated the usefulness of the ECG screenings by comparing the results of genetic tests between students who showed QT-prolongation in the screenings and patients with LQTS.

METHODS AND RESULTS: We genetically screened 341 students (106 PS, 173 JHS, and 62 HS). Of these, 230 subjects showed QT-prolongation during regular screenings (S-S group), and the other 111 patients were clinically consulted with suspected LQTS by paediatricians (C-C group). Genotype-phenotype relationships were compared between the two groups. The positive rates in the genetic tests were comparable among the two groups; however, symptomatic subjects were significantly fewer in the S-S group than the C-C group (3% vs. 70%). Compared to the genotype-negative subjects, the positive subjects showed significantly longer QTc (P < 0.0001) and more frequently presented LQTS risk scores with ≥3.5 points (P < 0.0001). Lethal arrhythmic events (LAE) occurred only in the C-C group; 18 subjects experienced LAE and 83% of them were found to carry variant(s) in the LQTS-related genes.

CONCLUSION: The school-based ECG screenings are effective in identifying young patients with LQTS who require genetic analysis. If individuals are screened at a younger age, we can identify patients at risk earlier and provide preventative treatments.

PMID:35060598 | DOI:10.1093/europace/euab320