Category: Statistics

PLoS One. 2021 Oct 1;16(10):e0258042. doi: 10.1371/journal.pone.0258042. eCollection 2021.

ABSTRACT

OBJECTIVE: To investigate the perceived-stigma level of COVID-19 patients in the early stage of the epidemic and analysed related factors and correlations that affected the stigma levels.

METHODS: The COVID-19 patients were selected using the convenience sampling method. Perceived-stigma level was evaluated using the Social Impact Scale (SIS). Frequency was used to describe the general information and disease investigation status of COVID-19 patients; mean and standard deviation were used for describing stigma levels, Wilcoxon signed-ranks test (nonparametric test) was applied for pairwise comparison. Kruskal-Wallis non-parametric test for grade data, and Dwass-Steel-Critchlow-Fligner test for multiple comparative analysis. Multiple linear regression analysis was performed, and statistically significant indicators in single-factor analysis were included to investigate the independent factors of stigma. The p<0.05 was considered statistically significant.

RESULTS: SIS score of the 122 COVID-19 patients averaged 57.37±9.99 points. There were statistically significant differences in perceived-stigma levels among patients of different ages (p = 0.008), occupation (p <0.001), marital status (p = 0.009), and disease severity (p = 0.020). Multivariate logistic regression analysis revealed that age was the main influencing factor of stigma (p<0.05).

CONCLUSIONS: The overall perceived-stigma level of COVID-19 patients in the early stage of the epidemic was moderate. Younger, unmarried, and severely ill patients had a higher level of perceived-stigma, with age being the main factor. More attention should be given to the young COVID-19 patients.

PMID:34597354 | DOI:10.1371/journal.pone.0258042

Am J Health Syst Pharm. 2021 Oct 1:zxab382. doi: 10.1093/ajhp/zxab382. Online ahead of print.

ABSTRACT

DISCLAIMER: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

PURPOSE: Hyperkalemia more commonly affects patients with a glomerular filtration rate of less than 60 mL/min. Using intravenous (IV) insulin to shift potassium intracellularly may cause hypoglycemia, requiring additional treatment or longer hospitalization. Literature on insulin dosing in this context is limited, with one previous study indicating that 5 units of IV insulin might be as effective and result in less hypoglycemia than the standard dose of 10 units of IV insulin. The hyperkalemia treatment pathway at our institution was revised in May 2018 to include a reduced-dose option (5 units of insulin) for patients with end-stage renal disease. This study aimed to compare the prevalence of hypoglycemia between patients who received standard-dose vs reduced-dose IV insulin.

METHODS: This single-center, retrospective, quasi-experimental study evaluated the impact of revision of the hyperkalemia treatment pathway by assessing rates of hypoglycemia during the 6 months before and after implementation of the revised pathway. The primary endpoint was prevalence of hypoglycemia, defined as a blood glucose level of less than or equal to 70 mg/dL.

RESULTS: There was no statistically significant difference in the occurrence of hypoglycemia when comparing the pre- and postimplementation groups (36 [17.7%] patients vs 34 [18.7%] patients; P = 0.7924). The postimplementation group had a statistically significant lower reduction in potassium levels after treatment than the preimplementation group (mean [interquartile range], -0.9 [-1.3, -0.5] mEq/L vs -0.6 [-1.2, -0.2] mEq/L; P = 0.0095). Baseline potassium levels were similar between the groups.

CONCLUSION: Administration of reduced-dose IV insulin for treatment of hyperkalemia was significantly less effective in lowering serum potassium levels and did not decrease prevalence of hypoglycemia. When accounting for potential confounders, the only variable that was associated with hypoglycemia was pretreatment glucose level.

PMID:34597356 | DOI:10.1093/ajhp/zxab382

PLoS One. 2021 Oct 1;16(10):e0258137. doi: 10.1371/journal.pone.0258137. eCollection 2021.

ABSTRACT

Online education, including college English education, has been developing rapidly in the recent decade in China. Such aspects as e-readiness, benefits and challenges of online education were well-researched under normal situations, but fully online language teaching on a large-scale in emergencies may tell a different story. A survey of 2310 non-English-major college students and 149 English teachers from three types of twelve higher education institutions in Wuhan was conducted to evaluate their readiness for online English education during the COVID-19 pandemic, to figure out challenges encountered by them and to draw implications for future online college English education. Quantitative statistics gathered using two readiness scales adapted from previous studies showed that both cohorts were slightly below the ready level for the unexpected online transition of college English education. The overall level of readiness for students was 3.68 out of a score of 5, and that for teachers was 3.70. Individual differences were explored and reported. An analysis of qualitative results summarized six categories of challenges encountered by the students, i.e. technical challenges, challenges concerning learning process, learning environment, self-control, efficiency and effectiveness, and health concern. Though the students reported the highest level of readiness in technology access, they were most troubled by technical problems during online study. For teachers, among three types of challenges, they were most frustrated by pedagogical ones, especially students’ disengagement in online class. The survey brought insights for online college English education development. Institutions should take the initiative and continue promoting the development of online college English education, because a majority of the respondents reported their willingness and intention to continue learning/teaching English in online or blended courses in the post-pandemic period. They are supposed to remove technical barriers for teachers and students, and assess the readiness levels of both cohorts before launching English courses online. Institutions should also arrange proper training for instructors involved, especially about pedagogical issues. Language teachers are suggested to pay special attention to students’ engagement and communication in online courses.

PMID:34597337 | DOI:10.1371/journal.pone.0258137

PLoS One. 2021 Oct 1;16(10):e0258160. doi: 10.1371/journal.pone.0258160. eCollection 2021.

ABSTRACT

BACKGROUND: There was no clear evidence whether the initial dose of enzalutamide affects the incidence of adverse events (AEs), and oncological outcome in patients with castration-resistant prostate cancer (CRPC).

METHODS: The clinical charts of 233 patients with CRPC treated with enzalutamide were reviewed retrospectively. After 1:3 propensity score matching (PSM), 124 patients were divided into a reduced dose group and a standard dose group, and the prostate specific antigen (PSA) response and the incidence of AEs were compared.

RESULTS: 190 patients with CRPC initiated with standard dose enzalutamide were younger and better performance status compared with 43 patients beginning with reduced dose. After PSM, the baseline characteristics were not different between the standard and the reduced dose group. In the PSM cohort, the PSA response rate was significantly lower in the reduced dose group than in the standard dose group (-66.3% and -87.4%, p = 0.02). The incidence rates of AEs were not statistically different between the groups (22.6% and 34.4%, respectively, p = 0.24).

CONCLUSION: Initiating treatment with a reduced dose of enzalutamide did not significantly decrease the incidence rate of AEs, and it showed poorer PSA response rate. There is no clear rationale for treating with a reduced initial dose of enzalutamide to reduce the incidence of AEs.

PMID:34597353 | DOI:10.1371/journal.pone.0258160

PLoS One. 2021 Oct 1;16(10):e0258049. doi: 10.1371/journal.pone.0258049. eCollection 2021.

ABSTRACT

OBJECTIVE: To assess obstetric factors associated with hysterotomy extension among women undergoing a second-stage cesarean.

STUDY DESIGN: This 5-year retrospective cohort study (2013-2017) included all women with second-stage cesarean deliveries of live-born singleton fetuses in cephalic presentation at term. It took place at a tertiary center that practices delayed pushing. We performed univariable and multivariable logistic regression to assess the maternal, obstetric, and neonatal factors associated with hysterotomy extension mentioned in the surgical report. Operative time, postpartum hemorrhage, and maternal complications were also studied.

RESULTS: Of the 3350 intrapartum cesareans, 2637 were performed at term for singleton fetuses in cephalic presentation: 747 (28.3%) during the second stage of labor, 83 (11.1%) of which were complicated by a hysterotomy extension. The median duration of the passive phase of the second stage did not differ between women with and without an extension (164 min versus 160 min, P = 0.85). No other second-stage obstetric characteristics, i.e., duration of the active phase, fetal head station, or fetal malposition, were associated with the risk of extension. Factors significantly associated with extension were the surgeon’s experience and forceps use during the cesarean. Women with an extension, compared to women without one, had a longer median operative time (49 min versus 32 min, P<0.001) and higher rates of postpartum hemorrhage and blood transfusion (respectively, 30.1% versus 15.1%, p = 0.002 and 7.2% versus 2.4%, P = 0.03).

CONCLUSION: The risk of a hysterotomy extension does not appear to be associated with second-stage obstetric characteristics, including the duration of the passive phase of this stage. In our center, which practices delayed pushing, prolonging this passive phase beyond 2 hours does not increase the risk of hysterotomy extension in second-stage cesareans.

PMID:34597319 | DOI:10.1371/journal.pone.0258049

Pediatr Pulmonol. 2021 Oct 1. doi: 10.1002/ppul.25712. Online ahead of print.

ABSTRACT

BACKGROUND: The marked heterogeneity in CF disease complicates selection of those most likely to benefit from existing or emergent treatments.

OBJECTIVE: We aimed to predict progression of bronchiectasis in preschool children with CF.

METHODS: Using data collected up to three years of age, in the Australian Respiratory Early Surveillance Team for CF (AREST CF) cohort study, clinical information, chest computed tomography (CT) scores and biomarkers from bronchoalveolar lavage were assessed in a multivariable linear regression model as predictors for CT bronchiectasis at age 5-6.

RESULTS: Follow-up at 5-6 years was available in 171 children. Bronchiectasis prevalence at 5-6 was 134/171 (78%) and median bronchiectasis score 3 (range 0-12). The internally validated multivariate model retained eight independent predictors accounting for 37% (Adjusted R² ) of the variance in bronchiectasis score. The strongest predictors of future bronchiectasis were: pancreatic insufficiency, repeated intravenous treatment courses, recurrent lower respiratory infections in the first 3 years of life and lower airway inflammation. Dichotomizing the resulting prediction score at a bronchiectasis score of above the median resulted in a diagnostic odds ratio of 13 (95% CI 6.3-27) with positive and negative predictive values of 80% (95%CI 72%-86%) and 77% (95% CI 69%-83%) respectively.

CONCLUSION: Early assessment of bronchiectasis risk in children with CF is feasible with reasonable precision at a group level, which can assist in high-risk patient selection for interventional trials. The unexplained variability in disease progression at individual patient level remains high, limiting the use of this model as a clinical prediction tool. This article is protected by copyright. All rights reserved.

PMID:34596357 | DOI:10.1002/ppul.25712

Pediatr Endocrinol Diabetes Metab. 2021 Oct 1:44673. doi: 10.5114/pedm.2021.107717. Online ahead of print.

ABSTRACT

INTRODUCTION: Numerous studies have demonstrated the clinical benefits of using continuous glucose monitoring (CGM) systems among patients with type 1 diabetes (T1D). Aim of the study was to assess the effectiveness of CGM on metabolic control in children with T1D and well-controlled disease prior to the study.

MATERIAL AND METHODS: This prospective analysis included 99 children (46 girls) at the median age of 11.23 years and diabetes duration of at least 1 year (median: 5.16 years), generally well controlled metabolically (median HbA1c: 7.0%), and treated with continuous subcutaneous insulin infusion (CSII). The patients had used CGM for at least 150 days. We analysed the participants in subgroups based on baseline HbA1c < 7%, ≥ 7%, age, and sex.

RESULTS: Children with baseline HbA1c < 7% were characterized by significantly increased HbA1c after the median of 273 days (217; 320) of CGM usage (6.3% vs. 6.6%, respectively; p = 0.002). No significant change in HbA1c was noted in children with baseline HbA1c ≥ 7% (7.5% vs. 7.4%, respectively; p = 0.191), but 20% of the group reached the target of HbA1c < 7.0%. The analysis of CGM data revealed that no group achieved the CGM targets of good metabolic control. Total daily insulin requirements remained stable in both groups (p = 0.752; p = 0.274), but the amount of basal insulin increased statistically in both groups (p = 0.009; p ≤ 0.001).

CONCLUSIONS: The application of CGM provides detailed information concerning glycaemic control and is beneficial in some, but not all, T1D children with good diabetes control.

PMID:34596369 | DOI:10.5114/pedm.2021.107717

Plant Genome. 2021 Oct 1:e20155. doi: 10.1002/tpg2.20155. Online ahead of print.

ABSTRACT

Plant phenotyping under field conditions plays an important role in agricultural research. Efficient and accurate high-throughput phenotyping strategies enable a better connection between genotype and phenotype. Unmanned aerial vehicle-based high-throughput phenotyping platforms (UAV-HTPPs) provide novel opportunities for large-scale proximal measurement of plant traits with high efficiency, high resolution, and low cost. The objective of this study was to use time series normalized difference vegetation index (NDVI) extracted from UAV-based multispectral imagery to characterize its pattern across development and conduct genetic dissection of NDVI in a large maize population. The time series NDVI data from the multispectral sensor were obtained at five time points across the growing season for 1,752 diverse maize accessions with a UAV-HTPP. Cluster analysis of the acquired measurements classified 1,752 maize accessions into two groups with distinct NDVI developmental trends. To capture the dynamics underlying these static observations, penalized-splines (P-splines) model was used to obtain genotype-specific curve parameters. Genome-wide association study (GWAS) using static NDVI values and curve parameters as phenotypic traits detected signals significantly associated with the traits. Additionally, GWAS using the projected NDVI values from the P-splines models revealed the dynamic change of genetic effects, indicating the role of gene-environment interplay in controlling NDVI across the growing season. Our results demonstrated the utility of ultra-high spatial resolution multispectral imagery, as that acquired using a UAV-based remote sensing, for genetic dissection of NDVI.

PMID:34596348 | DOI:10.1002/tpg2.20155

Orthop Surg. 2021 Oct 1. doi: 10.1111/os.13107. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the functional outcomes after a novel method of H-loop knotless double-row technique in patients with rotator cuff tears.

METHOD: From June 2020 to September 2020, a total of six patients (five women, one man) with arthroscopic rotator cuff repair using the H-loop knotless double-row technique were enrolled in our study. The average age is 54 years (range: 50-61 years). The preoperative and final follow-up clinical outcome were evaluated using the American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS), University of California Los Angeles (UCLA) score, and Constant-Murley score. The active shoulder range of motion (ROM) was also collected preoperatively and postoperatively at the final follow-up (forward flexion and abduction). Accordingly, intraoperative and postoperative complications were observed as well.

RESULT: There were six patients that underwent arthroscopic rotator cuff repair using the H-loop knotless double-row technique. The average follow-up period was 7.52 ± 0.70 months. The VAS, UCLA, ASES, and Constant-Murley scores improved from 5 ± 2.45, 15.67 ± 3.44, 47.67 ± 17.41 and 49.17 ± 8.98 preoperatively, to 0.83 ± 0.75, 36.27 ± 3.83, 91.67 ± 10.76 and 85.83 ± 4.31 at the final follow-up, with statistical significances of P = 0.009, P < 0.001, P = 0.006, and P = 0.001, respectively. Meanwhile, the active shoulder ROM (forward flexion and abduction) improved from 135.00 ± 46.80 and 125 ± 56.48 preoperatively, to 173.67 ± 4.13 and 172 ± 3.27 at final follow-up, respectively (P = 0.082, P = 0.088). During the follow-up, there were no postoperative complications such as wound-site infection, nerve or vessel damage, subcutaneous hematoma, and suture anchor problems.

CONCLUSION: With the benefit of reducing the possibility of strangulation and blood supply affection for the rotator cuff, The H-loop knotless double row technique may be an alternative method to significantly improve subjective functional outcomes and increase the healing rate of medium-sized rotator cuff tears with degeneration issues and poor tissue quality.

PMID:34596353 | DOI:10.1111/os.13107

Pest Manag Sci. 2021 Oct 1. doi: 10.1002/ps.6663. Online ahead of print.

ABSTRACT

BACKGROUND: The Colorado potato beetle (CPB) is the most harmful pest of potato in potato cultivation regions globally. Although it is an economically important agricultural pest, the population structure and colonization route of this species in Turkey are uncertain. We used microsatellite and mtDNA markers to obtain information about the population source, structure and bio-invasion route of CPB populations in Turkey.

RESULTS: The common single mtDNA haplotype in European CPB populations was obtained in all Turkish CPB populations based on mtDNA data analysis. However, microsatellites revealed a low level of genetic variation in CPB populations. The results of microsatellite analysis (FCA, BAPS, UPGMA dendrogram, F-statistics and Nei’s distances) indicated three groups for invasive CPB: Thrace-Marmara and Aegean; Black Sea, Central Anatolia and Mediterranean; Northeastern Anatolia. Region-specific alleles have been identified in regions, where commercial potato cultivation and insecticide use are intensive.

CONCLUSION: The detection of a single fixed European haplotype in all Turkish populations has proved that CPB in Turkey originated from Europe as a result of a founder event occurred in European populations. Low genetic variation was due to the short time period since the spread of CPB from America to Europe. The highest number of private alleles were found in the top commercial potato cultivation region-Central Anatolia from where the CPB populations spread to other parts of Turkey. This article is protected by copyright. All rights reserved.

PMID:34596319 | DOI:10.1002/ps.6663