Category: Statistics

Eur J Obstet Gynecol Reprod Biol. 2021 Apr 1;260:212-217. doi: 10.1016/j.ejogrb.2021.03.035. Online ahead of print.

ABSTRACT

OBJECTIVE: Laparoscopic high uterosacral ligament suspension (l-HUSLS) is a laparoscopic-transposed vaginal technique for the treatment of pelvic organ prolapse. Nowadays data regarding quality of life and sexual functions in patients who underwent l-HUSLS for pelvic organ prolapse are few and generic with most of the study investigating the anatomical outcome. For these reasons, the aim of our study is to evaluate these subjective outcomes in women undergoing this surgical procedure with the support of validated questionnaires.

STUDY DESIGN: This is a retrospective study with the primary aim of analysing the quality of life, sexual function, patient satisfaction rates and anatomical outcome among patients who underwent l-HUSLS in our institution. The SPSS Version 26.0 for Windows (Statistical package for the social studies, Chicago, IL, USA) was used for the statistical analysis.

RESULTS: A total of 60 patients underwent l-HUSLS between 2016 and 2018. All patients had a high grade of apical prolapse. No intraoperative and major postoperative complications were registered. The median follow-up was 24 months (24-48). PGI-I score was 1-2 in 55 (91.6 %) women. We observed a significant improvement of EQ-5D index and VAS scores from the baseline to the 2 years follow-up: from 0.72 (0.67-1) to 0.91 (0.79-1) and from 50 (30-90) to 70 (50-100) respectively (p = 0.000). All women showed a statistically significant amelioration of FSDS and ICIQ-SF scores. Anatomical success rate after 24 months was 83.7 %.

CONCLUSIONS: l-HUSLS appears to be a safe, feasible and effective treatment for advanced pelvic organ prolapse with high rates of patient self-reported cure.

PMID:33862432 | DOI:10.1016/j.ejogrb.2021.03.035

Rev Chil Pediatr. 2020 Dec;91(6):917-923. doi: 10.32641/rchped.vi91i6.1831. Epub 2020 Dec 12.

ABSTRACT

INTRODUCTION: There is a close relationship between chronic kidney disease (CKD) and cardiovascular disease. One of its clinical manifestations is left ventricular hypertrophy (LVH), expressed as Left Ventricular Mass Index (LVMI gr/m27). In CKD patients with growth retardation, the LVMI calculation should be adjusted by correcting age for length/height.

OBJECTIVE: To compare the age-corrected LVMI for length/height with the value calculated by chronological age in CKD children on dialysis.

PATIENTS AND METHOD: Cross-sectional study. We analyzed echocardiographies of CKD children on dialysis aged between 1 and 18, from January 2016 to July 2017. LVMI was evaluated by adjusting the value expressed in gr/m27 to the percentile for the chronological child’s age, and then the value was adjusted to the age-corrected length/height. We used descriptive statistics and concordance study for LVMI assessments calculating by chronological age and for age-corrected length/height.

RESULTS: 26 patients were included and 75 echocardiograms. 56% had left ventricular hypertrophy using chronological age versus 46.6% age-corrected LVMI for length/height. When comparing the percentile groups of LVMI-chronological age vs. age-adjusted LVMI for actual length/height, it was observed that 18.6% of the sample changed percentile groups, 100% of them to a lower percentile group. The agreement evaluated based on the Kappa coefficient was 0.72 (perfect agreement > 0.8), confirming differences when adjusting the LVMI for age-corrected length/height.

CONCLUSION: Calculating LVMI by chro nological age overestimates the cardiovascular involvement in children with CKD who are charac teristically stunted. The results suggest that the age-adjusted, length/height-corrected calculation of LVMI gives greater accuracy to the diagnosis of left ventricular hypertrophy in this group of patients.

PMID:33861828 | DOI:10.32641/rchped.vi91i6.1831

Addiction. 2021 Apr 16. doi: 10.1111/add.15511. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaire screens for harmful drinking using a 12-month timeframe. A score of 0 is assigned to individuals who report abstaining from alcohol in the past year. However, many middle-aged individuals reporting current abstinence are former drinkers (FDs). Because FDs may be more genetically prone to harmful alcohol use than life-long abstainers (LAs) and are often combined with LAs, we evaluated the impact of differentiating them on the identification of genetic association.

DESIGN AND SETTING: The UK Biobank (UKBB) includes AUDIT-C and alcohol drinker status.

PARTICIPANTS: 131,510 Europeans, including 5,135 FDs.

MEASUREMENTS: We compared three genome-wide association (GWAS) analyses to explore the effects of removing FDs: the full AUDIT-C data, AUDIT-C data without FDs, and data from a random sample numerically matched to the data without FDs. Because prior studies show a consistent association of the ADH1B polymorphism rs1229984 with both alcohol consumption and alcohol use disorder, we compared allele frequencies for rs1229984 stratified by AUDIT-C value and FD versus LA status. Additionally, we calculated polygenic risk scores (PRS) of related diseases.

FINDINGS: The rs1229984 allele frequencies among FDs were numerically comparable to those with high AUDIT-C scores and very different from those of LAs. Removing FDs from GWAS yielded a stronger association with rs1229984 (p-value after removal: 1.9 x10^-70 versus 1.7×10^-65 and 2.5 x10^-62 ), more statistically significant single nucleotide polymorphisms (SNPs) (after removal: 11 versus 9 and 8), and genomic loci (after removal: 11 versus 9 and 7). Additional independent SNPs were identified after removal of FDs: rs2817866 (PTGER3), rs7105867 (ANO3), and rs17601612 (DRD2). For PRS of alcohol use disorder and major depressive disorder, there are statistically significant differences between FDs and LAs.

CONCLUSIONS: Differentiating between former drinkers and life-long abstainers can improve Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) genome-wide association results.

PMID:33861876 | DOI:10.1111/add.15511

Psychooncology. 2021 Apr 2. doi: 10.1002/pon.5691. Online ahead of print.

ABSTRACT

OBJECTIVE: Black Americans are disproportionately affected by cancer and chronic diseases. Black patients with cancer and their family caregivers may concurrently experience symptoms that influence their wellbeing. This study investigates the influence of mental and physical symptom distress on quality of life (QOL) among Black Americans with cancer and their family caregivers from a dyadic perspective.

METHODS: One hundred and fifty-one dyads comprised of a Black American with breast, colorectal, lung or prostate cancer and a Black family caregiver were included in this secondary analysis of pooled baseline data from three studies. Self-reports of problems managing 13 symptoms were used to measure mental and physical symptom distress. Descriptive statistics and the actor-partner interdependence model were used to examine symptom prevalence and the influence of each person’s symptom distress on their own and each other’s QOL.

RESULTS: Fatigue, sleep problems, pain and mental distress were prevalent. Patients and caregivers reported similar levels of mental distress; however, patients reported higher physical distress. Increased patient mental distress was associated with decreased patient QOL (overall, emotional, social, functional). Increased patient physical distress was associated with decreased patient QOL (overall, physical, emotional, functional) and decreased caregiver emotional wellbeing. Increased caregiver mental distress was associated with decreased caregiver QOL (overall, emotional, social, functional) and decreased patient overall QOL. Increased caregiver physical distress was associated with decreased caregiver QOL (overall, physical, functional), decreased patient emotional wellbeing, and better patient social wellbeing.

CONCLUSIONS: Supporting symptom management in Black patient/caregiver dyads may improve their QOL.

PMID:33861891 | DOI:10.1002/pon.5691

IET Syst Biol. 2021 Apr 16. doi: 10.1049/syb2.12018. Online ahead of print.

ABSTRACT

The dynamics of cortical neuronal activity plays important roles in controlling body movement and is regulated by connection weights between neurons in a cortex-basal ganglia-thalamus (BGCT) loop. Beta-band oscillation of cortical activity is closely associated with the movement disorder of Parkinson’s disease, which is caused by an imbalance in the connection weights of direct and indirect pathways in the BGCT loop. In this study, the authors investigate how the dynamics of cortical activity are modulated by connection weights of direct and indirect pathways in the BGCT loop under low dopamine levels through bifurcation analyses and potential landscapes. The results reveal that cortical activity displays rich dynamics under different connection weights, including one, two, or three stable steady states, one or two stable limit cycles, and the coexistence of one stable limit cycle with one stable steady state or two stable ones. For a low dopamine level, cortical activity exhibits oscillation for larger connection weights of direct and indirect pathways. The stability of these stable dynamics is explored by the potential landscapes.

PMID:33861900 | DOI:10.1049/syb2.12018

PLoS One. 2021 Apr 16;16(4):e0250269. doi: 10.1371/journal.pone.0250269. eCollection 2021.

ABSTRACT

BACKGROUND: Given the economic and social divide that exists in South Africa, it is critical to manage the health response of its residents to the Covid-19 pandemic within the different socio-economic contexts that define the lived realities of individuals.

OBJECTIVE: The objective of this study is to analyse the Covid-19 preventive behaviour and the socio-economic drivers behind the health-response behaviour.

DATA: The study employs data from waves 1 and 2 of South Africa’s nationally representative National Income Dynamics Study (NIDS)-Coronavirus Rapid Mobile Survey (CRAM). The nationally representative panel data has a sample of 7073 individuals in Wave 1 and 5676 individuals in Wave 2.

METHODS: The study uses bivariate statistics, concentration indices and multivariate estimation techniques, ranging from a probit, control-function approach, special-regressor method and seemingly unrelated regression to account for endogeneity while identifying the drivers of the response behaviour.

FINDINGS: The findings indicate enhanced behavioural responsiveness to Covid-19. Preventive behaviour is evolving over time; the use of face mask has overtaken handwashing as the most utilised preventive measure. Other measures, like social distancing, avoiding close contact, avoiding big groups and staying at home, have declined between the two periods of the study. There is increased risk perception with significant concentration among the higher income groups, the educated and older respondents. Our findings validate the health-belief model, with perceived risk, self-efficacy, perceived awareness and barriers to preventive strategy adoption identified as significant drivers of health-response behaviour. Measures such as social distancing, avoiding close contact, and the use of sanitisers are practised more by the rich and educated, but not by the low-income respondents.

CONCLUSION: The respondents from lower socio-economic backgrounds are associated with optimism bias and face barriers to the adoption of preventive strategies. This requires targeted policy attention in order to make response behaviour effective.

PMID:33861811 | DOI:10.1371/journal.pone.0250269

PLoS One. 2021 Apr 16;16(4):e0250370. doi: 10.1371/journal.pone.0250370. eCollection 2021.

ABSTRACT

BACKGROUND: Accurately predicting the survival rate of breast cancer patients is a major issue for cancer researchers. Machine learning (ML) has attracted much attention with the hope that it could provide accurate results, but its modeling methods and prediction performance remain controversial. The aim of this systematic review is to identify and critically appraise current studies regarding the application of ML in predicting the 5-year survival rate of breast cancer.

METHODS: In accordance with the PRISMA guidelines, two researchers independently searched the PubMed (including MEDLINE), Embase, and Web of Science Core databases from inception to November 30, 2020. The search terms included breast neoplasms, survival, machine learning, and specific algorithm names. The included studies related to the use of ML to build a breast cancer survival prediction model and model performance that can be measured with the value of said verification results. The excluded studies in which the modeling process were not explained clearly and had incomplete information. The extracted information included literature information, database information, data preparation and modeling process information, model construction and performance evaluation information, and candidate predictor information.

RESULTS: Thirty-one studies that met the inclusion criteria were included, most of which were published after 2013. The most frequently used ML methods were decision trees (19 studies, 61.3%), artificial neural networks (18 studies, 58.1%), support vector machines (16 studies, 51.6%), and ensemble learning (10 studies, 32.3%). The median sample size was 37256 (range 200 to 659820) patients, and the median predictor was 16 (range 3 to 625). The accuracy of 29 studies ranged from 0.510 to 0.971. The sensitivity of 25 studies ranged from 0.037 to 1. The specificity of 24 studies ranged from 0.008 to 0.993. The AUC of 20 studies ranged from 0.500 to 0.972. The precision of 6 studies ranged from 0.549 to 1. All of the models were internally validated, and only one was externally validated.

CONCLUSIONS: Overall, compared with traditional statistical methods, the performance of ML models does not necessarily show any improvement, and this area of research still faces limitations related to a lack of data preprocessing steps, the excessive differences of sample feature selection, and issues related to validation. Further optimization of the performance of the proposed model is also needed in the future, which requires more standardization and subsequent validation.

PMID:33861809 | DOI:10.1371/journal.pone.0250370

PLoS One. 2021 Apr 16;16(4):e0250359. doi: 10.1371/journal.pone.0250359. eCollection 2021.

ABSTRACT

Tobacco smoking is associated with an increased risk of oral leukoplakia and head and neck cancer. Although it has recently been reported that the establishment of an immunosuppressive microenvironment in oral potentially malignant disorders may lead to malignant transformation, it is unclear whether the microenvironments of oral potentially malignant disorders differ according to smoking status. We examined differences in programmed death-ligand 1 (PD-L1) expression and subepithelial CD163+ TAM and CD8+ cell/lymphocyte counts in the microenvironment of oral leukoplakia of smoking and non-smoking patients and investigated their associations with malignant transformation. Pathology reports and original biopsy request forms from 1995-2015 were retrospectively reviewed. Lesions clinically characterized as white plaques/lesions of the oral mucosa and pathologically diagnosed as oral epithelial dysplasia were included. Immunohistochemistry was performed to evaluate PD-L1 expression and subepithelial CD163+/CD8+ cell counts. The significance of prognostic factors in predicting malignant transformation was determined using Cox regression analysis. Statistical significance was defined as P<0.05. In total, 200 patients with oral leukoplakia were selected. The mean age at diagnosis was higher in non-smoking patients (n = 141; 66.9 years) than in smoking patients (n = 59; 60.5 years). The 5-year cumulative malignant transformation rate was higher in non-smoking patients than in smoking patients (9.3% vs. 3.0%, respectively). Oral leukoplakia was associated with significantly higher PD-L1 expression and increased numbers of subepithelial CD163+ cells in the non-smoking group compared with the smoking group. Non-smoking-related oral leukoplakia with positive PD-L1 expression was associated with a 6.97-fold (95% confidence interval: 2.14-22.7) increased risk of malignant transformation. The microenvironment of oral leukoplakia differed according to smoking status. A combination of smoking status and PD-L1 expression may predict malignant transformation in oral leukoplakia patients. This study highlights the importance of understanding the interaction between smoking and the microenvironment in oral leukoplakia.

PMID:33861793 | DOI:10.1371/journal.pone.0250359

PLoS One. 2021 Apr 16;16(4):e0250323. doi: 10.1371/journal.pone.0250323. eCollection 2021.

ABSTRACT

With current trends in cannabis legalization, large efforts are being made to understand the effects of less restricted legislation on human consumption, health, and abuse of these products. Little is known about the effects of cannabis legalization and increased cannabis use on vulnerable populations, such as dogs. The objective of this study was to examine the effects of different state-level cannabis legislation, county-level socioeconomic factors, and dog-level characteristics on dog cannabis poisoning reports to an animal poison control center (APCC). Data were obtained concerning reports of dog poisoning events, county characteristics, and state cannabis legislation from the American Society for the Prevention of Cruelty to Animals’ (ASPCA) APCC, the US Census Bureau, and various public policy-oriented and government websites, respectively. A multilevel logistic regression model with random intercepts for county and state was fitted to investigate the associations between the odds of a call to the APCC being related to a dog being poisoned by a cannabis product and the following types of variables: dog characteristics, county-level socioeconomic characteristics, and the type of state-level cannabis legislation. There were significantly higher odds of a call being related to cannabis in states with lower penalties for cannabis use and possession. The odds of these calls were higher in counties with higher income variability, higher percentage of urban population, and among smaller, male, and intact dogs. These calls increased throughout the study period (2009-2014). Reporting of cannabis poisonings were more likely to come from veterinarians than dog owners. Reported dog poisonings due to cannabis appear to be influenced by dog-level and community-level factors. This study may increase awareness to the public, public health, and veterinary communities of the effects of recreational drug use on dog populations. This study highlights the need to educate dog owners about safeguarding cannabis products from vulnerable populations.

PMID:33861797 | DOI:10.1371/journal.pone.0250323

PLoS One. 2021 Apr 16;16(4):e0250321. doi: 10.1371/journal.pone.0250321. eCollection 2021.

ABSTRACT

OBJECTIVE: Obesity is a negative prognostic factor for various clinical conditions. In this observational cohort study, we evaluated a CT-based assessment of the adipose tissue distribution as a potential non-invasive prognostic parameter in critical illness.

METHODS: Routine CT-scans upon admission to the intensive care unit (ICU) were used to analyze the visceral and subcutaneous adipose tissue areas at the 3rd lumbar vertebra in 155 patients. Results were correlated with various prognostic markers and both short-term- and overall survival. Multiple statistical tools were used for data analysis.

RESULTS: We observed a significantly larger visceral adipose tissue area in septic patients compared to non-sepsis patients. Interestingly, patients requiring mechanical ventilation had a significantly higher amount of visceral adipose tissue correlating with the duration of mechanical ventilation. Moreover, both visceral and subcutaneous adipose tissue area significantly correlated with several laboratory markers. While neither the visceral nor the subcutaneous adipose tissue area was predictive for short-term ICU survival, patients with a visceral adipose tissue area above the optimal cut-off (241.4 cm2) had a significantly impaired overall survival compared to patients with a lower visceral adipose tissue area.

CONCLUSIONS: Our study supports a prognostic role of the individual adipose tissue distribution in critically ill patients. However, additional investigations need to confirm our suggestion that routine CT-based assessment of adipose tissue distribution can be used to yield further information on the patients’ clinical course. Moreover, future studies should address functional and metabolic analysis of different adipose tissue compartments in critical illness.

PMID:33861804 | DOI:10.1371/journal.pone.0250321