Nevin Manimala

J Med Internet Res. 2021 Mar 4. doi: 10.2196/27009. Online ahead of print.

ABSTRACT

BACKGROUND: The dissemination of rumor rebuttal on social media is vital for rumor control and disease containment during the public health crisis. Previous researches on the effectiveness of rumor rebuttal, to a certain extent, ignored or simplified the structure of dissemination network and users’ cognition, decision-making and interaction behaviors.

OBJECTIVE: This research aimed to roughly evaluate the effectiveness of rumor rebuttal, deeply dig into the attitude-based echo chamber effect in the users’ response towards rumor rebuttal under multiple topics on Weibo, a Chinese social media, in the early stage of COVID-19 epidemic, and its impact on information characteristics of user interaction content.

METHODS: We called Sina Weibo API to crawl rumor rebuttal related to COVID-19 from 10:00 a.m. on January 23, 2020 to 0:00 a.m. on April 8, 2020. Using content analysis, sentiment analysis, social network analysis and statistical analysis, we first analyzed whether and to what extent there was echo chamber effect in individual’s attitude shaping when retweeting or commenting on others. Then, we tested the heterogeneity of attitude distribution within communities and the homophily of interactions between communities. Based on the results of user- and community- levels, we made comprehensive judgments. Finally, we examined the users’ interaction content from three dimensions of sentimental expression, information seeking/sharing, and civilization to test the impact of echo chamber effect.

RESULTS: Our results indicated that the retweeting mechanism played an essential role in promoting polarization and the commenting mechanism in consensus building, denied that there might be significant echo chamber effect in community interaction, and verified that compared to like-minded interactions, cross-cutting interactions significantly contained more negative sentiment, information seeking/sharing and incivility. Besides, we found that online users’ information seeking was accompanied by incivility, and information sharing was accompanied by more negative sentiment, which was often accompanied by incivility.

CONCLUSIONS: Our findings revealed the existence and degree of echo chamber effect from multiple dimensions (such as topic, interaction mechanism, interaction level) and its impact on interaction content. These findings can provide several suggestions for preventing or alleviating group polarization to achieve better rumor rebuttal.

PMID:33690145 | DOI:10.2196/27009

IEEE Trans Vis Comput Graph. 2021 Mar 10;PP. doi: 10.1109/TVCG.2021.3065124. Online ahead of print.

ABSTRACT

This paper contributes a novel visualization method, Missingness Glyph, for analysis and exploration of missing values in data. Missing values are a common challenge in most data generating domains and may cause a range of analysis issues. Missingness in data may indicate potential problems in data collection and pre-processing, or highlight important data characteristics. While the development and improvement of statistical methods for dealing with missing data is a research area in its own right, mainly focussing on replacing missing values with estimated values, considerably less focus has been put on visualization of missing values. Nonetheless, visualization and explorative analysis has great potential to support understanding of missingness in data, and to enable gaining of novel insights into patterns of missingness in a way that statistical methods are unable to. The Missingness Glyph supports identification of relevant missingness patterns in data, and is evaluated and compared to two other visualization methods in context of the missingness patterns. The results are promising and confirms that the Missingness Glyph in several cases perform better than the alternative visualization methods.

PMID:33690119 | DOI:10.1109/TVCG.2021.3065124

Seizure. 2021 Mar 4;87:56-60. doi: 10.1016/j.seizure.2021.03.003. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to evaluate the incidence and period prevalence of epilepsy in the Republic of North Macedonia, an upper-middle-income country with universal access to healthcare, based on a nationwide healthcare platform (NHP).

METHODS: NHP contains reports from all inpatient and outpatient medical encounters and procedures, and all electronic medical records are linked together with a unique patient number. We performed the analysis of the data maintained at the Macedonian Ministry of Health, concerning the five years of the study (2014 through 2018). Population and demographic data for each year were obtained from the State Statistical Office.

RESULTS: The period prevalence was 6.67 per 1,000 inhabitants. There were 6383 (46.2%) females and 7435 (53.8%) males; the gender difference was significant: 6.17 per 1,000 females and 7.16 per 1,000 males (p = 0.0000). Between 2015 and 2018 the median annual incidence of epilepsy was 68 new epilepsy patients per 100,000, with an upward trend over time. The age-specific incidence was high in childhood and adolescence, was constant (and low) in the adult years, and gradually increased in each successive age group after the age of 50 years. The greatest incidence was found in group 70-79 years of age. The incidence in childhood and adolescence tends to gradually decrease from 2015 to 2018, while it progressively increased in population over 50 years of age, which may explain a rise in overall incidence. We found a statistically significant higher incidence in males than in females, a ratio consistently being 1.2: 1.

CONCLUSION: The data from the study provides accurate findings on the prevalence and incidence of epilepsy in the upper-middle-income Southeastern European country.

PMID:33690108 | DOI:10.1016/j.seizure.2021.03.003

J Surg Res. 2021 Mar 6;263:207-214. doi: 10.1016/j.jss.2021.01.043. Online ahead of print.

ABSTRACT

BACKGROUND: Childhood papillary thyroid cancer is more aggressive than carcinomas in adults. Current American Thyroid Association pediatric guidelines recommend a total or near-total thyroidectomy for all pediatric patients without gross evidence of lymph node metastases. Our objective is to analyze trends in the surgical management of pediatric papillary thyroid cancer and assess how well the guidelines are implemented.

METHODS: A retrospective cohort study of pediatric patients (ages 19 y and under) who underwent a thyroidectomy was conducted using the Surveillance, Epidemiology, and End Results database 2006-2017. Procedure type was classified as lobectomy or less and subtotal or total thyroidectomy. Descriptive statistics to illustrate patient and tumor characteristics as well as chi-square analysis to evaluate frequency of treatment with total thyroidectomies versus lobectomy or less were performed. Logistic regression analysis controlling for age, sex, size of tumor, rural versus urban institutions, and surgery year was conducted to identify factors predictive of procedure type.

RESULTS: A total of 2271 children underwent surgical management of papillary thyroid cancer between 2006 and 2017. Most patients received a subtotal or total thyroidectomy as surgical management (n = 2,085, 91.8%). One hundred eighty-six patients (8.2%) received a lobectomy or less. The number of lobectomies or less increased with time, with 41 (6.6%) patients between 2006 and 2009, 98 (8.0%) between 2009 and 2015, and 47 (11.1%) between 2016 and 2017 (P = 0.03). Mortality rates were low (n = 15, 0.7%). On logistic regression analysis, later stages, larger sizes, and earlier operative years were predictive of a near-total or total thyroidectomy.

CONCLUSIONS: Despite the American Thyroid Association Guidelines recommending a total thyroidectomy for pediatric well-differentiated thyroid cancer, the results of this study demonstrate that thyroid lobectomies are being performed in increasing frequency for smaller tumors in earlier stages of disease. Further investigation of whether this trend actually affects the outcomes in this patient cohort is needed.

PMID:33690052 | DOI:10.1016/j.jss.2021.01.043

Appl Ergon. 2021 Mar 6;94:103384. doi: 10.1016/j.apergo.2021.103384. Online ahead of print.

ABSTRACT

Despite female soldiers representing a growing user population, military body armour systems are currently better suited to the anthropometric dimensions of male soldiers. The aim of this study was to explore issues that female soldiers experience with current Australian Defence Force (ADF)-issue body armour. Following a sequential exploratory design, an initial questionnaire was completed by 97 Australian female soldiers. Subsequently, 33 Australian female soldiers participated in one of three focus groups. Descriptive statistics of questionnaire data considered alongside thematic analysis of focus group transcripts revealed problems with the design (fit, form and function) of current ADF-issue body armour, as well as problems with the issuance and education surrounding use of the system. It is recommended that anthropometric data of female soldiers be better incorporated into future body armour designs, that these data inform processes surrounding both acquisition and issuance of body armour and that training protocols for body armour use be reviewed.

PMID:33690018 | DOI:10.1016/j.apergo.2021.103384

Comput Med Imaging Graph. 2021 Feb 25;89:101888. doi: 10.1016/j.compmedimag.2021.101888. Online ahead of print.

ABSTRACT

Unruptured intracranial aneurysms (UIAs) are prevalent neurovascular anomalies which, in rare circumstances, rupture to cause a catastrophic subarachnoid haemorrhage. Although surgical management can reduce rupture risk, the majority of UIAs exist undiscovered until rupture. Current clinical practice in the detection of UIAs relies heavily on manual radiological review of standard imaging modalities. Recent computer-aided UIA diagnoses can sensitively detect and measure UIAs within cranial angiograms but remain limited to low specificities whose output also requires considerable radiologist interpretation not amenable to broad screening efforts. To address these limitations, we have developed a novel automatic pipeline algorithm which inputs medical images and outputs detected UIAs by characterising single-voxel morphometry of segmented neurovasculature. Once neurovascular anatomy of a specified resolution is segmented, correlations between voxel-specific morphometries are estimated and spatially-clustered outliers are identified as UIA candidates. Our automated solution detects UIAs within magnetic resonance angiograms (MRA) at unmatched 86% specificity and 81% sensitivity using 3 min on a conventional laptop. Our approach does not rely on interpatient comparisons or training datasets which could be difficult to amass and process for rare incidentally discovered UIAs within large MRA files, and in doing so, is versatile to user-defined segmentation quality, to detection sensitivity, and across a range of imaging resolutions and modalities. We propose this method as a unique tool to aid UIA screening, characterisation of abnormal vasculature in at-risk patients, morphometry-based rupture risk prediction, and identification of other vascular abnormalities.

PMID:33690001 | DOI:10.1016/j.compmedimag.2021.101888

Drug Alcohol Depend. 2021 Feb 19;221:108594. doi: 10.1016/j.drugalcdep.2021.108594. Online ahead of print.

ABSTRACT

BACKGROUND: Sexual and gender minority (SGM) young persons are experiencing compounding effects of COVID-19 due to unique social inequalities and existent mental health and substance use challenges. Given that 41% of all young persons are enrolled in universities, and the increased vulnerabilities faced by SGM young persons during the pandemic, it is imperative to understand the effects of alcohol use on mental health among SGM university students amid COVID-19. This study aims to examine the associations between changes in alcohol use since the start of COVID-19 and mental distress among SGM university students in the U.S., and to explore sex-stratified differences.

METHODS: A nonprobability cross-sectional sample of 509 SGM university students (M_age = 22.04 years, SD = 3.99) were retrospectively surveyed online between May-August 2020 and asked if their alcohol use had changed since the start of COVID-19. Statistical analyses explored the association between changes in alcohol use since the start of COVID-19 and mental distress.

RESULTS: Average psychological distress (M = 27.79, SD = 7.82) was relatively high as per existing research and established clinical cutoff scores. Roughly 32% had increased alcohol use since the start of COVID-19. Subsequently, greater alcohol use (p < .05) since the start of COVID-19 was associated with higher psychological distress among SGM university students, and among females but not males assigned at birth.

CONCLUSIONS: Higher education, medical, and behavioral health professionals should consider how to adapt their practice to address alcohol use and psychological burdens among SGM university students (especially females) who are facing health inequities during and beyond COVID-19, requiring SGM-affirmative care.

PMID:33689965 | DOI:10.1016/j.drugalcdep.2021.108594

Environ Pollut. 2021 Feb 22;278:116752. doi: 10.1016/j.envpol.2021.116752. Online ahead of print.

ABSTRACT

Stillbirth has a great impact on contemporary and future generations. Increasing evidence show that ambient air pollution exposure is associated with stillbirth. However, previous studies showed inconsistent findings. To clarify the effect of maternal air pollution exposure on stillbirth, we searched for studies examining the associations between air pollutants, including particulate matter (diameter ≤ 2.5 μm [PM_2.5] and ≤10 μm [PM₁₀]) and gaseous pollutants (sulfur dioxide [SO₂], nitrogen dioxide [NO₂], carbon monoxide [CO] and ozone [O₃]), and stillbirth published in PubMed, Web of Science, Embase and Cochrane Library until December 11, 2020. The pooled effect estimates and 95% confidence intervals (CI) were calculated, and the heterogeneity was evaluated using Cochran’s Q test and I² statistic. Publication bias was assessed using funnel plots and Egger’s tests. Of 7546 records, 15 eligible studies were included in this review. Results of long-term exposure showed that maternal third trimester PM_2.5 and CO exposure (per 10 μg/m³ increment) increased the odds of stillbirth, with estimated odds ratios (ORs) of 1.094 (95% CI: 1.008-1.180) and 1.0009 (95% CI: 1.0001-1.0017), respectively. Entire pregnancy exposure to PM_2.5 was also associated with stillbirth (OR: 1.103, 95% CI: 1.074-1.131). A 10 μg/m³ increment in O₃ in the first trimester was associated with stillbirth, and the estimated OR was 1.028 (95% CI: 1.001-1.055). Short-term exposure (on lag day 4) to O₃ was also associated with stillbirth (OR: 1.002, 95% CI: 1.001-1.004). PM₁₀, SO₂ and NO₂ exposure had no significant effects on the incidence of stillbirth. Additional well-designed cohort studies and investigations regarding potential biological mechanisms are warranted to elaborate the suggestive association that may help improve intergenerational inequality.

PMID:33689950 | DOI:10.1016/j.envpol.2021.116752

Pract Radiat Oncol. 2021 Mar 6:S1879-8500(21)00059-X. doi: 10.1016/j.prro.2021.02.009. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to investigate the contemporary distribution of medical physics (MP) employment opportunities across the country.

METHODS: An annual record (2018-19) of advertised full-time MP jobs were created using publicly available information from the aapm.org, American Association of Physicists in Medicine – AAPM and indeed.com websites. Listed jobs were categorized based on the position name, work experience, job function, and geographical region. To account for regional population differences, a preponderance of employment opportunities per 10 million was computed. Using CAMPEP residency accreditation data the nationwide locations of the MP training centers and the number of residency positions per annum were identified. A Chi-square goodness of fit test was used for statistical analysis.

RESULTS: A total of 441 unique MP jobs were reported nationwide per annum (2018-19). The highest percentage of MP jobs was reported from the South (33.6%), and the lowest (17.2%) was from the West region. Current analysis revealed 148 (33.6%) jobs were academic and 293 (66.4%) non-academic. The South shows the highest overall academic jobs (31.8%), while the West had the lowest (13.5%). Regionally, the highest percentage of academic jobs (46.9%) were reported from the Northeast, while the West showed the lowest (26.3%). The analysis of academic versus non-academic job comparison by regions shows statistically significant (P=0.0133) differences. The Midwest and the West regions showed the highest (18.2) and lowest (10.24) number of jobs per unit population, measured in 10 million.

CONCLUSION: This is one of the first national quantitative job data analyses of the MP job distributions. This study revealed the current level of demand for qualified candidates demonstrating an imbalance between academic and non-academic positions over the regions. Moreover, the geographical distribution of job listings deviated significantly from expectation given the relative population of each region.

PMID:33689922 | DOI:10.1016/j.prro.2021.02.009

Contemp Clin Trials. 2021 Mar 6:106336. doi: 10.1016/j.cct.2021.106336. Online ahead of print.

ABSTRACT

Matched-pair cluster randomization design is becoming increasingly used in clinical and health behavioral studies. Investigators often encounter incomplete observations in the data collected. Statistical inference for matched-pair cluster randomization design with incomplete observations has been extensively studied in literature. However, sample size method for such study design is sparsely available. We propose a closed-form sample size formula for matched-pair cluster randomization design with continuous outcomes, based on the generalized estimating equation approach by treating incomplete observations as missing data in a marginal linear model. The sample size formula is flexible to accommodate different correlation structures, missing patterns, and magnitude of missingness. In the presence of missing data, the proposed method would lead to a more accurate sample size estimation than the crude adjustment method. Simulation studies are conducted to evaluate the finite-sample performance of the proposed sample size method under various design configurations. We use bias-corrected variance estimators to address the issue of inflated type I error when the number of clusters per group is small. A real application example of physical fitness study in Ecuadorian adolescents is presented for illustration.

PMID:33689919 | DOI:10.1016/j.cct.2021.106336