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Nevin Manimala Statistics

Symptoms and SARS-CoV-2 positivity in the general population in the UK

Clin Infect Dis. 2021 Nov 8:ciab945. doi: 10.1093/cid/ciab945. Online ahead of print.

ABSTRACT

BACKGROUND: ‘Classic’ symptoms (cough, fever, loss of taste/smell) prompt SARS-CoV-2 PCR-testing in the UK. Studies have assessed the ability of different symptoms to identify infection, but few have compared symptoms over time (reflecting variants) and by vaccination status.

METHODS: Using the COVID-19 Infection Survey, sampling households across the UK, we compared symptoms in PCR-positives vs. PCR-negatives, evaluating sensitivity of combinations of 12 symptoms (percentage symptomatic PCR-positives reporting specific symptoms) and tests per case (TPC) (PCR-positives or PCR-negatives reporting specific symptoms/ PCR-positives reporting specific symptoms).

RESULTS: Between April 2020 and August 2021, 27,869 SARS-CoV-2 PCR-positive episodes occurred in 27,692 participants (median 42 years), of whom 13,427 (48%) self-reported symptoms (“symptomatic PCR-positives”). The comparator comprised 3,806,692 test-negative visits (457,215 participants); 130,612 (3%) self-reported symptoms (“symptomatic PCR-negatives”). Symptom reporting in PCR-positives varied by age, sex, and ethnicity, and over time, reflecting changes in prevalence of viral variants, incidental changes (e.g. seasonal pathogens (with sore throat increasing in PCR-positives and PCR-negatives from April 2021), schools re-opening) and vaccination roll-out. After May-2021 when Delta emerged, headache and fever substantially increased in PCR-positives, but not PCR-negatives. Sensitivity of symptom-based detection increased from 74% using ‘classic’ symptoms, to 81% adding fatigue/weakness, and 90% including all eight additional symptoms. However, this increased TPC from 4.6 to 5.3 to 8.7.

CONCLUSIONS: Expanded symptom combinations may provide modest benefits for sensitivity of PCR-based case detection, but this will vary between settings and over time, and increases tests/case. Large-scale changes to targeted PCR-testing approaches require careful evaluation given substantial resource and infrastructure implications.

PMID:34748629 | DOI:10.1093/cid/ciab945

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Nevin Manimala Statistics

Association of Impaired Fasting Glucose with Cardiovascular Disease in the Absence of Risk Factor

J Clin Endocrinol Metab. 2021 Nov 8:dgab809. doi: 10.1210/clinem/dgab809. Online ahead of print.

ABSTRACT

BACKGROUND: The association between impaired fasting glucose (IFG) and cardiovascular disease (CVD) in participants without atherosclerotic cardiovascular disease (ASCVD) risk factors based on current definitions is unclear. The study aimed to examine the association of fasting glucose levels with CVD and its subtypes in persons without ASCVD risk factors.

METHODS: This study included 38,297 participants (men, 62.1%; mean age, 47.9 [12.9] years) who were free of a history of CVD, absent of ASCVD risk factors, and had a fasting plasma glucose (FPG) level between 70 to 125 mg/dl at baseline from Kailuan Study during 2006 to 2007, participants were followed up until new-onset CVD event, death or December 31, 2017. Cox proportional hazards models were performed to evaluate the associations.

RESULTS: During a median follow-up of 11.0 years (interquartile range, 10.7-11.2 years), we observed 1,217 incident CVD events. Compared with participants with FPG 70 to 99 mg/dl, the multivariable adjusted hazard ratios for CVD among participants with FPG 100 to 109 mg/dl and 110 to 125 mg/dl were 1.18 (95% confidence interval [CI], 1.02-1.38) and 1.27 (95%CI, 1.03-1.55), respectively. Multivariable-adjusted spline regression model showed a J-shaped association between FPG and the risk of CVD.

CONCLUSIONS: We found that among individuals without diabetes or other traditional ASCVD risk factors, there is an increased risk of incident CVD with increasing abnormal FPG levels. These results highlight the importance of primordial prevention for FPG level increases along with other traditional ASCVD risk factors.

PMID:34748624 | DOI:10.1210/clinem/dgab809

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Nevin Manimala Statistics

Cytomegalovirus seroprevalence among U.S. children 1 to 5 years of age: The National Health and Nutrition Examination Surveys (NHANES), 2017 – March 2020 Pre-pandemic dataset

Clin Infect Dis. 2021 Nov 8:ciab947. doi: 10.1093/cid/ciab947. Online ahead of print.

NO ABSTRACT

PMID:34748626 | DOI:10.1093/cid/ciab947

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Nevin Manimala Statistics

A cross-sectional investigation of SARS-CoV-2 seroprevalence and associated risk factors in children and adolescents in the United States

PLoS One. 2021 Nov 8;16(11):e0259823. doi: 10.1371/journal.pone.0259823. eCollection 2021.

ABSTRACT

BACKGROUND: Pediatric SARS-CoV-2 data remain limited and seropositivity rates in children were reported as <1% early in the pandemic. Seroepidemiologic evaluation of SARS-CoV-2 in children in a major metropolitan region of the US was performed.

METHODS: Children and adolescents ≤19 years were enrolled in a cross-sectional, observational study of SARS-CoV-2 seroprevalence from July-October 2020 in Northern Virginia, US. Demographic, health, and COVID-19 exposure information was collected, and blood analyzed for SARS-CoV-2 spike protein total antibody. Risk factors associated with SARS-CoV-2 seropositivity were analyzed. Orthogonal antibody testing was performed, and samples were evaluated for responses to different antigens.

RESULTS: In 1038 children, the anti-SARS-CoV-2 total antibody positivity rate was 8.5%. After multivariate logistic regression, significant risk factors included Hispanic ethnicity, public or absent insurance, a history of COVID-19 symptoms, exposure to person with COVID-19, a household member positive for SARS-CoV-2 and multi-family or apartment dwelling without a private entrance. 66% of seropositive children had no symptoms of COVID-19. Secondary analysis included orthogonal antibody testing with assays for 1) a receptor binding domain specific antigen and 2) a nucleocapsid specific antigen had concordance rates of 80.5% and 79.3% respectively.

CONCLUSIONS: A much higher burden of SARS-CoV-2 infection, as determined by seropositivity, was found in children than previously reported; this was also higher compared to adults in the same region at a similar time. Contrary to prior reports, we determined children shoulder a significant burden of COVID-19 infection. The role of children’s disease transmission must be considered in COVID-19 mitigation strategies including vaccination.

PMID:34748615 | DOI:10.1371/journal.pone.0259823

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Nevin Manimala Statistics

A short comparative study on modified Duckworth-Lewis methods

PLoS One. 2021 Nov 8;16(11):e0259423. doi: 10.1371/journal.pone.0259423. eCollection 2021.

ABSTRACT

In this paper, the Duckworth-Lewis-Stern (DLS) and Duckworth-Lewis-McHale-Asif (DLMA) methods of revising targets for a team batting in second innings in an interrupted Limited Overs International Cricket (LOI), are examined for fairness. The work discusses four significant points: flexibility, intuition, simplicity, and goodness-of-fit of the two mentioned methods. The research findings have shown that the DLMA method is better in every aspect than the DLS method. Further, the data of 1764 ODI matches played during 2004-2021 to investigate the compatibility of the DLMA for high run-scoring One-Day International matches. The results show that DLMA is compatible to the situation of the well-above run-scoring situation.

PMID:34748588 | DOI:10.1371/journal.pone.0259423

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Nevin Manimala Statistics

Magnification effect on fine motor skills of dental students

PLoS One. 2021 Nov 8;16(11):e0259768. doi: 10.1371/journal.pone.0259768. eCollection 2021.

ABSTRACT

OBJECTIVES: This study observed the effect of different magnification systems on dental students’ real and perceived fine motor skills.

METHODS: This was a laboratory-based experimental study. Students in the fifth year of an undergraduate dentistry program (N = 92) participated in this study. The dependent variables were real motor skills, perceived motor skills and time required to complete the fine motor skills test. The independent variable was the use of a magnification system under four conditions. For each condition, the Dental Manual Dexterity Assessment was performed, which consisted of inserting the #3195FF bur into targets positioned on a Styrofoam plate. The accuracy of each penetration of the targets was scored, using a point system with a maximum possible score of 246 points. Students’ perceived fine motor skills were assessed using a visual analog scale (VAS) that ranged from zero for no skills to ten for maximum skills. A descriptive statistical analysis and the repeated measures ANOVA were performed (α = 0.05).

RESULTS: The Galilean and Keplerian loupes were found to positively affect students’ real fine motor skills (p<0.01); however, perceived fine motor skills and time were significantly better (p<0.01) under the naked eye.

CONCLUSIONS: Dental students’ real fine motor skills were better when Galilean and Keplerian loupes were used, but the perceived fine motor skills were not.

PMID:34748614 | DOI:10.1371/journal.pone.0259768

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Nevin Manimala Statistics

Home, sweet home? The impact of working from home on the division of unpaid work during the COVID-19 lockdown

PLoS One. 2021 Nov 8;16(11):e0259580. doi: 10.1371/journal.pone.0259580. eCollection 2021.

ABSTRACT

A lockdown implies a shift from the public to the private sphere, and from market to non-market production, thereby increasing the volume of unpaid work. Already before the pandemic, unpaid work was disproportionately borne by women. This paper studies the effect of working from home for pay (WFH), due to a lockdown, on the change in the division of housework and childcare within couple households. While previous studies on the effect of WFH on the reconciliation of work and family life and the division of labour within the household suffered from selection bias, we are able to identify this effect by drawing upon the shock of the first COVID-19 lockdown in Austria. The corresponding legal measures left little choice over WFH. In any case, WFH is exogenous, conditional on a small set of individual and household characteristics we control for. We employ data from a survey on the gendered aspects of the lockdown. The dataset includes detailed information on time use during the lockdown and on the quality and experience of WFH. Uniquely, this survey data also includes information on the division, and not only magnitude, of unpaid work within households. Austria is an interesting case in this respect as it is characterized by very conservative gender norms. The results reveal that the probability of men taking on a larger share of housework increases if men are WFH alone or together with their female partner. By contrast, the involvement of men in childcare increased only in the event that the female partner was not able to WFH. Overall, the burden of childcare, and particularly homeschooling, was disproportionately borne by women.

PMID:34748585 | DOI:10.1371/journal.pone.0259580

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Nevin Manimala Statistics

Contribution of “complete response to treatment” to survival in patients with unresectable metastatic colorectal cancer: A retrospective analysis

PLoS One. 2021 Nov 8;16(11):e0259622. doi: 10.1371/journal.pone.0259622. eCollection 2021.

ABSTRACT

BACKGROUND: The aim of the study is to reveal the contribution of complete response (CR) to treatment to overall survival (OS) in patients with unresectable metastatic colorectal cancer. In addition, to evaluate progression-free survival (PFS) in patients who attained CR to treatment and to examine the clinicopathologic features of the patient group with CR.

METHODS: This article is a retrospective chart review. Patients diagnosed with metastatic colorectal cancer were divided into two groups. The systemic treatment was compared with the patients who received a full response according to the Response Evaluation Criteria in Solid Tumors (RECIST1.1) and those who did not attain CR (progression partial response and stable response) in terms of both PFS and OS data, and the effect of attaining CR to treatment on prognosis was evaluated.

RESULTS: A total of 222 patients were included in the study. 202 of 222 patients could be evaluated in terms of complete response. All data from their files were tabulated and analyzed retrospectively. The mean age of diagnosis of the study group was 60.13 ± 12.52 years. The total number of patients who attained CR to treatment was 31 (15.3%); 171 (84.6%) patients did not attain CR. Patients who had a CR had longer median PFS times than patients who did not have a CR (15.2 vs. 7.4 months, P<0.001). Patients who had CR had longer median survival times than patients who did not have a CR (39.2 vs. 16.9 months, P<0.001). In subgroup patients who underwent primary surgery, the number of patients who attained CR was statistically higher compared with the number of patients who did not attain CR (p<0.001). Complete response was less common in the presence of liver metastasis and bone metastasis (p = 0.041 and p = 0.046, respectively), had a negative prognostic effect. In other words, 89.1% of patients with liver metastasis, 100.0% of patients with bone metastasis, and 88.7% of those who died did not have a CR to the treatment. According to multivariate analysis, CR to treatment, primary surgery, first-line chemotherapy (combination compared with fluoropyrimidine), and no bone metastasis were found to be predictors for OS.

CONCLUSION: Providing CR with systemic treatment in patients with unresectable metastatic colorectal cancer (mCRC) contributes to prognosis. The primary resection in our secondary acquisitions from the study, the number of metastatic regions and the combination therapy regimens also contributed to the prognosis.

PMID:34748587 | DOI:10.1371/journal.pone.0259622

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Nevin Manimala Statistics

Temporal SNR optimization through RF coil combination in fMRI: The more, the better?

PLoS One. 2021 Nov 8;16(11):e0259592. doi: 10.1371/journal.pone.0259592. eCollection 2021.

ABSTRACT

For functional MRI with a multi-channel receiver RF coil, images are often reconstructed channel by channel, resulting into multiple images per time frame. The final image to analyze usually is the result of the covariance Sum-of-Squares (covSoS) combination across these channels. Although this reconstruction is quasi-optimal in SNR, it is not necessarily the case in terms of temporal SNR (tSNR) of the time series, which is yet a more relevant metric for fMRI data quality. In this work, we investigated tSNR optimality through voxel-wise RF coil combination and its effects on BOLD sensitivity. An analytical solution for an optimal RF coil combination is described, which is somewhat tied to the extended Krueger-Glover model involving both thermal and physiological noise covariance matrices. Compared experimentally to covSOS on four volunteers at 7T, the method yielded great improvement of tSNR but, surprisingly, did not result into higher BOLD sensitivity. Solutions to improve the method such as for example the t-score for the mean recently proposed are also explored, but result into similar observations once the statistics are corrected properly. Overall, the work shows that data-driven RF coil combinations based on tSNR considerations alone should be avoided unless additional and unbiased assumptions can be made.

PMID:34748584 | DOI:10.1371/journal.pone.0259592

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Nevin Manimala Statistics

Effect of decision to delivery interval on perinatal outcomes during emergency cesarean deliveries in Ethiopia: A prospective cohort study

PLoS One. 2021 Nov 8;16(11):e0258742. doi: 10.1371/journal.pone.0258742. eCollection 2021.

ABSTRACT

BACKGROUND: The National guidelines of most developed countries suggest a target of 30 minutes of the decision to delivery interval for emergency cesarean section. Such guidelines may not be feasible in poorly resourced countries and busy obstetric settings. It is generally accepted that the decision to delivery interval should be kept to the minimum time achievable to prevent adverse outcomes. Therefore, this study aimed to determine the average decision to delivery interval and its effect on perinatal outcomes in emergency cesarean section.

METHODS: A prospective cohort study was conducted from May to July 2020 at Bahir Dar City Public Hospitals. A total of 182 participants were enrolled, and data were collected using a structured and pre-tested questionnaire. A systematic sampling technique was applied to select the study subjects. Data were cleaned and entered into Epi-Data version 4.6 and exported to SPSS version 25 software for analysis. Logistic regression analysis was performed to identify predictors of outcome variables, and variables with a p-value of <0.05 were considered statistically significant.

RESULTS: The average decision to delivery interval was 43.73 ±10.55 minutes. Anesthesia time [AOR = 2.1, 95%CI = (1.3-8.4)], and category of emergency cesarean section [AOR = 3, 95% CI = (2.1-11.5)] were predictors of decision to delivery interval. The prolonged decision to delivery interval had a statistically significant association with composite adverse perinatal outcomes (odds ratio [OR] = 1.8, 95% confidence interval [CI] = (1.2-6.5).

CONCLUSION: The average decision to delivery interval was longer than the recommended time. It should always be considered an important factor contributing to perinatal outcomes. Therefore, to prevent neonatal morbidity and mortality, a time-dependent action is needed.

PMID:34748563 | DOI:10.1371/journal.pone.0258742