Tag: statistics

Facial Plast Surg Aesthet Med. 2024 Feb 19. doi: 10.1089/fpsam.2023.0281. Online ahead of print.

ABSTRACT

Background: Many open-access artificial intelligence (AI)-based websites that rate facial attractiveness are available, but none have been compared with human focus group outcomes. Objective: To compare human and AI-based websites scoring of facial attractiveness of adult female white faces. Methods: A 40-photograph database of AI-generated adult, white, female, expressionless, and frontal-view facial images were scored by otolaryngology residents and five AI-based facial rating websites: prettyscale.com, attractivenesstest.com, face-score.com/en, hotchat3000.com, and beautyscoretest.com. Sample t-test and bivariate correlation were performed for statistical analyses. Results: The focus group of 24 otolaryngology residents consisted of 62.5% males and 58.3% white participants. There was a strong positive correlation between average human score and average AI score for each photo (Pearson’s correlation 0.84, p < 0.01). The average human raters’ scores were significantly lower than the average AI scores (5.0 ± 1.8 vs. 6.9 ± 0.9, p < 0.01). Thirty images (75.0%) had statistically higher scores from the AI websites versus the focus group. On correlation analysis, all AI-based websites individually had scores that positively correlate with the human scores (all p < 0.05). Conclusion: AI-based websites and human focus-group scoring of facial attractiveness of adult white female faces were significantly correlated with the AI ratings biased toward higher values, encouraging their cautious utilization in future research.

PMID:38377584 | DOI:10.1089/fpsam.2023.0281

Diabetes Care. 2024 Feb 20:dc231652. doi: 10.2337/dc23-1652. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe disparities in prescribing and dispensing sodium-glucose cotransporter 2 inhibitors (SGLT2i) in Israel.

RESEARCH DESIGN AND METHODS: This was a population-based retrospective cohort study of adults with type 2 diabetes eligible for SGLT2i treatment from 2017 to 2023. The primary outcome was the time between initial eligibility and the first prescription of SGLT2i.

RESULTS: Among 32,742 eligible patients, only 53% were prescribed SGLT2i. Multivariable analyses, adjusting for death as a competing risk, revealed delays in prescription were associated with older age, Arab or Bedouin ethnicity, neoplasms, acute kidney failure, falls, previous hospitalization, urinary tract infections, and dementia. Factors associated with shorter time intervals to prescription were sex (men), medium/high socioeconomic status, and residing in an intermediate or central area of Israel.

CONCLUSIONS: Disparities in drug prescription exist, even in a country with universal health coverage. Addressing these disparities requires improvements in health care systems, education, and alert systems to overcome barriers to evidence-based interventions.

PMID:38377492 | DOI:10.2337/dc23-1652

J Interferon Cytokine Res. 2024 Feb;44(2):80-93. doi: 10.1089/jir.2023.0091.

ABSTRACT

Leptospirosis has a wide spectrum of clinical manifestations ranging from mild to severe disease. The cytokine response is considered one of the key drivers for this varying manifestation. The different cytokine response observed in patients with leptospirosis could be due to the variation of infecting serovars. Since the rfb locus codes for the lipopolysaccharide synthesis of the bacterial cell wall, which also determines the serovar, this locus may play a role in driving a specific cytokine response in the host. We investigated 12 commonly used cytokine profiles in serum samples of culture, microscopic agglutination test (MAT), or polymerase chain reaction (PCR)-positive patients with leptospirosis. The sequences of the rfb locus in culture-positive samples were generated from whole genome sequencing and serovar status was drawn from original data published. Isolated cultures were subjected to whole genome sequencing using the PacBio RS II system, and the resulting data were used to determine the species. The recovered genomic data were annotated with the Rapid Annotation using Subsystem Technology (RAST) subsystem, and the rfb locus was extracted. The cytokine analysis was carried out using the Qiagen human ELISA kit. Eighteen samples were found to be positive by culture, while the other 7 samples were positive by PCR or MAT. Infections from Leptospira interrogans serovar Autumnalis (5), Pyrogens (3), Icterohaemorrhagiae (1) Leptospira borgpetersenii (all 7 samples clustered in same clonal group with serovar status not determined), Leptospira weilii (1 with serovar status not determined), and Leptospira kirschneri serovar Grippotyphosa (1) were included in the analysis. Three patients [infected with Leptospira interrogansserovar Autumnalis (2) and Pyrogens (1)] and 2 MAT-positive patients (highest titer against serovar Bratislava of L.interrognas) were reported to have severe clinical manifestations, while the rest had mild to moderate symptoms. Although the serum cytokine concentration of patients with severe clinical manifestation was comparatively higher, a statistically significant difference was observed only for interleukin (IL)-1β (P < 0.05). IL-10/tumor necrosis factor-alpha (TNF-α) ratio was high in patients with severe complications. In general, patients infected with L. interrogans showed higher concentration of cytokines compared to L. borgpetersenii.

PMID:38377491 | DOI:10.1089/jir.2023.0091

J Physician Assist Educ. 2024 Mar 1;35(1):88-93. doi: 10.1097/JPA.0000000000000550. Epub 2023 Sep 1.

ABSTRACT

PURPOSE: To understand health care students’ perception of implicit bias and examine their insights to create a bias-free training environment.

METHODS: Clinical phase students from one university’s 4 health care programs participated in this study. Students were surveyed regarding their knowledge of implicit bias and perception of their experiences in the clinical learning environment.

RESULTS: The response rate was 50.9%, N = 161. In total, 52.6% reported having prior training on implicit bias, and 55% self-reported that they had personally observed preceptors who exhibited an implicit bias toward patients based on race, ethnicity, or other qualities. There was no statistically significant relationship between those with prior training on implicit bias and being able to identify implicit bias exhibited by preceptors. Participants also expressed their unwillingness to report an incident unless it is confidential due to fear of retribution.

CONCLUSION: This study found that health care students from one university’s 4 health care programs perceived implicit bias in their clinical learning environment, which they believe could be improved by taking intentional steps. Some suggestions provided were “Safe space to report and openly discuss bias,” “Education/training on implicit bias,” “Time for self-reflection,” and “Hiring process that evaluates/trains against implicit bias.” The implication of our study is to create a bias-free training environment that will help interrupt the propagation of biases contributing to health disparity. Further research should examine a national population and identify interventional methods and outcomes in multiple health care disciplines.

PMID:38377463 | DOI:10.1097/JPA.0000000000000550

J Occup Environ Med. 2024 Feb 20. doi: 10.1097/JOM.0000000000003076. Online ahead of print.

ABSTRACT

OBJECTIVE: The study identifies work-related risk factors that are relevant to mental health and quantifies their influence. This allows estimation of risk levels for individual workplaces and of the proportion of occupational causation in the emergence of mental health problems.

METHODS: Swiss Health Survey data, containing information on several potential risk factors and health indicators that cover aspects of mental health, were used in multiple multivariate logistic regression analyses.

RESULTS: Stress was the predominant risk factor, followed by exposure to violence, unergonomic work processes, and work that conflicted with family life. Hotel and restaurant industries and health and social services had high exposure to risk factors. One out of 20 workplaces was deemed high-risk based on an odds ratio > 4.

CONCLUSIONS: Up to one-third of mental health problems within the active workforce may have highly predominant occupational causation.

PMID:38377435 | DOI:10.1097/JOM.0000000000003076

Brain Behav Immun Health. 2019 Dec 17;2:100027. doi: 10.1016/j.bbih.2019.100027. eCollection 2020 Feb.

ABSTRACT

BACKGROUND: Psychobiological processes linking stress and vascular diseases remain poorly understood. The retina and the brain share a common embryonic-diencephalon origin and blood-barrier physiology e.g. ongoing ischemia facilitates S100B release with astrocytic activity and glial-fibrillary-acidic-protein expression (GFAP). However, GFAP decreases revealed astrocyte pathology in the prefrontal cortex of depression/suicide cases; and might be a key mechanism in stress – disease pathways.

METHODS: A chronic emotional stress phenotype independent of age, ethnicity or sex was used to stratify the current prospective cohort (N ​= ​359; aged 46 ​± ​9 years) into Stress (N ​= ​236) and no-Stress groups (N ​= ​123). Prospective data for glia ischemia risk markers were obtained, including 24 ​h BP, fasting S100B, GFAP, HbA_1C and tumor-necrosis-factor-α (TNF-α). At 3-yr follow-up: diastolic-ocular-perfusion-pressure (indicating hypo-perfusion risk) was measured and retinal vessel calibers were quantified from digital images in the mydriatic eye.

RESULTS: Higher hypertension (75% vs. 16%), diabetes (13% vs. 0%) and retinopathy (57% vs. 45%) prevalence was observed in Stress compared to no-Stress individuals. Stressed individuals had consistently raised S100B, TNF-α, HbA_1C and higher diastolic-ocular-perfusion-pressure, but decreases in GFAP and GFAP:S100B. Furthermore stroke risk markers, arterial narrowing and venous widening were associated with consistently raised S100B, GFAP:S100B (p ​= ​0.060), TNF-α and higher diastolic-ocular-perfusion-pressure [Adj. R² 0.39-0.41, p ​≤ ​0.05]. No retinal-glia associations were evident in the no-Stress group.

CONCLUSIONS: Retinal-glia ischemia and inflammation was induced by chronic stress. Persistent higher inflammation and S100B with GFAP decreases further reflected stress-induced astrocyte pathology in the human retina. It is recommended to increase awareness on chronic stress and susceptibility for brain ischemia.

PMID:38377420 | PMC:PMC8474432 | DOI:10.1016/j.bbih.2019.100027

J Natl Cancer Inst. 2024 Feb 20:djae038. doi: 10.1093/jnci/djae038. Online ahead of print.

ABSTRACT

BACKGROUND: Adolescents and young adults (AYAs) frequently receive chemotherapy near death. We know less about use of targeted agents and immunotherapy or trends over time.

METHODS: We conducted a retrospective cohort study of 1,836 AYAs with cancer who died between 2009-2019 after receiving care at one of three sites (Dana-Farber Cancer Institute, Kaiser Permanente Northern California, and Kaiser Permanente Southern California). We reviewed electronic health data and medical records to examine use of cancer-directed therapy in the last 90 days of life, including chemotherapy, targeted therapy, immunotherapy, and investigational drugs.

RESULTS: Over the study period, 35% of AYAs received chemotherapy in the last 90 days of life; 24% received targeted therapy, 7% immunotherapy, and 5% investigational drugs. Fifty-six percent received at least one form of systemic cancer-directed therapy in the last 90 days of life. After adjustment for patient sex, race, ethnicity, age, site of care, diagnosis, and years from diagnosis to death, the proportion of AYAs receiving targeted therapy (odds ratio (OR) 1.05 per year of death, 95% confidence interval (CI) 1.02-1.10, P = .006), immunotherapy (OR 1.27, 95%CI 1.18-1.38, P<.0001), and any cancer-directed therapy (OR1.04, 95%CI 1.01-1.08, P=.01) in the last 90 days of life increased over time.

CONCLUSIONS: More than half of AYAs receive cancer therapy in the last 90 days of life, and use of novel agents such as targeted therapy and immunotherapy are increasing over time. While some AYAs may wish to continue cancer therapy while living with advanced disease, efforts are needed to ensure that use of cancer-directed therapy meets preferences of AYAs approaching death.

PMID:38377408 | DOI:10.1093/jnci/djae038

Bioinformatics. 2024 Feb 20:btae098. doi: 10.1093/bioinformatics/btae098. Online ahead of print.

ABSTRACT

MOTIVATION: Missing values are commonly observed in metabolomics data from mass spectrometry (MS). Imputing them is crucial because it assures data completeness, increases the statistical power of analyses, prevents inaccurate results, and improves the quality of exploratory analysis, statistical modeling, and machine learning. Numerous Missing Value Imputation Algorithms (MVIAs) employ heuristics or statistical models to replace missing information with estimates. In the context of metabolomics data, we identified 52 MVIAs implemented across 70 R functions. Nevertheless, the usage of those 52 established methods poses challenges due to package dependency issues, lack of documentation and their instability.

RESULTS: Our R package, imputomics, provides a convenient wrapper around 41 (plus random imputation as a baseline model) out of 52 MVIAs in the form of a command-line tool and a web application. In addition, we propose a novel functionality for selecting MVIAs recommended for metabolomics data with the best performance or execution time.

AVAILABILITY: imputomics is freely available as an R package (github.com/BioGenies/imputomics) and a Shiny web application (biogenies.info/imputomics-ws). The documentation is available at biogenies.info/imputomics.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:38377398 | DOI:10.1093/bioinformatics/btae098

Aesthet Surg J. 2024 Feb 20:sjae039. doi: 10.1093/asj/sjae039. Online ahead of print.

ABSTRACT

BACKGROUND: The infraorbital hollow (IOH) is a concavity that interrupts the smooth transition between the lower eyelid and the cheek, resulting in a fatigued and aged appearance. Injectable fillers may be used to correct volume deficit in the under-eye area, restoring a more youthful appearance.

OBJECTIVES: To demonstrate the effectiveness and safety of a Cohesive Polydensified Matrix® (CPM) hyaluronic acid (HA) filler with lidocaine (Belotero Balance® (+)) for correcting volume deficit in the IOH.

METHODS: Eligible patients with a moderate or severe rating on the Merz Infraorbital Hollow Assessment Scale (MIHAS) were randomized 2:1 to treatment or control. Controls remained untreated until Week 8 and were then treated. Touch-up injections were allowed; retreatment was offered only in the treatment group. Effectiveness was evaluated by the MIHAS. Adverse events were recorded over a 76-week period.

RESULTS: The estimated average response rate (≥ 1 point MIHAS improvement) was 80.6% [95% confidence interval (CI): 71.4%, 87.4%] in treated patients and 1.9% [95% CI: 0.3%, 10.2%] in controls at Week 8. The difference in estimated response rates was 78.7% [95% CI: 66.3%, 85.6%], demonstrating a statistically significant, superior response rate in treated patients compared to untreated controls. A total of 88/97 (90.7%) patients who responded to treatment at Week 8 retained improvement 48 weeks after treatment. Use of Belotero Balance (+) in the IOH had a favorable safety profile, with no unexpected adverse events reported.

CONCLUSIONS: Belotero Balance (+) is a safe and effective treatment for correcting volume deficit in the IOH.

PMID:38377391 | DOI:10.1093/asj/sjae039

Aesthet Surg J. 2024 Feb 20:sjae035. doi: 10.1093/asj/sjae035. Online ahead of print.

ABSTRACT

BACKGROUND: Since the early 2000s, Acellular Dermal Matrix has been a popular adjunct to prepectoral breast reconstruction to enhance outcomes.

OBJECTIVES: This study investigated the differences in the postoperative course of two standard acellular dermal matrix companies, AlloDerm SELECT Ready To Use and DermACELL.

METHODS: A prospective, patient-blind study of patients undergoing bilateral nipple and/or skin-sparing mastectomies to either tissue expander or silicone implant insertion between 2019 to 2022 were selected for this study. The study design used patients as their own controls between two products randomly assigned to the left or right breast. Outcomes between the brands included average time for drain removal, infection rate, seroma rate, and incorporation rates.

RESULTS: Prospective clinical data of 55 patients (110 breasts) was recorded for 90 days. There were no significant differences between drain removal time, average drain output, or seroma aspiration amount. There was a higher percentage of seromas recorded in the breasts with AlloDerm (30.91%) compared to breasts containing DermACELL (14.55%, p < 0.05), and a statistically significant difference between incorporation rates of AlloDerm (93.4%) and DermACELL (99.8%, p < 0.05) was observed.

CONCLUSIONS: Irrespective of patient demographic disparities, both products had a 94.55% success rate for reconstruction outcomes. AlloDerm was determined to have a higher incidence of seromas as a postoperative complication and a trend to lower incorporation.

PMID:38377366 | DOI:10.1093/asj/sjae035