Tag: statistics

Stat Med. 2022 Feb 27. doi: 10.1002/sim.9357. Online ahead of print.

ABSTRACT

False negative rates of severe acute respiratory coronavirus 2 diagnostic tests, together with selection bias due to prioritized testing can result in inaccurate modeling of COVID-19 transmission dynamics based on reported “case” counts. We propose an extension of the widely used Susceptible-Exposed-Infected-Removed (SEIR) model that accounts for misclassification error and selection bias, and derive an analytic expression for the basic reproduction number R0 as a function of false negative rates of the diagnostic tests and selection probabilities for getting tested. Analyzing data from the first two waves of the pandemic in India, we show that correcting for misclassification and selection leads to more accurate prediction in a test sample. We provide estimates of undetected infections and deaths between April 1, 2020 and August 31, 2021. At the end of the first wave in India, the estimated under-reporting factor for cases was at 11.1 (95% CI: 10.7,11.5) and for deaths at 3.58 (95% CI: 3.5,3.66) as of February 1, 2021, while they change to 19.2 (95% CI: 17.9, 19.9) and 4.55 (95% CI: 4.32, 4.68) as of July 1, 2021. Equivalently, 9.0% (95% CI: 8.7%, 9.3%) and 5.2% (95% CI: 5.0%, 5.6%) of total estimated infections were reported on these two dates, while 27.9% (95% CI: 27.3%, 28.6%) and 22% (95% CI: 21.4%, 23.1%) of estimated total deaths were reported. Extensive simulation studies demonstrate the effect of misclassification and selection on estimation of R0 and prediction of future infections. A R-package SEIRfansy is developed for broader dissemination.

PMID:35224743 | DOI:10.1002/sim.9357

Aust Dent J. 2022 Feb 28. doi: 10.1111/adj.12908. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate the effect of three different surface treatments on the microhardness and color change of artificial enamel lesions.

MATERIALS AND METHODS: One hundred bovine teeth were randomly assigned into four groups. Artificial enamel lesions were created using demineralizing solution for all groups except the sound enamel group. Different surface treatments were then performed G1: resin-infiltrant; G2: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP); G3: artificial saliva; G4: Sound Enamel. Each group was subdivided into three subgroups, where each subgroup was subjected to a different testing method. Subgroup 1: surface microhardness; subgroup 2: cross-sectional microhardness; subgroup 3: color measurement. Statistical analysis was performed by ANOVA, followed by Tukey’s post-hoc test.

RESULTS: Sound enamel group recorded the highest surface and cross-sectional microhardness results. No significant difference was found between the resin-infiltrant group and CPP-ACP regarding surface and cross-sectional microhardness at different lesion depths. Resin-infiltrant group showed the least color change (∆E) results compared to the other groups.

CONCLUSION: Resin-infiltrant can effectively enhance surface microhardness and enamel resistance to demineralization, additionally, reduce the staining susceptibility of white spot lesions (WSLs) after treatment. CPP-ACP application for four weeks seems to improve surface microhardness; however, has a limited effect in resisting staining of WSLs after treatment. © 2022 Australian Dental Association.

PMID:35224731 | DOI:10.1111/adj.12908

Eur J Clin Invest. 2022 Feb 27:e13762. doi: 10.1111/eci.13762. Online ahead of print.

ABSTRACT

BACKGROUND: Randomized controlled trials (RCT) in mental disorders research commonly use active control groups including psychotherapeutic shams or inactive medication. This meta-analysis assessed whether placebo conditions (active controls) had an effect compared to no treatment or usual care (passive controls).

METHODS: PubMed, Scopus, PsycINFO, PsycARTICLES, Ovid, the Cochrane Central Register of Controlled Trials and Web of Science were searched from inception to April 2021 and reference lists of relevant articles. Three-arm RCTs, including active and passive control groups, were selected. Where individual standardized mean difference (SMD) was calculable, random effects meta-analyses were performed to estimate an overall effect size with 95% confidence intervals (CI) comparing active vs passive controls. Heterogeneity was assessed using I² statistic and meta-regression. Funnel asymmetry was evaluated using Egger’s test (Prospero registration: CRD42021242940).

RESULTS: 24 articles with 25 relevant RCTs were included in the review, of which 11 studies were of high risk of bias. There was an improvement in outcomes favouring the placebo conditions, compared to passive controls, overall (25 studies, SMD 0.24, 95% CI 0.06-0.42, I² = 43%) and in subgroups with anxiety (SMD 0.45, 95% CI 0.07-0.84, I² = 59%) or depression (SMD 0.22, 95% CI 0.04-0.39, I² = 0%). Meta-regression did not show a significant explanation for heterogeneity. Egger’s test showed no asymmetry (p = .200).

CONCLUSIONS: A small placebo effect was observed in mental disorders research overall, and in patients with anxiety or depression. These findings should be interpreted with caution in the light of heterogeneity and risk of bias.

PMID:35224726 | DOI:10.1111/eci.13762

Trop Anim Health Prod. 2022 Feb 27;54(2):117. doi: 10.1007/s11250-022-03110-0.

ABSTRACT

The aim of this study was to find the direct economic losses due to the three viral causes of the avian respiratory syndrome, including Newcastle disease (ND), H9N2 influenza, and infectious bronchitis (IB) in stamped-out broiler farms during 2016-2017 across the country. This study was carried out on the information on cross-sectional monitoring in the years 2016-2017. The statistical society of the study was all the active broiler farms of the country stamped out due to respiratory syndrome. This study used compensation insurance data, and other sources. One-way ANOVA or Kruskal-Wallis tests were used to analyze normally and non-normally distributed data. In total, during the study period, 132 broiler farms and 1,723,131 fowls were stamped out. According to the results of the present investigation, the sum of costs and losses due to respiratory complex was 9.47 $US Million, 2016-2017 (5.72 from $US Million chicken meat losses and 3.75 $US Million was the total cost). ND was the main cause of economic losses and costs with 3.86 $US equal to 40.8% of the total. Cost of feeding was the highest followed by veterinary services and medicines, vaccination, and 1-day-old chicks costs with 2.27, 1.11, 0.33, and 0.036 $US Million, 2016-2017. In conclusion, we need to improve the preventive measures against respiratory viruses, especially NDV. Additionally, as the cost of feeding was the largest, it is important to shorten the time interval between disease occurrence and stamping out to reduce the cost.

PMID:35224709 | DOI:10.1007/s11250-022-03110-0

Acta Obstet Gynecol Scand. 2022 Feb 27. doi: 10.1111/aogs.14335. Online ahead of print.

ABSTRACT

INTRODUCTION: Customized intrauterine growth charts are widely used for growth monitoring and research. They are based on three assumptions: (1) estimated fetal weight (EFW) has a normal distribution with a constant coefficient of variation at all gestational ages; (2) Hadlock’s growth curve accurately describes the relationship between EFW and gestational ages; (3) associations between EFW and the fetal and maternal characteristics included in the customization model (fetal sex, pre-pregnancy weight, height, parity) are proportional throughout pregnancy. The aim of this study was to test whether these underlying assumptions are verified.

MATERIAL AND METHODS: Data came from (1) the French Longitudinal Study of Children (ELFE) cohort, which recruited births after 32 weeks’ gestation in 349 maternity hospitals in France in 2011, and (2) the National Perinatal Survey, which included births from all French maternity hospitals in 2016. The study population included, respectively, 6 920 and 8 969 singleton non-malformed term live births with data on customization characteristics and EFW. We computed the coefficient of variation by gestational age and then modeled the association of gestational age, maternal and fetal characteristics with EFW at the second and third trimester ultrasound and with birthweight using linear regression. To assess the proportionality of the impact of maternal and fetal characteristics, we computed the percent change in weight associated with these characteristics at these three time points.

RESULTS: The coefficient of variation was close to 12% at each gestational age, but EFW was not normally distributed, leading to small but systematic underestimation of fetuses under the 10th percentile. Weights representing the 50th and 10th percentiles based on Hadlock’s growth trajectory were lower than observed or predicted weights. Most characteristics more strongly impacted weight at birth than during pregnancy. In the French Longitudinal study of Children (ELFE) cohort, boys were 1.8% (95% confidence interval [CI] 1.3-2.4) heavier than girls in the third trimester, whereas this percentage was 4.6% (95% CI 4.0-5.2) at birth. In the National Perinatal Survey, these percentages were 2.3% (95% CI 1.8-2.8) and 4.3% (95% CI 3.8-4.8).

CONCLUSIONS: These results from two independent sources revealed discrepancies between routine clinical EFW data used for growth monitoring and the customized growth model’s assumptions.

PMID:35224718 | DOI:10.1111/aogs.14335

Environ Sci Pollut Res Int. 2022 Feb 28. doi: 10.1007/s11356-022-19379-5. Online ahead of print.

ABSTRACT

Phenol is a widely used synthetic organic compound, which according to global estimations, is discharged into the environment at a rate of 10 tons/year through industrial waste. Phenol is a recalcitrant pollutant, and human exposure to water containing phenolic substances can lead to health issues. It has been found both in drinking water and wastewater. Solar heterogeneous photocatalytic phenol degradation, measured through chemical oxygen demand, was performed on a thin film tilted plate reactor with TiO₂ immobilized onto different support materials. A full factorial experimental design (4 × 3 × 3) was carried out to statistically evaluate if the independent variables’ effects were significant. Four advanced oxidation processes (photolysis, photolysis + H₂O₂, heterogeneous photocatalysis, and heterogeneous photocatalysis + H₂O₂), three support materials (quartz, calcite, and glass), and three pH levels (3, 5.4, and 9) were evaluated. Reaction kinetics were fitted to the pseudo-first-order reaction rate and data was analyzed with an ANCOVA and means test, considering solar light intensity as a covariate. Photolysis/calcite at pH 5.4 and heterogeneous photocatalysis + H₂O₂/glass plate at pH 3 gave the best results, with a reaction rate constant k_ph = 3.047 × 10^-3 min^-1 and k_phC = 4.498 × 10^-3 min^-1, respectively. The three independent variables and their interactions had a significant effect in the phenol degradation (p < 0.05).

PMID:35224700 | DOI:10.1007/s11356-022-19379-5

Environ Sci Pollut Res Int. 2022 Feb 28. doi: 10.1007/s11356-022-19438-x. Online ahead of print.

ABSTRACT

A growing number of biological studies suggest that exogenous sulfur dioxide (SO₂) at a certain concentration may promote human resistance to Mycobacterium tuberculosis. However, the results of most relevant studies are inconsistent, and few studies have explored the relationship between SO₂ exposure and tuberculosis risk at provincial level. In addition, occupational exposure has long been considered to have a certain impact on the human body, so for the first time, we discussed the differences between different occupations in the study on the relationship between air pollutant exposure and tuberculosis risk, and evaluated the impact of occupational exposure. This study aimed to explore the association between short-term SO₂ exposure and the risk of outpatient visits to tuberculosis in Anhui province and 16 prefecture-level cities from 2015 to 2020. We used several models for multi-stage analysis, including distributed lag nonlinear model (DLNM), Poisson generalized linear regression model, and random-effects model. The association was assessed using the 28-day cumulative lag effect RR and 95%CI for each 10-unit increase in SO₂ concentration. We divided all patients into the following six occupations: Worker, Farmer, Retired people, Children and Students, Cadre and Office clerk, and Service staff (catering, business, etc.). Sex, age, and season were analyzed by subgroup. Finally, the robustness of the multi-pollutant model was tested. At provincial level, the overall effect value of SO₂ was RR=0.8191 (95%CI: 07702~0.8712); after grouping all patients by occupation, the association found only among Farmers (RR = 0.7150, 95%CI: 0.6699-0.7632, lag 0-28 days) and Workers (RR = 0.8566, 95%CI: 0.7930-0.9930, lag 0-4 days) was still statistically significant. Estimates for individual cities and using random-effects models to estimate average associations showed that SO₂ exposure was associated with a reduced risk of outpatient TB visits in 14 municipalities, which remained significant when aggregated (RR = 0.9030, 95%CI: 0.8730-0.9340). Analysis of patients grouped by occupation in each municipality showed that statistical significance was again observed only in the Farmer (RR = 0.8880, 95%CI: 0.8610-0.9160) and Worker (RR = 0.8250, 95%CI: 0.7290-0.9340) groups. Stratified analysis of age, sex, and season showed that the effect of SO₂ exposure was greater for middle-aged people (18-64 years old) and males, and less for seasonal changes. In summary, we found that exposure to SO₂ reduces the risk of outpatient visits to tuberculosis, with farmers and workers more susceptible to SO₂. Gender and age had a greater impact on the risk of TB outpatient visits than seasonal variations.

PMID:35224697 | DOI:10.1007/s11356-022-19438-x

Emerg Med Australas. 2022 Feb 27. doi: 10.1111/1742-6723.13937. Online ahead of print.

ABSTRACT

The wide-spread use of an initial ‘Glasgow Coma Scale (GCS) 8 or less’ to define and dichotomise ‘severe’ from ‘mild’ or ‘moderate’ traumatic brain injury (TBI) is an out-dated research heuristic that has become an epidemiological convenience transfixing clinical care. Triaging based on GCS can delay the care of patients who have rapidly evolving injuries. Sole reliance on the initial GCS can therefore provide a false sense of security to caregivers and fail to provide timely care for patients presenting with GCS greater than 8. Nearly 50 years after the development of the GCS – and the resultant misplaced clinical and statistical definitions – TBI remains a heterogeneous entity, in which ‘best practice’ and ‘prognoses’ are poorly stratified by GCS alone. There is an urgent need for a paradigm shift towards more effective initial assessment of TBI.

PMID:35220682 | DOI:10.1111/1742-6723.13937

Clin Exp Dent Res. 2022 Feb 27. doi: 10.1002/cre2.546. Online ahead of print.

ABSTRACT

OBJECTIVES: The push-out bond strength (POBS) of calcium silicate-based cements (CSCs) to the dentinal wall is considered one of the essential physical properties for clinical success. The presence of blood in the treatment area affects the POBS of these types of cement. This study aimed to evaluate the impact of blood contamination on the bond strength of CSCs and dentinal walls.

MATERIAL AND METHODS: This systematic review was performed by searching electronic databases (MEDLINE-PubMed, Scopus, and EMBASE) to include relevant in vitro studies published between 1992 and April 2020. Two reviewers independently evaluated the selected studies and extracted data on the type of studied CSCs, evaluated area of the teeth, sample size, the dimension of a prepared area, slice thickness, storage duration, the setting of the universal testing machine (UTM), effects of blood contamination on POBS of CSCs and their failure modes. The bond strength of evaluated CSCs in studies was used for network meta-analysis.

RESULTS: Initial searches identified 292 articles, while only 13 articles met the inclusion criteria. Full texts of these articles were evaluated, and data extraction was performed. The effect of blood contamination on bond strength to the dentinal wall was assessed in various CSCs such as PMTA, Biodentine, and AMTA. The network meta-analysis results showed that the bond strength of Biodentine was significantly higher than other types of cement in blood presence (p < .05).

CONCLUSIONS: Based on the current systematic review, despite controversies among the result of the different articles and the lack of data for some CSCs like bioaggregate, it could be concluded that the bond strength of Biodentine to the dentinal wall is better than other evaluated CSCs in the presence of blood.

PMID:35220692 | DOI:10.1002/cre2.546

Musculoskeletal Care. 2022 Feb 26. doi: 10.1002/msc.1623. Online ahead of print.

ABSTRACT

INTRODUCTION: Due to COVID-19 the ability to see all patients face-to-face (FTF) was removed. Services implemented telehealth to cater for patients requiring musculoskeletal care. A service evaluation was undertaken to assess the effectiveness of a mixed telehealth/FTF approach and identify if stratifying patients could help tailor intervention.

METHODS: Retrospective analysis of data collected from patients who were assessed by Musculoskeletal Physiotherapists in one Scottish health board was undertaken. Patients were divided into low, medium and high risk sub-groups through the Keele STarT MSK tool. Outcome measures for pain and musculoskeletal health were taken at baseline/discharge along with satisfaction/preference. Descriptive and Inferential statistical analysis was conducted to establish whether changes in the outcome measures within and between risk sub-groups were statistically significant.

RESULTS: Pain level difference from baseline to discharge demonstrated clinically and statistically significant improvements across all risk groups (N = 89). Musculoskeletal health demonstrated clinically significant improvements across all risk groups and statistically significant improvements in the medium/high risk groups but not the low risk. Patients with knee osteoarthritis and low back pain in the medium risk group had fewest appointments while patients with chronic shoulder pain had the most. The majority of patients were satisfied with all mediums but preferred FTF or an option between telehealth/FTF in the future.

CONCLUSION: Telehealth is a promising model of care when utilised in combination with FTF for patients with musculoskeletal conditions. Through stratification, identifying specific conditions and shared decision making it may be possible to treat certain patient groups via telehealth.

PMID:35220671 | DOI:10.1002/msc.1623