Tag: statistics

Eur J Radiol. 2022 Mar 18;150:110267. doi: 10.1016/j.ejrad.2022.110267. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the inter-reader agreement of the Prostate imaging quality (PI-QUAL) for multiparametric magnetic resonance imaging (mpMRI).

METHODS: We included 66 men who underwent 1.5 T mpMRI in June 2020-July 2020 in center 1, with no exclusion criteria. mpMRI included multiplanar T2-weighted imaging (T2WI), Diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCE). Two readers from center 2 (experience <1000 to >1500 examinations), blinded to clinical history but not to acquisition parameters, independently assessed PI-QUAL qualitative/anatomical items of each mpMRI sequence, final PI-QUAL score (1-5), and the Prostate imaging reporting and data system version 2.1 (PI-RADSv2.1) category of the index lesion. Cohen’s kappa statistics (k) or prevalence-adjusted-bias-adjusted kappa (PABAK) were used to calculate the inter-reader agreement in assessing the PI-QUAL (1-to-5 scale and 1-2 versus 3 versus 4-5), the diagnostic quality of each mpMRI sequence, qualitative/anatomical items, and PI-RADSv2.1 category.

RESULTS: The inter-reader agreement for PI-QUAL category was moderate upon 1-5 scale (k = 0.55; 95%CI 0.39-0.71) or 1-3 scale (k = 0.51; 95%CI 0.29-0.72), with 90.9% examinations categorized PI-QUAL ≥ 3 by readers. The agreement in assessing a sequence as diagnostic was higher for T2WI (k = 0.76) than DCE (PABAK = 0.61) and DWI (k = 0.46), ranging moderate-to-substantial for most of the items. Readers provided comparable PI-RADSv2.1 categorization (k = 0.88 [excellent agreement]; 95%CI 0.81-0.96), with most PI-RADSv2.1 ≥ 3 assignments found in PI-QUAL ≥ 3 examinations (43/46 by reader 1, and 47/47 by reader 2).

CONCLUSIONS: The reproducibility of PI-QUAL was moderate. Higher PI-QUAL scores were associated with excellent inter-reader agreement for PI-RADSv2.1 categorization.

PMID:35325773 | DOI:10.1016/j.ejrad.2022.110267

J Biomech. 2022 Mar 12;135:111048. doi: 10.1016/j.jbiomech.2022.111048. Online ahead of print.

ABSTRACT

Musculoskeletal modeling is commonly used to simulate and compare various movements between individuals. For conditions such as femoroacetabular impingement syndrome (FAIS), individuals tend to walk with more anterior pelvic tilt than those without FAIS. However, it is unknown whether accounting for pelvic tilt in musculoskeletal modeling would lead to a change in muscle forces and in turn, joint forces. Gait data of six individuals were collected and processed using Vicon and Visual3D. Each participant’s pelvic tilt was adjusted by ± 10° at all time points during gait. Three analyses were performed per individual: no adjustment in tilt, one posterior (positive) tilt, and one anterior (negative) tilt. The resulting data were imported into OpenSim to determine muscle forces and the resulting femur-on-acetabulum (hip joint) forces in the pelvic and femoral reference frames. Data for each participant were normalized for gait cycle and body weight in MATLAB, and statistical parametric mapping was used to determine if the differences in joint and muscle forces were significant across different pelvic orientations. Shifting from posterior to anterior pelvic tilt reduced resultant forces. In the pelvic reference frame, anteriorly-directed joint forces decreased, while medially-directed forces increased. In the femoral reference frame, anteriorly- and medially-directed joint forces increased, while superiorly-directed forces decreased. Anterior gluteus medius and iliacus muscle forces decreased, while quadratus femoris, piriformis, and gemellus muscle forces increased. Given these results, future studies using musculoskeletal modeling should account for pelvic tilt in musculoskeletal models to obtain more realistic comparisons between healthy and pathological conditions.

PMID:35325751 | DOI:10.1016/j.jbiomech.2022.111048

Res Vet Sci. 2022 Mar 18;146:53-59. doi: 10.1016/j.rvsc.2022.03.012. Online ahead of print.

ABSTRACT

Variations in Cytokine inducible SH2-containing protein (CISH) gene influence human susceptibility to common infectious diseases, but little is known about CISH in swine. The objectives of this study were to 1) determine porcine CISH (pCISH) mRNA expression level in different tissues of piglets, 2) predict putative functional genetic variations within pCISH, 3) investigate the association between a identified variation in the 3’UTR and piglets phenotype traits in Min (n = 226) and Landrace (n = 186) population, and explore the function of this variation. Results of quantitative PCR showed pCISH mRNA expressed in all the collected tissues with higher level in lung and ileum than colon (p < 0.05). In-silico analysis indicated none of the functional ns-SNPs existed in pCISH coding region. Results from the characterizing of 3’UTR presented a novel 12-bp insertion/deletion (indel) mutation. Statistical analysis demonstrated that this 12-bp indel associated with piglets diarrhea score in the Landrace population, and animals with AA genotype (12-bp insertion) presented lower diarrhea score when compared with BB (p < 0.05) or AB (p < 0.01) carriers. The in vitro study indicated that the luciferase activity of reconstruct plasmid psiCHECK-2-CISH-AA or psiCHECK-2-CISH-BB was significantly lower than the negative control (p < 0.05), and luciferase activity of psiCHECK-2-CISH-AA was higher than that of the psiCHECK-2-CISH-BB (p < 0.05). Although results herein suggested the 12-bp indel might affect Landrace piglet susceptibility to diarrhea, further association studies in more populations are needed before this preliminary finding could be used for pig breeding.

PMID:35325756 | DOI:10.1016/j.rvsc.2022.03.012

Mult Scler Relat Disord. 2022 Mar 8;60:103732. doi: 10.1016/j.msard.2022.103732. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the disease burden and health economics of inpatients with multiple sclerosis (MS) in China by evaluating the direct, indirect, and intangible costs.

METHODS: A total of 863 patients were included for a cross-sectional retrospective study in 50 centers. The direct economic burden was measured by the cost of hospitalization and out-of-hospital application drugs, and the indirect economic burden was measured by the human capital method. The disability-adjusted life year (DALY) was used to express the intangible economic burden. Cost-utility analysis (CUA) using DALYs as indicators of health benefits was performed by calculating the incremental cost-utility ratio.

RESULTS: The mean direct economic burden/year, daily medication expenses/year, DALY, indirect economic burden, and indirect economic burden/year were 27,655.57 Yuan, 17,944.97 Yuan, 10.89 Yuan, 512,041.7 Yuan, and 11,299.85 Yuan, respectively. For the study period of two years, the direct economic burden, daily medication expense, and indirect economic burden were 48.6%, 31.5%, and 19.85% of the total economic burden, respectively. Disease burden and the number of episodes of remission were not statistically significant (p>0.001). The direct economic burden and total economic burden of the disease-modifying therapy (DMT) group were higher than those of the non-DMT group, but DALYs had no statistical significance (p>0.001). CUA showed that inpatients with MS in the DMT group received a DALY every time compared with the non-DMT group.

CONCLUSION: The DALY losses are concentrated in young and middle-aged Chinese people. In this two-year study, CUA prompted the application of DMT drugs to increase the economic burden and DALYs. However, follow-up time is still short, and further follow-up observation is required.

PMID:35325723 | DOI:10.1016/j.msard.2022.103732

Ticks Tick Borne Dis. 2022 Mar 6;13(3):101935. doi: 10.1016/j.ttbdis.2022.101935. Online ahead of print.

ABSTRACT

Understanding factors that shape tick population genetic structure is important as they may be exploited in crafting strategies for vector control. Amblyomma tholloni, or “elephant tick” is a three-host tick whose adults preferentially parasitize African elephants. The aim of this study was to determine the influence of fragmentation of the host populations on the genetic structure of this tick species from different ecosystems in Kenya, using the second internal transcribed spacer (ITS-2) and mitochondrial cytochrome oxidase 1 (CO1) loci. Population genetic analysis of ticks collected from four elephant populations using ITS-2 and CO1 loci revealed high gene diversity. Gene diversity at the ITS-2 locus was 0.91 and the nucleotide diversity was, 0.01. ITS-2 gene diversity was highest in Laikipia-Samburu ecosystem (0.947) and lowest in Tsavo (0.80). The CO1 locus also had high gene diversity, 0.790, and low nucleotide diversity, 0.006, and like ITS-2, gene diversity was higher in Laikipia-Samburu ecosystem (1.00) and lower in Tsavo (0.286). There was a modest statistically significant genetic differentiation among the four tick populations based on ITS-2 (F_ST = 0.104, P < 0.001; Φ_ST = 0.105, P < 0.001), and a 10% of molecular variance attributed to genetic variation between populations. There was also statistically significant differentiation among tick populations using haplotype frequencies for CO1 locus (F_ST = 0.167, P < 0.001) accounting for 17% of genetic variance among populations, but not modelled genetic distances (Φ_ST = 0.029, P = 0.095) suggesting very recent genetic differentiation. In addition, populations of A. tholloni in Kenya had a significantly negative Tajima D and Fu & Li’s F* and D* at the CO1 locus suggesting recent positive selection. The extensive acaricide use in livestock, which host the larval stage, could be driving purifying selection and genetic hitchhiking of the CO1 locus. However, tests sensitive to demography such as Fu’s F_S, Ramos-Onsins & Rozas’s R₂ and raggedness index r were statistically significant at the ITS-2 locus suggesting ancient demographic expansion. Elephant population fragmentation appears to shape the genetic structure of A. tholloni, while agro-ecological factors could influence the genetic diversity of ticks.

PMID:35325688 | DOI:10.1016/j.ttbdis.2022.101935

Clin Biomech (Bristol, Avon). 2022 Mar 11;94:105623. doi: 10.1016/j.clinbiomech.2022.105623. Online ahead of print.

ABSTRACT

BACKGROUND: Although it is generally accepted that sports activities present a high risk of lateral ligament injury, the extent to which ligaments are loaded during functional activities is less explored. This is relevant when considering ankle sprain prevention and staged rehabilitation following ligament sprain or reinforcing surgery. Therefore, anterior talofibular ligament, calcaneofibular ligament and posterior talofibular ligament strain and loading were evaluated, based on a newly developed loading index, during movements executed during daily life and rehabilitation.

METHODS: Three-dimensional motion analysis data was acquired in 10 healthy volunteers during eleven different movements and processed using musculoskeletal modelling. Maximal lateral ligament strain and ligament loading, based on an new index accounting for the ankle and subtalar moment magnitude, ligament strain magnitude and duration, were calculated and statistically compared to ligament strain and loading during walking and a reference clinical (talar tilt) test.

FINDINGS: Anterior talofibular, calcaneofibular and posterior talofibular lateral ligament loading were highest during vertical drop jumps, medio-lateral single leg hops and running. Additionally, anterior talofibular loading was high during stair descending, calcaneofibular loading during single leg stance without visual feedback and posterior talofibular loading during anterior single leg hops. During the clinical test, anterior talofibular and calcaneofibular ligament strain were substantially lower than the maximal strain during different movements.

INTERPRETATION: Our results allow classification of exercises according to the ligament loading index and maximal strain, thereby providing objective data to progressively stage ligament loading during rehabilitation.

PMID:35325713 | DOI:10.1016/j.clinbiomech.2022.105623

Accid Anal Prev. 2022 Mar 21;169:106639. doi: 10.1016/j.aap.2022.106639. Online ahead of print.

ABSTRACT

Until recently, statistical approaches used for real-time crash prediction modeling were limited to case-control design and “sampling of alternatives” approaches. A recent study has developed a duration-based real-time crash prediction model capable of incorporating dynamic (time-varying) covariates within its framework. The modeling approach discretizes the duration between crashes into equal time intervals which can be modeled as alternatives in a multinomial logit framework. The approach, however, requires a reformulation of the original crash dataset to fit its modeling framework which results in considerably large data making model estimation computationally demanding. Additionally, validation of the model in the original study is based on crash data from just one interstate, I-405, assuming homogenous highway segments each 5 miles in length. This study improves upon the original study by investigating sampling techniques that can be applied to the reformulated data to reduce computational load using 2019 crash data from two interstates, I-40 and I-55, in Memphis, Tennessee. Furthermore, discretization of inter-crash duration is undertaken following non-homogenous segmentation of the interstates that is based on highway geometry, terrain, and posted speed limit. To accomplish the study objectives, a relatively small future window of 1 h with 15-minute time intervals is used to discretize the inter-crash duration and obtain the reformulated data. Sampling of crashes for model estimation is then done at the crash, epoch, and segment levels to answer the question of which sampling technique (by crash, epoch, or segment) would result in reasonable accuracy when compared with the complete (100%) data. Results show that 25% of samples drawn at the epoch level can result in a considerable reduction of computational load while providing reasonably consistent estimates.

PMID:35325676 | DOI:10.1016/j.aap.2022.106639

J Infect Public Health. 2022 Mar 4;15(4):400-405. doi: 10.1016/j.jiph.2022.02.010. Online ahead of print.

ABSTRACT

BACKGROUND: Healthcare workers are considered to be at a higher risk of acquiring tuberculosis (TB) infection than the general population. Clinical medical students are part of the healthcare team and clinical practice are done during their clinical rotation. They could be exposed to similar occupational risks as the healthcare workers. Most students who become infected have latent tuberculosis infection (LTBI) and may not exhibit any clinical symptoms. Some students with LTBI can progress to TB disease during clinical rotations in the hospitals. Therefore, screening for LTBI in this population represents hospital aspect of public health strategy and infection control in medical school in high TB burden countries.

OBJECTIVE: We aimed to determine the prevalence of LTBI among fourth-year medical students and sixth-year medical students by using QuantiFERON-TB Gold Plus (QFT-Plus) and Tuberculin Skin Test (TST).

METHODS: A cross-sectional study of fourth-year medical students (n = 73) and sixth-year medical students (n = 85) was conducted at the School of Medicine, Chulalongkorn University, Bangkok, Thailand. The medical students (n = 158) who met the eligibility criteria were recruited into the study. LTBI was detected by using QFT-Plus and some of the participants had a tuberculin skin test (TST). The TST was interpreted after 48-72 h. The participants who tested positive by QFT-Plus were considered to have LTBI. Demographic information and data on occupational TB exposure were collected via a questionnaire. A multivariate logistic regression was used to test for associations between independent variables and results of the QFT-Plus.

RESULTS: A total of 158 participants were included in this study. The overall prevalence of LTBI was 6.3% (n = 10) as determined by QFT-Plus. The LTBI prevalence was higher in the sixth-year medical students (9.4%) compared to the fourth-year medical students (2.7%). Higher risk of LTBI was associated with sixth-year medical students (odds ratio, 3.69 [95%CI, 0.75-17.96]), but this was not significant. Moreover, history of occupational TB exposure without PPE yielded an odds ratio of 2.98 [95%CI, 0.68-13.12] but it was not statistically significant due to the small sample size. One hundred thirty-nine (88%) participants were BCG vaccinated as per the national vaccination requirements. No abnormal chest X-rays were found for any of the positive participants. Of the 158 participants, 41 (25.9%) of them had TST. Of the 41 participants, 6 (14.6%) tested positive at a cut-off of ≥ 10 mm for TST, which was concordant with QFT-Plus results. The agreement between the two tests was 0.57 using kappa coefficients.

CONCLUSION: The screening of TB infection in new healthcare workers (HCWs), especially medical students, is essential to reduce future nosocomial TB incidences in the hospitals. This study showed that there was a high prevalence of LTBI among sixth-year medical students compared to fourth-year medical students. Our results suggest that tendency of higher LTBI prevalence might be associated with advanced clinical years, thus tailored public health education strategy and infection control in tertiary care hospitals for new healthcare workers in TB endemic countries may prevent nosocomial TB disease from developing in the future. Therefore, active surveillance should be done for all new HCWs, and TB preventive therapy should be administered to recent converters.

PMID:35325687 | DOI:10.1016/j.jiph.2022.02.010

Clin Imaging. 2022 Mar 18;86:31-37. doi: 10.1016/j.clinimag.2022.03.012. Online ahead of print.

ABSTRACT

BACKGROUND: Immune checkpoint inhibitor-related pneumonia (ICIP) is an independent risk factor for immunotherapy-related death.

PURPOSE: To evaluate the ICIP, dynamic observation of computed tomography (CT) images of lung cancer patients with ICIP was conducted to study the relationship between the occurrence of ICIP and clinical information.

MATERIAL AND METHODS: CT images and clinical information of lung cancer patients (n = 76) from two hospitals who received immune checkpoint inhibitor (ICI) treatment were collected. A total of 49 cases were enrolled after screening according to the inclusion and exclusion criteria. We performed statistical analysis on the imaging features and clinical information.

RESULTS: Analysis of imaging characteristics revealed two types of ICIP: the limited-onset type and diffuse-onset type. The median onset time of limited-onset ICIP was significantly earlier than that of diffuse-onset ICIP (1.5 months vs. 2.8 months; p = 0.045). Statistical analysis based on differences within the group showed that the clinical ICIP grade and immunotherapy response rate of limited-onset cases were statistically significant (p = 0.003) and the imaging/clinical ICIP grade and the outcome of ICIP were statistically significant (p = 0.031/0.007). The immunotherapy strategy of diffuse-onset cases and the response rate of immunotherapy were statistically significant (p = 0.016).

CONCLUSIONS: This study suggests that pre-existing lung lesions can be one of the possible predisposing factors for ICIP and describes the development of ICIP through continuous imaging. Our findings indicate pre-existing lung lesions as a referential monitoring target for the onset and progression of ICIP for clinical practice.

PMID:35325631 | DOI:10.1016/j.clinimag.2022.03.012

Facial Plast Surg Aesthet Med. 2022 Mar 21. doi: 10.1089/fpsam.2021.0379. Online ahead of print.

ABSTRACT

Purpose: Our aim was to determine if intraoperative navigation (ION) improved radiographic outcomes in patients undergoing delayed primary/secondary orbital reconstruction for inferomedial defects, as measured by volume restoration, enophthalmos correction, and positional accuracy of implants. Patients and Methods: A prospective quasiexperimental study was performed to compare two groups of patients requiring orbital reconstruction. Use of ION was the exposure evaluated. Outcome measures were (i) intraorbital volume and enophthalmos evaluated radiologically, (ii) implant position accuracy, and (iii) procedural duration. Data were analyzed statistically to compare variance between groups. Results: Forty patients (6 females and 34 males) were recruited into the study with a mean age of 27.3 years. The study group demonstrated a greater reduction of intraorbital volume (0.49 cu.cm; p = 0.02) and enophthalmos (0.72 mm; p = 0.001). Implant positioning was more accurate using ION, with less mediolateral (p = 0.006) and yaw (p = 0.04) deviations. Surgical time for implant positioning was shorter by 17 min, with navigation (p < 0.001). Conclusion: The use of ION demonstrated radiographic improvements in volume restoration, enophthalmos correction, as well as accuracy of implant positioning, in patients requiring delayed primary/secondary orbital reconstruction.

PMID:35325573 | DOI:10.1089/fpsam.2021.0379