Tag: statistics

PLoS One. 2022 Apr 8;17(4):e0266062. doi: 10.1371/journal.pone.0266062. eCollection 2022.

ABSTRACT

INTRODUCTION: Pakistan is among the countries with the highest maternal death rates. Obstetric hemorrhage accounts for 41% of these deaths. Uterine rupture is a grave obstetric emergency with high maternal and neonatal morbidity and mortality. It is important to identify its frequency and associated risk factors to formulate programs for its prevention and management. This study aimed to assess the frequency, associated risk factors, fetomaternal outcomes, and management of women with the ruptured uterus at our hospital.

MATERIAL AND METHODS: It was a retrospective study of 206 women to review data collected from cases of uterine rupture managed at the WCTH Bannu, Pakistan from October 2016 to October 2018. A structured proforma was designed and used to extract data from operating theatre registers and the hospital medical records. In our hospital, there is a strong system of maintaining all information of the patients related to demographics, obstetric information, operative notes, and postoperative course during their hospital stay in the patient’s charts. Detailed information on operative procedures is further maintained in the operation theater register and all these registers are checked in the weekly statistical meetings to ensure proper documentation. Data was entered and analyzed in SPSS package version 21 (IBM Corp.; Armonk, NY, USA). Frequency and percentages were calculated for the categorical variables. For inferential statistics, chi-square or Fischer exact tests were used. A p-value of < 0.05 was considered statistically significant.

RESULTS: The overall incidence of the ruptured uterus was 1.71%. The important etiological factors were grand multiparity 62 (35.2%), obstructed/neglected labour 58 (32.9%), injudicious use of Oxytocin 56 (31.8%) and prostaglandins 26 (14.7%), previous cesarean section 35 (19.8%) and previous pelvic surgery (0.5%). Hysterectomy was done in 80.6% of cases, 34 (19.2%) patients underwent uterine repair and 4.5% had bladder repair. The mortality rate was 21%, mainly due to irreversible shock or disseminated intravascular coagulation. Perinatal mortality was 91.4%. Duration of surgery more than two hours and presentation to the hospital at night time was significantly associated with poor maternal outcome (p = 0.00).

CONCLUSION: Uterine rupture is a preventable obstetric emergency associated with high fetomaternal morbidity and mortality. The main causes were grand multigravidity, obstructed labour, previous C-sections and injudicious use of oxytocin and prostaglandins. Women with prolonged surgery and admission at night time had a poor maternal outcome.

PMID:35395033 | DOI:10.1371/journal.pone.0266062

PLoS One. 2022 Apr 8;17(4):e0266602. doi: 10.1371/journal.pone.0266602. eCollection 2022.

ABSTRACT

I test the possibility that over-estimating negative consequences of COVID-19 (e.g., hospitalizations, deaths, and threats to children) will be associated with stronger support the ‘new normal’ (i.e., continuation of restrictions for an undefined period starting with wide-spread access to vaccines and completed vaccinations of vulnerable people). The new normal was assessed by endorsing practices such as vaccine passports, travel restrictions, mandatory masking, continuing contact tracing, and pursuing elimination. Results are based on five samples (N = 1,233 from April 2021 and N = 264 from January 2022) and suggest that people over-estimate COVID-19 risks to children and healthy people, as evidenced by median estimates that 5% of all global deaths were children, 29% were generally healthy people under 65, and that a healthy person under the age of 65 has 5% chance of dying from COVID-19. Over-estimates observed in this study align with those based on representative samples, and they were consistently related to stronger support for the new normal. This relationship emerged when participants estimated risks with percentages (core indicators) and indicated the extent to which risk-based statements are true/supported with evidence or false/unsupported (alternative indicators). People were notably more likely to support continuing restrictions if they believed that COVID-19 risk and risk mitigation tactics are true, even when they are not (e.g., children need to be prioritized for boosters). These relationships persisted when considering competing explanations (political ideology, statistics literacy, belief in conspiracy theories). I trace these effects to well-meaning efforts to prevent under-estimation. Public policy and people’s perceptions of risks are intertwined, where even inaccurate judgments may influence decisions. Failure to combat all misinformation with equal rigor may jeopardize the restoration of the social and economic life essential for building adaptive post-pandemic societies.

PMID:35395026 | DOI:10.1371/journal.pone.0266602

PLoS One. 2022 Apr 8;17(4):e0266763. doi: 10.1371/journal.pone.0266763. eCollection 2022.

ABSTRACT

BACKGROUND: Furazolidone is a synthetic nitrofuran with a broad spectrum of antimicrobial action and has been widely used in the treatment of Helicobacter pylori (H. pylori) infection. However, its safety profile has not been clarified. Moreover, the drug fever associated with its use is frequently misdiagnosed. The aim of this study was to explore the risk factors of furazolidone-associated fever to increase awareness and stimulate further research on this topic.

METHODS: This was a retrospective case-control study of patients referred to a specialist clinic for furazolidone-containing quadruple regimens for H. pylori infection at a tertiary care hospital located in Eastern China between July 2018 and September 2018. We evaluated adult patients who received furazolidone treatment for Helicobacter pylori infection. The exclusion criteria were as follows: (1) patients were pregnant or breastfeeding; (2) patients received furazolidone treatment not for Helicobacter pylori infection; (3) patients had taken antibiotics or any acid suppressant or non-steroidal anti-inflammatory drug in the last 4 weeks; (4) patients had chronic hepatic, renal, or pulmonary disease. Pertinent information was retrieved from medical records and telephone follow-up. All statistical analysis was performed in SPSS version 22.0.

RESULTS: A total of 1499 patients received furazolidone and met the overall inclusion criterion. Of these 1499 patients, 27 (1.80%) developed drug fever. The mean time between initiation of furazolidone and the onset of fever is 11.00 ± 1.84 days, and the median peak fever was 38.87 ± 0.57°C. We found no differences in age and past drug allergy between the non-fever and fever groups. Through multiple logistic regression analysis, we found two variables as independent risk factors for furazolidone-associated fever, including gender (OR, 3.16; 95% CI, 1.26-7.91; P = 0.014) and clarithromycin (OR, 4.83; 95% CI, 2.17-10.79; P<0.001).

CONCLUSIONS: This retrospective cohort study identified two risk factors for furazolidone-associated fever, which were female and clarithromycin. We also analyzed the characteristics of drug fever during anti-Helicobacter pylori therapy. However, the underlying mechanisms are uncertain and require further research.

PMID:35395029 | DOI:10.1371/journal.pone.0266763

PLoS Comput Biol. 2022 Apr 8;18(4):e1009991. doi: 10.1371/journal.pcbi.1009991. Online ahead of print.

ABSTRACT

Cellular barcoding methods offer the exciting possibility of ‘infinite-pseudocolor’ anatomical reconstruction-i.e., assigning each neuron its own random unique barcoded ‘pseudocolor,’ and then using these pseudocolors to trace the microanatomy of each neuron. Here we use simulations, based on densely-reconstructed electron microscopy microanatomy, with signal structure matched to real barcoding data, to quantify the feasibility of this procedure. We develop a new blind demixing approach to recover the barcodes that label each neuron, and validate this method on real data with known barcodes. We also develop a neural network which uses the recovered barcodes to reconstruct the neuronal morphology from the observed fluorescence imaging data, ‘connecting the dots’ between discontiguous barcode amplicon signals. We find that accurate recovery should be feasible, provided that the barcode signal density is sufficiently high. This study suggests the possibility of mapping the morphology and projection pattern of many individual neurons simultaneously, at high resolution and at large scale, via conventional light microscopy.

PMID:35395020 | DOI:10.1371/journal.pcbi.1009991

PLoS One. 2022 Apr 8;17(4):e0266138. doi: 10.1371/journal.pone.0266138. eCollection 2022.

ABSTRACT

Scorpion envenomation is a significant public health concern in São Paulo, Brazil, and its incidence and mortality have increased in recent decades. The present study analyzed documented scorpion envenomation notifications from 2008 to 2018 throughout the 645 municipalities of São Paulo. Annual incidence and mortality rates were calculated and stratified according to sex and age. The local empirical Bayesian method and Getis-Ord Gi* statistic were used to represent standardized incidence rates in the municipalities and to identify high- and low-risk agglomerates. The incidence rate of scorpion envenomation quintupled between 2008 and 2018. Overall, the risk was higher for man, and increased with age. Deaths due to envenomation, however, were concentrated almost entirely in children 0-9 years of age. Incidence maps showed that the risk of envenomation increased in almost all regions and municipalities of São Paulo throughout the study period. The highest incidence rates were found in the western, northwestern and northern regions of the state, in contrast to the São Paulo metropolitan area and southern and coastal regions. Hot spots were identified in the Presidente Prudente, Barretos, São José do Rio Preto, and Araçatuba regional health districts, which over time formed a single high-risk cluster. In spatial terms, however, deaths were randomly distributed. In this study, we identified areas and populations at risk of scorpion envenomation and associated-fatalities, which can be used to support decision-making by health services to reduce human contact with these arachnids and avoid fatalities, especially in children.

PMID:35395017 | DOI:10.1371/journal.pone.0266138

PLoS One. 2022 Apr 8;17(4):e0265815. doi: 10.1371/journal.pone.0265815. eCollection 2022.

ABSTRACT

Mathematical models of infectious diseases exhibit robust dynamics, such as stable endemic, disease-free equilibriums or convergence of the solutions to periodic epidemic waves. The present work shows that the accuracy of such dynamics can be significantly improved by including global effects of host movements in disease models. To demonstrate improved accuracy, we extended a standard Susceptible-Infected-Recovered (SIR) model by incorporating the global dynamics of the COVID-19 pandemic. The extended SIR model assumes three possibilities for susceptible individuals traveling outside of their community: • They can return to the community without any exposure to the infection. • They can be exposed and develop symptoms after returning to the community. • They can be tested positively during the trip and remain quarantined until fully recovered. To examine the predictive accuracy of the extended SIR model, we studied the prevalence of the COVID-19 infection in six randomly selected cities and states in the United States: Kansas City, Saint Louis, San Francisco, Missouri, Illinois, and Arizona. The extended SIR model was parameterized using a two-step model-fitting algorithm. The extended SIR model significantly outperformed the standard SIR model and revealed oscillatory behaviors with an increasing trend of infected individuals. In conclusion, the analytics and predictive accuracy of disease models can be significantly improved by incorporating the global dynamics of the infection.

PMID:35395018 | DOI:10.1371/journal.pone.0265815

Graefes Arch Clin Exp Ophthalmol. 2022 Apr 8. doi: 10.1007/s00417-022-05644-3. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the dynamics of Bruch’s membrane opening-based morphometrics of the optic nerve head (ONH) using spectral-domain optical coherence tomography (SD-OCT) during the first week after glaucoma surgery by trabeculectomy with mitomycin C.

METHODS: Prospective, longitudinal analysis of 25 eyes of 25 patients treated by trabeculectomy. Twenty-four eyes had evaluable postoperative SD-OCT examinations. Bruch’s membrane opening minimum rim width (BMO-MRW) and peripapillary retinal nerve fiber layer (RNFL) thickness were analyzed at baseline before surgery, 1 day, 2 to 3 days, and 1 week after surgery. Changes compared to baseline were correlated to intraocular pressure (IOP).

RESULTS: One day after surgery, the mean BMO-MRW changed by + 26.17 µm, p = 0.001 (mean IOP reduction by 17.01 mmHg). This increase persisted on day 2-3 with a mean increase of BMO-MRW of + 25.33 µm, p = 0.001 (mean IOP reduction by 20.46 mmHg) and by week 1 with a mean BMO-MRW increase of + 33.17 µm, p < 0.001 (mean IOP reduction by 22.55 mmHg). The increase in BMO-MRW correlated significantly with the reduction of IOP on day 1 (Spearman’s rho ρ = 0.656, p = 0.003) and d2-3 (Spearman’s rho ρ = 0.479, p = 0.038). There was no statistically significant correlation found between the IOP and the increase in BMO-MRW in week 1. RNFL thickness showed no significant changes at day 1 as well as days 2-3 (p ≥ 0.078, respectively). It showed a small but significant increase in week 1 by 3.94 µm, p = 0.015.

CONCLUSIONS: Structural reversal of disc cupping in BMO-MRW occurs as early as 1 day after trabeculectomy and correlates to the extent of the IOP reduction. During the whole first week after surgery, a strong increase in BMO-MRW can be noted. The changes in BMO-based parameters need to be considered when evaluating patients’ longitudinal follow-up.

PMID:35394209 | DOI:10.1007/s00417-022-05644-3

Graefes Arch Clin Exp Ophthalmol. 2022 Apr 8. doi: 10.1007/s00417-022-05645-2. Online ahead of print.

ABSTRACT

PURPOSE: To compare the decompressive effect around the optic nerve canal among 3 different decompression procedures (medial, balanced, and inferomedial) using 3D printed models.

METHODS: In this experimental study, based on data obtained from 9 patients (18 sides) with dysthyroid optic neuropathy, a preoperative control model and 3 plaster decompression models were created using a 3D printer (total, 72 sides of 36 models). A pressure sensor was placed at the optic foramen, and the orbital space was filled with silicone. The surface of the silicone was pushed down directly, and changes in pressure were recorded at 2-mm increments of pushing.

RESULTS: At 10 mm of pushing, there was significantly lower pressure in the medial (19,782.2 ± 4319.9 Pa, P = 0.001), balanced (19,448.3 ± 3767.4 Pa, P = 0.003), and inferomedial (15,855.8 ± 4000.7 Pa, P < 0.001) decompression models than in the control model (25,217.8 ± 6087.5 Pa). Overall, the statistical results for each 2-mm push were similar among the models up to 10 mm of pushing (P < 0.050). At each push, inferomedial decompression caused the greatest reduction in pressure (P < 0.050), whereas there was no significant difference in pressure between the medial and balanced decompression models (P > 0.050).

CONCLUSION: All 3 commonly performed decompression procedures significantly reduced retrobulbar pressure. Because inferomedial decompression models obtained the greatest reduction in pressure on the optic nerve canal, inferomedial decompression should be considered the most reliable procedure for rescuing vision in dysthyroid optic neuropathy.

PMID:35394208 | DOI:10.1007/s00417-022-05645-2

Lung. 2022 Apr 8. doi: 10.1007/s00408-022-00531-4. Online ahead of print.

ABSTRACT

PURPOSE: Malignant pleural mesothelioma (MPM) is a malignant neoplasm of the pleura caused by asbestos exposure. For diagnosis of MPM, immunohistochemistry using multiple markers is recommended to rule out differential diagnoses, such as pulmonary adenocarcinoma. However, the specificity of currently used markers is not fully satisfactory. We previously developed a monoclonal antibody named S1, which recognizes 6-sulfo sialyl Lewis x, an L-selectin ligand expressed on high endothelial venules. During the screening process, we discovered that this antibody stained normal pleural mesothelium. This finding prompted us to hypothesize that the epitope recognized by S1 might serve as a new diagnostic marker for MPM.

METHODS: To test this hypothesis, we immunostained human MPM (n = 22) and lung adenocarcinoma (n = 25) tissues using S1 antibody.

RESULTS: 77.3% of MPM were S1 positive, and if limited to epithelioid type, the positivity rate was 100%, while that of lung adenocarcinoma was only 36.0%. Statistical analysis revealed a significant difference in the S1 positivity rate between each disease. Furthermore, immunohistochemistry using a series of anti-carbohydrate antibodies combined with glycosidase digestion revealed the structure of sulfated glycans expressed in MPM to be 6-sulfo sialyl N-acetyllactosamine attached to core 2-branched O-glycans.

CONCLUSION: We propose that the S1 glycoepitope could serve as a new diagnostic marker for MPM.

PMID:35394203 | DOI:10.1007/s00408-022-00531-4

Int J Legal Med. 2022 Apr 8. doi: 10.1007/s00414-022-02812-2. Online ahead of print.

ABSTRACT

Numerous intrinsic and extrinsic factors influence bone remodelling rates and have shown to affect the accuracy of histological aging methods. The present study investigates the rib cortex from two Mediterranean skeletal collections exploring the development of population-specific standards for histomorphometric age-at-death estimation. Eighty-eight standard ribs from two samples, Cretans and Greek-Cypriots, were processed histologically. Thirteen raw and composite histomorphometric parameters were assessed and observer error tested. The correlation between age and the parameters and the differences between sex and population subsamples were explored through group comparisons and analysis of covariance. General linear models assessed through data fit indicators and cross-validation were generated from the total dataset, and by sex and population subsamples. Most of the histological variables showed a statistically significant correlation with age with some differences observed by sex and by sample. From the twelve models generated, the optimal model for the whole sample included osteon population density (OPD), osteon perimeter, and osteon circularity producing an error of 10.71 years. When sex and samples were separated, the best model selected included OPD and osteon perimeter producing an error of 8.07 years for Greek-Cypriots. This research demonstrates the feasibility of quantitative bone histology to estimate age, obtaining errors rates in accordance with macroscopic ageing techniques. Sex and sample population differences need further investigation and inter-population variation in remodelling rates is suggested. Moreover, this study contributes to the creation of population-specific standards for Cretans and Greek-Cypriots.

PMID:35394177 | DOI:10.1007/s00414-022-02812-2