Tag: statistics

Matern Child Health J. 2022 Feb 22. doi: 10.1007/s10995-021-03370-6. Online ahead of print.

ABSTRACT

INTRODUCTION: The Maternal and Child Health (MCH) Pipeline Training Program, promotes development of a diverse health workforce by training undergraduate students from underrepresented minorities. We aimed to evaluate the success of this program based on three domains: (1) demographic characteristics, (2) academic and career development, and (3) attitudes towards the field of MCH and the training programs among graduates.

METHODS: Three domains of success were determined through a collaborative effort between current program directors and the funding agency project officers. The survey with questions related to the three domains was distributed via an online platform to graduates from seven sites (one former site and six current sites). Data were analyzed and presented utilizing descriptive statistics.

RESULTS: The survey was distributed to 550 graduates, 162 responded (37% response rate). Demographically, 78% were female, 54% were Black/African American, 22% were Latinx and 83% did not report any disability. Eighty percent of respondents applied to graduate/professional schools, 67% received admission. Graduates often continued to work in MCH fields (70%). Majority felt confident and knowledgeable in the field (89%) and agreed the faculty were supportive at their training sites (90%).

CONCLUSION: The study highlights successes in recruiting from underrepresented minorities, particularly Black/African Americans and first-time college goers in the family into the MCH Pipeline Training Programs. Programs were successful in furthering academic and career development for most trainees. Attitudes towards MCH and the training programs were overwhelmingly positive. Continued support of these programs is critical in addressing health disparities and achieving health equity.

PMID:35192126 | DOI:10.1007/s10995-021-03370-6

Cancer Causes Control. 2022 Feb 22. doi: 10.1007/s10552-021-01535-w. Online ahead of print.

ABSTRACT

OBJECTIVE: To characterize the epidemiological trends and sociodemographic variation of pediatric and adolescent neurological cancers by histological subtypes over time in the USA.

METHODS: A total of 16,511 patients aged 0-19 years diagnosed with neurological cancers between 2000 and 2018, including 13,024 with central nervous system (CNS) neoplasms and 3,487 with neuroblastomas, were identified from 18 registries of the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. Incidence trends over time and incidence rate ratios by race/ethnicity, sex, and age were calculated for histological subtype. Age-standardized incidence rates (ASIR) by year of diagnosis and average annual percent changes (AAPC) were calculated to measure incidence rates. ASIR by race/ethnicity, sex, and age were calculated to examine the incidence variation by these factors.

RESULTS: Overall, age-standardized annual incidence per 100,000 person-years increased from 2.20 in 2000 to 3.21 in 2018 with an AAPC of 1.4% (95% confidence interval or CI: 0.5% to 2.4%); however, that of Hispanic decreased from 2.93 in 2000 to 2.59 in 2018 with an AAPC of – 0.8% (95% CI: – 1.2% to – 0.3%). Non-Hispanic Black children and adolescents had a statistically significantly lower incidence than non-Hispanic White peers both for CNS neoplasms (incidence rate ratio or IRR: 0.67; 95% CI: 0.63 to 0.71) and neuroblastomas (IRR: 0.75; 95% CI: 0.68 to 0.83). Females generally had a lower incidence than males, especially among those with intracranial and intraspinal embryonal tumors (IRR: 0.69; 95% CI: 0.64 to 0.75). The highest incidence rate of neuroblastoma was among newborns aged less than 1 year, and the highest incidence rate of CNS neoplasms was among children aged 1-4 years.

CONCLUSION: The incidence of neurological cancers has increased among children and adolescents from 2000 to 2018, with wide variation across demographic groups.

PMID:35192107 | DOI:10.1007/s10552-021-01535-w

Int J Cardiovasc Imaging. 2022 Feb 22. doi: 10.1007/s10554-022-02566-3. Online ahead of print.

ABSTRACT

There is a growing body of literature supporting the utilization of machine learning (ML) to improve diagnosis and prognosis tools of cardiovascular disease. The current study was to investigate the impact that the ML framework may have on the sensitivity of predicting the presence or absence of congenital heart disease (CHD) using fetal echocardiography. A comprehensive fetal echocardiogram including 2D cardiac chamber quantification, valvar assessments, assessment of great vessel morphology, and Doppler-derived blood flow interrogation was recorded. The postnatal echocardiogram was used to ascertain the diagnosis of CHD. A random forest (RF) algorithm with a nested tenfold cross-validation was used to train models for assessing the presence of CHD. The study population was derived from a database of 3910 singleton fetuses with maternal age of 28.8 ± 5.2 years and gestational age at the time of fetal echocardiography of 22.0 weeks (IQR 21-24). The proportion of CHD was 14.1% for the studied cohort confirmed by post-natal echocardiograms. Our proposed RF-based framework provided a sensitivity of 0.85, a specificity of 0.88, a positive predictive value of 0.55 and a negative predictive value of 0.97 to detect the CHD with the mean of mean ROC curves of 0.94 and the mean of mean PR curves of 0.84. Additionally, six first features, including cardiac axis, peak velocity of blood flow across the pulmonic valve, cardiothoracic ratio, pulmonary valvar annulus diameter, right ventricular end-diastolic diameter, and aortic valvar annulus diameter, are essential features that play crucial roles in adding more predictive values to the model in detecting patients with CHD. ML using RF can provide increased sensitivity in prenatal CHD screening with very good performance. The incorporation of ML algorithms into fetal echocardiography may further standardize the assessment for CHD.

PMID:35192082 | DOI:10.1007/s10554-022-02566-3

Int J Cardiovasc Imaging. 2022 Feb 22. doi: 10.1007/s10554-021-02516-5. Online ahead of print.

ABSTRACT

Cardiac magnetic resonance (CMR) is the gold standard for evaluating myocardial fibrosis. Few studies have explored the association between ventricular arrhythmias (VAs) and fibrosis in apparently normal hearts. We aimed to investigate the association between the occurrence and morphology of VAs and left ventricular late gadolinium enhancement (LV-LGE) in patients without known structural heart diseases. This study enrolled 78 patients with apparently normal hearts who underwent 24-h ambulatory Holter electrocardiogram (ECG) and CMR examinations simultaneously. The presence and extent of LGE was determined using CMR imaging and compared based on occurrence and morphology of VAs. The clinical characteristics were also recorded and calculated. LV-LGE was observed in 19 (37.3%) and 4 (14.8%) patients with and without VAs, respectively (P = 0.039). It was more frequently observed in patients with polymorphic VAs (P = 0.024). The polymorphic VAs had a higher tendency of LGE extent than monomorphic VAs, while the difference did not reach statistical significance (P = 0.055). In multivariable analyses, the presence of polymorphic VAs [hazard ratio (HR) 11.19, 95% CI 1.64-76.53, P = 0.014] and hypertension (HR 4.64, 95% CI 1.08-19.99, P = 0.039) were associated with greater prevalence of LV-LGE. In patients without structural heart diseases, besides hypertension, multiple VA morphologies on Holter ambulatory ECG measurements is another important marker of increased incidence of myocardial fibrosis.

PMID:35192083 | DOI:10.1007/s10554-021-02516-5

Support Care Cancer. 2022 Feb 22. doi: 10.1007/s00520-022-06882-1. Online ahead of print.

ABSTRACT

PURPOSE: This study aims to explore the association between mindfulness and social engagement among Chinese breast cancer survivors (BCSs) and the mediator role of stigma in the relation of mindfulness and social engagement.

METHODS: This cross-sectional study was conducted among 937 BCSs from March to April 2021 in Shanghai, China. Data were collected using the Mindful Attention Awareness Scale, the Stigma Scale for Chronic Illness 8-item version, and the index of social engagement. Descriptive statistics, independent-sample t-test, one-way ANOVA, and regression analyses were used to explore the role of stigma in the association of mindfulness and social engagement among Chinese BCSs.

RESULTS: Social engagement levels differed significantly by participant’s BMI, education level, employment status, personal monthly income, monthly per capita household income. Mindfulness was positively correlated with social engagement, and stigma was negatively correlated with mindfulness and social engagement among Chinese BCSs. Stigma plays a complete mediating role in the relationship between mindfulness and social engagement in BCSs.

CONCLUSION: In the practice of individual mindfulness intervention on social engagement of BCSs, health care providers should identify and eliminate the constraints, which restrain the reduction of stigma level while individual mindfulness is being enhanced.

PMID:35192056 | DOI:10.1007/s00520-022-06882-1

Arch Gynecol Obstet. 2022 Feb 21. doi: 10.1007/s00404-022-06430-6. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: There is a complex relationship between obesity and pelvic organ prolapse. The objective of our study was to evaluate whether body mass index (BMI) changes the relationship between signs and symptoms of prolapse.

METHODS: This was a retrospective observational study based on datasets of women seen in a tertiary urogynecological center with symptoms of pelvic floor and lower urinary tract dysfunction between April 2012 and October 2015. Patients underwent a structured interview, clinical examination (based on the POP-Q) and 4D transperineal ultrasound (TPUS). Offline assessment of sonographic organ descent was undertaken later, blinded to all patient data.

RESULTS: Weight and BMI affect the relationship between symptoms and signs of prolapse. This effect is statistically highly significant. The more obese a patient is, the less likely she is to notice a given degree of objective prolapse, regardless of whether it is diagnosed clinically or on imaging.

CONCLUSIONS: In this retrospective study, we found a highly significant effect of weight and BMI on prolapse perception in the sense that obesity seems to mask prolapse while a low BMI increases the likelihood of a given degree of prolapse being noticed by the patient.

PMID:35192039 | DOI:10.1007/s00404-022-06430-6

Abdom Radiol (NY). 2022 Feb 22. doi: 10.1007/s00261-022-03450-3. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the diagnostic performance and inter-observer variability of differentiating T1 and T2 gallbladder (GB) cancers using multi-detector row CT (MDCT).

METHODS: This retrospective study included 151 patients with surgically confirmed T1 (n = 49)- or T2 (n = 102)-stage GB cancer who underwent contrast-enhanced MDCT from 2016 to 2020. Five radiologists (two experienced and three less experienced) evaluated the T-stage with a confidence level calculated using a six-point scale. GB cancers were morphologically classified into three types: polypoid, polypoid with wall thickening, and wall thickening. The diagnostic performance of T-staging was assessed using receiver operating characteristic (ROC) curve analysis. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated based on a binary scale (T1 = positive). Inter-observer agreement was assessed using Fleiss κ statistics.

RESULTS: The area under the receiver operating characteristic (ROC) curve of each reviewer for T-staging ranged from 0.69 to 0.80 (median 0.77). The overall accuracy of the five radiologists was 78% (95% confidence interval [CI] 71-84%). Sensitivity was higher and specificity was lower in experienced radiologists than in less experienced radiologists (P < 0.001). The overall inter-observer agreement was fair (κ = 0.36; 95% CI 0.31, 0.41). The overall accuracy for T-stage was 63% (95% CI 48-76), 78% (95% CI 63-88), and 87% (95% CI 77-93) for polypoid, polypoid with wall thickening, and wall thickening type, respectively.

CONCLUSION: The accuracy of MDCT for differentiating T1 and T2 GB cancer is limited, and there is considerable inter-observer variability.

PMID:35192044 | DOI:10.1007/s00261-022-03450-3

Environ Manage. 2022 Feb 22. doi: 10.1007/s00267-022-01610-1. Online ahead of print.

ABSTRACT

The Covid-19 pandemic has caused the alteration of many aspects of the solid waste management chain, such as variations in the waste composition, generation and disposal. Various studies have examined these changes with analysis of integrated waste management strategies; qualitative studies on perceived variations and statistical evaluations based on waste collected or disposed in landfills. Despite this information there is a need for updated data on waste generation and composition, especially in developing countries. The objective of this article is to develop a data sampling and analytical approach for the collection of data on household waste generation and composition during the pandemic; and, in addition, estimate the daily generation of masks in the study area. The proposed methodology is based on the principles of citizen science and utilizes virtual tools to contact participants, and for the training and collection of information. The study participants collected the information, installed segregation bins in their homes and trained their relatives in waste segregation. The article presents the results of the application of the methodology in an urban district of Lima (Peru) in August 2020. The results suggest an apparent decrease in household waste per capita and a slight increase in plastics composition in the study area. It is estimated that each participant generates 0.124 masks per day and 0.085 pairs of gloves per day. The method developed and results presented can be used as a tool for public awareness and training on household waste characterization and segregation. Furthermore it can provide the necessary evidence to inform policy directives in response household waste issues and Covid-19 restrictions.

PMID:35192024 | DOI:10.1007/s00267-022-01610-1

Pediatr Cardiol. 2022 Feb 22. doi: 10.1007/s00246-022-02835-x. Online ahead of print.

ABSTRACT

Pediatric single ventricle patients have seen dramatic improvements in overall outcomes over the past several decades. This is attributed to the development of home monitoring programs for interstage patients. In today’s current COVID-19 pandemic, the use of telemedicine has allowed providers to care for these patients and support their families effectively while minimizing the risk of COVID-19 exposure. Our single-center study reviewed the charts of nine patients followed by our single ventricle team through the COVID-19 pandemic. Patients discharged from the hospital and enrolled in our digital home monitoring program were included. Records were retrospectively reviewed for total number of outpatient visits, adverse events, unplanned hospital readmissions, and unplanned procedures. These results were then compared to outcomes from 2018 to 2019. In-person visits averaged every 6 weeks compared to every 2-3-week pre-pandemic. Zero adverse events reported with the use of telemedicine compared to one adverse event pre-pandemic. There was a 50% decrease in unplanned readmissions and 60% decrease in unplanned procedures during our study period. One patient was diagnosed with acute COVID-19 infection and managed conservatively via telemedicine with full recovery. To our knowledge, this is the only case-control study reporting the use of telemedicine during the COVID-19 pandemic in the interstage population. Although not statistically significant, we report a decrease in total adverse events, unplanned procedures, and unplanned admissions. Telemedicine visits allowed for identification of issues requiring hospital readmission as well as conservative management of one patient with COVID-19.

PMID:35192020 | DOI:10.1007/s00246-022-02835-x

Eur Radiol. 2022 Feb 22. doi: 10.1007/s00330-022-08606-9. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the effects of O⁶-methylguanine DNA methyltransferase (MGMT) promoter methylation status of gliomas on O-(2-¹⁸F-fluoroethyl)-L-tyrosine ([¹⁸F]FET) uptake and cerebral blood flow (CBF) of arterial spin labeling (ASL), evaluated by hybrid PET/MR. Stereotactic biopsy was used to validate the findings.

METHODS: A set of whole tumor and reference volumes of interest (VOIs) based on PET/FLAIR imaging were delineated and transferred to the corresponding [¹⁸F]FET PET and CBF maps in 57 patients with newly diagnosed gliomas. The mean and max tumor-to-brain ratio (TBR) and normalized CBF (nCBF) were calculated. The predictive efficacy of [¹⁸F]FET PET and CBF in determining MGMT promoter methylation status of glioma were evaluated by whole tumor analysis and stereotactic biopsy. The correlation between PET/MR parameters and MGMT promoter methylation were analyzed using histological specimens acquired from multiple stereotactic biopsies.

RESULTS: Based on the analysis of whole tumor volume and biopsy site, TBRmean, TBRmax, nCBFmean, and nCBFmax showed no statistically significant differences between gliomas with and without MGMT promoter methylation (all p > 0.05). Furthermore, stereotactic biopsy demonstrated that TBRmean, TBRmax, nCBFmean, and nCBFmax showed no correlation with MGMT promoter methylation (r = -0.117, p = 0.579; r = -0.161, p = 0.443; r = -0.271, p = 0.191; r = -0.300, p = 0.145; respectively).

CONCLUSIONS: MGMT promoter methylation status shows no effect on [¹⁸F]FET uptake and CBF of ASL in gliomas. Stereotactic biopsy validates it and further reveals there is no correlation of [¹⁸F]FET PET uptake and CBF with the percentages of MGMT promoter methylation.

KEY POINTS: • Based on whole tumor VOI assessment, MGMT promoter methylation status shows no effect on [¹⁸F]FET uptake and CBF of ASL in gliomas. • For WHO grade IV glioblastomas, [¹⁸F]FET PET and ASL parameters based on hybrid PET/MR fail to predict the MGMT promoter methylation status. • Stereotactic image-based histology reveals that there is no correlation of [¹⁸F]FET PET uptake and CBF with the status and percentages of MGMT promoter methylation in gliomas.

PMID:35192012 | DOI:10.1007/s00330-022-08606-9