Tag: statistics

Int J Clin Pract. 2021 Oct 8:e14961. doi: 10.1111/ijcp.14961. Online ahead of print.

ABSTRACT

AIM: We aimed to investigate the effect of short-term pirfenidone treatment on prolonged COVID-19 pneumonia.

METHOD: Hospital files of patients hospitalized with a diagnosis of critical COVID-19 pneumonia between November 2020 and March 2021 were retrospectively reviewed. Chest computed tomography images taken both before treatment and 2 months after treatment, demographic characteristics and laboratory parameters of patients receiving pirfenidone+methylprednisolone (n=13) and only methylprednisolones (n=9) were recorded. Pulmonary function tests were performed after the second month of the treatment. CT involvement rates were determined by machine learning.

RESULTS: A total of 22 patients, 13 of whom (59.1%) were using methylprednisolone + pirfenidone and 9 of whom (40.9%) were using only methylprednisolone were included. When the blood gas parameters and pulmonary function tests of the patients were compared at the end of the second month, it was found that the FEV1, FEV1%, FVC, and FVC% values were statistically significantly higher in the methylprednisolone + pirfenidone group compared to the methylprednisolone group (p=0.025, p=0.012, p=0.026, and p=0.017, respectively). When the rates of change in CT scans at diagnosis and second month of treatment were examined, it was found that the involvement rates in the methylprednisolone + pirfenidone group were statistically significantly decreased (p<0.001).

CONCLUSION: Antifibrotic agents can reduce fibrosis that may develop in the future. These can also help dose reduction and/or non-use strategy for methylprednisolone therapy, which has many side effects. Further large series and randomized controlled studies are needed on this subject.

PMID:34624155 | DOI:10.1111/ijcp.14961

Fam Med. 2021 Oct;53(9):760-765. doi: 10.22454/FamMed.2021.415039.

ABSTRACT

BACKGROUND AND OBJECTIVES: Antiretroviral treatment has transformed human immunodeficiency virus (HIV) infection into a chronic disease. Prior research demonstrated a discrepancy between preparation to provide HIV care and current provision among recent residency graduates. Our study aimed to describe characteristics related to preparedness and provision of HIV care, and to identify the associations between physician and practice characteristics with current provision of HIV care among those prepared.

METHODS: We obtained data from the 2016 through 2019 American Board of Family Medicine (ABFM) National Family Medicine Graduate Survey. Our main outcome was self-reported provision of HIV care. Bivariate statistics compared differences in personal and practice characteristics with self-reported preparation for HIV care, then among those prepared, provision of HIV care. We used logistic regression to determine associations between HIV care, among those prepared, with practice and personal characteristics.

RESULTS: The response rate was 68.7% and our final sample size was 6,740 respondents. Only 25% of respondents reported preparedness in residency, and 44% of them reported current provision. Among those prepared, female gender (OR=0.604; 95% CI, 0.494-0.739) was associated with lower odds of practicing HIV care. Those working in high HIV prevalence areas (OR=1.718; 95% CI, 1.259-2.344) and in Northeast census region (OR=1.557; 95% CI, 1.137-2.132) had higher odds of providing HIV care.

CONCLUSIONS: Fewer than half of those prepared in residency reported currently providing HIV care. Working in a high HIV prevalence area was associated with higher odds of providing HIV care, which suggests early-career family physicians are responding to community needs.

PMID:34624123 | DOI:10.22454/FamMed.2021.415039

Fam Med. 2021 Oct;53(9):766-772. doi: 10.22454/FamMed.2021.292421.

ABSTRACT

BACKGROUND AND OBJECTIVES: Current literature on review of applicant social media (SoMe) content for resident recruitment is scarce. With the recent increase in the use of privacy settings, and the cost of the recruitment process, the aim of this study was to describe the practice and outcomes of review of applicant SoMe in resident recruitment and its association with program director or program characteristics.

METHODS: This study was part of the 2020 Council of Academic Family Medicine’s Educational Research Alliance (CERA) annual survey of family medicine residency program directors (PDs) in the United States.

RESULTS: The overall response rate for the survey was 39.8% (249/626). About 40% of PDs reported reviewing applicant SoMe content. The majority (88.9%) of programs did not inform applicants of their SoMe review practices. The most common findings of SoMe review were that the content raised no concerns (38/94; 40.4%) or was consistent with the application material (34/94; 36.2%). Forty PDs (17.0%) have ever moved an applicant up or down the rank list based on SoMe review. Review of applicant SoMe was not statistically associated with program size, program type, PD age, PD SoMe use, or program SoMe use.

CONCLUSIONS: SoMe review has not become routine practice in family medicine resident recruitment. The outcome of SoMe review was mostly consistent with the applicant profile without any concerns and only very few changed the ranking order. This calls for more studies to explore the value of SoMe review for resident selection regarding its effect on future performance.

PMID:34624124 | DOI:10.22454/FamMed.2021.292421

Blood. 2020 Oct 8:blood.2021012081. doi: 10.1182/blood.2021012081. Online ahead of print.

ABSTRACT

Burkitt lymphoma (BL) is an aggressive lymphoma type that is currently treated by intensive chemoimmunotherapy. Despite the favorable clinical outcome of the majority of BL patients, chemotherapy-related toxicity and disease relapse remain as major clinical challenges, emphasizing the need for innovative therapies. Using genome-scale CRISPR-Cas9 screens, we identified B-cell receptor (BCR) signaling, specific transcriptional regulators and one-carbon metabolism as vulnerabilities in BL. We focused on serine hydroxymethyltransferase 2 (SHMT2), a key enzyme in one-carbon metabolism. Inhibition of SHMT2 by either knockdown or pharmacological compounds induced anti-BL effects in vitro and in vivo. Mechanistically, SHMT2 inhibition led to a significant reduction of intracellular glycine and formate levels, which inhibited the mTOR pathway and thereby triggered autophagic degradation of the oncogenic transcription factor TCF3. As a consequence, this led to a collapse of tonic B-cell receptor signaling, which is controlled by TCF3 and is essential for BL cell survival. In terms of clinical translation, we furthermore identified drugs such as methotrexate that synergized with SHMT inhibitors (SHMT2i). Overall, our study has uncovered the dependency landscape in BL, identified and validated SHMT2 as a drug target and revealed a mechanistic link between SHMT2 and the transcriptional master regulator TCF3, opening up new perspectives for innovative therapies.

PMID:34624079 | DOI:10.1182/blood.2021012081

Oper Dent. 2021 Oct 8. doi: 10.2341/20-198-L. Online ahead of print.

ABSTRACT

This study aimed to evaluate the cementation and mechanical behavior of flared root canals restored with CAD/CAM milled glass fiber post-and-core systems. Sixty-six endodontically treated human canines with a flared root canal were divided into three different groups according to the type of post: GPF received prefabricated posts; GREL received relined glass fiber posts, and GMILLED received CAD/CAM milled glass fiber posts. Cementation was performed with self-adhesive resin cement. The samples were submitted to x-ray microcomputed tomography analysis for the analysis of voids and gaps. The roots were sectioned and submitted to the push-out bond strength test. The load-to-fracture was evaluated in post-and-core systems. GMILLED presented lower void and lower gap volumes when compared to GPF and GREL. On the load-to-fracture test, GREL presented statistically significant higher values than GMILLED. GPF values had no statistically significant difference from the two other groups. On the push-out bond strength test, GPF presented statistically significant lower values when compared to GREL and GMILLED. The most common failure pattern was between dentin and cement in all groups. CAD/CAM milled glass fiber post-and-core systems presented an enhanced adaptation of glass fiber posts to flared root canal systems. Their results were comparable to relined posts in bond strength, while load-to-fracture-results for GMILLED were lower than those for GPF.

PMID:34624118 | DOI:10.2341/20-198-L

PLoS One. 2021 Oct 8;16(10):e0258377. doi: 10.1371/journal.pone.0258377. eCollection 2021.

ABSTRACT

BACKGROUND: There is currently no validated risk prediction model for recurrent events among patients with acute ischemic stroke (AIS) and atrial fibrillation (AF). Considering that the application of conventional risk scores has contextual limitations, new strategies are needed to develop such a model. Here, we set out to develop and validate a comprehensive risk prediction model for stroke recurrence in AIS patients with AF.

METHODS: AIS patients with AF were collected from multicenter registries in South Korea and Japan. A developmental dataset was constructed with 5648 registered cases from both countries for the period 2011‒2014. An external validation dataset was also created, consisting of Korean AIS subjects with AF registered between 2015 and 2018. Event outcomes were collected during 1 year after the index stroke. A multivariable prediction model was developed using the Fine-Gray subdistribution hazard model with non-stroke mortality as a competing risk. The model incorporated 21 clinical variables and was further validated, calibrated, and revised using the external validation dataset.

RESULTS: The developmental dataset consisted of 4483 Korean and 1165 Japanese patients (mean age, 74.3 ± 10.2 years; male 53%); 338 patients (6%) had recurrent stroke and 903 (16%) died. The clinical profiles of the external validation set (n = 3668) were comparable to those of the developmental dataset. The c-statistics of the final model was 0.68 (95% confidence interval, 0.66 ‒0.71). The developed prediction model did not show better discriminative ability for predicting stroke recurrence than the conventional risk prediction tools (CHADS2, CHA2DS2-VASc, and ATRIA).

CONCLUSIONS: Neither conventional risk stratification tools nor our newly developed comprehensive prediction model using available clinical factors seemed to be suitable for identifying patients at high risk of recurrent ischemic stroke among AIS patients with AF in this modern direct oral anticoagulant era. Detailed individual information, including imaging, may be warranted to build a more robust and precise risk prediction model for stroke survivors with AF.

PMID:34624070 | DOI:10.1371/journal.pone.0258377

PLoS One. 2021 Oct 8;16(10):e0257962. doi: 10.1371/journal.pone.0257962. eCollection 2021.

ABSTRACT

The objective of the paper is to diagnose organisational culture of selected universities and analyse its impact on the innovation processes within them. The subject matter of the study was organisational culture and innovation at universities. The subjects were four selected universities in Poland, Austria, Germany, and Ukraine. The paper provided a definition of organisational culture and its typology. It further discussed the organisational culture of universities and the relationships between organisational culture and innovativeness. The literature review provided foundations for building a model for the formation of a type of organisational culture at universities that is innovation-friendly, which is the added value of the paper. It offers actions worth taking to shape innovation-friendly culture at universities. It is particularly important during difficult time of changing labour market, when universities greatly impact the attitudes of young people. The knowledge of how to shape innovation-friendly organisational culture at universities is necessary for academia to profile future employees in times of continuous changes. To investigate the relationship between organisational culture and the innovativeness of universities, we designed an original survey questionnaire [S1 File]. Organisational culture was diagnosed with the Organizational Culture Assessment Instrument by K.S. Cameron and R.E. Quinn. The analyses were conducted in Dell Statistica v. 13.1 (StatSoft Polska). We normalised data from the Likert rating scale using Kaufman’s and Rousseeuw’s formula. We used Spearman’s correlation coefficient and Kendall’s W to calculate correlations. The research shows that the investigated Polish and Austrian universities are dominated by hierarchy and market cultures. On the other hand, the German and Ukrainian universities host all cultures, but clan and adhocracy dominate there. Moreover, the analyses demonstrated that although the adhocracy culture was the least visible in the investigated organisations, it contributes to university innovativeness the most. The conclusions were used to build a model for promoting innovation-friendly organisational culture at universities. The model contains answers to the research questions. In addition, it offers guidelines for shaping organisational culture to bolster innovation at universities. The research identified relationships between organisational culture and university innovativeness and components that create innovation opportunities at universities as its contribution to management theory. When applied in practice, the guidelines can help form the university’s organisational culture bottom-up.

PMID:34624041 | DOI:10.1371/journal.pone.0257962

PLoS One. 2021 Oct 8;16(10):e0258347. doi: 10.1371/journal.pone.0258347. eCollection 2021.

ABSTRACT

INTRODUCTION: Breastfeeding is one of the most effective ways to ensure infant health and survival. Inadequate breastfeeding practices, and knowledge among adolescent mothers have led to unprecedented infant and child morbidity and mortality. Given, the high global prevalence of adolescent mothers it is imperative to understand how the knowledge of breastfeeding practices operates among adolescent girls across different socio-economic settings.

MATERIALS & METHODS: Data was carried out from Understanding the Lives of Adolescents and Young Adults (UDAYA) survey, conducted in 2015-16. Descriptive statistics along with bivariate analysis was done to examine the preliminary results. For analysing the association between the binary outcome variable and other explanatory variables, binary logistic regression method was used. The explanatory variables were educational status of the respondent, media exposure, working status, ever pregnant status (only for married adolescent girls), sex and age of the household head, educational status of the head of the household, caste, religion, wealth index, residence and states.

RESULTS: About 42%, 50%, and 42% of married adolescent girls had knowledge of immediate breastfeeding, yellowish milk, and exclusive breastfeeding respectively. The odds of knowledge about immediate breastfeeding [married-AOR: 1.57; CI: 1.09-2.28 and unmarried-AOR: 1.30; CI: 1.08-1.55], yellowish milk feeding [married-AOR: 2.09; CI: 1.46-3.01 and unmarried-AOR: 1.39; CI: 1.17-1.66], and exclusive breastfeeding [married-AOR: 1.74; CI: 1.2-2.52 and unmarried-AOR: 1.46; CI: 1.22-1.76] were significantly more among adolescent girls aged 19 years old compared to 15 years old girls. Adolescent married and unmarried girls with 10 & above years of schooling were 1.82 times [AOR: 1.82; CI: 1.52-2.18] and 2.69 times [AOR: 2.69; CI: 2.08-3.47] more likely to have knowledge about immediate breastfeeding, 1.74 times [AOR: 1.74; CI: 1.45-2.09] and 2.10 times [AOR: 2.10; CI: 1.68-2.62] more likely to have knowledge about yellowish milk feeding, and 3.13 times [AOR: 3.13; CI: 2.6-3.78] and 3.87 times [AOR: 3.87; CI: 2.95-5.08] more likely to have knowledge about exclusive breastfeeding respectively than girls with no schooling.

CONCLUSION: Breastfeeding practices and interpersonal counselling from elders in the household should be encouraged. Ongoing breastfeeding promotion programs of the government should promote high education of adolescent girls. Mass media interventions should be encouraged.

PMID:34624069 | DOI:10.1371/journal.pone.0258347

PLoS One. 2021 Oct 8;16(10):e0258215. doi: 10.1371/journal.pone.0258215. eCollection 2021.

ABSTRACT

Agricultural index insurance contracts increasingly use remote sensing data to estimate losses and determine indemnity payouts. Index insurance contracts inevitably make errors, failing to detect losses that occur and issuing payments when no losses occur. The quality of these contracts and the indices on which they are based, need to be evaluated to assess their fitness as insurance, and to provide a guide to choosing the index that best protects the insured. In the remote sensing literature, indices are often evaluated with generic model evaluation statistics such as R2 or Root Mean Square Error that do not directly consider the effect of errors on the quality of the insurance contract. Economic analysis suggests using measures that capture the impact of insurance on the expected economic well-being of the insured. To bridge the gap between the remote sensing and economic perspectives, we adopt a standard economic measure of expected well-being and transform it into a Relative Insurance Benefit (RIB) metric. RIB expresses the welfare benefits derived from an index insurance contract relative to a hypothetical contract that perfectly measures losses. RIB takes on its maximal value of one when the index contract offers the same economic benefits as the perfect contract. When it achieves none of the benefits of insurance it takes on a value of zero, and becomes negative if the contract leaves the insured worse off than having no insurance. Part of our contribution is to decompose this economic well-being measure into an asymmetric loss function. We also argue that the expected well-being measure we use has advantages over other economic measures for the normative purpose of insurance quality ascertainment. Finally, we illustrate the use of the RIB measure with a case study of potential livestock insurance contracts in Northern Kenya. We compared 24 indices that were made with 4 different statistical models and 3 remote sensing data sources. RIB for these indices ranged from 0.09 to 0.5, and R2 ranged from 0.2 to 0.51. While RIB and R2 were correlated, the model with the highest RIB did not have the highest R2. Our findings suggest that, when designing and evaluating an index insurance program, it is useful to separately consider the quality of a remote sensing-based index with a metric like the RIB instead of a generic goodness-of-fit metric.

PMID:34624022 | DOI:10.1371/journal.pone.0258215

PLoS One. 2021 Oct 8;16(10):e0256868. doi: 10.1371/journal.pone.0256868. eCollection 2021.

ABSTRACT

Ecological Niche Modeling is a process by which spatiotemporal, climatic, and environmental data are analyzed to predict the distribution of an organism. Using this process, an ensemble ecological niche model for West Nile virus habitat prediction in the state of Florida was developed. This model was created through the weighted averaging of three separate machine learning models-boosted regression tree, random forest, and maximum entropy-developed for this study using sentinel chicken surveillance and remote sensing data. Variable importance differed among the models. The highest variable permutation value included mean dewpoint temperature for the boosted regression tree model, mean temperature for the random forest model, and wetlands focal statistics for the maximum entropy mode. Model validation resulted in area under the receiver curve predictive values ranging from good [0.8728 (95% CI 0.8422-0.8986)] for the maximum entropy model to excellent [0.9996 (95% CI 0.9988-1.0000)] for random forest model, with the ensemble model predictive value also in the excellent range [0.9939 (95% CI 0.9800-0.9979]. This model should allow mosquito control districts to optimize West Nile virus surveillance, improving detection and allowing for a faster, targeted response to reduce West Nile virus transmission potential.

PMID:34624026 | DOI:10.1371/journal.pone.0256868