Tag: statistics

J Vet Intern Med. 2022 Jan 27. doi: 10.1111/jvim.16366. Online ahead of print.

ABSTRACT

BACKGROUND: Disseminated aspergillosis (DA) in dogs has a guarded prognosis and there is a lack of a gold standard treatment protocol.

OBJECTIVE: To retrospectively assess survival times and factors influencing survival times.

ANIMALS: Dogs diagnosed with DA from January 2007 to June 2017.

METHODS: Disseminated aspergillosis case data were retrieved from 13 Australian veterinary referral centers, with a diagnosis confirmed with culture or PCR. Factors influencing survival time after diagnosis were quantified using a Cox proportional hazards regression model.

RESULTS: Thirty-four dogs met the study inclusion criteria. Twenty-two dogs were treated with antifungal treatment and 12 dogs received no antifungal treatment. Accounting for censoring of dogs that were either still alive on the date of data collection or were loss to follow-up, dogs treated with itraconazole alone (n = 8) had a median survival time (MST) of 63 (95% CI: 20-272) days compared to 830 (95% CI: 267-1259) days for the n = 14 dogs that received multimodal antifungal therapy ( ${\chi }^2$ test statistic 8.6; $\mathrm{df}$ = 1; P < .01). The daily hazard of death (DHOD) for dogs with abnormally high serum creatinine concentration at the time of diagnosis was 7.4 (95% CI: 1.9-29) times that of dogs with serum creatinine within the reference interval.

CONCLUSION AND CLINICAL IMPORTANCE: Serum creatinine concentration at the time of diagnosis is a useful prognostic indicator for survival after a diagnosis of DA. The MST for dogs treated with multimodal antifungal therapy is longer than itraconazole alone and warrant further investigation (P < .01).

PMID:35085412 | DOI:10.1111/jvim.16366

PLoS One. 2022 Jan 27;17(1):e0263139. doi: 10.1371/journal.pone.0263139. eCollection 2022.

ABSTRACT

OBJECTIVE: The main purpose of this study was to investigate the pooled prevalence of prediabetes and type-2 diabetes in the general population of Malaysia.

METHOD: We systematically searched Medline (PubMed), Embase, Web of Science, Google Scholar and Malaysian Journals Online to identify relevant studies published between January 1, 1995, and November 30, 2021, on the prevalence of type-2 diabetes in Malaysia. Random-effects meta-analyses were used to obtain the pooled prevalence of diabetes and prediabetes. Subgroup analyses also used to analyze to the potential sources of heterogeneity. Meta- regression was carried to assess associations between study characteristics and diabetes prevalence. Three independent authors selected studies and conducted the quality assessment. The quality of the final evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

RESULTS: Of 2689 potentially relevant studies, 786 titles and abstract were screened. Fifteen studies with 103063 individuals were eligible to be included in the meta-analyses. The pooled prevalence of diabetes was 14.39% (95% CI, 12.51%-16.38%; I2 = 98.4%, 103063 participants from 15 studies). The pooled prevalence of prediabetes was 11.62% (95% CI, 7.17%-16.97%; I2 = 99.8, 88702 participants from 9 studies). The subgroup analysis showed statistically significant differences in diabetes prevalence by the ethical sub-populations with highest in Indians (25.10%; 95% CI, 20.19%-30.35%), followed by Malays (15.25%; 95% CI, 11.59%-19.29%), Chinese (12.87%; 95% CI, 9.73%-16.37%), Bumiputeras (8.62%; 95% CI, 5.41%-12.47%) and others (6.91%; 95% CI, 5.71%-8.19%). There was no evidence of publication bias, although heterogeneity was high (I2 ranged from 0.00% to 99·8%). The quality of evidence based on GRADE was low.

CONCLUSIONS: Results of this study suggest that a high prevalence of prediabetes and diabetes in Malaysia. The diabetes prevalence is associated with time period and increasing age. The Malaysian government should develop a comprehensive approach and strategy to enhance diabetes awareness, control, prevention, and treatment.

TRIAL REGISTRATION: Trial registration no. PROSPERO CRD42021255894; https://clinicaltrials.gov/.

PMID:35085366 | DOI:10.1371/journal.pone.0263139

PLoS One. 2022 Jan 27;17(1):e0263336. doi: 10.1371/journal.pone.0263336. eCollection 2022.

ABSTRACT

BACKGROUND: Gestational diabetes mellitus (GDM) in pregnancy leads to a range of perinatal complications. Although several randomized controlled trials (RCT) have tested the effect of non-pharmacological standard GDM care adjuncts on these outcomes, there is no agglomerated statistical evidence on how their occurrence risk varies across interventions and with placebo. Therefore, a systematic review and network meta-analysis (NMA) protocol is proposed here to address this evidence gap.

MATERIALS AND METHODS: A search for above RCTs published in the English language will transpire in PubMed, Embase, and Scopus databases irrespective of date and geographic boundary. The RCTs must test nutritional supplementation, digital intervention, structured exercise program, educational program, counseling service, or a combination of these prenatally in GDM patients. These should report ≥1 of the following outcomes- cesarean section, pre-eclampsia, polyhydramnios, preterm birth, macrosomia, prolonged labor, gestational hypertension, premature rupture of membranes, congenital anomaly, Apgar scores, birth weight, birth length, gestational age at birth, neonatal hypoglycemia, neonatal hyperbilirubinemia, and neonatal Corpulence Index. The risk of bias assessment of the recruited trials will transpire using the Revised Cochrane risk-of-bias tool. Determination of the comparative effectiveness between interventions will occur by the frequentist method NMA for respective outcomes. The categorical and continuous outcomes effect size will get calculated in risk ratio and weighted or standardized mean difference, respectively. For each NMA model, network maps and league tables will show the connections between interventions and effect sizes with their 95% confidence intervals for each intervention pair compared, respectively. The publication bias assessment will occur using comparison-adjusted funnel plots. Best intervention prediction for NMA models with statistically significant intervention effect will happen by determining the surface under the cumulative ranking curve values. Statistical analysis will ensue using Stata software (v16). The statistical significance estimation will happen at p<0.05 and 95% confidence interval.

TRIAL REGISTRATION: PROSPERO registration no: CRD42021271199; https://clinicaltrials.gov/.

PMID:35085374 | DOI:10.1371/journal.pone.0263336

PLoS One. 2022 Jan 27;17(1):e0263130. doi: 10.1371/journal.pone.0263130. eCollection 2022.

ABSTRACT

OBJECTIVE: To evaluate the cost-effectiveness of the Cardiac Care Bridge (CCB) nurse-led transitional care program in older (≥70 years) cardiac patients compared to usual care.

METHODS: The intervention group (n = 153) received the CCB program consisting of case management, disease management and home-based cardiac rehabilitation in the transition from hospital to home on top of usual care and was compared with the usual care group (n = 153). Outcomes included a composite measure of first all-cause unplanned hospital readmission or mortality, Quality Adjusted Life Years (QALYs) and societal costs within six months follow-up. Missing data were imputed using multiple imputation. Statistical uncertainty surrounding Incremental Cost-Effectiveness Ratios (ICERs) was estimated by using bootstrapped seemingly unrelated regression.

RESULTS: No significant between group differences in the composite outcome of readmission or mortality nor in societal costs were observed. QALYs were statistically significantly lower in the intervention group, mean difference -0.03 (95% CI: -0.07; -0.02). Cost-effectiveness acceptability curves showed that the maximum probability of the intervention being cost-effective was 0.31 at a Willingness To Pay (WTP) of €0,00 and 0.14 at a WTP of €50,000 per composite outcome prevented and 0.32 and 0.21, respectively per QALY gained.

CONCLUSION: The CCB program was on average more expensive and less effective compared to usual care, indicating that the CCB program is dominated by usual care. Therefore, the CCB program cannot be considered cost-effective compared to usual care.

PMID:35085361 | DOI:10.1371/journal.pone.0263130

PLoS One. 2022 Jan 27;17(1):e0263051. doi: 10.1371/journal.pone.0263051. eCollection 2022.

ABSTRACT

With the development of measurement technology, data on the movements of actual games in various sports can be obtained and used for planning and evaluating the tactics and strategy. Defense in team sports is generally difficult to be evaluated because of the lack of statistical data. Conventional evaluation methods based on predictions of scores are considered unreliable because they predict rare events throughout the game. Besides, it is difficult to evaluate various plays leading up to a score. In this study, we propose a method to evaluate team defense from a comprehensive perspective related to team performance by predicting ball recovery and being attacked, which occur more frequently than goals, using player actions and positional data of all players and the ball. Using data from 45 soccer matches, we examined the relationship between the proposed index and team performance in actual matches and throughout a season. Results show that the proposed classifiers predicted the true events (mean F1 score > 0.483) better than the existing classifiers which were based on rare events or goals (mean F1 score < 0.201). Also, the proposed index had a moderate correlation with the long-term outcomes of the season (r = 0.397). These results suggest that the proposed index might be a more reliable indicator rather than winning or losing with the inclusion of accidental factors.

PMID:35085344 | DOI:10.1371/journal.pone.0263051

PLoS One. 2022 Jan 27;17(1):e0262890. doi: 10.1371/journal.pone.0262890. eCollection 2022.

ABSTRACT

Identifying genes with the largest expression changes (gene selection) to characterize a given condition is a popular first step to drive exploration into molecular mechanisms and is, therefore, paramount for therapeutic development. Reproducibility in the sciences makes it necessary to emphasize objectivity and systematic repeatability in biological and informatics analyses, including gene selection. With these two characteristics in mind, in previous works our research team has proposed using multiple criteria optimization (MCO) in gene selection to analyze microarray datasets. The result of this effort is the MCO algorithm, which selects genes with the largest expression changes without user manipulation of neither informatics nor statistical parameters. Furthermore, the user is not required to choose either a preference structure among multiple measures or a predetermined quantity of genes to be deemed significant a priori. This implies that using the same datasets and performance measures (PMs), the method will converge to the same set of selected differentially expressed genes (repeatability) despite who carries out the analysis (objectivity). The present work describes the development of an open-source tool in RStudio to enable both: (1) individual analysis of single datasets with two or three PMs and (2) meta-analysis with up to five microarray datasets, using one PM from each dataset. The capabilities afforded by the code include license-free portability and the possibility to carry out analyses via modest computer hardware, such as personal laptops. The code provides affordable, repeatable, and objective detection of differentially expressed genes from microarrays. It can be used to analyze other experiments with similar experimental comparative layouts, such as microRNA arrays and protein arrays, among others. As a demonstration of the capabilities of the code, the analysis of four publicly-available microarray datasets related to Parkinson´s Disease (PD) is presented here, treating each dataset individually or as a four-way meta-analysis. These MCO-supported analyses made it possible to identify MMP9 and TUBB2A as potential PD genetic biomarkers based on their persistent appearance across each of the case studies. A literature search confirmed the importance of these genes in PD and indeed as PD biomarkers, which evidences the code´s potential.

PMID:35085348 | DOI:10.1371/journal.pone.0262890

PLoS One. 2022 Jan 27;17(1):e0262930. doi: 10.1371/journal.pone.0262930. eCollection 2022.

ABSTRACT

This study aims to investigate the influence of all the mixture components of high-performance concrete (HPC) on its early compressive strength, ranging from 1 to 14 days. To this purpose, a Gaussian Process Regression (GPR) algorithm was first constructed using a database gathered from the available literature. The database included the contents of cement, blast furnace slag (BFS), fly ash (FA), water, superplasticizer, coarse, fine aggregates, and testing age as input variables to predict the output of the problem, which was the early compressive strength. Several standard statistical criteria, such as the Pearson correlation coefficient, root mean square error and mean absolute error, were used to quantify the performance of the GPR model. To analyze the sensitivity and influence of the HPC mixture components, partial dependence plots analysis was conducted with both one-dimensional and two-dimensional. Firstly, the results showed that the GPR performed well in predicting the early strength of HPC. Second, it was determined that the cement content and testing age of HPC were the most sensitive and significant elements affecting the early strength of HPC, followed by the BFS, water, superplasticizer, FA, fine aggregate, and coarse aggregate contents. To put it simply, this research might assist engineers select the appropriate amount of mixture components in the HPC production process to obtain the necessary early compressive strength.

PMID:35085343 | DOI:10.1371/journal.pone.0262930

PLoS One. 2022 Jan 27;17(1):e0262929. doi: 10.1371/journal.pone.0262929. eCollection 2022.

ABSTRACT

BACKGROUND: Rapid diagnosis of tuberculosis (TB) and detection of drug resistance are very important for timely and appropriate management of patients. Xpert MTB/RIF assay is approved for use in TB and rifampicin-resistance diagnosis. However, data are limited on the impact of Xpert MTB/RIF assay under routine clinical settings with a heterogeneous group of patients and sample types in Ethiopia.

METHODS: A retrospective study was carried out in 2220 presumptive TB cases at Jimma University Medical Center. Data were gathered from the registration logbook using formatted data extraction tools and double entered to epidata version 3.1 and further transported to SPSS version 20 for analysis. Associations were determined using the Chi-square test and P-value <0.05 was considered statistically significant.

RESULTS: Of 2220 cases enrolled, 1665 (75%) were adults and the remaining 555 (25%) were children aged less than 14 years. The majority, 1964 (88.46%), had pulmonary manifestation and 256 (11.54%) had extrapulmonary involvements. The overall, frequency of Mycobacterium tuberculosis (MTB) was 9.3% (206/2220), among this 10.27% (171/1665) and 6.3% (35/555) were adults and children, respectively. M. tuberculosis was detected from 171 (8.75%) of pulmonary patients and 35 (13.28%) of extrapulmonary manifested patients. Out of 206 M. tuberculosis positive cases, 7(3.4%) were rifampicin-resistant: four from pulmonary tuberculosis (PTB) patients and three from EPTB patients. In the Chi-square test, the age group of 15-24 years, previous history of TB, pus/lymph node sample, and being HIV positive were significantly associated with TB positivity by Xpert MTB/RIF (P-value <0.001).

CONCLUSION: These data suggest that the overall frequency of M. tuberculosis and rifampicin resistance was found to be relatively low compared to the previous reports in Ethiopia. Nevertheless, better diagnostic tools and approaches are still vital to halt the burden of TB and drug-resistant TB in the country.

PMID:35085337 | DOI:10.1371/journal.pone.0262929

PLoS One. 2022 Jan 27;17(1):e0262896. doi: 10.1371/journal.pone.0262896. eCollection 2022.

ABSTRACT

BACKGROUND: The COVID-19 pandemic started a little later in Ethiopia than the rest of the world and most of the initial cases were reported to have a milder disease course and a favorable outcome. This changed as the disease spread into the population and the more vulnerable began to develop severe disease. Understanding the risk factors for severe disease in Ethiopia was needed to provide optimal health care services in a resource limited setting.

OBJECTIVE: The study assessed COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia for characteristics associated with COVID-19 disease severity.

METHODS: A cross-sectional study was conducted from June to August 2020 among 686 randomly selected patients. Chi-square test was used to detect the presence of a statistically significant difference in the characteristics of the patients based on disease severity (Mild vs Moderate vs Severe). A multinomial logistic regression model was used to identify factors associated with COVID-19 disease severity where Adjusted Odds ratio (AOR), 95% CIs for AOR and P-values were used for significance testing.

RESULTS: Having moderate as compared with mild disease was significantly associated with having hypertension (AOR = 2.30, 95%CI = 1.27,4.18), diabetes mellitus (AOR = 2.61, 95%CI = 1.31,5.19for diabetes mellitus), fever (AOR = 6.12, 95%CI = 2.94,12.72) and headache (AOR = 2.69, 95%CI = 1.39,5.22). Similarly, having severe disease as compared with mild disease was associated with age group (AOR = 4.43, 95%CI = 2.49,7.85 for 40-59 years and AOR = 18.07, 95%CI = 9.29,35.14for ≥ 60 years), sex (AOR = 1.84, 95%CI = 1.12,3.03), hypertension (AOR = 1.97, 95%CI = 1.08,3.59), diabetes mellitus (AOR = 3.93, 95%CI = 1.96,7.85), fever (AOR = 13.22, 95%CI = 6.11, 28.60) and headache (AOR = 4.82, 95%CI = 2.32, 9.98). In addition, risk factors of severe disease as compared with moderate disease were found to be significantly associated with age group (AOR = 4.87, 95%CI = 2.85, 8.32 for 40-59 years and AOR = 18.91, 95%CI = 9.84,36.331 for ≥ 60 years), fever (AOR = 2.16, 95%CI = 1.29,3.63) and headache (AOR = 1.79, 95%CI = 1.03, 3.11).

CONCLUSIONS: Significant factors associated with severe COVID-19 in Ethiopia are being older than 60 years old, male, a diagnosis of hypertension, diabetes mellitus, and the presence of fever and headache. This is consistent with severity indicators identified by WHO and suggests the initial finding of milder disease in Ethiopia may have been because the first people to get COVID-19 in the country were the relatively younger with fewer health problems.

PMID:35085338 | DOI:10.1371/journal.pone.0262896

PLoS One. 2022 Jan 27;17(1):e0262833. doi: 10.1371/journal.pone.0262833. eCollection 2022.

ABSTRACT

BACKGROUND: According to the literature, pigmentary disorders have a significantly negative impact on a person’s health-related quality of life. Moreover, among pigmentary disorders, incidence of melasma ranks high. The Melasma Area and Severity Index (MASI) is the scale that is generally used to evaluate a melasma-affected area and its severity. However, the relationship between the MASI and Melasma Quality of Life (MELASQoL) scores, as well as the impact of melasma on patients’ quality of life, remain unclear.

OBJECTIVES: To explore the influence of melasma on patients’ lives, analyze the relationship between the MASI and MELASQoL scores, and identify the factors that may be influencing the quality of life of patients with melasma.

METHODS: Two reviewers independently searched four databases (PubMed, Embase, the Cochrane Library, and Web of Science) for literature on quality of life of patients with melasma. In addition to an epidemiological study, a cross-sectional study, and validation studies, gray literature was also included. StataSE version 16 software was used for the meta-analysis. The score of each item on the MELASQoL scale was determined using a random-effects model.

RESULTS: Fourteen studies with a total of 1398 melasma patients were included in the systematic review, four of which were eligible for meta-analysis. The relationship between the MELASQoL and MASI scores was found to be mixed. Five studies concluded that the MASI and MELASQoL scores were statistically correlated, while seven studies found no statistical correlation between the two. It is obvious that melasma causes emotional distress and has a negative impact on patients’ social lives. Patients were most bothered by the appearance of their skin condition. However, the MELASQoL score had no definite correlation with patient characteristics such as age, education levels, and history.

CONCLUSION: Melasma has a significant negative impact on patients’ quality of life. Thus, evaluating the quality of life of patients with melasma should not be ignored. Additionally, utilization of the MELASQoL scale should be considered in the care plan. Further studies with larger sample sizes are needed to confirm the relationship between melasma and quality of life.

PMID:35085327 | DOI:10.1371/journal.pone.0262833