Tag: statistics

Obstet Gynecol. 2021 Mar 10. doi: 10.1097/AOG.0000000000004308. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the length of the second stage of labor in twin deliveries and to compare the length of the second stage in twin and singleton gestations.

METHODS: This is a retrospective cohort study from three large hospitals in Israel. Clinical data were collected from the electronic medical record. The primary outcome was the length of the second stage (the time from documented 10-cm dilation until spontaneous vaginal delivery of the first twin). Multivariable linear regression was used to examine the association of clinical factors with the length of the second stage. The length of the second stage in twin and singleton pregnancies was compared.

RESULTS: From 2011 to June, 2020, there were 2,009 twin deliveries and 135,217 singleton deliveries. Of the twin deliveries, 655 (32.6%) of the patients were nulliparous (95th percentile length of the second stage 3 hours and 51 minutes), 1,235 (61.5%) were parous (95th percentile 1 hour 56 minutes), and 119 (5.9%) were grand multiparous (five or more prior deliveries) (95th percentile 1 hour 24 minutes). In women delivering twins, epidural use was associated with a statistically significant increase in the length of the second stage of 40 minutes in nulliparous patients and 15 minutes in parous patients. In all groups, the length of the second stage was longer in patients delivering twins compared with singletons. Second-stage length longer than the 95th percentile in twins was associated with admission to the neonatal intensive care unit and need for phototherapy.

CONCLUSION: Second-stage labor is longer in twins than singletons and is associated with obstetric history. Normal ranges for the second stage may be useful in guiding clinical practice.

PMID:33706361 | DOI:10.1097/AOG.0000000000004308

J Oral Implantol. 2021 Feb 1;47(1):25-29. doi: 10.1563/aaid-joi-D-19-00137.

ABSTRACT

The most commonly reported complication during the sinus elevation surgical procedure is the perforation of the Schneiderian membrane. The aim of this retrospective study was to compare the rate of sinus membrane perforation during lateral window augmentation using either conventional sinus curettes or medical-grade polyurethane sponges. This retrospective study included patients who received a lateral window approach for sinus floor elevation. The sinus elevation procedures using medical-grade polyurethane sponges (test) or conventional curettes (control) were recorded and analyzed. All subjects’ demographic data and preexisting conditions were evaluated. A total of 38 procedures met inclusion criteria, and those data were evaluated for analysis. There were no statistically significant differences in demographic data or preexisting conditions including age, sex, treatment location, presence and absence of septum, Schneiderian membrane thickness, and residual bone height between test and control groups. The membrane perforation rate was 7% in the test group and 43% in the control group; however, this difference did not reach statistical significance (P = .064). Within the limitations of this study, although there was no statistically significant reduction of sinus membrane perforation with the use of medical-grade polyurethane sponges, the decreased incidence of perforation might be of clinical significance.

PMID:33706369 | DOI:10.1563/aaid-joi-D-19-00137

Facial Plast Surg. 2021 Mar 11. doi: 10.1055/s-0041-1725174. Online ahead of print.

ABSTRACT

As our previous studies have shown, cosmetic surgery has a positive correlation with postoperative well-being. The aim of this study was to prospectively examine the postoperative changes in quality of life (QoL) after a rhinoplasty. Thirty-four patients who underwent septorhinoplasty performed by a single surgeon from July 2015 to October 2018 reported in indication-specific self-developed and different validated questionnaires (FLZM or Fragen zur Lebenszufriedenheit Module, Freiburg Personality Inventor, Rosenberg self-esteem scale, Functional Rhinoplasty Outcome Inventory 17 [FROI-17], and Glasgow Benefit Inventory [GBI]) on the status of their QoL preoperatively (T0) and 6 months’ follow-up (T1). Our goal was to assess the difference in psyche and self-esteem and to get objective insights into the effect of the operation. Significant improvements in QoL in terms of general module, health, and appearance were noted. The general part of the FLZM showed increasing T1 values in the sum scores (p = 0.005). With regard to the item “health,” T1 was better than the norm data (p = 0.003). The statistically significant improvement for the item nose appearance (p < 0.0001) after operation and T1 versus reference data (p < 0.010) should be highlighted. The subjective patient ratings showed statistically significant T1 improvements for all items of the FROI-17: overall nose (p < 0.0001), nasal function (p = 0.001), general/further symptoms (p = 0.006), and confidence increased by aesthetic changes (p < 0.0001). Furthermore, the GBI score shows an improved QoL after rhinoplasty (p < 0.0001). Based on the assessment of a variety of disease- and nondisease-specific validated questionnaires, numerous improvements in the QoL of the patients were observed. Therefore, we support septorhinoplasty as a meaningful procedure regarding QoL improvement. The level of evidence is Level II prospective cohort study.

PMID:33706388 | DOI:10.1055/s-0041-1725174

Neuropsychobiology. 2021 Mar 11:1-14. doi: 10.1159/000514126. Online ahead of print.

ABSTRACT

AIM: The Val66Met single-nucleotide polymorphism (SNP) on the BDNF gene has established pleiotropic effects on schizophrenia incidence and morphologic alterations in the illness. The effects of brain-derived neurotrophic factor (BDNF) on brain volume measurements are however mixed seeming to be less established for most brain regions. The current meta-analytic review examined (1) the association of the Val66Met SNP and brain volume alterations in schizophrenia by comparing Met allele carriers to Val/Val homozygotes and (2) the association of serum BDNF with brain volume measurements.

METHOD: Studies included in the meta-analyses were identified through an electronic search of PubMed and PsycInfo (via EBSCO) for English language publications from January 2000 through December 2017. Included studies had conducted a genotyping procedure of Val66Met or obtained assays of serum BDNF and obtained brain volume data in patients with psychotic disorders. Nonhuman studies were excluded.

RESULTS: Study 1 which included 52 comparisons of Met carriers and Val/Val homozygotes found evidence of lower right and left hippocampal volumes among Met allele carriers with schizophrenia. Frontal measurements, while also lower among Met carriers, did not achieve statistical significance. Study 2 which included 7 examinations of the correlation between serum BDNF and brain volume found significant associations between serum BDNF levels and right and left hippocampal volume with lower BDNF corresponding to lower volumes.

DISCUSSION: The meta-analyses provided evidence of associations between brain volume alterations in schizophrenia and variations on the Val66Met SNP and serum BDNF. Given the limited number of studies, it remains unclear if BDNF effects are global or regionally specific.

PMID:33706323 | DOI:10.1159/000514126

J Korean Acad Nurs. 2021 Feb;51(1):40-53. doi: 10.4040/jkan.20207.

ABSTRACT

PURPOSE: The purpose of this study was to develop and compare the prediction model for suicide attempts by Korean adolescents using logistic regression and decision tree analysis.

METHODS: This study utilized secondary data drawn from the 2019 Youth Health Risk Behavior web-based survey. A total of 20 items were selected as the explanatory variables (5 of sociodemographic characteristics, 10 of health-related behaviors, and 5 of psychosocial characteristics). For data analysis, descriptive statistics and logistic regression with complex samples and decision tree analysis were performed using IBM SPSS ver. 25.0 and Stata ver. 16.0.

RESULTS: A total of 1,731 participants (3.0%) out of 57,303 responded that they had attempted suicide. The most significant predictors of suicide attempts as determined using the logistic regression model were experience of sadness and hopelessness, substance abuse, and violent victimization. Girls who have experience of sadness and hopelessness, and experience of substance abuse have been identified as the most vulnerable group in suicide attempts in the decision tree model.

CONCLUSION: Experiences of sadness and hopelessness, experiences of substance abuse, and experiences of violent victimization are the common major predictors of suicide attempts in both logistic regression and decision tree models, and the predict rates of both models were similar. We suggest to provide programs considering combination of high-risk predictors for adolescents to prevent suicide attempt.

PMID:33706330 | DOI:10.4040/jkan.20207

Obstet Gynecol. 2021 Mar 10. doi: 10.1097/AOG.0000000000004315. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare contraception choices of those who are undergoing abortion procedures for fetal indications or surgical management of pregnancy loss with those who are having abortions for another indication.

METHODS: We conducted a cross-sectional study at University of California, Irvine, from December 1, 2017, through December 31, 2018, and included gestational ages up to 24 0/7 weeks. We abstracted data from electronic medical records and analyzed them using descriptive statistics, χ2, Fisher exact tests, and a multivariate logistic regression model for primary outcome (whether a contraception method was chosen) and secondary outcome (whether a long-active reversible contraception was chosen).

RESULTS: Those with fetal indication were less likely to choose contraception than those with other indication (68/134, 50.7% vs 142/158, 89.9%, P<.001), and among those choosing contraception those with fetal indication were less likely to choose long-acting reversible contraception (LARC) (19/68, 27.9% vs 94/142, 66.2%, P<.001). Differences remained significant in multivariable analysis that controlled for age, gestational age in weeks, race, parity, procedure type, and comorbidities (among those with fetal indication for choosing any contraception: adjusted odds ratio [aOR] 0.11, 95% CI 0.05-0.23; choosing LARC: aOR 0.17, 95% CI 0.07-0.39).

CONCLUSION: Only half of those seeking abortion for a fetal indication or surgical management of pregnancy loss were interested in contraception.

PMID:33706340 | DOI:10.1097/AOG.0000000000004315

Psychiatry Res. 2021 Feb 24;299:113820. doi: 10.1016/j.psychres.2021.113820. Online ahead of print.

ABSTRACT

This study sought to investigate the association between paranoia and performance in a range of neurocognitive domains using a large community sample. We conducted a cross-sectional survey of 4507 individuals within the PISMA-ep Study. We used a large community sample selected after multistage sampling using standard stratification techniques. Socio-demographic variables such as age, gender, educational level, urbanicity, and geographical region were recorded. The Spanish version of the Green Paranoid Thought Scale (S-GPTS) was used to assess paranoid thoughts. The Screening for Cognitive Impairment in Psychiatry (SCIP) was used to assess neurocognitive performance both globally and by domains (i.e., immediate and delayed verbal learning, working memory, verbal fluency and processing speed). Individuals with high S-GPTS paranoia scores showed significantly lower performance on global cognitive function and also on immediate (but not delayed) verbal learning, working memory, verbal fluency and processing speed. These results held statistical significance even after controlling for the effects of education and estimated IQ. We propose that cognitive deficits may be mediators of paranoid thinking formation and need to be considered when assessing patients with high levels of paranoia.

PMID:33706196 | DOI:10.1016/j.psychres.2021.113820

Neural Netw. 2021 Feb 27;139:149-157. doi: 10.1016/j.neunet.2021.02.014. Online ahead of print.

ABSTRACT

Network initialization is the first and critical step for training neural networks. In this paper, we propose a novel network initialization scheme based on the celebrated Stein’s identity. By viewing multi-layer feedforward sigmoidal neural networks as cascades of multi-index models, the projection weights to the first hidden layer are initialized using eigenvectors of the cross-moment matrix between the input’s second-order score function and the response. The input data is then forward propagated to the next layer and such a procedure can be repeated until all the hidden layers are initialized. Finally, the weights for the output layer are initialized by generalized linear modeling. Such a proposed SteinGLM method is shown through extensive numerical results to be much faster and more accurate than other popular methods commonly used for training neural networks.

PMID:33706228 | DOI:10.1016/j.neunet.2021.02.014

Caries Res. 2021 Mar 11:1-7. doi: 10.1159/000514168. Online ahead of print.

ABSTRACT

The prevention of dental caries in preschool children is a priority for dental services. The aim of the study was to investigate the caries-preventive effect of 2 fluoride varnishes in caries-active preschool children, and then compare the outcome with a non-varnish control group. After screening, 180 preschool children aged 36-71 months, with at least 1 noncavitated lesion, were enrolled and randomly allocated into 3 parallel groups, namely A: 1.5% ammonium fluoride varnish (Fluor Protector S), B: 5% NaF varnish (Duraphat), and C: professional tooth-cleaning. All children were recalled every third month for intervention and their parents were instructed to have them brush their teeth with a 1,000-ppm fluoride toothpaste twice daily. Caries were recorded at baseline and after 12 months by a calibrated examiner and the incidence was scored on noncavitated (d2) and cavitated (d3) level. We tested differences between the groups with the χ2 and two-sided t tests. One hundred and seventy-two children (95.6%) completed the trial and 56 (32.6%) and 35 (19.2%) developed new d2 and d3 lesions, respectively. Both varnishes reduced the incidence of caries compared with the control group, but there was no significant difference between group A and group B. Compared with group C, the relative risk for developing cavitated lesions was 0.39 (95% CI 0.22-0.62) in group A and 0.26 (95% CI 0.14-0.50) in group B. The total prevented fraction (Δd2d3mft) for group A and group B was 19.9 and 22.5% (p < 0.05), respectively. No adverse effects were observed or reported during the study period. In conclusion, the 2 fluoride varnishes demonstrated an equal capacity to reduce the incidence of caries in caries-active preschool children over a 12-month period in comparison with a control group.

PMID:33706305 | DOI:10.1159/000514168

Cerebrovasc Dis. 2021 Mar 11:1-9. doi: 10.1159/000512604. Online ahead of print.

ABSTRACT

BACKGROUND: Comparison of symptomatic intracranial hemorrhage (SICH) rates between stroke patients treated with bridging therapy (BT) and primary mechanical thrombectomy (PMT) are scarce and difficult to interpret due to baseline differences between both populations.

METHODS: Retrospective analysis of patients with acute ischemic stroke treated with endovascular therapy (BT or PMT) was performed at our center between January 2010 and June 2017.

RESULTS: Six hundred twenty-three patients were included. Global SICH rate was 9% overall: 6.8% in the PMT group and 12.6% in the BT group. The following factors significantly associated with SICH after multivariate analysis: MCA occlusion (p: 0.047), stroke of unknown origin (p: 0.025), BT (p: 0.024), and procedural time over 65 min (p: 0.027). The following variables presented a statistically significant higher frequency in patients treated with PMT: atrial fibrillation (p: 0.005), anticoagulant medication (p < 0.001), wake-up strokes (p < 0.001), atherothrombotic etiology (p < 0.05), combined thrombectomy technique (p: 0.008), longer procedural times (p: 0.025), and favorable outcome at 3 months (p: 0.011). The following variables presented a statistically significant higher frequency in patients treated with BT: antiplatelet medication (p: 0.048), MCA occlusions (p: 0.017), cardioembolic etiology (p < 0.05), stent retriever/aspiration technique (p: 0.008), and SICH (p: 0.013). Patients with MCA occlusions had twice the risk of SICH after BT than after PMT (16.4 and 8.6%, p: 0.038).

CONCLUSIONS: In this clinical series, the SICH rate was higher in patients treated with BT than in those treated with PMT. Relevant differences in baseline (related to IVT contraindications) were found between both groups. Randomized studies of BT versus PMT in populations with similar baseline characteristics might be of interest.

PMID:33706319 | DOI:10.1159/000512604