Clinical Utility of the Inflammatory Factors Combined With Lipid Markers in the Diagnostic and Prognostic Assessment of Ischemic Stroke: Based on Logistic Regression Models

2020 ◽  
Vol 29 (4) ◽  
pp. 104653
Author(s):  
Zhaoxi Ma ◽  
Yushan Yue ◽  
Yan Luo ◽  
Wanhua Wang ◽  
Yongjun Cao ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischemic Stroke ◽  
Regression Models ◽  
Clinical Utility ◽  
Inflammatory Factors ◽  
Logistic Regression Models ◽  
Prognostic Assessment ◽  
Lipid Markers

scholarly journals Prediction of independence in bowel function after spinal cord injury: validation of a logistic regression model

Spinal Cord ◽  
2020 ◽  
Author(s):  
Omar Khan ◽  
Jetan H. Badhiwala ◽  
Michael G. Fehlings
Keyword(s):  
Spinal Cord ◽  
Logistic Regression ◽  
Regression Model ◽  
Regression Models ◽  
Clinical Utility ◽  
Logistic Regression Model ◽  
Bowel Function ◽  
Motor Score ◽  
Logistic Regression Models ◽  
Cord Injury

Abstract Study design Retrospective analysis of prospectively collected data. Objectives Recently, logistic regression models were developed to predict independence in bowel function 1 year after spinal cord injury (SCI) on a multicenter European SCI (EMSCI) dataset. Here, we evaluated the external validity of these models against a prospectively accrued North American SCI dataset. Setting Twenty-five SCI centers in the United States and Canada. Methods Two logistic regression models developed by the EMSCI group were applied to data for 277 patients derived from three prospective multicenter SCI studies based in North America. External validation was evaluated for both models by assessing their discrimination, calibration, and clinical utility. Discrimination and calibration were assessed using ROC curves and calibration curves, respectively, while clinical utility was assessed using decision curve analysis. Results The simplified logistic regression model, which used baseline total motor score as the predictor, demonstrated the best performance, with an area under the ROC curve of 0.869 (95% confidence interval: 0.826–0.911), a sensitivity of 75.5%, and a specificity of 88.5%. Moreover, the model was well calibrated across the full range of observed probabilities and displayed superior clinical benefit on the decision curve. Conclusions A logistic regression model using baseline total motor score as a predictor of independent bowel function 1 year after SCI was successfully validated against an external dataset. These findings provide evidence supporting the use of this model to enhance the care for individuals with SCI.

scholarly journals The Presence of Gut Microbial Genes Encoding Bacterial Genotoxins or Pro-Inflammatory Factors in Stool Samples from Individuals with Colorectal Neoplasia

Diseases ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 16 ◽  
Author(s):  
Ramón Gómez-Moreno ◽  
María González-Pons ◽  
Marievelisse Soto-Salgado ◽  
Marcia Cruz-Correa ◽  
Abel Baerga-Ortiz
Keyword(s):  
Logistic Regression ◽  
Regression Models ◽  
Colorectal Neoplasia ◽  
Bacterial Toxin ◽  
Inflammatory Factors ◽  
Logistic Regression Models ◽  
The Us ◽  
Genes Encoding ◽  
Stool Samples ◽  
Bacterial Genes

Gut bacterial toxins are thought to contribute to the development of colorectal cancer (CRC). This study examines the presence of specific gut bacterial toxin genes in stool samples from individuals with colorectal neoplasia (adenomas and/or CRC). The presence of bacterial genes encoding genotoxic or pro-inflammatory factors (pks, tcpC, gelE, cnf-1, AMmurB, and usp) was established by PCR of stool samples from individuals from mainland US (n = 30; controls = 10, adenoma = 10, CRC = 10) and from Puerto Rico (PR) (n = 33; controls = 13; adenomas = 8; CRC = 12). Logistic regression models and multinomial logistic regression models were used to estimate the magnitude of association. Distinct bacterial gene profiles were observed in each sample cohort. In individuals with CRC, AMmurB was detected more frequently in samples from the US and gelE in samples from PR. In samples from PR, individuals with ≥2 gut bacterial toxin genes in stool had higher odds of having colorectal neoplasia (OR = 11.0, 95%: CI 1.0–637.1): however, no significant association between bacterial genes and colorectal neoplasia was observed in the US cohort. Further analyses are warranted in a larger cohort to validate these preliminary findings, but these encouraging results highlight the importance of developing bacterial markers as tools for CRC diagnosis or risk stratification.

The impact of SPY angiography on intraoperative decision making and outcomes for post-mastectomy reconstruction

2019 ◽  
pp. 1-5
Keyword(s):  
Decision Making ◽  
Logistic Regression ◽  
Skin Necrosis ◽  
Regression Models ◽  
Multivariable Analysis ◽  
P Value ◽  
Flap Necrosis ◽  
Single Institution ◽  
Logistic Regression Models ◽  
The Impact

Objective: While the use of intraoperative laser angiography (SPY) is increasing in mastectomy patients, its impact in the operating room to change the type of reconstruction performed has not been well described. The purpose of this study is to investigate whether SPY angiography influences post-mastectomy reconstruction decisions and outcomes. Methods and materials: A retrospective analysis of mastectomy patients with reconstruction at a single institution was performed from 2015-2017.All patients underwent intraoperative SPY after mastectomy but prior to reconstruction. SPY results were defined as ‘good’, ‘questionable’, ‘bad’, or ‘had skin excised’. Complications within 60 days of surgery were compared between those whose SPY results did not change the type of reconstruction done versus those who did. Preoperative and intraoperative variables were entered into multivariable logistic regression models if significant at the univariate level. A p-value <0.05 was considered significant. Results: 267 mastectomies were identified, 42 underwent a change in the type of planned reconstruction due to intraoperative SPY results. Of the 42 breasts that underwent a change in reconstruction, 6 had a ‘good’ SPY result, 10 ‘questionable’, 25 ‘bad’, and 2 ‘had areas excised’ (p<0.01). After multivariable analysis, predictors of skin necrosis included patients with ‘questionable’ SPY results (p<0.01, OR: 8.1, 95%CI: 2.06 – 32.2) and smokers (p<0.01, OR:5.7, 95%CI: 1.5 – 21.2). Predictors of any complication included a change in reconstruction (p<0.05, OR:4.5, 95%CI: 1.4-14.9) and ‘questionable’ SPY result (p<0.01, OR: 4.4, 95%CI: 1.6-14.9). Conclusion: SPY angiography results strongly influence intraoperative surgical decisions regarding the type of reconstruction performed. Patients most at risk for flap necrosis and complication post-mastectomy are those with questionable SPY results.

scholarly journals Effect of prostatic apex shape (Lee types) and urethral sphincter length in preoperative MRI on very early continence rates after radical prostatectomy

2021 ◽  
Author(s):  
Mike Wenzel ◽  
Felix Preisser ◽  
Matthias Mueller ◽  
Lena H. Theissen ◽  
Maria N. Welte ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Radical Prostatectomy ◽  
Regression Models ◽  
Urethral Sphincter ◽  
Anatomical Characteristics ◽  
Logistic Regression Models ◽  
Pad Test ◽  
Type D ◽  
Multivariable Logistic Regression ◽  
Type C

Abstract Purpose To test the effect of anatomic variants of the prostatic apex overlapping the membranous urethra (Lee type classification), as well as median urethral sphincter length (USL) in preoperative multiparametric magnetic resonance imaging (mpMRI) on the very early continence in open (ORP) and robotic-assisted radical prostatectomy (RARP) patients. Methods In 128 consecutive patients (01/2018–12/2019), USL and the prostatic apex classified according to Lee types A–D in mpMRI prior to ORP or RARP were retrospectively analyzed. Uni- and multivariable logistic regression models were used to identify anatomic characteristics for very early continence rates, defined as urine loss of ≤ 1 g in the PAD-test. Results Of 128 patients with mpMRI prior to surgery, 76 (59.4%) underwent RARP vs. 52 (40.6%) ORP. In total, median USL was 15, 15 and 10 mm in the sagittal, coronal and axial dimensions. After stratification according to very early continence in the PAD-test (≤ 1 g vs. > 1 g), continent patients had significantly more frequently Lee type D (71.4 vs. 54.4%) and C (14.3 vs. 7.6%, p = 0.03). In multivariable logistic regression models, the sagittal median USL (odds ratio [OR] 1.03) and Lee type C (OR: 7.0) and D (OR: 4.9) were independent predictors for achieving very early continence in the PAD-test. Conclusion Patients’ individual anatomical characteristics in mpMRI prior to radical prostatectomy can be used to predict very early continence. Lee type C and D suggest being the most favorable anatomical characteristics. Moreover, longer sagittal median USL in mpMRI seems to improve very early continence rates.

785 Reported Restful Sleep Predicting Emotional Distress: Does Exercise (and its modalities) moderate?

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A305-A306
Author(s):  
Jesse Moore ◽  
Ellita Williams ◽  
Collin Popp ◽  
Anthony Briggs ◽  
Judite Blanc ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Aerobic Exercise ◽  
Regression Models ◽  
Regression Analyses ◽  
Logistic Regression Models ◽  
The Past ◽  
Strengthening Exercise ◽  
Waking Up ◽  
The Relationship ◽  
Age And Sex

Abstract Introduction Literature shows that exercise moderates the relationship between sleep and emotional distress (ED.) However, it is unclear whether different types of exercise, such as aerobic and strengthening, affect this relationship differently. We investigated the moderating role of two types of exercise (aerobic and strengthening) regarding the relationship between ED and sleep. Methods Our analysis was based on data from 2018 National Health Interview Survey (NHIS), a nationally representative study in which 2,814 participants provided all data. Participants were asked 1) “how many days they woke up feeling rested over the past week”, 2) the Kessler 6 scale to determine ED (a score &gt;13 indicates ED), and 3) the average frequency of strengthening or aerobic exercise per week. Logistic regression analyses were performed to determine if the reported days of waking up rested predicted level of ED. We then investigated whether strengthening or aerobic exercise differentially moderated this relationship. Covariates such as age and sex were adjusted in the logistic regression models. Logistic regression analyses were performed to determine if subjective reporting of restful sleep predicted level of ED. We investigated whether strengthening exercise or aerobic exercise differentially moderated this relationship. Covariates such as age and sex were adjusted in the logistic regression models. Results On average, participants reported 4.41 restful nights of sleep (SD =2.41), 3.43 strengthening activities (SD = 3.19,) and 8.47 aerobic activities a week (SD=5.91.) We found a significant association between days over the past week reporting waking up feeling rested and ED outcome according to K6, Χ2(1) = -741, p= &lt;.001. The odds ratio signified a decrease of 52% in ED scores for each unit of restful sleep (OR = .48, (95% CI = .33, .65) p=&lt;.001.) In the logistic regression model with moderation, aerobic exercise had a significant moderation effect, Χ2(1) = .03, p=.04, but strengthening exercise did not. Conclusion We found that restful sleep predicted reduction in ED scores. Aerobic exercise moderated this relationship, while strengthening exercise did not. Further research should investigate the longitudinal effects of exercise type on the relationship between restful sleep and ED. Support (if any) NIH (K07AG052685, R01MD007716, K01HL135452, R01HL152453)

scholarly journals Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain

2021 ◽  
Vol 18 (3) ◽  
pp. 932
Author(s):  
Samuel López-López ◽  
Raúl del Pozo-Rubio ◽  
Marta Ortega-Ortega ◽  
Francisco Escribano-Sotos
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Regression Models ◽  
Financial Risk ◽  
Household Expenditure ◽  
Financial Protection ◽  
Logistic Regression Models ◽  
Ordered Logistic Regression ◽  
Out Of Pocket Payments ◽  
The Subject

Background. The financial effect of households’ out-of-pocket payments (OOP) on access and use of health systems has been extensively studied in the literature, especially in emerging or developing countries. However, it has been the subject of little research in European countries, and is almost nonexistent after the financial crisis of 2008. The aim of the work is to analyze the incidence and intensity of financial catastrophism derived from Spanish households’ out-of-pocket payments associated with health care during the period 2008–2015. Methods. The Household Budget Survey was used and catastrophic measures were estimated, classifying the households into those above the threshold of catastrophe versus below. Three ordered logistic regression models and margins effects were estimated. Results. The results reveal that, in 2008, 4.42% of Spanish households dedicated more than 40% of their income to financing out-of-pocket payments in health, with an average annual gap of EUR 259.84 (DE: EUR 2431.55), which in overall terms amounts to EUR 3939.44 million (0.36% of GDP). Conclusion. The findings of this study reveal the existence of catastrophic households resulting from OOP payments associated with health care in Spain and the need to design financial protection policies against the financial risk derived from facing these types of costs.

scholarly journals Association of ADH1B polymorphism and alcohol consumption with increased risk of intracerebral hemorrhagic stroke

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Chun-Hsiang Lin ◽  
Oswald Ndi Nfor ◽  
Chien-Chang Ho ◽  
Shu-Yi Hsu ◽  
Disline Manli Tantoh ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Alcohol Consumption ◽  
Genetic Variants ◽  
Regression Models ◽  
Hemorrhagic Stroke ◽  
Alcohol Exposure ◽  
Modifiable Risk Factors ◽  
Aldehyde Dehydrogenase 2 ◽  
Logistic Regression Models ◽  
Increased Risk

Abstract Background Alcohol consumption is one of the modifiable risk factors for intracerebral hemorrhage, which accounts for approximately 10–20% of all strokes worldwide. We evaluated the association of stroke with genetic polymorphisms in the alcohol metabolizing genes, alcohol dehydrogenase 1B (ADH1B, rs1229984) and aldehyde dehydrogenase 2 (ALDH2, rs671) genes based on alcohol consumption. Methods Data were available for 19,500 Taiwan Biobank (TWB) participants. We used logistic regression models to test for associations between genetic variants and stroke. Overall, there were 890 individuals with ischemic stroke, 70 with hemorrhagic stroke, and 16,837 control individuals. Participants with ischemic but not hemorrhagic stroke were older than their control individuals (mean  ±  SE, 58.47 ± 8.17 vs. 48.33 ± 10.90 years, p  <  0.0001). ALDH2 rs671 was not associated with either hemorrhagic or ischemic stroke among alcohol drinkers. However, the risk of developing hemorrhagic stroke was significantly higher among ADH1B rs1229984 TC  +  CC individuals who drank alcohol (odds ratio (OR), 4.85; 95% confidence interval (CI) 1.92–12.21). We found that the test for interaction was significant for alcohol exposure and rs1229984 genotypes (p for interaction  =  0.016). Stratification by alcohol exposure and ADH1B rs1229984 genotypes showed that the risk of developing hemorrhagic stroke remained significantly higher among alcohol drinkers with TC  +  CC genotype relative to those with the TT genotype (OR, 4.43, 95% CI 1.19–16.52). Conclusions Our study suggests that the ADH1B rs1229984 TC  +  CC genotype and alcohol exposure of at least 150 ml/week may increase the risk of developing hemorrhagic stroke among Taiwanese adults.

HPV Vaccine Initiation and Completion Among Native Hawaiian and Pacific Islander Adults, United States, 2014

2021 ◽  
pp. 101053952110274
Author(s):  
Sameer Vali Gopalani ◽  
Amanda E. Janitz ◽  
Sydney A. Martinez ◽  
Janis E. Campbell ◽  
Sixia Chen
Keyword(s):  
United States ◽  
Logistic Regression ◽  
Vaccination Coverage ◽  
Hpv Vaccine ◽  
Regression Models ◽  
Insurance Coverage ◽  
Hpv Vaccination ◽  
Pacific Islander ◽  
Logistic Regression Models ◽  
Vaccine Initiation

Native Hawaiian and Pacific Islander (NHPI) adults bear a disproportionate burden of certain human papillomavirus (HPV)-associated cancers. In 2015, data from the National Health Interview Survey (NHIS) showed vaccination coverage among adults by racial and ethnic groups; however, coverage data for NHPI adults were unavailable. In this study, we estimated the initiation and completion of HPV vaccination and assessed the factors associated with vaccination among NHPI adults aged 18 to 26 years in the United States. We analyzed public data files from the 2014 NHPI NHIS (n = 1204). We specified sampling design parameters and fitted weighted logistic regression models to calculate the odds of HPV vaccine initiation. We developed a directed acyclic graph to identify a minimally sufficient set for adjustment and adjusted for insurance coverage (for education and ethnicity) and doctor visit (for insurance coverage, earnings, ethnicity, and sex). Overall, 24.9% and 11.5% of NHPI adults had initiated and completed the HPV vaccination series, respectively. Weighted logistic regression models elucidated that the odds of HPV vaccine initiation were higher for females (weighted odds ratio = 5.4; 95% confidence interval = 2.8-10.4) compared with males. Low vaccination coverage found among NHPI adults provides an opportunity for targeted programs to reduce the burden of HPV-associated cancers.

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