scholarly journals P–495 Telemedicine in ART during SARS-CoV–2 pandemic : far and yet close

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S Stigliani ◽  
C Massarotti ◽  
E Maccarini ◽  
F Sozzi ◽  
P Scaruffi ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Drop Out ◽  
Clinical Tests ◽  
Chi Square ◽  
Oncological Patients ◽  
Registration Number ◽  
Chi Square Test ◽  
Number Of Cycles ◽  
Time To First Treatment

Abstract Study question Could telemedicine help in the management of the infertile couple’s path at a fertility center? Summary answer The introduction of telemedicine increased the number of cycles within 6 months from the first consultation and reduced the drop-out rate. What is known already In Italy during the complete lockdown due to the first pandemic wave of SARS-CoV–2 the activity of fertility centers were stopped, with the exception of fertility preservation procedures for oncological patients. We therefore proposed a service of telemedicine to our patients, that we called SmartPMA. Study design, size, duration A longitudinal study performed at a public infertility center. The SmartPMA service was offered to 93 couples referred to our center from March 9th to May 31st, 2020. Initially 72 couples was interested in SmartPMA. Our center gradually re-opened and the first oocytes retrieval was performed on June 9th . Participants/materials, setting, methods Sixty-one out of 72 couples (85%) performed the SmartPMA from April 7th to June 16th, 2020. After acquiring informed consent and sending two anamnestic questionnaires, we booked a video-consultation with a gynecologist and a biologist. Afterwards, we sent medical prescriptions for appropriate clinical tests. At the re-opening, we offered the chance to start the ART cycle. Time to the first treatment and drop-out rates were compared to historical controls (2017–2019) using chi-square test. Main results and the role of chance Eleven couples declined the SmartPMA and booked an appointment at the reopening. Only 2 of these couples (18%) actually performed an IVF treatment within six months. Three out the 61 couples that accepted the SmartPMA did not perform IVF treatments because the age of women exceeded the legal limit to access to a public ART center. Twelve out of 58 couples (21%) did not performed any IVF treatment for the following reasons: 4 women spontaneously got pregnant, 1 couple gave up for medical reasons, 3 were referred to ovodonation, and 4 were lost to follow-up. Thirty-eight out of 58 couples (66%) (median age of woman: 36 + 4 years, range 27–43) performed at least one ART treatment (14 IUI, 12 ICSI cycle, 12 FIVET cycle). Eight out of 58 couples (14%) needed further clinical tests and their treatments are ongoing. The mean time to first treatment in the SmartPMA couples was 4 + 1 months (range 1–6). After SmartPMA, 66% of the couples performed the first cycle within 6 months, compared to 37% of controls (333/898 couples at their first access to our center from 2017 to 2019), p < 0.00001. The drop-out was reduced from 39% to 20%, p = 0 .0038. Limitations, reasons for caution We cannot exclude that the couples that joined the SmartPMA service during the pandemic period were particularly motivated to perform IVF treatments. We are aware of the small sample size and that this is a monocentric study. Wider implications of the findings: Even after the pandemic, telemedicine can be an useful tool for fertility centers to reduce the discomfort of several visits in hospital, without losing patients but rather ultimately reducing the time to treatments and drop-out. Trial registration number Not applicable

scholarly journals Conditional Inference in Small Sample Scenarios Using a Resampling Approach

Stats ◽  
2021 ◽  
Vol 4 (4) ◽  
pp. 837-849
Author(s):  
Clemens Draxler ◽  
Andreas Kurz
Keyword(s):  
Power Function ◽  
Small Sample Size ◽  
R Package ◽  
Small Sample ◽  
Conditional Inference ◽  
Test Statistics ◽  
Chi Square ◽  
Large Sample Theory ◽  
Chi Square Test ◽  
True Values

This paper discusses a non-parametric resampling technique in the context of multidimensional or multiparameter hypothesis testing of assumptions of the Rasch model. It is based on conditional distributions and it is suggested in small sample size scenarios as an alternative to the application of asymptotic or large sample theory. The exact sampling distribution of various well-known chi-square test statistics like Wald, likelihood ratio, score, and gradient tests as well as others can be arbitrarily well approximated in this way. A procedure to compute the power function of the tests is also presented. A number of examples of scenarios are discussed in which the power function of the test does not converge to 1 with an increasing deviation of the true values of the parameters of interest from the values specified in the hypothesis to be tested. Finally, an attempt to modify the critical region of the tests is made aiming at improving the power and an R package is provided.

scholarly journals Examiner reliability and clinical responsiveness of motion palpation to detect biomechanical dysfunction of the the hip joint

2017 ◽  
Author(s):  
◽  
Gina Leigh Bertolotti
Keyword(s):  
Hip Joint ◽  
Diagnostic Tool ◽  
Small Sample Size ◽  
Diagnostic Techniques ◽  
Small Sample ◽  
Hip Pain ◽  
Anatomical Landmarks ◽  
Chi Square ◽  
Left Hand ◽  
Chi Square Test

Background: Hip pain is a common problem. Motion palpation is a manual technique applied by the hands in various degrees of joint motion that specifically evaluates range of motion in relation to specific anatomical landmarks, joint play and end feel. Motion palpation remains one of the most used diagnostic techniques and yet it remains unclear whether or not it is a reliable, sensitive and specific tool; especially in the hip joint. Objectives: This study assessed intra- and inter-examiner reliability and clinical responsiveness of motion palpation when it is used as a diagnostic tool in patients with non-specific unilateral anterior hip pain and unilateral asymptomatic hip joints. Methods: Ten participants, between the ages of 18 and 60, were included in this study (three ballet dancers, three golfers and four participants from the general population). The participants were assessed randomly by three blinded examiners. All of the participants then received one adjustment delivered by the researcher (half on the symptomatic side and half on the asymptomatic). The participants were then re-assessed. Data was recorded on a data collection sheet and analysed using SPSS version 23. Intra-examiner reliability and clinical responsiveness were analysed using McNemar’s test and the Chi-Square Test of Independence. Inter-examiner reliability was analysed using Fleiss’ Kappa. Results: Intra-examiner reliability showed to be markedly better on the left-hand side for all three examiners. Kappa scores for inter-examiner reliability varied from none to perfect. The average pairwise agreement scores ranged from 33.3% to 100% at the first assessment, and from 46.6% to 100% in the second assessment. A mean and standard deviation were calculated for the pairwise agreements which represented the sensitivity and specificity respectively. Both showed improvement between the first and second assessments which is positive for inter-examiner reliability. Clinical responsiveness was shown to be absent for examiners A and B but was present for examiner C on the left. Conclusion: This study found that, contrary to the expectations of many clinicians, motion palpation has limited to poor levels of intra-examiner reliability, inter-examiner reliability and clinical responsiveness. This is however limited by the small sample size and methodological limitations in this study. Therefore, the role of palpation as a diagnostic tool used in the diagnosis hip dysfunction may be limited.

scholarly journals An evaluation of the usefulness of British Columbia's guideline in educating food bank operators

2019 ◽  
Author(s):  
Diane K. Lee ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Helen Heacock ◽  
Lorraine McIntyre
Keyword(s):  
Food Safety ◽  
Small Sample Size ◽  
Small Sample ◽  
Food Distribution ◽  
Food Banks ◽  
Food Bank ◽  
Chi Square ◽  
Chi Square Test ◽  
Meal Programs ◽  
Safety Knowledge

  Background: Food Distribution Organizations (FDOs), such as food banks, community kitchen, and meal programs, are essential resources to relieve food insecurity in British Columbia. FDOs collect, process, store, and distribute donated food to the needy population. The BC Centre for Disease Control (BCCDC) published the Guidelines for Food Distribution Organizations with Grocery or Meal Programs in 2016 with purpose to educate FDOs on food safety and assist with their operational challenges. The guideline plays an important role especially for food bank operators who are not required to take food safety training. The purpose of this study was to evaluate the extent of the guideline use among food bank operators and assess its usefulness. This study also determines if the guideline use had a statistically significant association with higher knowledge in food safety. Methods: Self-administered electronic surveys created on Survey Monkey Canada were distributed to Foodbanks BC members by weekly online newsletter and email. The survey assessed the extent of usage of the guideline, current issues and knowledge level of FDO operators in BC. The survey response was collected over three weeks long period. Results: Among 37 FDO operators participated, 30 completed the survey. The majority of the operators was from BC, worked in food banks and had longer than 5 years long experience. 47% of participants did not know about the guideline. Among the guideline users, 83% agreed or strongly agreed that the guideline was useful. While retailers and groceries were the most common food donors, caterers and restaurants were the least common. Assessing each food item for safety was the most commonly encountered issue for FDOs. The least commonly encountered issue was having another FDO taking our donation from the donor. There was no association between the guideline use and level of food safety knowledge according to the Chi-square test (p= 0.89). There was no association between the years of experience and level of food safety knowledge (p= 0.23). The results did not show a statistically significant result potentially due to small sample size (n= 30). Conclusion: The results indicated while the guideline is useful among the users, the extent of its use should be widened. There is a need to improve accessibility of the guideline by modifying the content to address current practical issues, formatting it in a more user-friendly way, and utilizing better distribution means.  

scholarly journals The rs2071559 AAVEGFR-2Genotype Frequency Is Significantly Lower in Neovascular Age-Related Macular Degeneration Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Stefano Lazzeri ◽  
Paola Orlandi ◽  
Michele Figus ◽  
Anna Fioravanti ◽  
Elisa Cascio ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Gene Polymorphisms ◽  
Small Sample Size ◽  
Case Control ◽  
Small Sample ◽  
Age Related Macular Degeneration ◽  
Chi Square ◽  
Future Studies ◽  
Age Related ◽  
Chi Square Test

In this prospective, case-control genetic study, 120 consecutive neovascular age-related macular degeneration (AMD) cases and 78 controls were enrolled. Two SNPs (rs2071559 and rs1870377) ofVEGF-Areceptor-2 (VEGFR-2) gene were analyzed with the technique of Real-Time PCR to investigate a genetic link between AMD andVEGFR-2gene polymorphisms in Italian patients. The frequency of theVEGFR-2genotype rs2071559 AA was significantly lower (18.33%) in patients with AMD than in the control subjects (34.62%;P=0.0095, chi-square test;Pcorr=0.038;OR=0.42, 95% CI 0.22 to 0.82). In conclusion, although with the limitations of a small sample size and the few SNPs studied, this study demonstrates a lower frequency ofVEGFR-2rs2071559 AA genotype in an AMD patient population, suggesting future studies on the roleVEGFR-2SNPs.

scholarly journals Longitudinal assessment of S100B serum levels and clinical factors in youth patients with mood disorders

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aleksandra Rajewska-Rager ◽  
Monika Dmitrzak-Weglarz ◽  
Pawel Kapelski ◽  
Natalia Lepczynska ◽  
Joanna Pawlak ◽  
...  
Keyword(s):  
Mood Disorders ◽  
Calcium Binding ◽  
Clinical Symptoms ◽  
Small Sample Size ◽  
Serum Levels ◽  
Small Sample ◽  
Drop Out ◽  
Control Group ◽  
Longitudinal Assessment ◽  
Depressed Group

AbstractMood disorders have been discussed as being in relation to glial pathology. S100B is a calcium-binding protein, and a marker of glial dysfunctions. Although alterations in the S100B expression may play a role in various central nervous system diseases, there are no studies on the potential role of S100B in mood disorders in adolescents and young adults . In a prospective two-year follow-up study, peripheral levels of S100B were investigated in 79 adolescent/young adult patients (aged 14–24 years), diagnosed with mood disorders and compared with 31 healthy control subjects. A comprehensive clinical interview was conducted which focused on clinical symptoms and diagnosis change. The diagnosis was established and verified at each control visit. Serum S100B concentrations were determined. We detected: lower S100B levels in medicated patients, compared with those who were drug-free, and healthy controls; higher S100B levels in a depressed group with a family history of affective disorder; correlations between age and medication status; sex-dependent differences in S100B levels; and lack a of correlation between the severity of depressive or hypo/manic symptoms. The results of our study indicate that S100B might be a trait-dependent rather than a state-dependent marker. Due to the lack of such studies in the youth population, further research should be performed. A relatively small sample size, a lack of exact age-matched control group, a high drop-out rate.

scholarly journals Comparison of bacterial microleakage of three bioactive endodontic sealers in simulated underwater diving and aviation conditions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mehdi Dastorani ◽  
Behnam Malekpour ◽  
Mohsen AminSobhani ◽  
Mohammadsadegh Alemrajabi ◽  
Arezoo Mahdian ◽  
...  
Keyword(s):  
Atmospheric Pressure ◽  
Mineral Trioxide Aggregate ◽  
In Vitro Study ◽  
Chi Square ◽  
Custom Made ◽  
Single Cone ◽  
Registration Number ◽  
Chi Square Test ◽  
Pressure Changes

Abstract Background Bacterial microleakage is an important cause of apical periodontitis and endodontic treatment failure. This study aimed to assess the bacterial microleakage of nano-mineral trioxide aggregate (nano-MTA) as a sealer, Endoseal MTA, and GuttaFlow Bioseal sealers in atmospheric pressure, and simulated underwater diving and aviation conditions. Methods In this in vitro, experimental study, 180 extracted single-rooted teeth were cleaned and shaped, and were then randomly divided into three groups for single-cone obturation using Endoseal MTA, GuttaFlow Bioseal, or nano-MTA as a sealer. Each group was then randomly divided into three subgroups, and subjected to ambient atmospheric pressure, 2 atm pressure (to simulate underwater diving), and 0.5 atm pressure (to simulate aviation) using a custom-made pressure chamber. The teeth then underwent microbial leakage test using Streptococcus mutans (S. mutans), and the percentage of samples showing microleakage was recorded for up to 1 month, and analyzed using the Chi-square test. Results The three sealer groups were significantly different regarding bacterial microleakage (P < 0.05). The nano-MTA group showed significantly higher microleakage after 15 days than the other two groups (P = 0.006). The effect of pressure on bacterial microleakage was not significant in any sealer group (P > 0.05). Conclusion Within the limitations of this in vitro study, it may be concluded that single-cone obturation technique using nano-MTA as a sealer results in lower resistance to bacterial microleakage compared with the use of GuttaFlow Bioseal, and Endoseal MTA. Pressure changes in simulated underwater diving and aviation conditions had no significant effect on bacterial microleakage. Trial Registration Number This is not a human subject research.

scholarly journals Prevalence, Symptoms and Duration of Post Acute Effects in SARS-CoV-2 Positive Children – a Nationwide Cohort Study

2021 ◽  
Author(s):  
Luise Borch ◽  
Mette Holm ◽  
Maria Knudsen ◽  
Svend Ellermann-Eriksen ◽  
Soeren Hagstroem
Keyword(s):  
Cohort Study ◽  
Muscle Weakness ◽  
School Children ◽  
Small Sample Size ◽  
Risk Difference ◽  
Small Sample ◽  
Control Group ◽  
Respiratory Problems ◽  
Danish Health ◽  
Registration Number

Abstract Background: Most children have a mild course of acute COVID-19, but only a few mainly non-controlled studies with small sample size, have evaluated the long-term recovery from SARS-CoV-2 infection in children (‘long COVID’).Methods: We conducted a nationwide cohort study of 37,522 children age 0-17 years with RT-PCR verified SARS-CoV-2 infection and a control group of 78,037 randomly selected children. An electronic questionnaire was sent to both groups of children from March 24th until May 9th 2021.Results: Long COVID symptoms were reported by 12-51% of SARS-CoV-2 infected children. Among pre-school children, fatigue Risk Difference (RD) 0.05 (CI 0.04-0.06), loss of smell RD 0.01 (CI 0.01-0.01), loss of taste RD 0.01 (CI 0.01-0.02) and muscle weakness RD 0.01 (CI 0.00-0.01) were statistically significant symptoms of ‘long COVID’.Among school children the most significant symptoms were loss of smell RD 0.12 (CI 0.12-0.13), loss of taste RD 0.10 (CI 0.09-0.10), fatigue RD 0.05 (CI 0.05-0.06), respiratory problems RD 0.03 (CI 0.03-0.04), dizziness RD 0.02 (CI 0.02-0.03), muscle weakness RD 0.02 (CI 0.01-0.02), and chest pain RD 0.01 (CI 0.01-0.01). Children in the control group experienced significantly more concentration difficulties, headache, muscle- and joint pain, cough, nausea, diarrhea and fever than the SARS-CoV-2 infected. In most children ‘long COVID’ symptoms resolved within 1-5 months.Conclusions: This study provides new evidence of ‘long COVID’ symptoms in children.Trial registration number: The study was approved by The Danish Health Data Authority and registered at Central Denmark region (# 1-16-02-621-20).

scholarly journals A Pilot Placebo Controlled Randomized Trial of Dexamethasone for Chronic Subdural Hematoma

2016 ◽  
Vol 43 (2) ◽  
pp. 284-290 ◽  
Author(s):  
Michel Prud’homme ◽  
François Mathieu ◽  
Nicolas Marcotte ◽  
Sylvine Cottin
Keyword(s):  
Conservative Treatment ◽  
Adverse Events ◽  
Small Sample Size ◽  
Chronic Subdural Hematoma ◽  
Symptomatic Patient ◽  
Placebo Treatment ◽  
Small Sample ◽  
Chi Square ◽  
Serious Adverse Events ◽  
Before And After

AbstractBackground: Current opinions regarding the use of dexamethasone in the treatment of chronic subdural hematomas (CSDH) are only based on observational studies. Moreover, the use of corticosteroids in asymptomatic or minimally symptomatic patient with this condition remains controversial. Here, we present data from a prospective randomized pilot study of CSDH patients treated with dexamethasone or placebo. Methods: Twenty patients with imaging-confirmed CSDH were recruited from a single center and randomized to receive dexamethasone (12 mg/day for 3 weeks followed by tapering) or placebo as a conservative treatment. Patients were followed for 6 months and the rate of success of conservative treatment with dexamethasone versus placebo was measured. Parameters such as hematoma thickness and clinical changes were also compared before and after treatment with chi-square tests. Adverse events and complications were documented. Results: During the 6-month follow-up, one of ten patients treated with corticosteroids had to undergo surgical drainage and three of ten patients were treated surgically after placebo treatment. At the end of the study, all remaining patients had complete radiological resolution. No significant differences were observed in terms of hematoma thickness profile and impression of change; however, patients experienced more severe side effects when treated with steroids as compared with placebo. Dexamethasone contributed to many serious adverse events. Conclusions: Given the small sample size, these preliminary results have not shown a clear beneficial effect of dexamethasone against placebo in our patients. However, the number of secondary effects reported was much greater for corticosteroids, and dexamethasone treatment was responsible for significant complications.

A comparative assessment of orthodontic treatment outcomes using the quantitative light-induced fluorescence (QLF) method between direct bonding and indirect bonding techniques in adolescents: a single-centre, single-blind randomized controlled trial

2019 ◽  
Vol 42 (4) ◽  
pp. 441-453
Author(s):  
Aykan Onur Atilla ◽  
Taner Ozturk ◽  
Mustafa Murat Eruz ◽  
Ahmet Yagci
Keyword(s):  
Orthodontic Treatment ◽  
Small Sample Size ◽  
Controlled Trial ◽  
Small Sample ◽  
White Spot Lesion ◽  
Indirect Bonding ◽  
Signed Rank ◽  
Group 12 ◽  
Registration Number ◽  
Bonding Technique

Summary Introduction The aim of this two-arm parallel trial was to evaluate enamel demineralization in fixed orthodontic treatment using an indirect bonding technique in comparison to a direct bonding technique by the quantitative light-induced fluorescence (QLF) method. Design, settings and participants Fifty-six patients who needed fixed orthodontic treatment were randomly separated into either the direct bonding group or the indirect bonding group. The presence and extent of lesions on the buccal surfaces of all teeth, except the molar teeth, were assessed. The percentage of fluorescence loss (ΔF and ΔFmax), the degree of demineralization (ΔQ) and lesion area (WS area) were determined using the system’s software. The data were analysed with the Wilcoxon signed-rank and Mann–Whitney U-tests (P &lt; 0.05). Interventions Treatment with a direct bonding or an indirect bonding technique. Results This study was completed with 25 patients in the indirect bonding group (12 females, 13 males; mean age: 15.42 ± 1.71 years) and 26 patients in the direct bonding group (12 females, 14 males; mean age: 14.73 ± 1.65 years). In the indirect bonding technique, a few teeth (especially mandibular left canine: 50.45 ± 93.48; 95% confidence interval: −12.35 and 113.26) were found to develop significant white spot lesion (WSL) formation (P &lt; 0.05). However, the number of teeth with demineralization was higher in the direct bonding group (P &lt; 0.05). Conclusion The bonding procedures used in the indirect bonding technique contribute to reducing the degree of WSL formation. Further, the use of flowable composite adhesives in this bonding process is more effective at reducing the appearance of WSLs than in cases where conventional composite adhesives are used. Limitations The limitation of our trial may be the small sample size and the short follow-up time for the patients. Harms No harms were detected during the study. Protocol The protocol was not published before trial commencement. Registration This trial was registered post hoc at ‘Clinical Trials’ (http://www.clinicaltrials.gov), registration number (ID): NCT03738839.

scholarly journals Uterus transplantation: joys and frustrations of becoming a ‘complete’ woman—a qualitative study regarding self-image in the 5-year period after transplantation

2020 ◽  
Vol 35 (8) ◽  
pp. 1855-1863 ◽  
Author(s):  
Stina Järvholm ◽  
Anders Enskog ◽  
Catrina Hammarling ◽  
Pernilla Dahm-Kähler ◽  
Mats Brännström
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Post Transplantation ◽  
Uterus Transplantation ◽  
Self Image ◽  
Registration Number ◽  
Competing Interest ◽  
The Government

Abstract STUDY QUESTION How is a women’s self-image affected by uterus transplantation (UTx)? SUMMARY ANSWER Women experienced receiving a uterus in both positive and negative ways, but in general, their self-image was positively affected; regardless of whether they have given birth to a child or not, recipients describe themselves as being ‘back to normal’ after the hysterectomy to remove the transplanted uterus. WHAT IS KNOWN ALREADY UTx has repeatedly proved to be a successful treatment for absolute uterine factor infertility. However, there has been no previous qualitative long-term research into the self-image of women undergoing UTx. STUDY DESIGN, SIZE, DURATION This complete, prospective cohort study included the nine recipients of the first UTxs performed in Sweden mostly in 2013. Interviews took place in the 5 years following surgery. PARTICIPANTS/MATERIALS, SETTING, METHODS Eight out of the nine recipients had congenital absence of the uterus, a characteristic of Mayer–Rokitansky–Küster–Hauser syndrome, and one recipient lacked a uterus after a radical hysterectomy due to cervical cancer. The mean age of participants was 31.5 years at inclusion and at this time they all lived in stable marital relationships. Post-transplantation, interviews were performed annually for 5 years, comprising a total of 43 interviews. The interview followed a semi-structured guide. All interviews (median duration of around 25 minutes) were recorded, transcribed verbatim and then analysed by thematic approach. MAIN RESULTS AND THE ROLE OF CHANCE The joys and frustrations of becoming a ‘complete’ woman are seen as a master theme, which influences the three underlying subthemes, a changed self-perception, a changed body and a changed sexuality. Each of these subthemes have three underlying categories. LIMITATIONS, REASONS FOR CAUTION The small sample size is a limitation. WIDER IMPLICATIONS OF THE FINDINGS The results provide information that will be helpful in pre-operative screening procedures and in the psychological support offered both to women who experienced successful and unsuccessful outcomes following UTx. STUDY FUNDING/COMPETING INTEREST(S) Funding was received from the Jane and Dan Olsson Foundation for Science; the Knut and Alice Wallenberg Foundation; an ALF grant from the Swedish state under an agreement between the government and the county councils; the Swedish Research Council; a Ferring Pharmaceuticals scholarship in memory of Robert Edwards; and the Iris Jonzén-Sandblom and Greta Jonzén Foundation. The authors have no competing interests. TRIAL REGISTRATION NUMBER NCT01844362.

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