Chances and risks in the development of the smallest villages in Vysočina Region

Vysočina is the region with highest numbers of the smallest villages in the Czech Republic. The current levels of the infrastructure, conditions of living of the inhabitants and chances for development of the communities were examined by means of a questionnaire area survey over the entire number of villages and towns of Vysočina Region in 2007. Survey results were tested as concerns representativity, statistically grouped and ordered in the manner of contingenc tables. For those aspects, where the community representatives felt a degree of deterioration a detailed statistical analysis was carried out. For the groups of villages up to 199 head and up to 499 head significance tests were carried out first and the degree of dependence measured by the Cramer coefficient. Statistical significance was an argument for deeper analyses. Sign sketches for 0,1 %, 1 % and 5 % significance levels were prepared for all the contingency tables. The answers of the conjuncture research were reduced to an alternative statistical variable and association was further studied between the village size and the problem areas of the community development. Probabilities of the separate variants were stated and risks and chances were evaluated for the possibilities for the smallest villages to be threatened as compared with the larger ones. The research results are presented in the shape of risk probabilities, both the relative and absolute ones, using the less applied measures for the risk measurement in two-way contingency tables. The computations are commented verbally and they bring new looks upon the perception of increased risk and chances improvement problems by means of qualitative statistical attributes. The solution is not only practically important but it offers an applicable general methodology instruction, too, for detailed analyses in the empirical research of qualitative phenomena.

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OP407 Network Meta-Analysis Of Prolonged Release Calcifediol And Paricalcitol

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462320001075 ◽

2020 ◽

Vol 36 (S1) ◽

pp. 8-8

Author(s):

Joel Gunnarsson ◽

Rosa Lauppe ◽

Philipp Csomor ◽

Michele Intorcia ◽

Marco Soro

Keyword(s):

Kidney Disease ◽

Disease Risk ◽

Early Stage ◽

Meta Analysis ◽

Statistical Significance ◽

General Pattern ◽

Serum Levels ◽

Prolonged Release ◽

Increased Risk ◽

Significance Levels

IntroductionSecondary hyperparathyroidism (SHPT) is a consequence of non-dialysis chronic kidney disease (ND-CKD), causing disturbances in metabolic parameters including increased phosphate and parathyroid hormone (PTH) and reduced calcium serum level, which can cause bone disease, extra-skeletal calcification and increased cardiac disease risk through vascular and visceral calcification. According to Kidney Disease Improving Global Outcomes (KDIGO) guidelines in 2017, treatment with paricalcitol is no longer recommended in early stage CKD due to increased risk of hypercalcemia. Prolonged release calcifediol (PRC) has been developed as a novel treatment for SHPT in ND-CKD. The objective of this study was to compare the efficacy and safety of PRC versus paricalcitol by assessing biomarkers such as PTH, calcium and phosphate.MethodsTo identify relevant randomized control trials (RCTs) to be included in the network meta-analysis (NMA), a systematic literature search was performed in PubMed. All analyses were performed with a frequentist random-effects NMA. Comparisons were made between the overall treatment effects of the two drugs (including all studies, with fixed and titrated dosage regimens), and between low fixed doses (PRC: 30 μg/day, paricalcitol: 1 μg/day) and high fixed doses (PRC: 60 μg/day, paricalcitol: 2 μg/day).ResultsNine RCTs, comprising a total of 1,426 patients, were included in the analyses. No statistically significant differences in PTH reduction were found. Paricalcitol showed significantly larger increases in calcium when overall effects and high doses were analyzed. No differences in effects on phosphate were observed. Although effect sizes and statistical significance levels vary somewhat across analyses, the general pattern of similar PTH reductions and larger increases in calcium from paricalcitol are observed in all analyses.ConclusionsThe non-inferiority shown by PRC in lowering PTH and the tendency to increase calcium serum levels observed with paricalcitol treatment indicates that PRC might be used as an equally effective but potentially safer alternative to paricalcitol in treating patients with SHPT.

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Percutaneous Coronary Intervention in Patients with Diabetes and Multivessel or Left Main Disease – a Review

Interventional Cardiology Review ◽

10.15420/icr.2012.7.1.37 ◽

2012 ◽

Vol 7 (1) ◽

pp. 37

Author(s):

Donald E Cutlip ◽

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Statistical Significance ◽

Bare Metal Stents ◽

Coronary Intervention ◽

Metal Stents ◽

Increased Risk ◽

Percutaneous Coronary ◽

Patients With Diabetes ◽

The Impact

Coronary artery disease in patients with diabetes is frequently a diffuse process with multivessel involvement and is associated with increased risk for myocardial infarction and death. The role of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in patients with diabetes and multivessel disease who require revascularisation has been debated and remains uncertain. The debate has been continued mainly because of the question to what degree an increased risk for in-stent restenosis among patients with diabetes contributes to other late adverse outcomes. This article reviews outcomes from early trials of balloon angioplasty versus CABG through later trials of bare-metal stents versus CABG and more recent data with drug-eluting stents as the comparator. Although not all studies have been powered to show statistical significance, the results have been generally consistent with a mortality benefit for CABG versus PCI, despite differential risks for restenosis with the various PCI approaches. The review also considers the impact of mammary artery grafting of the left anterior descending artery and individual case selection on these results, and proposes an algorithm for selection of patients in whom PCI remains a reasonable strategy.

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PEMBERDAYAAN MASYARAKAT DESA DANASARI KECAMATAN PEMALANG KABUPATEN PEMALANG

Jurnal Ilmu Dakwah ◽

10.21580/jid.v36i1.1624 ◽

2017 ◽

Vol 36 (1) ◽

pp. 26

Author(s):

Purnama Rozak ◽

Hafiedh Hasan ◽

Sugarno Sugarno ◽

Srifariyati Srifariyati ◽

Afsya Septa Nugraha

Keyword(s):

Community Development ◽

Human Resources ◽

Human Development ◽

Human Development Index ◽

Scale Parameter ◽

Collective Responsibility ◽

Community Empowerment ◽

Per Capita ◽

Primary Focus ◽

The Village

The success of the development of a nation is determined by the Human Development Index (HDI). International scale parameter indicates the level of development of human resources emphasizes on three areas: education, health, and income per capita. The various dimensions of community development was a collective responsibility to make it happen. One way to do is through the proselytizing activities of community empowerment. This is as done in the village of Pemalang district, Danasari that has HDI levels is low compared than other villages. Community development in this village was done by taking three primary focus , they are the field of economics, health, and education and religion.***Keberhasilan pembangunan suatu bangsa ditentukan oleh Human Develop-ment Indeks (HDI). Parameter berskala internsional ini menunjukkan tingkat pengembangan sumber daya manusia yang menitiberatkan pada tiga bidang yaitu pendidikan, kesehatan, dan pendapatan perkapita. Pengembangan masyarakat yang berbagai dimensi tadi merupakan tanggung jawab bersama untuk mewujudkannya. Salah satu cara yang dapat dilakukan adalah melalui kegiatan dakwah pemberdayaan masyarakat. Hal ini sebagaimana dilakukan di Desa Danasari Kabupaten Pemalang yang memiliki tingkat HDI yang rendah dibandingkan desa lainnya. Pemberdayaan masyarakat di desa ini dilakukan dengan mengambil tiga fokus utama yaitu bidang ekonomi, bidang kesehatan, dan pendidikan dan keagamaan. Potensi yang ada perlu diberdayakan secara bersama dengan tujuan pencapaian perbaikan kehidupan masyarakat desa Danasari.

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COVID-19 and Its Symptoms’ Panoply: A Case-Control Study of 919 Suspected Cases in Locked-Down Ovar, Portugal

Portuguese Journal of Public Health ◽

10.1159/000514925 ◽

2021 ◽

pp. 1-8

Author(s):

Regina Sá ◽

Tiago Pinho-Bandeira ◽

Guilherme Queiroz ◽

Joana Matos ◽

João Duarte Ferreira ◽

...

Keyword(s):

Large Scale ◽

Case Control Study ◽

Statistical Significance ◽

Case Control ◽

Case Definition ◽

Suspected Case ◽

Risk Characteristics ◽

Increased Risk ◽

Wide Range ◽

Control Study

Background: Ovar was the first Portuguese municipality to declare active community transmission of SARS-CoV-2, with total lockdown decreed on March 17, 2020. This context provided conditions for a large-scale testing strategy, allowing a referral system considering other symptoms besides the ones that were part of the case definition (fever, cough, and dyspnea). This study aims to identify other symptoms associated with COVID-19 since it may clarify the pre-test probability of the occurrence of the disease. Methods: This case-control study uses primary care registers between March 29 and May 10, 2020 in Ovar municipality. Pre-test clinical and exposure-risk characteristics, reported by physicians, were collected through a form, and linked with their laboratory result. Results: The study population included a total of 919 patients, of whom 226 (24.6%) were COVID-19 cases and 693 were negative for SARS-CoV-2. Only 27.1% of the patients reporting contact with a confirmed or suspected case tested positive. In the multivariate analysis, statistical significance was obtained for headaches (OR 0.558), odynophagia (OR 0.273), anosmia (OR 2.360), and other symptoms (OR 2.157). The interaction of anosmia and odynophagia appeared as possibly relevant with a borderline statistically significant OR of 3.375. Conclusion: COVID-19 has a wide range of symptoms. Of the myriad described, the present study highlights anosmia itself and calls for additional studies on the interaction between anosmia and odynophagia. Headaches and odynophagia by themselves are not associated with an increased risk for the disease. These findings may help clinicians in deciding when to test, especially when other diseases with similar symptoms are more prevalent, namely in winter.

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Melanoma is associated with an increased risk of bullous pemphigoid: a large population-based longitudinal study

Archives of Dermatological Research ◽

10.1007/s00403-021-02211-4 ◽

2021 ◽

Author(s):

Khalaf Kridin ◽

Jennifer E. Hundt ◽

Ralf J. Ludwig ◽

Kyle T. Amber ◽

Dana Tzur Bitan ◽

...

Keyword(s):

Bullous Pemphigoid ◽

Statistical Significance ◽

Large Population ◽

Underlying Mechanism ◽

Population Based ◽

Control Subjects ◽

Increased Risk ◽

Bidirectional Association ◽

History Of ◽

Incident Cases

AbstractThe association between bullous pemphigoid (BP) and melanoma is yet to be investigated. We aimed to assess assess the bidirectional association between BP and melanoma and to delineate the epidemiological features of patients with both diagnoses. A population-based cohort study was performed comparing BP patients (n = 3924) with age-, sex- and ethnicity-matched control subjects (n = 19,280) with regard to incident cases of melanoma. A case–control design was additionally adopted to estimate the risk of BP in individuals with a preexisting diagnosis of melanoma. The prevalence of preexisting melanoma was higher in patients with BP than in control subjects (1.5% vs. 1.0%, respectively; P = 0.004). A history of melanoma confers a 50% increase in the risk of subsequent BP (OR 1.53; 95% CI 1.14–2.06). This risk was higher among males (OR 1.66; 95% CI 1.09–2.54) and individuals older than 80 years (OR 1.63; 95% CI 1.11–2.38), and persisted after adjustment for multiple putative confounders including PD-1/PDL-1 antagonists (adjusted OR 1.53; 95% CI 1.14–2.06). Conversely, the risk of melanoma among patients with BP was slightly elevated, but did not reach the level of statistical significance (adjusted HR 1.13; 95% CI 0.73–1.74). Patients with a dual diagnosis of BP and melanoma were older at the onset of BP and had lower body mass index. A history of melanoma is associated with a 50% increase in the incidence of subsequent BP. Physicians managing patients with both conditions should be aware of this association. Further research is warranted to reveal the underlying mechanism of these findings.

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Impact of Diagnosed and Undiagnosed Respiratory Pseudomonas on VAP and VAE During Long-Term Acute Care

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.823 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s258-s259

Author(s):

James Harrigan ◽

Ebbing Lautenbach ◽

Emily Reesey ◽

Magda Wernovsky ◽

Pam Tolomeo ◽

...

Keyword(s):

Bacterial Community ◽

Acute Care ◽

Statistical Significance ◽

Rrna Gene ◽

Care Hospital ◽

16S Sequencing ◽

Increased Risk ◽

Wide Range ◽

The Impact

Background: Clinically diagnosed ventilator-associated pneumonia (VAP) is common in the long-term acute-care hospital (LTACH) setting and may contribute to adverse ventilator-associated events (VAEs). Pseudomonas aeruginosa is a common causative organism of VAP. We evaluated the impact of respiratory P. aeruginosa colonization and bacterial community dominance, both diagnosed and undiagnosed, on subsequent P. aeruginosa VAP and VAE events during long-term acute care. Methods: We enrolled 83 patients on LTACH admission for ventilator weaning, performed longitudinal sampling of endotracheal aspirates followed by 16S rRNA gene sequencing (Illumina HiSeq), and bacterial community profiling (QIIME2). Statistical analysis was performed with R and Stan; mixed-effects models were fit to relate the abundance of respiratory Psa on admission to clinically diagnosed VAP and VAE events. Results: Of the 83 patients included, 12 were diagnosed with P. aeruginosa pneumonia during the 14 days prior to LTACH admission (known P. aeruginosa), and 22 additional patients received anti–P. aeruginosa antibiotics within 48 hours of admission (suspected P. aeruginosa); 49 patients had no known or suspected P. aeruginosa (unknown P. aeruginosa). Among the known P. aeruginosa group, all 12 patients had P. aeruginosa detectable by 16S sequencing, with elevated admission P. aeruginosa proportional abundance (median, 0.97; IQR, 0.33–1). Among the suspected P. aeruginosa group, all 22 patients had P. aeruginosa detectable by 16S sequencing, with a wide range of admission P. aeruginosa proportional abundance (median, 0.0088; IQR, 0.00012–0.31). Of the 49 patients in the unknown group, 47 also had detectable respiratory Psa, and many had high P. aeruginosa proportional abundance at admission (median, 0.014; IQR, 0.00025–0.52). Incident P. aeruginosa VAP was observed within 30 days in 4 of the known P. aeruginosa patients (33.3%), 5 of the suspected P. aeruginosa patients (22.7%), and 8 of the unknown P. aeruginosa patients (16.3%). VAE was observed within 30 days in 1 of the known P. aeruginosa patients (8.3%), 2 of the suspected P. aeruginosa patients (9.1%), and 1 of the unknown P. aeruginosa patients (2%). Admission P. aeruginosa abundance was positively associated with VAP and VAE risk in all groups, but the association only achieved statistical significance in the unknown group (type S error <0.002 for 30-day VAP and <0.011 for 30-day VAE). Conclusions: We identified a high prevalence of unrecognized respiratory P. aeruginosa colonization among patients admitted to LTACH for weaning from mechanical ventilation. The admission P. aeruginosa proportional abundance was strongly associated with increased risk of incident P. aeruginosa VAP among these patients.Funding: NoneDisclosures: None

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Combination of AST to ALT and neutrophils to lymphocytes ratios as predictors of locally advanced disease in patients with bladder cancer subjected to radical cystectomy: Results from a single-institutional series

Urologia Journal ◽

10.1177/03915603211035191 ◽

2021 ◽

pp. 039156032110351

Author(s):

Alessandro Uleri ◽

Rodolfo Hurle ◽

Roberto Contieri ◽

Pietro Diana ◽

Nicolòmaria Buffi ◽

...

Keyword(s):

Bladder Cancer ◽

Radical Cystectomy ◽

Advanced Disease ◽

Independent Predictor ◽

Small Sample Size ◽

Statistical Significance ◽

Locally Advanced ◽

Small Sample ◽

Locally Advanced Disease ◽

Increased Risk

Background: Bladder cancer (BC) staging is challenging. There is an important need for available and affordable predictors to assess, in combination with imaging, the presence of locally-advanced disease. Objective: To determine the role of the De Ritis ratio (DRR) and neutrophils to lymphocytes ratio (NLR) in the prediction of locally-advanced disease defined as the presence of extravescical extension (pT ⩾ 3) and/or lymph node metastases (LNM) in patients with BC treated with radical cystectomy (RC). Methods: We retrospectively analyzed clinical and pathological data of 139 consecutive patients who underwent RC at our institution. Logistic regression models (LRMs) were fitted to test the above-mentioned outcomes. Results: A total of 139 consecutive patients underwent RC at our institution. Eighty-six (61.9%) patients had a locally-advanced disease. NLR (2.53 and 3.07; p = 0.005) and DRR (1 and 1.17; p = 0.01) were significantly higher in patients with locally-advanced disease as compared to organ-confined disease. In multivariable LRMs, an increasing DRR was an independent predictor of locally-advanced disease (OR = 3.91; 95% CI: 1.282–11.916; p = 0.017). Similarly, an increasing NLR was independently related to presence of locally-advanced disease (OR = 1.28; 95% CI: 1.027–1.591; p = 0.028). In univariate LRMs, patients with DRR > 1.21 had a higher risk of locally advanced disease (OR = 2.83; 95% CI: 1.312–6.128; p = 0.008). Similarly, in patients with NLR > 3.47 there was an increased risk of locally advanced disease (OR = 3.02; 95% CI: 1.374–6.651; p = 0.006). In multivariable LRMs, a DRR > 1.21 was an independent predictor of locally advanced disease (OR = 2.66; 95% CI: 1.12–6.35; p = 0.027). Similarly, an NLR > 3.47 was independently related to presence of locally advanced disease (OR = 2.24; 95% CI: 0.95–5.25; p = 0.065). No other covariates such as gender, BMI, neoadjuvant chemotherapy or diabetes reached statistical significance. The AUC of the multivariate LRM to assess the risk of locally advanced disease was 0.707 (95% CI: 0.623–0.795). Limitations include the retrospective nature of the study and the relatively small sample size.

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Cavalier Use of Inferential Statistics Is a Major Source of False and Irreproducible Scientific Findings

Mathematics ◽

10.3390/math9060603 ◽

2021 ◽

Vol 9 (6) ◽

pp. 603

Author(s):

Leonid Hanin

Keyword(s):

Sample Size ◽

Gaussian Approximation ◽

Statistical Significance ◽

Statistical Analyses ◽

Random Sample Size ◽

P Values ◽

The Central Limit Theorem ◽

Fixed Sample ◽

Large Numbers ◽

Significance Levels

I uncover previously underappreciated systematic sources of false and irreproducible results in natural, biomedical and social sciences that are rooted in statistical methodology. They include the inevitably occurring deviations from basic assumptions behind statistical analyses and the use of various approximations. I show through a number of examples that (a) arbitrarily small deviations from distributional homogeneity can lead to arbitrarily large deviations in the outcomes of statistical analyses; (b) samples of random size may violate the Law of Large Numbers and thus are generally unsuitable for conventional statistical inference; (c) the same is true, in particular, when random sample size and observations are stochastically dependent; and (d) the use of the Gaussian approximation based on the Central Limit Theorem has dramatic implications for p-values and statistical significance essentially making pursuit of small significance levels and p-values for a fixed sample size meaningless. The latter is proven rigorously in the case of one-sided Z test. This article could serve as a cautionary guidance to scientists and practitioners employing statistical methods in their work.

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Subclinical Hypothyroidism in PCOS: Impact on Presentation, Insulin Resistance, and Cardiovascular Risk

BioMed Research International ◽

10.1155/2016/2067087 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 13

Author(s):

Qun Yu ◽

Jin-Bei Wang

Keyword(s):

Cardiovascular Risk ◽

Subclinical Hypothyroidism ◽

Polycystic Ovarian Syndrome ◽

Normal Population ◽

Statistical Significance ◽

Cardiovascular Disorder ◽

Control Subjects ◽

Increased Risk ◽

Pcos Group ◽

Ovarian Syndrome

Aim of Study. To assess status of thyroid function and thyroid disorders particularly subclinical hypothyroidism (SCH) in subjects with polycystic ovarian syndrome (PCOS) and impact of SCH on various clinical and biochemical parameters and cardiovascular risk in PCOS.Methods. Hundred females diagnosed with PCOS as per Rotterdam criteria and 100 normal controls were recruited and were subjected to elaborate anthropometric, clinical, and biochemical assessment.Results. Notable findings included significantly higher frequency of subjects with subclinical hypothyroidism (p=0.0002), autoimmune thyroiditis (p<0.001), and goitre (p=0.02) in polycystic ovarian syndrome subjects compared to control subjects. Further SCH PCOS subjects were found to harbor significantly higher HOMA-IR (p<0.05) and frequency of subjects with dyslipidemia (p<0.05) compared to both euthyroid PCOS and euthyroid control subjects. Though frequency of subjects with cardiovascular risk factors was higher in SCH PCOS group than euthyroid PCOS group, it failed to reach statistical significance.Conclusion. We concluded that PCOS is associated with high incidence of SCH and AIT compared to normal population and SCH poses increased risk of cardiovascular disorder in PCOS.

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Coeliac disease and invasive pneumococcal disease: a population-based cohort study

Epidemiology and Infection ◽

10.1017/s0950268816003204 ◽

2017 ◽

Vol 145 (6) ◽

pp. 1203-1209 ◽

Cited By ~ 9

Author(s):

A. RÖCKERT TJERNBERG ◽

J. BONNEDAHL ◽

M. INGHAMMAR ◽

A. EGESTEN ◽

G. KAHLMETER ◽

...

Keyword(s):

Cohort Study ◽

Coeliac Disease ◽

Invasive Pneumococcal Disease ◽

Pneumococcal Disease ◽

Cox Regression ◽

Statistical Significance ◽

Pneumococcal Vaccination ◽

Population Based ◽

Increased Risk ◽

Severe Infections

SUMMARYSevere infections are recognized complications of coeliac disease (CD). In the present study we aimed to examine whether individuals with CD are at increased risk of invasive pneumococcal disease (IPD). To do so, we performed a population-based cohort study including 29 012 individuals with biopsy-proven CD identified through biopsy reports from all pathology departments in Sweden. Each individual with CD was matched with up to five controls (n = 144 257). IPD events were identified through regional and national microbiological databases, including the National Surveillance System for Infectious Diseases. We used Cox regression analyses to estimate hazard ratios (HRs) for diagnosed IPD. A total of 207 individuals had a record of IPD whereas 45/29 012 had CD (0·15%) and 162/144 257 were controls (0·11%). This corresponded to a 46% increased risk for IPD [HR 1·46, 95% confidence interval (CI) 1·05–2·03]. The risk estimate was similar after adjustment for socioeconomic status, educational level and comorbidities, but then failed to attain statistical significance (adjusted HR 1·40, 95% CI 0·99–1·97). Nonetheless, our study shows a trend towards an increased risk for IPD in CD patients. The findings support results seen in earlier research and taking that into consideration individuals with CD may be considered for pneumococcal vaccination.

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