scholarly journals Multiparametric MRI Radiomics for the Early Prediction of Response to Chemoradiotherapy in Patients With Postoperative Residual Gliomas: An Initial Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhaotao Zhang ◽  
Keng He ◽  
Zhenhua Wang ◽  
Youming Zhang ◽  
Di Wu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Models ◽  
Univariate Analysis ◽  
Roc Curves ◽  
Multiparametric Mri ◽  
Early Prediction ◽  
Validation Group ◽  
Logistic Regression Models ◽  
Calibration Curves ◽  
Postoperative Residual

PurposeTo evaluate whether multiparametric magnetic resonance imaging (MRI)-based logistic regression models can facilitate the early prediction of chemoradiotherapy response in patients with residual brain gliomas after surgery.Patients and MethodsA total of 84 patients with residual gliomas after surgery from January 2015 to September 2020 who were treated with chemoradiotherapy were retrospectively enrolled and classified as treatment-sensitive or treatment-insensitive. These patients were divided into a training group (from institution 1, 57 patients) and a validation group (from institutions 2 and 3, 27 patients). All preoperative and postoperative MR images were obtained, including T1-weighted (T1-w), T2-weighted (T2-w), and contrast-enhanced T1-weighted (CET1-w) images. A total of 851 radiomics features were extracted from every imaging series. Feature selection was performed with univariate analysis or in combination with multivariate analysis. Then, four multivariable logistic regression models derived from T1-w, T2-w, CET1-w and Joint series (T1+T2+CET1-w) were constructed to predict the response of postoperative residual gliomas to chemoradiotherapy (sensitive or insensitive). These models were validated in the validation group. Calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA) were applied to compare the predictive performances of these models.ResultsFour models were created and showed the following areas under the ROC curves (AUCs) in the training and validation groups: Model-Joint series (AUC, 0.923 and 0.852), Model-T1 (AUC, 0.835 and 0.809), Model-T2 (AUC, 0.784 and 0.605), and Model-CET1 (AUC, 0.805 and 0.537). These results indicated that the Model-Joint series had the best performance in the validation group, followed by Model-T1, Model-T2 and finally Model-CET1. The calibration curves indicated good agreement between the Model-Joint series predictions and actual probabilities. Additionally, the DCA curves demonstrated that the Model-Joint series was clinically useful.ConclusionMultiparametric MRI-based radiomics models can potentially predict tumor response after chemoradiotherapy in patients with postoperative residual gliomas, which may aid clinical decision making, especially to help patients initially predicted to be treatment-insensitive avoid the toxicity of chemoradiotherapy.

scholarly journals Sonographic Cervical Shortening after Labor Induction is a Predictor of Vaginal Delivery

2016 ◽  
Vol 38 (12) ◽  
pp. 585-588 ◽  
Author(s):  
Ugo Indraccolo ◽  
Gennaro Scutiero ◽  
Pantaleo Greco
Keyword(s):  
Logistic Regression ◽  
Vaginal Delivery ◽  
Regression Models ◽  
Operating Characteristic ◽  
Roc Curves ◽  
Cervical Length ◽  
Labor Induction ◽  
Logistic Regression Models ◽  
Independent Variables ◽  
Sonographic Evaluation

Objective Analyzing if the sonographic evaluation of the cervix (cervical shortening) is a prognostic marker for vaginal delivery. Methods Women who underwent labor induction by using dinoprostone were enrolled. Before the induction and three hours after it, the cervical length was measured by ultrasonography to obtain the cervical shortening. The cervical shortening was introduced in logistic regression models among independent variables and for calculating receiver operating characteristic (ROC) curves. Results Each centimeter in the cervical shortening increases the odds of vaginal delivery in 24.4% within 6 hours; in 16.1% within 24 hours; and in 10.5% within 48 hours. The best predictions for vaginal delivery are achieved for births within 6 and 24 hours, while the cervical shortening poorly predicts vaginal delivery within 48 hours. Conclusion The greater the cervical shortening 3 hours after labor induction, the higher the likelihood of vaginal delivery within 6, 24 and 48 hours.

scholarly journals Prevalence of chronic chikungunya and associated risks factors in the French West Indies (La Martinique). A prospective cohort study

2019 ◽  
Author(s):  
Bertolotti Antoine ◽  
Thioune Marême ◽  
Abel Sylvie ◽  
Belrose Gilda ◽  
Calmont Isabelle ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cohort Study ◽  
Acute Phase ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Regression Models ◽  
Functional Disability ◽  
Univariate Analysis ◽  
Logistic Regression Models ◽  
Adequate Hydration

AbstractBackgroundThe chikungunya virus (CHIKV) is a re-emerging alphavirus that can cause chronic rheumatic musculoskeletal disorders, named chronic chikungunya (CHIKC+), which may be long-term incapacitating. A chikungunya outbreak occurred in 2013 in La Martinique. We constituted the first prospective cohort study of CHIKV-infected subjects in the Caribbean to assess the prevalence of CHIKC+ at 12 months and to search for factors present at the acute stage significantly associated with chronicity.Methodology/Principal findingsA total of 193 patients who tested positive for RT-PCR CHIKV, were submitted to clinical investigations in the acute phase (<21 days), and 3, 6, and 12 months after their inclusion. A total of 167 participants could be classified as either suffering or not from CHIKC+. They were analyzed using logistic regression models. At 12 months, the overall prevalence of CHIKC+ was 52.1% (95%CI: 44.5-59.7). In univariate analysis, age (OR: 1.04; 95% CI: 1.02-1.07; p=0.0003), being male (OR: 0.51; 95%CI: 0.27-0.98; p=0.04), headache (OR: 1.90; 95%CI: 1.02-3.56; p=0.04), vertigo (OR: 2.06; 95%CI: 1.05-4.03; p=0.04), vomiting (OR: 2.51; 95%CI: 1.07-5.87; p = 0.03), urea (OR: 1.33; 95%CI: 1.05-1.70; p=0.02) were associated with CHIKC+. In final multivariate logistic regression models for 167 participants, predictors of CHIKC+ were age (OR 1.06; 95%CI: 1.03-1.08; p<0.0001), male sex (OR: 0.40; 95%CI: 0.19-0.84; p=0.015), vertigo (OR: 2.46; 95%CI: 1.16-5.20; p=0.019), hypotension (OR 4.72; 95% -CI: 1.19-18.79; p=0.028), recoloration time >3 seconds (OR: 3.79; 95%-CI: 1.01-14.25).ConclusionsThis cohort study in La Martinique confirms that CHIKC+ is a frequent complication of acute chikungunya disease. Analysis emphasized the importance of age and female sex for CHIKC occurrence, and pointed out the potential aggravating role of dehydration at the acute phase. Early and adequate hydration could reduce the risk chronic chikungunya disorders.Author SummaryChikungunya is a mosquito-borne virus found in tropical countries that has been re-emerging in the last decade. It has caused major epidemics in recent years, such as in Reunion Island and in Southeast Asia. Nearly 2.5 billion people around the world are at risk of contracting the virus. During the acute phase of the illness, patients experience a flu-like syndrome with fever, headache, myalgia, rash, and severe arthralgia. These symptoms can persist for several months in some patients, and can lead to significant functional disability. During the 2013 epidemic in Martinique, we followed nearly 200 patients who had contracted chikungunya. More than half of the patients had a chronic form of the disease—mainly women over 50 years of age. Our statistical analyses indicate that poor hydration during the acute phase may be a risk factor for developing chronic rheumatism. Therefore, in the context of a chikungunya epidemic, it seems important to encourage patients to drink plenty of fluids as soon as the first symptoms appear.

scholarly journals THE UTILITY OF STABILITY AND TEAR LOCATION IN A CLASSIFICATION SYSTEM FOR DISCOID MENISCUS SURGICAL PLANNING

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0016
Author(s):  
Brian W. Yang ◽  
Catherine Logan ◽  
Kathryn Williams ◽  
Frances Tepolt ◽  
Nikolaos Paschos ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Surgical Treatment ◽  
Treatment Planning ◽  
Classification System ◽  
Regression Models ◽  
Univariate Analysis ◽  
Classification Systems ◽  
Discoid Meniscus ◽  
Logistic Regression Models ◽  
Clinical Records

Background Discoid meniscus (DM) is a congenital variant that typically affects the lateral meniscus of the knee. Despite the presence of multiple classification systems for DM, no system has demonstrated utility in treatment planning. We performed a retrospective review of discoid menisci that underwent surgical intervention at our institution to assess for discoid meniscus characteristics associated with surgical treatment with or without repair. Next, we propose a new method of classifying lateral discoid meniscus and demonstrate its efficacy in predicting surgical treatment. Methods We searched the orthopedic database at our institution for patients who underwent surgical treatment for lateral discoid meniscus between 1991 and 2017. Clinical records were reviewed to determine the type of DM surgery performed (surgery with or without repair) as well as DM morphology, stability, tear presence, tear location, and tear type. Univariate associations between DM characteristics and surgery type were calculated and multivariable logistic regression models of surgery type were created. Based on the univariate analysis and logistic regression models, we propose a new classification system for discoid meniscus. Results There were 434 knees with discoid lateral menisci that received surgical treatment at our institution between 1991 and 2017. In univariate analysis, unstable menisci (93%, p<0.001) and menisci with a tear including the periphery (75%, p<0.001) were more likely to receive surgery with repair. By itself, instability demonstrated 89% sensitivity and 94% specificity in predicting surgery with repair. The main effects logistic regression model including stability and tear showed that that the odds of unstable lateral discoid menisci receiving surgery with repair was 133.1 times higher than stable menisci (p<0.001) while lateral discoid menisci that had a tear including the periphery had 6.54 times higher odds of receiving repair than those that had a tear in the central portion only (p<0.001). Conclusions/Significance Lateral discoid menisci stability and tear location were associated with surgical treatment type in both univariate analysis and logistic regression models (Table 1). Based on our results and clinical relevance, we propose a classification system for DM with utility in surgical treatment planning. Menisci are classified by stability (Stable (S0), Unstable (S1)), morphology (Incomplete (M0), Complete (M1)), and Tear (No tear (T0), Central tear (T1), or Peripheral tear (T2)) (Figure 1). Tables and Figures [Table: see text][Figure: see text]

scholarly journals Logistic Regression Analysis of Multiple Interosseous Hand-Muscle Activities using Surface Electromyography during Finger-Oriented Tasks

2018 ◽  
Author(s):  
Masayuki Yokoyama ◽  
Masao Yanagisawa
Keyword(s):  
Logistic Regression ◽  
Frequency Domain ◽  
Regression Models ◽  
Univariate Analysis ◽  
Proximal Phalanx ◽  
Median Frequency ◽  
Logistic Regression Models ◽  
Hand Muscles ◽  
Hand Muscle ◽  
Electromyographic Signals

ABSTRACTIntrinsic hand muscles are densely located in the hand, and the myoelectric observation from the surface is sometimes unreliable because of some outside influences that may interfere with the signals. In the present study, we evaluated the activities of multiple interosseous hand-muscles which densely located in the hand, through analyzing the surface electromyographic signals during finger-oriented tasks using univariate and multivariate logistic regression models. Ten healthy subjects participated in our experiment, and isometrically exercised each finger one by one in flexed form. The result of a univariate analysis with the power and amplitude domain predictor variables of the surface electromyographic signals showed significant consistency between the activated finger and the inserted finger of the dorsal interosseous muscles to the proximal phalanx (P < 0.001). Meanwhile, the results of a multivariate analysis showed a higher correlation of the regression model of the fourth dorsal interosseous muscle during the action of the ring finger using frequency-domain variables (the Nagelkerke R2 = 0.716 when the median frequency was used), compared to the model without the frequency-domain variables (the Nagelkerke R2 = 0.583). Our result showed that the logistic regression models have a particular possibility for the analysis of the surface electromyographic signals of densely located hand-muscle activities related to the finger-oriented tasks.

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.

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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