BACKGROUND: Using real working examples, we provide strategies and address challenges in linear and logistic regression to demonstrate best practice guidelines and pitfalls of regression modeling in surgical oncology research.
METHODS: To demonstrate our best practices, we reviewed patients who underwent tissue expander breast reconstruction between 2019 and 2021. We assessed predictive factors that affect BREAST-Q Physical Well-Being of the Chest (PWB-C) scores at 2 weeks with linear regression modeling and overall complications and malrotation with logistic regression modeling. Model fit and performance were assessed.
RESULTS: The 1986 patients were included in the analysis. In linear regression, age [β = 0.18 (95% CI: 0.09, 0.28); p < 0.001], single marital status [β = 2.6 (0.31, 5.0); p = 0.026], and prepectoral pocket dissection [β = 4.6 (2.7, 6.5); p < 0.001] were significantly associated with PWB-C at 2 weeks. For logistic regression, BMI [OR = 1.06 (95% CI: 1.04, 1.08); p < 0.001], age [OR = 1.02 (1.01, 1.03); p = 0.002], bilateral reconstruction [OR = 1.39 (1.09, 1.79); p = 0.009], and prepectoral dissection [OR = 1.53 (1.21, 1.94); p < 0.001] were associated with increased likelihood of a complication.
CONCLUSIONS: We provide focused directives for successful application of regression techniques in surgical oncology research. We encourage researchers to select variables with clinical judgment, confirm appropriate model fitting, and consider clinical plausibility for interpretation when utilizing regression models in their research.

BACKGROUND: Differentiated care strategies are rapidly becoming the norm for HIV care delivery globally. Building upon an interest in tailoring antiretroviral therapy (ART) delivery for client-centered needs, the Ministry of Health and Population in Haiti formally endorsed multiple-month dispenses (MMD) in the 2016 national ART guidelines This study explores heterogeneity in retention in care with MMD for specific Haitian populations living with HIV and evaluates if a targeted algorithm for optimal ART prescription intervals is warranted in Haiti.
METHODS: This study included ART-naïve individuals who started ART on or after January 1st, 2017 in Haiti. To identify subgroups in which to explore heterogeneity of retention, we implemented a double-lasso regression method to determine which individual characteristics would define the subgroups. Characteristics evaluated for potential subgroup definition included: sex, age category, WHO clinical stage, and body mass index category. We employed instrumental variable models to estimate the causal effect of increasing ART dispensing length on ART retention, by client subgroup. The outcome of interest was retention in care after one year in treatment. We then estimated the marginal effect of a 30-day increase to ART dispensing length to retention in care for each of these subgroups.
RESULTS: There was evidence for heterogeneity in the effect of extending ART dispensing intervals on retention by WHO clinical stage. We observed significant improvements to retention in care at one year with a 30-day increase in ART dispense length for all subgroups defined by WHO clinical stages 1-4. The effects ranged from a 14.7% increase (95% CI: 12.4-17.0) to the likelihood of retention for people with HIV in WHO stage 1 to a 21.6% increase (95% CI: 18.7-24.5) to the likelihood of retention for those in WHO stage 3.
CONCLUSIONS: All the subgroups defined by WHO clinical stage experienced a benefit of extending ART intervals to retention in care at one year. Though the effect did differ slightly by WHO stage, the effects went in the same direction and were of similar magnitude. Therefore, a standardized recommendation for MMD among those living with HIV and new on ART is appropriate for Haiti treatment guidelines.

暂无摘要。

BACKGROUND: Compliance with dietary guidelines among pregnant women can positively influence not only their own health but also the health of their babies. Measuring the compliance requires professional skills in nutrition and dietary counseling. In China, few simple and effective techniques assess dietary quality among pregnant women, especially in rural areas. We aimed to establish a new simple and effective assessment technique, the \"Chinese Dietary Guidelines Compliance Index for Pregnant Women (CDGCI-PW)\" and assess the association between maternal dietary compliance and risks of pregnancy complications.
METHODS: The CDGCI-PW consists of 13 main components which were based on the 2016 edition of the Chinese dietary guidelines for pregnant women. Each component was assigned a different score range, and the overall score ranged from 0 to 100 points. The Tongji Maternal and Child Health Cohort study (from September 2013 to May 2016) was a prospective cohort study designed to examine maternal dietary and lifestyle effects on the health of pregnant women and their offspring. The maternal diet during the second trimester was compared with the corresponding recommended intake of the Chinese balanced dietary pagoda for pregnant women to verify their compliance with dietary guidelines. The association between maternal dietary quality and risks of pregnancy complications was estimated by regression analysis. Receiver operating characteristic (ROC) curves were constructed to identify the optimal cut-off values of CDGCI-PW for gestational hypertension and gestational diabetes mellitus (GDM).
RESULTS: Among the 2708 pregnant women, 1489 were eventually followed up. The mean CDGCI-PW score was 74.1 (standard deviation (SD) 7.5) in the second trimester. The majority of foods showed the following trend: the higher the CDGCI-PW score, the higher the proportion of pregnant women who reported food intake within the recommended range. Moreover, a higher maternal CDGCI-PW score was significantly associated with lower risks of gestational hypertension [odds ratio (OR) (95% confidence interval [(CI): 0.30 (0.20, 0.37)] and GDM [OR (95% CI): 0.38 (0.31, 0.48)]. The optimal CDGCI-PW cut-off value for gestational hypertension was ≥68.5 (sensitivity 82%; specificity: 61%; area under the ROC curve, AUC = 0.743), and the optimal CDGCI-PW cut-off score for GDM was ≥75.5 (sensitivity 43%; specificity: 81%; area under the ROC curve, AUC = 0.714).
CONCLUSIONS: The CDGCI-PW is a simple and useful technique that assesses maternal diet quality during pregnancy, while adherence to the CDGCI-PW is associated with a lower risk of gestational hypertension and GDM.

To assess the reporting quality of split-mouth trials (SMTs) in orthodontic journals, and to identify factors associated with better reporting.
Seven leading orthodontic journals were hand searched for SMTs published during 2015-19. The CONSORT 2010 guideline and CONSORT for within-person trial (WPT) extension were used to assess the trial reporting quality (TRQ) and WPT-specific reporting quality (WRQ) of included SMTs, respectively. A binary score (0 or 1) was given to each item of the guidelines, and total scores were calculated for TRQ (score range, 0-32) and WRQ (score range, 0-15). Univariable and multivariable linear regression analyses were performed to identify factors associated with TRQ and WRQ.
A total of 42 SMTs were included. The mean overall scores for TRQ and WRQ were 16.8 [standard deviation (SD) 7.1] and 5.6 (SD 2.3), respectively. Only 11 SMTs (26.2%) presented the rationale for using a split-mouth design. Key methodological items including random sequence generation (22/42, 52.4%), allocation concealment (9/42, 21.4%), and blinding (20/42, 47.6%) were poorly reported. Only six SMTs (14.3%) used a paired method for sample size calculation, and half (21/42, 50.0%) considered the dependent nature of data in statistical analysis. In multivariable analyses, higher TRQ and WRQ were both significantly associated with journal, reported use of CONSORT and funding status.
The reporting quality of SMTs in orthodontics has much room for improvement. Joint efforts from relevant stakeholders are needed to improve the reporting quality of SMTs and reduce relevant avoidable research waste.

To understand the prevalence of high blood pressure among the general adult population under the new diagnostic criteria. PubMed and Embase databases were systematically searched. Two investigators independently performed data extraction and quality assessment, and the disagreements were resolved by consensus with a third investigator. The random-effects model was performed to pool the prevalence of high blood pressure among the population. Subgroup and meta-regression analyses were performed to explore the source of heterogeneity. The study protocol has been registered with PROSPERO, number CRD42019147330. In total, 52 articles included in the meta-analysis with a total of 54 studies. An obvious increase in the prevalence of high blood pressure was identified by the application of new diagnostic criteria. The pooled prevalence of high blood pressure among the population was 53.01% (95% confidence interval 51.13-54.88%). Subgroup analysis showed that the WHO region, national, and age could significantly influence the prevalence of hypertension (P < 0.01). Meta-regression analyses revealed that study quality and sex ratio (male, %) did not contribute to the heterogeneity of the results (P > 0.05). The sensitivity analysis showed that the results were stable. With the use of new diagnostic criteria, the prevalence of high blood pressure has shown an upward trend, especially in Europe countries. Prevention and control measures should focus more on improving cardiovascular and cerebrovascular status in Europe countries. Standard electronic blood pressure monitors were recommended for use in future studies, and at least two more readings should be taken during a visit.

To assess and compare the reporting quality of systematic review (SR) abstracts in operative dentistry published before and after the release of Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Abstracts (PRISMA-A), and to identify factors associated with reporting quality.
PubMed was searched for abstracts published during 2010-2012 (Pre-PRISMA period) and 2017-2019 (Post-PRISMA period). Reporting quality was assessed and scored using a modified 13-item PRSIMA-A checklist. Risk ratio (RR) was used to compare the adequate reporting rate of each item between the two periods. Univariable and multivariable linear regression analyses were performed to identify factors associated with reporting quality.
A total of 160 abstracts were included and assessed. Only four items (\'objective\', \'results of main outcomes\', \'description of the effect\' and \'interpretation\') were adequately reported in most abstracts (>75 %). According to the multivariable analysis, greater word count (P = 0.001), being published in the Post-PRISMA period (P = 0.025) and geographic origin from Asia (P = 0.025) or South America (P = 0.015) were significantly associated with higher reporting quality.
The reporting quality of SR abstracts in operative dentistry had improved significantly after the publication of PRISMA-A, but was still suboptimal. Researchers, reviewers and journal editors in operative dentistry need to be familiar with the PRISMA-A checklist, and make concerted efforts to improve the reporting of SR abstracts.

The rapid emergence of new measurement instruments and methods requires personnel and researchers of different disciplines to know the correct statistical methods to utilize to compare their performance with reference ones and properly interpret findings. We discuss the often-made mistake of applying the inappropriate correlation and regression statistical approaches to compare methods and then explain the concepts of agreement and reliability. Then, we introduce the intraclass correlation as a measure of inter-rater reliability, and the Bland-Altman plot as a measure of agreement, and we provide formulae to calculate them along with illustrative examples for different types of study designs, specifically single measurement per subject, repeated measurement while the true value is constant, and repeated measurement when the true value is not constant. We emphasize the requirement to validate the assumptions of these statistical approaches, and also how to deal with violations and provide formulae on how to calculate the confidence interval for estimated values of agreement and intraclass correlation. Finally, we explain how to interpret and report the findings of these statistical analyses.

OBJECTIVE: Feature matching of endoscopic images is of crucial importance in many clinical applications, such as object tracking and surface reconstruction. However, with the presence of low texture, specular reflections and deformations, the feature matching methods of natural scene are facing great challenges in minimally invasive surgery (MIS) scenarios. We propose a novel motion consensus-based method for endoscopic image feature matching to address these problems.
METHODS: Our method starts by correcting the radial distortion with the spherical projection model and removing the specular reflection regions with an adaptive detection method, which helps to eliminate the image distortion and to reduce the quantity of outliers. We solve the matching problem with a two-stage strategy that progressively estimates a consensus of inliers; the result is a precisely smoothed motion field. First, we construct a spatial motion field from candidate feature matches and estimate its maximum posterior with expectation maximization algorithm, which is computationally efficient and able to obtain smoothed motion field quickly. Second, we extend the smoothed motion field to the affine domain and refine it with bilateral regression to preserve locally subtle motions. The true matches can be identified by checking the difference of feature motion against the estimated field.
RESULTS: Evaluations are implemented on two simulation datasets of deformation (218 images) and four different types of endoscopic datasets (1032 images). Our method is compared with three other state-of-the-art methods and achieves the best performance on affine transformation and nonrigid deformation simulations, with inlier ratio of 86.7% and 94.3%, sensitivity of 90.0% and 96.2%, precision of 88.2% and 93.9%, and F1-Score of 89.1% and 95.0%, respectively. On clinical datasets evaluations, the proposed method achieves an average reprojection error of 3.7 pixels and a consistent performance in multi-image correspondence of sequential images. Furthermore, we also present a surface reconstruction result from rhinoscopic images to validate the reliability of our method, which shows high-quality feature matching results.
CONCLUSIONS: The proposed motion consensus-based feature matching method is proved effective and robust for endoscopic images correspondence. This demonstrates its capability to generate reliable feature matches for surface reconstruction and other meaningful applications in MIS scenarios.

To examine the prevalence of youth meeting the 24-hour healthy movement guidelines (ie, ≥60 minutes of moderate-to-vigorous physical activity, ≤2 hours of screen time, age-appropriate sleep duration), and which combination of meeting these guidelines was most associated with bodyweight status, in a nationally representative US sample.
Cross-sectional data from the 2016-2017 National Survey of Children\'s Health were used. A multinomial regression model of body weight status was generated (underweight, overweight, obese vs healthy weight) and then stratified by sex. Analyses were adjusted for potential confounders.
The sample (n = 30 478) was 50.4% female, 52.4% white, and the mean age was 13.85 ± 2.28 years; 15% percent were obese and 15.2% were overweight. Overall, 9.4% met all 3 of the 24-hour healthy movement guidelines, 43.6% met 2, 37.9% met 1, and 9.1% met none. Meeting zero guidelines (vs 3) was associated with the greatest likelihood of overweight (aOR, 1.85; 95% CI, 1.31-2.61), and obesity (aOR, 4.25; 95% CI, 2.87-6.31). Females (aOR, 4.97; 95% CI, 2.59-9.53) had higher odds of obesity than males (aOR, 3.99; 95% CI, 2.49-6.40) when zero (vs 3) guidelines were met. Meeting the moderate-to-vigorous physical activity guideline, either alone or in combination with screen time or sleep duration (vs all 3), was associated with the lowest odds for overweight and obesity in the full sample.
Meeting all movement guidelines was associated with the lowest risk for obesity, particularly in females. Meeting the moderate-to-vigorous physical activity guideline may be a priority to prevent overweight and obesity in youth.