COVID-19 vaccination attitudes across the European continent

This study was conducted to determine the predictors of COVID-19 vaccination attitudes across multiple waves in seven countries geographically spread across the European continent, using data from a COVID-19 survey provided by the Massachusetts Institute of Technology COVID-19. Facebook users from across the globe participated in this survey which collected information on their knowledge of COVID-19, attitudes towards risk and available information, and their willingness or lack thereof to take the vaccine. In this secondary data analysis study, neural networks were used with special attention given to the importance of the predictors of COVID-19 vaccination attitudes. Perception of social norms regarding COVID-19 vaccination was found to be the most important predictor of vaccine acceptance. Country of residence and wave of data collection were among the important predictors, with different patterns for each country emerging across different waves. Other strong predictors included attitudes towards masks and mask wearing; attitudes towards the influenza vaccine; distrust in government health authorities and scientists; and level of knowledge of existing treatments for COVID-19. The results of this study can inform effective public health prevention and intervention efforts against infectious diseases.peer-reviewe

Can ensemble learning approaches for offside detection work?

The analysis of data collected from various recreational activities and professional sports is essential to obtain more information on the activity in question or to make better data-driven decisions. Most literature related to offside detection related to the efficacy of manual offside detection or the use of an offside detection algorithm. In this study, the focus shall be on the detection of offside judgements in football/soccer using ensemble learning approaches such as random forest type algorithms, boosting type algorithms and majority voting. For random forests, we also consider three corresponding extensions: regularized random forests, guided regularized random forests, and guided random forests. Moreover, five boosting approaches are considered, namely: Discrete AdaBoost, Real AdaBoost, Gentle AdaBoost, Gradient Boosting and Extreme Gradient Boosting. Gentle AdaBoost is the best performing model on most metrics, except for sensitivity, where Extreme Gradient Boosting performs best. Furthermore, soft majority voting among the models considered is capable of improving the Cohen’s Kappa and the F1 score but does not provide improvements on other metrics.peer-reviewe

Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease

OBJECTIVE: Cardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease.  METHODS: The Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention. Associations between patient characteristics, country characteristics (income inequality expressed as Gini coefficient, health expenditure, schooling, gross domestic product, birth rate and hospital beds) and cardiac endpoints were checked in a three-level model (patient-centre-country).  RESULTS: A total of 30 countries enrolled 2924 patients from 89 centres. At least one endpoint occurred in 645 women (22.1%). Maternal age, New York Heart Association classification and modified WHO risk classification were associated with the combined endpoint and explained 37% of variance in outcome. Gini coefficient and country-specific birth rate explained an additional 4%. There were large differences between the individual countries, but the need for multilevel modelling to account for these differences disappeared after adjustment for patient characteristics, Gini and country-specific birth rate.  CONCLUSION: While there are definite interregional differences in pregnancy outcome in women with cardiac disease, these differences seem to be mainly driven by individual patient characteristics. Adjustment for country characteristics refined the results to a limited extent, but maternal condition seems to be the main determinant of outcome

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Motivators and barriers for shared bicycle use in ‘starter’ cycling cities : evidence from BSS user surveys in three Southern European island cities

Bicycle sharing systems (BSS) have the potential to contribute to the creation of a cycling culture, by normalizing cycling and providing access to bicycles. This research looks at the use of BSS in ‘starter’ cycling cities, where modal share of cycling thus far is low and there is only limited cycling infrastructure. Surveys with users of the BSS in Limassol, Las Palmas de Gran Canaria and Malta shed light on “who” uses the BSS and “why”. Through descriptive statistics and correlation analysis, the influence of individual, social environment and physical environment factors on shared bicycle use is analysed, looking at differences between frequent and infrequent BSS users, to get a better understanding of the motivators and barriers that influence BSS use. Frequent BSS use is positively associated with frequent use of other ‘alternative’ transport modes, such as public transport use, as well as with shorter distances from respondents’ residence and most frequent destinations to the nearest BSS station. Higher perceived safety of cycling was also associated with more frequent BSS use, as did a positive social norm, including support from friends and family, respect from other road users, and feeling that cycling is an accepted form of transport, confirming the importance of such factors in building a cycling culture.peer-reviewe

Special issue – Communications in statistics – Case studies and data analysis – 6th stochastic modeling techniques and data analysis international conference

Summarization: This Special Issue on Statistical Methods and Data Analysis contains eleven invited articles presented at the 6th Stochastic Modeling Techniques and Data Analysis International Conference (SMTDA2020). The invited articles, theoretical, experimental and observational, present new results that have applications in real-life problems. An important objective was to select articles that present new methods for analyzing real-life data and lead to the advancement of the related fields.Presented on