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Nevin Manimala Statistics

Cross-disciplinary advance care planning in oncology and palliative care amidst a pandemic: a best practice implementation project

JBI Evid Implement. 2024 Jul 23. doi: 10.1097/XEB.0000000000000445. Online ahead of print.

ABSTRACT

INTRODUCTION: Advance care planning (ACP) ensures that patients receive medical care aligned with their values, goals, and preferences, especially regarding end-of-life decisions in serious chronic illnesses.

OBJECTIVE: This project aimed to introduce and promote evidence-based ACP in oncology and palliative care at a midsized hospital near Berlin, Germany, during the COVID-19 pandemic.

METHODS: This project was guided by the JBI Evidence Implementation Framework and used a mixed methods audit cycle. A baseline audit was conducted using qualitative interviews and workshops with representatives from all the health care disciplines involved in oncology and palliative care at the hospital. The findings were compared with eight best practice recommendations. Targeted strategies aimed at the key stakeholders involved in ACP practice were then implemented. Finally, a semi-quantitative questionnaire was used in a follow-up audit with the same participants as in the baseline audit.

RESULTS: The baseline audit revealed a high level of familiarity with the concept of ACP. However, there was a lack of a uniformly accepted definition and understanding of ACP among the health care professionals, leading to a lack of coordination in task distribution. The follow-up audit revealed improvements with regard to education and training in ACP (Criterion 1: 50% to 100%) and organizational support to facilitate ACP conversations (Criterion 3: 87.5% to 100%). Other audit criteria compliance rates remained unchanged.

CONCLUSION: Clinical education and team-based process analysis can facilitate ACP implementation across disciplines in oncology and palliative care facilities. However, the project did not succeed in implementing lasting changes in clinical processes and best practice ACP due to the COVID-19 pandemic. Such an endeavor would demand considerable resources and time, both of which were constrained during the pandemic.

SPANISH ABSTRACT: http://links.lww.com/IJEBH/A236.

PMID:39036875 | DOI:10.1097/XEB.0000000000000445

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Nevin Manimala Statistics

Risk Factors of Poststroke Cognitive Impairment: A Meta-Analysis

Vasc Endovascular Surg. 2024 Jun 18:15385744241259700. doi: 10.1177/15385744241259700. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the potential risk factors of post stroke cognitive impairment (PSCI) by conducting a meta-analysis.

METHODS: Literature search was performed in databases (PubMed, Embase, Web of Science, CNKI) using keywords of PSCI. Cochrane ROB tool was adopted for evaluating the quality of the included studies. Afterwards, data was independently extracted by 2 investigators. Heterogeneity was quantified across studies by Chi-squared-based Q statistic test and I2 statistic. The random-effects model or fixed-effects model was employed to compute the pooled estimates depends on whether the heterogeneity was significant (I2 > 50% or P < .05) or not. Publication bias was evaluated by the funnel plot and Egger’s test. Sensitivity analysis was accomplished through eliminating studies 1 at a time to evaluate the stability of the pooled estimates.

RESULTS: 23 high-quality studies with 13322 patients were included. Compared with patients with no cognitive impairment, PSCI was more likely to develop in the elderly (pooled MD = 3.58, 95% CI = [1.82, 5.34]), female (pooled RR = 1.23, 95% CI = [1.07, 1.41]), or less-educated (pooled MD = -1.63, 95% CI = [-2.96, -.31]) patients with a history of hypertension (pooled RR = 1.07, 95% CI = [1.03, 1.11]), diabetes mellitus (pooled RR = 1.10, 95% CI = [1.03, 1.17]), atrial fibrillation (pooled RR = 1.38, 95% CI = [1.10, 1.74]), or stroke (pooled RR = 1.36, 95% CI = [1.09, 1.70]). Smoking did not affect the development of PSCI in patients (pooled RR = .96, 95% CI = [.78, 1.19]). Ischemic heart disease and region represented the sources of significant heterogeneity across studies. The pooled estimates were robust, and no publication bias was seen.

CONCLUSION: Age, gender, education, hypertension, diabetes mellitus, atrial fibrillation, and stroke were the risk factors of PSCI. Controlling these risk factors can help prevent PSCI.

PMID:39036866 | DOI:10.1177/15385744241259700

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Nevin Manimala Statistics

Bipedalism or bipedalisms: The os coxae of StW 573

J Anat. 2024 Jul 22. doi: 10.1111/joa.14106. Online ahead of print.

ABSTRACT

There has been a long debate about the possibility of multiple contemporaneous species of Australopithecus in both eastern and southern Africa, potentially exhibiting different forms of bipedal locomotion. Here, we describe the previously unreported morphology of the os coxae in the 3.67 Ma Australopithecus prometheus StW 573 from Sterkfontein Member 2, comparing it with variation in ossa coxae in living humans and apes as well as other Plio-Pleistocene hominins. Statistical comparisons indicate that StW 573 and 431 resemble humans in their anteroposteriorly great iliac crest breadth compared with many other early australopiths, whereas Homo ergaster KNM WT 15000 surprisingly also has a relatively anterioposteriorly short iliac crest. StW 573 and StW 431 appear to resemble humans in having a long ischium compared with Sts 14 and KNM WT 15000. A Quadratic Discriminant Function Analysis of morphology compared with other Plio-Pleistocene hominins and a dataset of modern humans and hominoids shows that, while Lovejoy’s heuristic model of the Ardipithecus ramidus os coxae falls with Pongo or in an indeterminate group, StW 573 and StW 431 from Sterkfontein Member 4 are consistently classified together with modern humans. Although clearly exhibiting the classic “basin shaped” bipedal pelvis, Sts 14 (also from Sterkfontein), AL 288-1 Australopithecus afarensis, MH2 Australopithecus sediba and KNM-WT 15000 occupy a position more peripheral to modern humans, and in some analyses are assigned to an indeterminate outlying group. Our findings strongly support the existence of two species of Australopithecus at Sterkfontein and the variation we observe in os coxae morphology in early hominins is also likely to reflect multiple forms of bipedality.

PMID:39036860 | DOI:10.1111/joa.14106

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Nevin Manimala Statistics

Adverse Childhood Experiences Among Adolescents With Body Dysmorphic Disorder: Frequency and Clinical Correlates

Clin Psychol Psychother. 2024 Jul-Aug;31(4):e3028. doi: 10.1002/cpp.3028.

ABSTRACT

Increasing empirical attention has been given to the role of adverse childhood experiences (ACEs) in the development and maintenance of body dysmorphic disorder (BDD). Yet, current research has predominantly focused on adult and nonclinical BDD samples, and little is known about relevance of ACEs in adolescent BDD. The present study examined (a) the frequency of ACEs in adolescents with a primary diagnosis of BDD (n = 50) versus obsessive compulsive disorder (OCD) (n = 50) and (b) the clinical profile of ACE-exposed youth with BDD. ACEs were ascertained through a systematic search of electronic patient records, as well as through a parent- and self-report screening item for exposure to traumatic events. Results showed higher rate of peer victimisation (74% vs. 38%) and child maltreatment (44% vs. 24%) among BDD versus OCD youths; sexual abuse was the most common type of child maltreatment documented in the BDD group (28%) according to patient records. Parent-reported exposure to traumatic events was also significantly higher in the BDD than the OCD group (40% vs. 18%, respectively). Clinical presentation and treatment outcomes did not differ between those with versus without a history of ACEs. The current study is the first to demonstrate that a range of ACEs are common in adolescent BDD. Our findings highlight the importance of screening for these experiences. Although further research is needed, our findings also indicate that adolescents with BDD who have a history of ACEs are broadly similar in their clinical presentation to those without, and benefit from BDD-focused treatment.

PMID:39036850 | DOI:10.1002/cpp.3028

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Nevin Manimala Statistics

Enhancing GaN Nanowires Performance Through Partial Coverage with Oxide Shells

Small. 2024 Jul 22:e2401139. doi: 10.1002/smll.202401139. Online ahead of print.

ABSTRACT

Core-shell gallium nitride (GaN)-based nanowires offer noteworthy opportunities for innovation in high-frequency opto- and microelectronics. This work delves deeply into the physical properties of crystalline GaN nanowires with aluminum and hafnium oxide shells. Particular attention is paid to partial coverage of nanowires, resulting with exceptional properties. First, the crystal lattice relaxation is observed by X-ray diffraction, photoluminescence, and Raman spectroscopy measurements. A high potential of partial coverage for optoelectronic applications is revealed with photo- and cathodoluminescence spectra along with an exploration of their temperature dependency. Next, the study focuses on understanding the mechanisms behind the observed enhancement of the luminescence efficiency. It is confirmed that nanowires are effectively protected against photoadsorption using partial coatings. This research advances the frontiers of nanotechnology, investigating the benefits of partial coverage, and shedding light on its complex interaction with cores.

PMID:39036823 | DOI:10.1002/smll.202401139

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Nevin Manimala Statistics

Impact of delayed presentation and surgical management on radiologic and clinical outcomes of pediatric septic hip

J Orthop. 2024 Mar 13;54:76-80. doi: 10.1016/j.jor.2024.03.019. eCollection 2024 Aug.

ABSTRACT

BACKGROUND: Septic arthritis of the hip joint (septic hip) is the bacterial infection of the hip. Delayed treatment increases the risk of extensive joint damage, systemic infection, prolonged recovery, higher healthcare costs, and long-term disability. This study explores the repercussions of delayed surgical treatment in pediatric septic hip.

METHODS: In this observational study, pediatric patients diagnosed with septic hip between 2012 and 2021 were retrospectively selected from a major referral center in Shiraz, Iran. We collected clinical and radiological data, including Kocher score and determined Choi classification in follow-up radiographs. Multivariate logistic regression analysis was used to assess the impact of delay to surgery on the development of clinical sequelae and radiological deformities in the presence of potential confounders of age and Kocher criteria.

RESULTS: Out of 49 children with delayed presentation, 46 survived and entered the study. Mean delay from symptom presentation to admission was 12.67 ± 10.51 days, and mean delay from admission to surgery was 5.33 ± 6.47 days. Of the 46 patients, 28.26% developed clinical sequelae. The Choi classification revealed that 54.35% of patients developed no residual deformity. A multivariate logistic regression analysis indicated a statistically significant association between delay to surgery and the development of radiological deformities (adjusted odds ratio: 1.36, 95% CI: 1.14-1.64, p = 0.001). Additionally, a separate analysis revealed that each additional day of delay was associated with a 12% increase in the odds of clinical sequelae (adjusted odds ratio: 1.12, 95% CI: 1.03-1.22, p = 0.006). Sensitivity analyses confirmed the relationship of delay from admission to surgery in developing both outcomes.

CONCLUSION: Delay in medical care and surgical management remains the most important factor affecting the outcomes of septic hip. The study underscores the critical role of timely surgical intervention in reducing complications in pediatric septic hip patients.

PMID:39036808 | PMC:PMC11259651 | DOI:10.1016/j.jor.2024.03.019

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Nevin Manimala Statistics

Cancer incidence and mortality in China, 2015

J Natl Cancer Cent. 2020 Dec 17;1(1):2-11. doi: 10.1016/j.jncc.2020.12.001. eCollection 2021 Mar.

ABSTRACT

BACKGROUND: National Cancer Center (NCC) updated nationwide cancer statistics using population-based cancer registry data in 2015.

METHODS: 501 cancer registries submitted data, among which 368 registries with high quality data were included in analysis. Numbers of nationwide new cancer cases and deaths were estimated using incidence and mortality rates and corresponding national population stratified by area, sex, age group and cancer site. The world Segi’s population was applied for the calculation of age-standardized rates.

RESULTS: About 3,929,000 new cancer cases were diagnosed. The crude incidence rate was 285.83/100,000 and the age-standardized incidence rate by world standard population (ASIRW) was 186.39/100,000. ASIRW was higher in urban areas than in rural areas. South China had the highest ASIRW while Southwest China had the lowest ASIRW. Age-specific incidence rate was higher in males for population younger than 20 years or over 49 years. From 2000 to 2015, the ASIRWs for esophageal cancer, gastric cancer and liver cancer decreased significantly. The ASIRWs for colorectal cancer in whole population and for lung cancer, breast cancer, cervix cancer, uterus cancer and thyroid cancer in females increased significantly. 2,338,000 cancer deaths were reported. The crude mortality rate was 170.05/100,000 and the age standardized mortality rate by world standard population (ASMRW) was 105.84/100,000. ASMRW was higher in rural areas than in urban areas. Central China had the highest ASMRW while North China had the lowest ASMRW. Age-specific mortality rates in males were higher than that in females in every age group. From 2000 to 2015, the ASMRWs for esophageal cancer, gastric cancer, liver cancer and lung cancer decreased significantly. The ASMRWs for colorectal cancer, pancreas cancer and prostate cancer in males and for breast cancer, cervix cancer and thyroid cancer in females increased significantly.

CONCLUSIONS: Cancer has become a major life-threatening disease in China. Disease burdens differed across areas. Disease burdens for esophageal cancer, gastric cancer and liver cancer have decreased, while disease burdens for colorectal cancer, female breast cancer, cervix cancer and thyroid cancer have increased over the last 15 years. National and regional initiative for cancer prevention and control should be prioritized.

PMID:39036787 | PMC:PMC11256613 | DOI:10.1016/j.jncc.2020.12.001

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Nevin Manimala Statistics

Matrix Reordering for Noisy Disordered Matrices: Optimality and Computationally Efficient Algorithms

IEEE Trans Inf Theory. 2024 Jan;70(1):509-531. doi: 10.1109/tit.2023.3305538. Epub 2023 Aug 15.

ABSTRACT

Motivated by applications in single-cell biology and metagenomics, we investigate the problem of matrix reordering based on a noisy disordered monotone Toeplitz matrix model. We establish the fundamental statistical limit for this problem in a decision-theoretic framework and demonstrate that a constrained least squares estimator achieves the optimal rate. However, due to its computational complexity, we analyze a popular polynomial-time algorithm, spectral seriation, and show that it is suboptimal. To address this, we propose a novel polynomial-time adaptive sorting algorithm with guaranteed performance improvement. Simulations and analyses of two real single-cell RNA sequencing datasets demonstrate the superiority of our algorithm over existing methods.

PMID:39036782 | PMC:PMC11257605 | DOI:10.1109/tit.2023.3305538

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Nevin Manimala Statistics

The effect of women’s bargaining power within couples on contraceptive use in Cameroon

Gates Open Res. 2021 May 19;4:20. doi: 10.12688/gatesopenres.13100.2. eCollection 2020.

ABSTRACT

Background: The prevalence of contraception among married women, evaluated at 23%, is low in Cameroon. Maternal death rates, estimated at 782 deaths per 100,000 live births, are very worrying. The National Strategic Plan for Reproductive, Maternal, Newborn and Child Health (2015-2020) and the Health Sector Strategy (2016-2027) focuses on increasing modern contraceptive prevalence as a means to reduce maternal death. This paper identifies women’s bargaining power as a factor that may stimulate contraceptive use. The objective of this study is to analyze the association between women’s bargaining power within couples and modern contraceptive use. Methods: The data used come from the fifth Demographic and Health Survey (DHS) conducted in 2018. Women’s bargaining power within couple is measured by a Woman Bargaining Power Composite Index (WBPCI) built through a multiple correspondence analysis. The logistic regression model was used to analyze the relationship between WBPCI and modern contraceptive use. Results: The results of the descriptive statistics show that women’s bargaining power is higher among women who use contraception than for those who do not. The results of the logistic regression model show that an increase of WBPCI was significantly associated with higher chances of using a modern contraceptive method (OR = 1.352; 95% CI: 1.257, 1.454; p <0.01). The education of women is also a key determinant since educated women were at least two times more likely to use a modern contraceptive method than uneducated women. Conclusions: To reduce high maternal death rates in Cameroon, public health policies should not only focus on the health system itself, but should also focus on social policies to empower women in the household.

PMID:39036780 | PMC:PMC11259594 | DOI:10.12688/gatesopenres.13100.2

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Nevin Manimala Statistics

The Effects of Hospital-Based School Lessons on Children’s Emotions, Distress and Pain

Contin Educ. 2024 Jul 15;5(1):100-110. doi: 10.5334/cie.118. eCollection 2024.

ABSTRACT

Lessons conducted in hospitals ensure school continuity for hospitalized children unable to attend regular school. Hospital-based school (HS) provides a tailored experience that ensures normality for children through education. The objective of this study is to evaluate the effects of the proposed lessons in reducing negative emotions, distress, and pain in children, as well as fostering positive affects. The study was conducted with 32 hospitalized children, aged 8-12 years, in the Onco-Hematology and Pediatric Unit of Meyer Children’s Hospital IRCCS (Florence, Italy). Positive and negative emotions were measured using the Positive and Negative Affect Scale for Children; distress was measured using the Physiological Hyperarousal for Children; pain was measured using the Visual Analogue Scale for children. Variables were assessed before (T0) and after (T1) lessons, for three times; for each variable, collected data were averaged at both T0 and T1. Statistical analyses showed a significant increase in positive emotions in hospitalized children and a significant decrease in negative emotions, distress, and pain; nevertheless, only for pain the significant correlation between its scores before and after the HS lessons indicated that the detected change occurred for all participants in much the same way. These preliminary results suggest that HS lessons can promote hospitalized children’s well-being, at least as far as pain reduction is concerned.

PMID:39036770 | PMC:PMC11259103 | DOI:10.5334/cie.118