Category: Statistics

J Int Adv Otol. 2024 May;20(3):216-224. doi: 10.5152/iao.2024.231270.

ABSTRACT

BACKGROUND: Chronic unilateral hearing loss causes imbalanced auditory input to the brain that triggers cortical reorganization. The effect of sensorineural hearing loss on the central auditory system (CAS) has been thoroughly studied, while there is a paucity of research on the effect of conductive hearing loss (CHL). The aim of this study was to assess the P1-N1-P2 cortical auditory evoked response potential (CAEP) in adult individuals with chronic acquired unilateral CHL.

METHODS: This study included 108 participants of both genders: 54 patients with unilateral chronic CHL who were compared to well-matched 54 controls. All were subjected to history-taking, otologic examination, basic audiological evaluation, and bone conduction N1-P2 CAEP.

RESULTS: The affected ears of the cases showed highly statistically significant shorter CAEPs N1, P2, N1-P2 latencies but not P1, and showed highly statistically significant larger N1, P2, N1P2, amplitude than the control group. Latencies decreased and amplitudes increased as the degree of CHL increased, but were not affected by patients’ age, side, or duration of the CHL. Cases with tinnitus had statistically significant and worse results than those without tinnitus.

CONCLUSION: Unilateral chronic CHL might enhance neurocortical plasticity, with greater changes occurring at greater degrees of the CHL.

PMID:39128038 | DOI:10.5152/iao.2024.231270

Thorac Res Pract. 2024 May;25(3):121-129. doi: 10.5152/ThoracResPract.2024.23056..

ABSTRACT

OBJECTIVE: The study aimed to investigate the utility of telemedicine conducted via video counseling in comparison to the previous structured approach and to compare prepandemic smoking cessation success rates with traditional counseling.

MATERIAL AND METHODS: The applicants of the outpatient clinic for smoking cessation support pre- and post-pandemic periods were included in the study. The time intervals were retrospectively between 1 March and 30 August 2021 and the last 3 months of the year 2019. The data were revealed retrospectively. Age, sex, occupation, smoking history as package year, and the score of the Fagerström test for nicotine dependence, accompanying chronic diseases, treatment method, and quitting status between 6 and 9 months of follow-up.

RESULTS: The number of applicants was 200 (87% male) and 89 (95% male) in groups 1 and 2, respectively. The age difference was not significant. The difference was statistically significant according to having at least 1 accompanying chronic disease, specifically a lung disease. None of the parameters have affected the success of quitting smoking. The smoking cessation rate was 3.9 fold higher in the telemedicine group than in the traditional group.

CONCLUSION: The main principle appears to be allocating enough time, as required on an individual basis, to clearly assess the situation, including identifying barriers and options. Since immediate systematic physical examination and laboratory testing may not be mandatory for individuals seeking smoking cessation support, telemedicine emerges as a reasonable option and a promising field for comprehensive video counseling.

PMID:39128028 | DOI:10.5152/ThoracResPract.2024.23056.

Bioinformatics. 2024 Aug 10:btae505. doi: 10.1093/bioinformatics/btae505. Online ahead of print.

ABSTRACT

MOTIVATION: Mendelian randomization (MR) is a widely used approach to estimate causal effect of variation in gene expression on complex traits. Among several MR-based algorithms, transcriptome-wide summary statistics-based Mendelian Randomization approach (TWMR) enables the uses of multiple SNPs as instruments and multiple gene expression traits as exposures to facilitate causal inference in observational studies.

RESULTS: Here we present a Python-based implementation of TWMR and revTWMR. Our implementation offers GPU computational support for faster computations and robust computation mode resilient to highly correlated gene expressions and genetic variants.

AVAILABILITY: PyTWMR is available at github.com/soreshkov/pyTWMR.

CONTACT: [email protected]; [email protected].

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

PMID:39128017 | DOI:10.1093/bioinformatics/btae505

Crit Rev Anal Chem. 2024 Aug 11:1-23. doi: 10.1080/10408347.2024.2388817. Online ahead of print.

ABSTRACT

The continuing development of heavy industry worldwide has led to an exponential increase in the amount of wastewater discharged from factories and entering the natural world in the form of rivers and air. As the top of the food chain in the natural world, toxic ions penetrate the human body through the skin, nose, and a few milligrams of toxic ions can often cause irreversible damage to the human body, so ion detection and adsorption is related to the health and safety of human beings. Hydrogel is a hydrophilic three-dimensional reticulated polymer material that first synthesized by Wichterle and Lim in 1960, which is rich in porous structure and has a variety of active adsorption sites as a new type of adsorbent and can be used to detect ions through the introduction of photonic crystals, DNA, fluorescent probe, and other materials. This review describes several synthetic and natural hydrogels for the adsorption and detection of ions and discusses the mechanism of ion adsorption by hydrogels, and provide a perspective for the future development.

PMID:39128001 | DOI:10.1080/10408347.2024.2388817

Inflammopharmacology. 2024 Aug 11. doi: 10.1007/s10787-024-01542-8. Online ahead of print.

ABSTRACT

BACKGROUND: The potential effects of insulin therapy on osteoarthritis (OA) risk are poorly understood. This study aimed to explore the causal relationship between insulin therapy and OA.

METHODS: Mendelian randomization (MR) analysis was performed to examine the association between genetically proxied inhibition of insulin targets and the risk of overall, hip (HOA) and knee OA (KOA). We then performed univariable MR using summary statistics regarding insulin target genes derived from the DrugBank database. Data related to blood glucose reduction levels were used as a proxy for insulin levels. Two phenotypes, type 2 diabetes, and glycosylated hemoglobin levels, were selected as positive controls to confirm the direction and validity of the proxies. The OA datasets were derived from the UK Biobank cohort. Multivariable MR was adjusted for body mass index, sedentary behavior, cigarette smoking, frequency of alcohol intake, age, and genetic sex.

RESULTS: Genetically proxied insulin therapy was associated with an increased risk of overall OA [odds ratio (OR):1.2595; 95% confidence interval (CI):1.0810-1.4675] and HOA (OR:1.4218; 95%CI:1.1240-1.7985), which remained consistent across multiple MR methods. After adjusting for confounders, we found evidence supporting a significant causal link with a higher risk of overall OA and HOA. A further two-step MR analysis revealed no significant mediation effects from the six mediators in the associations.

CONCLUSION: There was a causal association between genetically proxied insulin therapy and a higher risk of OA, especially HOA.

PMID:39127978 | DOI:10.1007/s10787-024-01542-8

J Am Pharm Assoc (2003). 2024 Aug 9:102175. doi: 10.1016/j.japh.2024.102175. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic syndrome is a cluster of disease states that increases an individual’s risk of developing diabetes or cardiovascular disease. When treating metabolic syndrome, lifestyle and diet are primary areas for interventions. A dietician-led grocery nutrition system scoring patients’ purchases may correlate to better control of metabolic health.

OBJECTIVE: To compare the number of medications taken for metabolic syndrome for patients with grocery nutrition scores at goal versus those below goal as pre-defined by the dietician team.

PRACTICE DESCRIPTION: This exploratory, retrospective cohort pilot study took place in a single pharmacy within a large community pharmacy chain in Northwest Ohio.

PRACTICE INNOVATION: This retrospective cohort study compared the number of medications taken for metabolic syndrome between two groups: patients with a grocery nutrition score at a dietician-set goal and patients not at goal.

EVALUATION METHODS: Data were collected from May 2022 to March 2023, with patients completing a questionnaire collecting information on demographics. In addition, the questionnaire, grocery nutrition scores, and patient medication records were collected. Descriptive statistics were calculated for demographic items. A number of medications taken for metabolic syndrome by patients at dietician-set grocery nutrition score goal and not at goal were compared using a Mann-Whitney U test.

RESULTS: A total of 40 patients were enrolled in this study. There was not a significant difference in a number of medications taken for metabolic syndrome between groups, with patients who had a grocery nutrition score at goal taking an average of 1.20 medications compared to 1.96 for those with grocery nutrition scores below goal.

CONCLUSIONS: While no statistical difference in mean medication use was identified, grocery nutrition scores may help understand patients’ dietary habits. Larger studies are required to test the relationship between grocery nutrition scores, patient-specific factors, and medications taken for metabolic syndrome.

PMID:39127949 | DOI:10.1016/j.japh.2024.102175

J Am Pharm Assoc (2003). 2024 Aug 10:102174. doi: 10.1016/j.japh.2024.102174. Online ahead of print.

ABSTRACT

BACKGROUND: Pre-exposure prophylaxis (PrEP) is highly effective at reducing the risk of human immunodeficiency virus (HIV) acquisition in at-risk individuals; however, it is largely underutilized. The Veterans Health Administration has created an HIV PrEP dashboard to identify at-risk veterans in attempt to increase PrEP enrollment.

OBJECTIVE: This study aimed to determine whether the use of an HIV PrEP dashboard would prove effective at increasing PrEP enrollment at a single facility.

METHODS: This was a single-center quality improvement project. Three pharmacists used the HIV PrEP dashboard and retrospective chart review to identify eligible patients for PrEP. A multimodal process of contacting patients was conducted. The primary objective was to evaluate the number of patients who enrolled in PrEP during the study period. Secondary objectives included evaluating the ability of the HIV PrEP dashboard to identify eligible patients, identify effective strategies to target PrEP enrollment, and compare those patients who accepted with those who declined PrEP to evaluate barriers to enrollment.

RESULTS: Of the 94 patients reviewed, 26 patients (27.7%) were found eligible for PrEP. Of the eligible patients, 3 patients (11.5%) were enrolled, and 7 patients (26.9%) declined PrEP. The others were lost to follow-up (9 of 26, 34.6%), had no action taken on a chart note to provider (6 of 26, 23.1%), or did not have a primary care provider assigned at the local facility (1 of 26, 3.9%). The 3 patients who were successfully enrolled in PrEP were all contacted and prescribed PrEP through the infectious diseases (ID) clinic. There were no statistically significant differences between the cohorts of patients who accepted and declined PrEP.

CONCLUSIONS: The use of an HIV PrEP dashboard aided in identifying eligible patients for PrEP. Enrollment through the ID clinic was the most successful modality. Further research is needed to characterize barriers to PrEP uptake and to develop strategies to increase prescribing from non-ID providers.

PMID:39127948 | DOI:10.1016/j.japh.2024.102174

J Am Pharm Assoc (2003). 2024 Aug 10:102178. doi: 10.1016/j.japh.2024.102178. Online ahead of print.

ABSTRACT

BACKGROUND: The Pharmacist Electronic Care (eCare) plan is an electronic documentation and billing platform that allows for exchanging and integrating pharmacy patient care information. eCare plans make it easier for pharmacists to track recommendations and referrals to both patients and providers and to bill for services.

OBJECTIVES: To determine the impact on the type and number of vaccines administered after the completion of immunization eCare plans and to examine sociodemographic differences in patients who received immunizations were documented in an eCare plan in a community-based pharmacy setting.

PRACTICE DESCRIPTION: Bremo Pharmacy is an independently owned pharmacy located in Richmond, Virginia. Bremo Pharmacy offers a medication synchronization program targeting patients for enrollment in compliance packaging and clinical services.

PRACTICE INNOVATION: Bremo Pharmacists use eCare plans to track patient and provider interactions, goals, and medication-related information. Pharmacists used eCare plans to document vaccine recommendations and interactions with patients as a tool to increase vaccinations.

EVALUATION METHODS: Reports were generated to extract data containing information from each eCare plan during the intervention period and the number and type of vaccines administered 1 and 2 years before the intervention. Percent change was used to calculate the change in vaccines administered between years. The sociodemographic data was analyzed using descriptive statistics and bivariate statistical analysis using SAS 9.0 (Cary, NC).

RESULTS: There were a total of 1105 immunization eCare plans completed. An increase of 136.6% in vaccines administered occurred after the implementation of the eCare plans. While the number of vaccines administered increased, no significant differences were found in vaccine uptake by gender or age.

CONCLUSION: Immunization eCare plans are a useful tool to help pharmacists increase the number of vaccines administered in an independent pharmacy.

PMID:39127945 | DOI:10.1016/j.japh.2024.102178

J Am Pharm Assoc (2003). 2024 Aug 10:102180. doi: 10.1016/j.japh.2024.102180. Online ahead of print.

ABSTRACT

BACKGROUND: Depression is a major source of morbidity but often goes undiagnosed. Broader screening is recommended, and pharmacists could contribute.

OBJECTIVES: This study aimed to assess the feasibility of community pharmacy depression and anxiety screening and describe the medication-related problems (MRPs) identified, pharmacist interventions, and provider responses for high-risk patients.

METHODS: This pilot was conducted between October 2022 and January 2023 at an independently owned community pharmacy in the Midwest United States. Patients aged 18-45 years with ready prescriptions were identified through weekly reports, and tags were placed on prescription bags. A convenience sample of patients fluent in English were offered the Patient Health Questionnaire (PHQ2) and Generalized Anxiety Disorder (GAD2), with follow-up PHQ9 and GAD7 for at-risk individuals. High-risk individuals met with the pharmacist for consultation and recommendations were discussed. Descriptive statistics were calculated for participant demographics, questionnaire responses, MRPs, and provider responses. Patient profiles were examined 2 months after the workup to identify medication changes.

RESULTS: A total of 29 patients volunteered to be screened for anxiety and depression; of these, 41% scored in the high-risk category for depression or anxiety and met with the pharmacist for the consultation. The pharmacist identified multiple MRPs. The most common was the need for additional therapy and inadequate dosages. Patients were reluctant for the pharmacist to follow up with their prescriber and were unreachable for telephone follow-up. Profiles reviewed 2 months after assessment showed half of the at-risk patients had one or more mental health medication changes.

CONCLUSION: Community pharmacists may have a role in the screening and management of patient mental health, although there were challenges with screening uptake and follow-up. The pharmacist identified multiple MRPs for this high-risk group for which greater routine monitoring and follow-up may be beneficial. More work seems needed to engage both patients and prescribers.

PMID:39127944 | DOI:10.1016/j.japh.2024.102180

J Am Pharm Assoc (2003). 2024 Aug 10:102177. doi: 10.1016/j.japh.2024.102177. Online ahead of print.

ABSTRACT

BACKGROUND: Despite expanded indications and demonstrated cardiovascular and renal benefits, prescribing rates of sodium-glucose cotransporter-2 (SGLT-2) inhibitors are low.

OBJECTIVES: The study aimed to identify factors impacting prescriber decision-making when prescribing SGLT-2 inhibitors in the outpatient setting and identify differences across specialties in self-identified prescribing patterns.

METHODS: An anonymous survey was administered electronically to prescribers in relevant specialties at a large community health system. Descriptive statistics were used to compile results, and subgroup comparisons were conducted utilizing Fisher’s exact test.

RESULTS: Fifty-one prescribers completed the survey, representing a 25.2% response rate. The highest reported prescribing rates were for type 2 diabetes (92%), and the lowest for HFpEF (20%) and ASCVD risk reduction (16%). Prescribers without clinic-embedded pharmacist were more likely to report cost and insurance had at least a moderate effect on prescribing compared to prescribers with clinic-embedded pharmacists (95.3% vs. 62.5%, P = 0.0228) and less likely to report hemoglobin A1c less than 6.5% to have at least a moderate effect on prescribing (20.9% vs. 62.5%, P = 0.0317). Compared to specialty providers, primary care prescribers were more likely to report hemoglobin A1c over 9% had at least a moderate effect on prescribing (92.0% vs. 42.9%, P = 0.0082) and less likely to note history of urinary tract infection (22.2% vs. 85.7%, P = 0.0028), history of mycotic infection (38.9% vs. 100%, P = 0.0036), and sex (male: 5.6% vs. 42.9%, P = 0.0242; female: 8.0% vs. 42.9%, P = 0.0447) had at least a moderate effect on prescribing.

CONCLUSION: Prescribing hesitancies vary across specialty and when clinic-embedded pharmacists are present. Pharmacists may help improve SGLT-2 inhibitor prescribing rates and use of guideline-directed therapies. Pharmacists can target identified hesitancies through medication-access consultations, education regarding adverse effects, and expanded benefits of the class. Future studies should examine the impact of pharmacist intervention on SGLT-2 inhibitor prescribing rates.

PMID:39127942 | DOI:10.1016/j.japh.2024.102177