Category: Statistics

Nanoscale. 2024 Jun 24. doi: 10.1039/d4nr00589a. Online ahead of print.

ABSTRACT

We conduct all-atom molecular dynamics simulations to systematically investigate the underlying mechanisms governing ion transport through a sub-nanometer pore decorated with negative charges in a “Janus” MoSSe membrane. The charge imbalance between S and Se atoms on each side of the membrane induces different types of ion adsorption processes depending on the pore inner charge configuration, and the polarity of external biases, which leads to asymmetry in ionic I–V characteristics. Statistical analysis of the total translocation times including adsorption-desorption processes, and ion dwell times indicates that potassium ions predominantly remain adsorbed during their interaction with the membrane before undertaking a quick translocation through the pore. High applied biases suppress cation adsorption, which results in fast translocation with the current flow boosted by negative inner charges around the pore. We also show that in a membrane consisting of several “Janus” layers, the applied bias necessary to overcome the sub-nm pore barrier increases with the number of layers, providing control over the ionic current.

PMID:38912547 | DOI:10.1039/d4nr00589a

Resusc Plus. 2024 Jun 5;19:100683. doi: 10.1016/j.resplu.2024.100683. eCollection 2024 Sep.

ABSTRACT

INTRODUCTION: Emergency Medical Service (EMS) providers are essential for out-of-hospital cardiac arrest (OHCA) survival, however implementing high-performance CPR guidelines in developing EMS settings presents challenges. This study assessed the impact of Continuous Quality Improvement (CQI) initiatives on OHCA outcomes in a hospital-based EMS agency in Bangkok, Thailand.

METHODS: A before-and-after study design was utilized, utilizing data from a prospective OHCA registry spanning 2019 to 2023. CQI interventions included low-dose high-frequency training in advanced airway management, high-performance CPR, and post-debriefing with video recording (VDO). Data collection encompassed patient characteristics, EMS management, and survival outcomes. Quality CPR metrics were assessed using the mobile defibrillator and CPR code review software. Statistical analyses compared outcomes between the pre-intervention period in 2019 and the post-full CQI implementation period in 2023.

RESULTS: Among enrolled OHCA patients, with 88 cases occurring in 2019 and 91 cases in 2023. The bystander CPR rate was similar between both groups (47.73% in 2023 vs 53.85%, p = 0.413). In 2023, there was a significantly higher rate of prehospital intubation (93.40% vs 70.45%, p < 0.001) compared to 2019. Prehospital return of spontaneous circulation (ROSC) improved from 30.68% to 49.45% (p = 0.012), with an adjusted odds ratio (aOR) of 2.16 (95% CI: 1.14-4.07). Survival to discharge increased significantly from 2.27% in 2019 to 7.69% in 2023 (p = 0.27), with an aOR of 3.81 (95% CI: 0.46-31.79).

CONCLUSION: Tailored CQI initiatives in a developing EMS setting were significantly associated with improved prehospital ROSC but showed an insignificant increase in survival to discharge.

PMID:38912534 | PMC:PMC11192784 | DOI:10.1016/j.resplu.2024.100683

Resusc Plus. 2024 Jun 5;19:100684. doi: 10.1016/j.resplu.2024.100684. eCollection 2024 Sep.

ABSTRACT

AIMS: Previous research has reported racial disparities in out-of-hospital cardiac arrest (OHCA) interventions, including bystander CPR and AED use. However, studies on other prehospital interventions are limited. The primary objective of this study was to investigate race/ethnic disparities in out-of-hospital cardiac arrest (OHCA) interventions: EMS response times, medication administration, and decisions for intra-arrest transport. The secondary objective was to evaluate differences in the provision of Bystander CPR (CPR) and application of AED.

METHODS: We retrospectively analyzed data from the Salt Lake City Fire Department (2010-2023). We included adults 18 years or older with EMS-treated OHCA. Race/ethnicity was categorized as White people, Asian people, Black people, Hispanic people, and others. We employed multivariable regression analysis to evaluate the association between race/ethnicity and the outcomes of interest.

RESULTS: Unadjusted analyses revealed no significant differences across ethnic groups in EMS response, medication administration, bystander CPR, or intra-arrest transport decisions. However, significant ethnic disparities were observed in Automated External Defibrillator (AED) utilization, Black people having the lowest rate (6.5%) and Asian people the highest (21.8%). The adjusted analysis found no significant association between race/ethnicity and all OHCA intervention measures, nor between race/ethnicity and survival outcomes.

CONCLUSIONS: Our multivariable analysis found no statistically significant association between race/ethnicity and EMS response time, epinephrine administration, antiarrhythmic medication use, bystander CPR, AED intervention, or intra-arrest transport. These results imply regional variations in ethnic disparities in OHCA may not be consistent across all areas, warranting further research into disparities in other regions and additional influential factors like neighborhood conditions and socioeconomic status.

PMID:38912531 | PMC:PMC11190541 | DOI:10.1016/j.resplu.2024.100684

Ther Clin Risk Manag. 2024 Jun 17;20:373-379. doi: 10.2147/TCRM.S455332. eCollection 2024.

ABSTRACT

INTRODUCTION: The management of patients with COVID-19 infection has placed great pressure on the healthcare systems around the world. The aim of this study was to investigate the impact of the COVID-19 pandemic on the treatment outcomes of patients with rectal cancer by comparing them to those of patients with the same diagnosis in the pre-pandemic period.

METHODS: Retrospective data analysis of patients undergoing multimodal treatment for rectal cancer at the four university hospitals during the COVID-19 pandemic (2020-2021) and the 2-year pre-pandemic period (2018-2019).

RESULTS: A total of 693 patients (319 in the pre-pandemic period and 374 in the pandemic period) with rectal cancer were included in the study. The demographic and clinical characteristics of patients in both study periods were comparable, as was the spectrum of surgical procedures. Palliative surgery was more common in the pandemic period (18% vs 13%, p=0.084). The proportion of patients undergoing minimally invasive surgery was higher during the COVID-19 pandemic (p=0.025). There were no statistically significant differences between the study periods in the incidence/severity of post-operative complications, 30-day mortality and length of hospital stay. The number of positive resection margins was similar (5% vs 5%). Based on these results, COVID-19 had no effect on the postoperative morbidity and mortality in patients undergoing surgery for rectal cancer. Neoadjuvant treatment was more common in the pre-pandemic period (50% vs 45%). Long-course RT was predominantly offered in the pre-pandemic period, short-course RT during the pandemic. Significantly shorter “diagnosis-surgery” intervals were observed during the pandemic (23 days vs 33 days, p=0.0002). The “surgery-adjuvant therapy” interval was similar in both analysed study periods (p=0.219).

CONCLUSION: Our study showed, that despite concerns about the COVID-19 pandemic, multimodal treatment of rectal cancer was associated with unchanged postoperative morbidity rates, increased frequency of short-course neoadjuvant RT administration and shorter “diagnosis-surgery” intervals.

PMID:38912517 | PMC:PMC11192038 | DOI:10.2147/TCRM.S455332

Heliyon. 2024 May 27;10(11):e31618. doi: 10.1016/j.heliyon.2024.e31618. eCollection 2024 Jun 15.

ABSTRACT

The security of images is one of the predominant pivotal aspects in the mammoth and still expanding digital domain. Due to chaotic system properties i.e. randomness and unpredictability is very appropriate to encrypt the images. In this research article, we construct an encryption model via 6D hyperchaotic map and a symmetric matrix for both color and grayscale images. We utilize the 6D hyperchaotic map in the confusion stage to change the pixel location and the symmetric matrix is used for changing the pixel value in the diffusion step for each RGB channel extraction from plain or original image. The image encryption model is checked over differential attacks (NPCR and UACI). Histogram analysis, correlation coefficients, and entropy analysis are also performed as statistical attacks. In conclusion, the image pixels are uniformly distributed, and the average entropy value are 7.9992 and 7.9973 for color and grayscale images, subsequently. The average NPCR and UACI for color images are 99.5956 and 33.4061, correspondingly, while the values for grayscale images are 99.5934 and 33.3054, respectively. These values are in the vicinity of optimal ranges. The suggested scheme’s great efficiency and the proposed algorithm’s resilience to a wide range of cryptanalytic attacks are implied by experimental results, statistical analysis, and differential attacks.

PMID:38912513 | PMC:PMC11190540 | DOI:10.1016/j.heliyon.2024.e31618

Heliyon. 2024 Jun 7;10(11):e32663. doi: 10.1016/j.heliyon.2024.e32663. eCollection 2024 Jun 15.

ABSTRACT

BACKGROUND: Indiscriminate use of antibiotics leads to antibiotic resistance (AMR) and results in mortality, morbidity, and financial burden. Antibiotic stewardship programs (ASPs) with education can resolve a number of barriers recognized in the implementation of successful ASPs. The aim of this study was to assess health professionals’ perceptions and status of ASPs in hospitals in 2022.

METHODS: A cross-sectional study was conducted from September 1, 2022 to October 30, 2022. A total of 181 health professionals were included, and a self-administered questionnaire was used to collect data. The status of hospitals was assessed using a checklist. The data were analyzed using SPSS version 23, and descriptive statistics and Chi-square tests (X²) at a P-value of <0.05 were used.

RESULTS: Of the 181 respondents, 163 (90.1 %), and 161 (89.0 %) believed that AMR is a significant problem in Ethiopia and globally, respectively. Easy access to antibiotics 155 (85.6 %), and inappropriate use 137 (75.7 %) were perceived as key contributors to AMR. Antibiotics were believed to be prescribed/dispensed without laboratory results 86 (47.5 %), and antibiotic susceptibility patterns were not considered to guide empiric therapy 81 (44.8 %). ASP was believed to reduce the duration of hospital stays and associated costs 137 (75.7 %), and improve the quality of patient care 133 (73.5 %), whereas 151 (83.4 %), 143 (79 %), and 142 (78.5 %) suggested education, institutional guidelines, and prospective audits with feedback interventions to combat AMR in their hospitals, respectively. There were significant differences in perception among professionals based on professional category and attempts by hospitals to implement ASPs. Although ASPs were not functioning according to standard, there have been attempts to implement it in three hospitals. The issue of ASP had never been heard in general hospitals. Currently, it is feasible to implement ASPs in four hospitals.

CONCLUSION: The status of ASP in hospitals was very poor. Despite a lack of prior knowledge on ASPs, most respondents do have a positive perception of AMR and the implementation of ASPs. Pharmacist-led prospective audits and feedback with education and institutional guidelines for empiric antibiotic use can be better implemented in hospitals. Involvement of representatives from infection prevention and control, and collaboration among hospitals in ASP implementation will help establish a strong ASP in the area.

PMID:38912506 | PMC:PMC11193037 | DOI:10.1016/j.heliyon.2024.e32663

Heliyon. 2024 Jun 1;10(11):e32282. doi: 10.1016/j.heliyon.2024.e32282. eCollection 2024 Jun 15.

ABSTRACT

This present study investigated how heat treatment affects the mechanical properties of 3D-printed black carbon fiber HTPLA by manipulating two parameters: heating temperature and holding time. The mechanical properties of 3D-printed black carbon fiber HTPLA components are crucial for assessing their structural integrity and performance. The shrinkage and dimensional accuracy of the 3D-printed parts were also explored using a vernier caliper. The microstructure of both heat-treated and non-heat-treated HTPLA black carbon fiber 3D-printed parts was examined using scanning electron microscopy. Samples were prepared, printed, heat-treated, and mechanically tested, and their microstructure was observed and recorded. The results showed that heat treatment improved the material’s strength, hardness, and crystallinity, leading to better mechanical properties. However, statistical analysis indicates no clear evidence that the two factors, optimum heating temperature and holding time, affect the mechanical properties of heat-treated printed parts. Nonetheless, further study suggests that these factors might be important in optimizing the heat treatment process.

PMID:38912502 | PMC:PMC11190666 | DOI:10.1016/j.heliyon.2024.e32282

Heliyon. 2024 Jun 2;10(11):e32145. doi: 10.1016/j.heliyon.2024.e32145. eCollection 2024 Jun 15.

ABSTRACT

Fuzzy hybrid models are efficient mathematical tools for managing unclear and vague data in real-world scenarios. This research explores the q-rung orthopair fuzzy soft set (q-ROFSS), which presents incomplete and ambiguous details in decision-making problems. The main intention of this study is to describe and evaluate the characteristics of the correlation coefficient (CC) and weighted correlation coefficient (WCC) for q-ROFSS. Also, the technique for order preference should be enhanced by similarity to the ideal solution (TOPSIS) with extended measures in q-ROFSS settings. Furthermore, we integrated mathematical formulations of correlation obstructions to confirm the consistency of the planned technique. It helps handle difficulties involving multi-attribute group decision-making (MAGDM). Moreover, a numerical illustration is presented to clarify how the advocated decision-making methodology can be implemented in evaluating suppliers in green supply chain management (GSCM). As a result, each alternative is assessed using multiple criteria, such as quality and reliability, capacity and scalability, compliance and certifications, and sustainability practices. The technique proposed in this study retains the selected research’s specific structure more effectively than current techniques. A comparative analysis further substantiates the feasibility and effectiveness of the proposed approach over other decision-making techniques.

PMID:38912497 | PMC:PMC11190557 | DOI:10.1016/j.heliyon.2024.e32145

Heliyon. 2024 Jun 1;10(11):e32038. doi: 10.1016/j.heliyon.2024.e32038. eCollection 2024 Jun 15.

ABSTRACT

The cure models based on standard distributions like exponential, Weibull, lognormal, Gompertz, gamma, are often used to analyze survival data from cancer clinical trials with long-term survivors. Sometimes, the data is simple, and the standard cure models fit them very well, however, most often the data are complex and the standard cure models don’t fit them reasonably well. In this article, we offer a novel generalized Gompertz promotion time cure model and illustrate its fitness to gastric cancer data by three different methods. The generalized Gompertz distribution is as simple as the generalized Weibull distribution and is not computationally as intensive as the generalized F distribution. One detailed real data application is provided for illustration and comparison purposes.

PMID:38912437 | PMC:PMC11190554 | DOI:10.1016/j.heliyon.2024.e32038

Data Brief. 2024 May 22;54:110548. doi: 10.1016/j.dib.2024.110548. eCollection 2024 Jun.

ABSTRACT

This study evaluated the level of knowledge of effects, knowledge of safe use, information complexity of natural health products and consumers’ perceived safety and efficacy toward natural health products used to control or cure Covid-19 viruses in Malaysia. The validated questionnaires were used to survey randomly selected stakeholders in Malaysia, who were asked to participate voluntarily in an online survey from 1st September 2020 to 31st December 2020. 723 respondents of adults above 18 years old returned completed questionnaires. The survey used for data collection consisted of 5 questions on knowledge of effects, 4 questions on knowledge for safe-use, 9 questions on perception towards safety and efficacy and 4 questions on the information complexity of natural health products. Besides that, 8 questions are being asked on the demography of respondents at the very end of the survey. The Statistical Package for the Social Sciences (SPSS) version 26 was used to analyse the data. The mean score, correlation and regression values were the focus of this study. The findings provide various opportunities to investigate Malaysian consumers’ perceptions which facilitates the development of regulation and strategic plans related to health, and encourage additional research by other researchers interested in the measures and data given.

PMID:38912420 | PMC:PMC11190492 | DOI:10.1016/j.dib.2024.110548