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Nevin Manimala Statistics

Factors Influencing Therapeutic Non-Adherence Behavior Among Patients with Type 2 Diabetes in Two Public Hospitals in the Gambia: A Cross-Sectional Study

Diabetes Metab Syndr Obes. 2024 Jul 9;17:2683-2692. doi: 10.2147/DMSO.S464761. eCollection 2024.

ABSTRACT

BACKGROUND: Type 2 Diabetes Mellitus (DM) is a significant public health problem in The Gambia. While therapeutic non-adherence is widely recognized as a common and costly problem, very little is known about therapeutic adherence behavior among patients with diabetes in The Gambia.

PURPOSE: The objective of this study was to determine the prevalence and factors that influence diabetic therapeutic non-adherence behavior among patients with type 2 diabetes in The Gambia.

METHODS: A cross-sectional study design was used, and participants were recruited from Edward Francis Small Teaching Hospital (EFSTH) and Kanifing General Hospital (KGH). The sample size of 145 patients with type 2 diabetes was included and data was collected using a structured questionnaire. Adherence to anti-diabetic medications was measured using the Morisky Medications Adherence Scale (MMAS-8). Logistic regression was used to determine the factors associated with diabetic therapeutic non-adherence.

RESULTS: The prevalence of non-adherence to anti-diabetic treatment was 27.6%. Perceived barrier (forgetfulness, long-term medication use, and medication side effects) to diabetic treatment (OR = 0.265, 95% CI: 0.113-0.621, p = 0.041) was statistically significantly associated with non-adherence to anti-diabetic treatment. However, the frequency of doctor’s visits (OR = 0.310, 95% CI: 0.046-2.111) was not significantly associated with non-adherence to anti-diabetic treatment.

CONCLUSION: The rate of non-adherence to antidiabetic treatment in this study was high. Perceived barriers to antidiabetic treatment such as forgetfulness, long-term medication use, and medication side effects influenced therapeutic non-adherence to antidiabetic treatment. While interventions should focus on how to eliminate these barriers, health education on diabetic self-care may help reinforce the importance of medication adherence to prevent complications.

PMID:39007155 | PMC:PMC11246075 | DOI:10.2147/DMSO.S464761

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Nevin Manimala Statistics

The Effect of Student Experience and Tooth Location on Finish Line Width and Angle of Full Metal Crown Preparations in Preclinical Setting

Adv Med Educ Pract. 2024 Jul 9;15:649-657. doi: 10.2147/AMEP.S460140. eCollection 2024.

ABSTRACT

PURPOSE: To determine the effect of experience and tooth location on the finish line width and angle of crown preparations performed by undergraduate students.

METHODS: Eighty full metal crown preparations on typodont teeth were divided into four groups: Group 1: 20 preparations performed on mandibular first molar in the first semester. Group 2: 20 preparations performed on mandibular first molar in the second semester. Group 3: 20 preparations performed on mandibular second molar in the first semester. Group 4: 20 preparations performed on mandibular second molar in the second semester. All prepared teeth were scanned, and the finish line width and angles were measured at 8 different locations. Paired t-test in the SPSS software was used to compare and determine the effect of experience and tooth location on the students’ performance.

RESULTS: There was a statistically significant difference in the mandibular first molar finish line width between the first and second semesters for the same student in the distal, distolingual, and mesiobuccal areas of the tooth. There was a statistically significant increase in finish line width between first and second molars in the distobuccal, distal, distolingual, lingual, and mesial side of the tooth. Regarding the finish line angle, there was a statistically significant difference between the first and second semesters on the distal side of the tooth. There was a statistically significant increase in finish line angle between first and second molars in the distobuccal side of the tooth.

CONCLUSION: As students gain more experience in different types of tooth preparations, they tend to produce a wider finish line than that recommended for full metal crown preparation. The tooth location in the mouth influences the width and angle of the finish line hence the more inaccessible areas on the tooth have a wider finish line.

PMID:39007125 | PMC:PMC11246083 | DOI:10.2147/AMEP.S460140

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Nevin Manimala Statistics

Making people happy or making happy people? Questionnaire-experimental studies of population ethics and policy

Soc Choice Welfare. 2017 Jun;49(1):145-169. doi: 10.1007/s00355-017-1055-7. Epub 2017 May 16.

ABSTRACT

Is a larger population of people living good lives a better population, all else equal? This question is central to population issues in social welfare, ethics, and policy. Many answers in the philosophical literature argue that if a policy choice results in the birth of additional people living good lives, these extra lives are irrelevant to any evaluation of the policy. This paper applies the questionnaire-experimental method of empirical studies of social choice to investigate participants’ policy choices and social orderings with respect to population size and average well-being. In general, heterogeneous responses depended on the quantitative and qualitative properties of the question. In particular, an experimentally manipulated increase in population size caused an option to be more likely to be selected, on average. Overall, responses suggest that population size is not neutral to social welfare. Many participants, although not all, reported that a larger population of people living good lives could be strictly preferable, at small or no costs to average well-being.

PMID:39007124 | PMC:PMC11245279 | DOI:10.1007/s00355-017-1055-7

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Nevin Manimala Statistics

Outcomes of patients with advanced solid tumors who discontinued immune-checkpoint inhibitors: a systematic review and meta-analysis

EClinicalMedicine. 2024 Jun 20;73:102681. doi: 10.1016/j.eclinm.2024.102681. eCollection 2024 Jul.

ABSTRACT

BACKGROUND: The outcome of patients with metastatic tumors who discontinued immune checkpoint inhibitors (ICIs) not for progressive disease (PD) has been poorly explored. We performed a meta-analysis of all studies reporting the clinical outcome of patients who discontinued ICIs for reasons other than PD.

METHODS: We searched PubMed, Embase and Scopus databases, from the inception of each database to December 2023, for clinical trials (randomized or not) and observational studies assessing PD-(L)1 and CTLA-4 inhibitors in patients with metastatic solid tumors who discontinued treatment for reasons other than PD. Each study had to provide swimmer plots or Kaplan-Meier survival curves enabling the reconstruction of individual patient-level data on progression-free survival (PFS) following the discontinuation of immunotherapy. The primary endpoint was PFS from the date of treatment discontinuation overall and according to tumor histotype, type of treatment and reason of discontinuation. The Combersure’s method was used to estimate meta-analytical non-parametric summary survival curves assuming random effects at study level.

FINDINGS: Thirty-six studies (2180 patients) were included. The pooled median PFS (mPFS) was 24.7 months (95% CI, 18.8-30.6) and the PFS-rate at 12, 24, and 36 months was respectively 69.8% (95% CI, 63.1-77.3), 51.0% (95% CI, 43.4-59.8) and 34.0% (95% CI, 27.0-42.9). Univariable analysis showed that the mPFS was significantly longer for patients with melanoma (43.0 months), as compared with non-small cell lung cancer (NSCLC, 13.5 months) and renal cell carcinoma (RCC, 10.0 months; between-strata comparison test p-value < 0.001); for patients treated with anti-PD-(L)1 + anti-CTLA-4 as compared with anti-PD-(L)1 monotherapy (44.6 versus 19.9 months; p-value < 0.001), and in NSCLC when the reason of treatment discontinuation was elective as compared with toxicity onset (19.6 versus 4.8 months; p-value = 0.003). The multivariable analysis confirmed these differences.

INTERPRETATION: The long-term outcome of patients who stopped ICIs for reasons other than PD was substantially affected by clinicopathological features: PFS after treatment discontinuation was longer in patients with melanoma, and/or treated with anti-PD-(L)1 + anti-CTLA-4, and shorter in patients with RCC or in those patients with NSCLC who stopped treatment for toxicity onset.

FUNDING: The Italian Ministry of University and Research (PRIN 2022Y7HHNW).

PMID:39007061 | PMC:PMC11245998 | DOI:10.1016/j.eclinm.2024.102681

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Nevin Manimala Statistics

AnXplore: a comprehensive fluid-structure interaction study of 101 intracranial aneurysms

Front Bioeng Biotechnol. 2024 Jun 24;12:1433811. doi: 10.3389/fbioe.2024.1433811. eCollection 2024.

ABSTRACT

Advances in computational fluid dynamics continuously extend the comprehension of aneurysm growth and rupture, intending to assist physicians in devising effective treatment strategies. While most studies have first modelled intracranial aneurysm walls as fully rigid with a focus on understanding blood flow characteristics, some researchers further introduced Fluid-Structure Interaction (FSI) and reported notable haemodynamic alterations for a few aneurysm cases when considering wall compliance. In this work, we explore further this research direction by studying 101 intracranial sidewall aneurysms, emphasizing the differences between rigid and deformable-wall simulations. The proposed dataset along with simulation parameters are shared for the sake of reproducibility. A wide range of haemodynamic patterns has been statistically analyzed with a particular focus on the impact of the wall modelling choice. Notable deviations in flow characteristics and commonly employed risk indicators are reported, particularly with near-dome blood recirculations being significantly impacted by the pulsating dynamics of the walls. This leads to substantial fluctuations in the sac-averaged oscillatory shear index, ranging from -36% to +674% of the standard rigid-wall value. Going a step further, haemodynamics obtained when simulating a flow-diverter stent modelled in conjunction with FSI are showcased for the first time, revealing a 73% increase in systolic sac-average velocity for the compliant-wall setting compared to its rigid counterpart. This last finding demonstrates the decisive impact that FSI modelling can have in predicting treatment outcomes.

PMID:39007055 | PMC:PMC11243300 | DOI:10.3389/fbioe.2024.1433811

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Nevin Manimala Statistics

Editorial: Advanced microfluidics for synthetic biology and/or biomedical applications

Front Bioeng Biotechnol. 2024 Jun 28;12:1440206. doi: 10.3389/fbioe.2024.1440206. eCollection 2024.

NO ABSTRACT

PMID:39007054 | PMC:PMC11239540 | DOI:10.3389/fbioe.2024.1440206

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Nevin Manimala Statistics

Geomembrane-based salt production method to increase the quantity and quality of small-scale salt producer

MethodsX. 2024 Jun 13;13:102803. doi: 10.1016/j.mex.2024.102803. eCollection 2024 Dec.

ABSTRACT

An appropriate salt production methods must be implemented to increase salt production’s quantity and quality. This paper was prepared to introduce and demonstrate a new method, namely a geomembrane-based salt production method, which can contribute directly to increasing the quantity and quality of people’s salt production. This method can be applied quickly with simple equipment, so this method is easy to replicate in various salt production center areas. The results of statistical tests directly show that there is a fundamental difference between the quantity and quality of salt produced by salt farmers using conventional salt production methods and geomembrane-based salt production methods, where geomembrane-based salt production methods are capable of producing much higher quantities of salt production with better quality.•The geomembrane-based salt production method is easy to implement because it uses simple equipment and can be made independently by salt farmers.•Using a geomembrane in this method can prevent leaks in the salt crystallization pond and optimize heat from solar energy to optimize the quantity of salt production.•This method prevents direct contact of seawater with soil. The effect is that the quality of salt produced from geomembrane-based salt production methods is higher than conventional salt production methods.

PMID:39007028 | PMC:PMC11245934 | DOI:10.1016/j.mex.2024.102803

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Nevin Manimala Statistics

Immunohistochemical Analysis of IL-19 and IL-24 Expression in Inflammatory Bowel Disease (IBD) Patients: Results From a Single Center Retrospective Study

Cureus. 2024 Jul 12;16(7):e64441. doi: 10.7759/cureus.64441. eCollection 2024 Jul.

ABSTRACT

Background IL-19 and IL-24 induce proinflammatory cytokine production through the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway. The primary objective of this study was to investigate any changes in IL-19 and IL-24 expression between inflammatory bowel disease (IBD) patients and healthy controls, as well as before and after the initiation of biologics. The secondary objective was to investigate any relation between their expression and disease phenotype and activity. Methods IL-19 and IL-24 expression was measured in intestinal tissue samples from 121 patients with moderate to severe IBD versus healthy controls using immunohistochemistry. Their expression was then measured 12 months after treatment on the patient group treated with biologics. The disease activity was measured before and after treatment using the Harvey Bradshaw Index (HBI) for Crohn’s disease (CD) patients and the Mayo Score (MS) for ulcerative colitis (UC) patients. Data were analyzed using SPSS (IBM Inc., Armonk, New York). Results IL-19 expression was raised in the IBD group versus healthy controls. In the CD group, the IL-19 expression was related with the disease activity score post-biologic treatment. IL-24 was also highly expressed in patients with active UC and CD and was increased post-treatment. Its expression in UC was statistically related with the MS. Conclusions IL-24 and IL-19 are key factors in IBD-related intestinal inflammation and this is one of the few human studies to suggest that. An immunosuppressive role of IL-24 was demonstrated in the UC group. A future use as biomarkers of disease activity and response to treatment might be feasible.

PMID:39007024 | PMC:PMC11245665 | DOI:10.7759/cureus.64441

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Nevin Manimala Statistics

An Analysis of Trainee Salaries Offered in Nurse Practitioner and Physician Assistant/Associate Postgraduate Residency and Fellowship Programs in the United States

Cureus. 2024 Jul 12;16(7):e64434. doi: 10.7759/cureus.64434. eCollection 2024 Jul.

ABSTRACT

Background Although there has been steady growth in the number of postgraduate nurse practitioner (NP) and physician assistant/associate (PA) residency and fellowship programs in the United States, little is known about annual salaries paid to trainees across a national sample of postgraduate programs and specialties. We describe postgraduate program NP and PA trainee salaries and the relationship to specific variables. Methodology An electronic survey was distributed via email to 336 postgraduate NP, PA, and joint NP/PA residency/fellowship programs between November 2023 and December 2023. Frequency tables (for categorical variables) and descriptive statistics (for continuous variables) were used to summarize the data. Chi-square tests of independence were used to determine the relationship between trainee salary and program type, geographical location, and clinical setting. Results There was a statistically significant association between trainee salary for primary care and clinical profession (χ2(6) = 13.993, p = 0.022). Over half of NP respondents (52.1%) reported that their trainees had an annual salary between $76000 and $86000. The majority of PA respondents (57.1%) reported that their trainees had an annual salary below $75000. Respondents who were non-clinical professionals (50.0%) reported that their trainees had an annual salary of over $86000. The single physician respondent also reported that their trainees’ had an annual salary of over $86000. It appears that PA respondents were more likely to report lower trainee salaries than respondents who were NPs and non-clinical professionals. Additionally, respondents associated with primary care joint NP/PA cohorts were more likely to report higher trainee salaries than participants having NP-only cohorts. Lastly, there was a statistically significantly positive relationship between trainee salary and the number of postgraduate advanced practice provider (APP) trainees in psychiatric mental health (τb = 0.451, p = 0.006). Conclusion To the best of our knowledge, this national study is the first of its kind to examine and summarize APP postgraduate trainee annual salaries across multiple specialties. Additional studies are needed to clarify the relationships between trainee salaries and other variables.

PMID:39007022 | PMC:PMC11245340 | DOI:10.7759/cureus.64434

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Nevin Manimala Statistics

Evaluation of Locally Made Phantom Models for Gynecologic Ultrasound-guided Procedures Simulating Transabdominal and Transvaginal Approaches

Acta Med Philipp. 2024 Jun 28;58(11):54-61. doi: 10.47895/amp.v58i11.9664. eCollection 2024.

ABSTRACT

BACKGROUND AND OBJECTIVES: Phantom and simulation models are valuable training tools for teaching and skill enhancement, yet high costs and limitations of commercial options drive the search for alternatives. This study evaluated the locally sourced phantom models developed for transvaginal and transabdominal gynecologic interventional ultrasound procedures, aiming to cater to the educational needs of OB-GYN ultrasound subspecialists.

METHODS: Four phantom models simulating biopsy and cyst aspiration/paracentesis through transvaginal and transabdominal approaches, were developed, and assessed by 37 ultrasound subspecialists in obstetrics and gynecology. The respondents, comprising 19 experienced and 18 with limited exposure to guided procedures, utilized an 11-item Likert-scored questionnaire to evaluate the models’ acceptability and suitability for training. Responses were analyzed using descriptive statistics.

RESULTS: Both experienced and less-experienced groups consistently assigned high scores, particularly highlighting the realistic ultrasound image and positioning of structures. The models proved effective in enhancing confidence and proficiency during simulation-based training for probe manipulation, aspiration, and biopsy procedures. While respondents identified concerns like durability and needle track marks, no significant differences emerged between the two groups in evaluating the model.

CONCLUSIONS: The overall evaluation of the developed phantom model was positive, showcasing its acceptability among end-users and suitability for training ultrasound-guided procedures in obstetrics and gynecology. The identified issues provide valuable insights for potential improvements in future iterations of the model.

PMID:39006995 | PMC:PMC11239992 | DOI:10.47895/amp.v58i11.9664