Category: Statistics

Am J Speech Lang Pathol. 2024 Aug 22:1-17. doi: 10.1044/2024_AJSLP-24-00005. Online ahead of print.

ABSTRACT

PURPOSE: The current study used behavioral measures of discourse complexity and story recall accuracy in an expository discourse task to distinguish older adults testing within range of cognitive impairment according to a standardized cognitive screening tool in a sample of self-reported healthy older adults.

METHOD: Seventy-three older adults who self-identified as healthy completed an expository discourse task and neuropsychological screener. Discourse data were used to classify participants testing within range of cognitive impairment using multiple machine learning algorithms and stability analysis for identifying reliably predictive features in an effort to maximize prediction accuracy. We hypothesized that a higher rate of pronoun use and lower scores on story recall would best classify older adults testing within range of cognitive impairment.

RESULTS: The highest classification accuracy exploited a single variable in a remarkably intuitive way: using 66% story recall as a cutoff for cognitive impairment. Forcing this decision tree model to use more features or increasing its complexity did not improve accuracy. Permutation testing confirmed that the 77% accuracy and 0.18 Brier skill score achieved by the model were statistically significant (p < .00001).

CONCLUSIONS: These results suggest that expository discourse tasks that place demands on executive functions, such as working memory, can be used to identify aging adults who test within range of cognitive impairment. Accurate representation of story elements in working memory is critical for coherent discourse. Our simple yet highly accurate predictive model of expository discourse provides a promising assessment for easy identification of cognitive impairment in older adults.

SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.26543824.

PMID:39173074 | DOI:10.1044/2024_AJSLP-24-00005

PLoS One. 2024 Aug 22;19(8):e0307753. doi: 10.1371/journal.pone.0307753. eCollection 2024.

ABSTRACT

BACKGROUND: The administration of intravenous (IV) medications is a technically complicated and error-prone process. Especially, in the hematopoietic stem cell transplantation (HSCT) setting where toxic drugs are frequently used and patients are in critical immunocompromised conditions, medication errors (ME) can have catastrophic reactions and devastating outcomes such as death. Studies on ME are challenging due to poor methodological approaches and complicated interpretations. Here, we tried to resolve this problem using reliable methods and by defining new denominators, as a crucial part of an epidemiological approach.

METHODS: This was an observational, cross-sectional study. A total of 525 episodes of IV medication administration were reviewed by a pharmacist using the disguised direct observation method to evaluate the preparation and administration processes of 32 IV medications in three HSCT wards. We reported errors in 3 ratios; 1) Total Opportunities for Error (TOE; the number of errors/sum of all administered doses observed plus omitted medications), 2) Proportional Error Ratio (the number of errors for each drug or situation/total number of detected errors) and, 3) Corrected Total Opportunities for Errors (CTOE; the number of errors/ Sum of Potential Errors (SPE)).

RESULTS: A total of 1,568 errors were observed out of 5,347 total potential errors. TOE was calculated as 2.98 or 298% and CTOE as 29.3%. Most of the errors occurred at the administration step. The most common potential errors were the use of an incorrect volume of the reconstitution solvent during medication preparation and lack of monitoring in the administration stage.

CONCLUSION: Medication errors frequently occur during the preparation and administration of IV medications in the HSCT setting. Using precise detection methods, denominators, and checklists, we identified the most error-prone steps during this process, for which there is an urgent need to implement effective preventive measures. Our findings can help plan targeted preventive measures and investigate their effectiveness, specifically in HSCT settings.

PMID:39173064 | DOI:10.1371/journal.pone.0307753

PLoS One. 2024 Aug 22;19(8):e0298773. doi: 10.1371/journal.pone.0298773. eCollection 2024.

ABSTRACT

Epilepsy, particularly in older people, is associated with significant changes in physical activities, social and occupational functions, and diet. It is associated with significant changes in physical activities, social and occupational functions, and diet. Valid and reliable instruments are needed to assess these changes. This study aimed to develop and validate a questionnaire to assess lifestyle in older people with epilepsy, named the Epilepsy Lifestyle Questionnaire (ELQ). This methodological study was conducted in 2022. The primary ELQ items were generated through reviewing the literature. Then, its face, content, construct, convergent, and discriminant validity, internal consistency, and test-retest stability were evaluated. Older patients aged ≥ 60 years were recruited from the Iranian Epilepsy Association to assess construct validity using confirmatory factor analysis (CFA). Data were analyzed using the SPSS (v. 26.0), AMOS (v. 24.0), and JASP software. The primary ELQ had 99 items with five subscales, namely health-oriented self-care, risk-averse behavior, emotional and psychosocial adaptation, epilepsy stigma, and intimacy and sexual behaviors. Sixty five items were deleted during psychometric evaluation. CFA showed the good fitting of the five-factor structure of the 34-item ELEQ (PCFI = 0.741, PNFI = 0.693, CMIN/DF = 0.073, IFI = 0.917, CFI = 0.916, AND GFI = 0.902). The values of internal consistency based on Cronbach’s alpha and test-retest reliability based on intraclass correlation coefficient (ICC) of ELQ were 0.89 and 0.95, respectively. The ELQ is a valid and reliable self-report instrument. The results suggest that the ELQ is a useful clinical tool for assessing the lifestyle of patients with epilepsy.

PMID:39173054 | DOI:10.1371/journal.pone.0298773

Int J Oral Maxillofac Implants. 2024 Aug 16:1-22. doi: 10.11607/jomi.10956. Online ahead of print.

ABSTRACT

Purpose: This study aimed to evaluate the relationship between risk profile assessments of dental implants that have been in function for at least two-year and peri-implant marginal bone loss during the follow-up period using the Implant Disease Risk Assessment Diagram. Material and Methods: A total of 70 patients and 170 implants who had been functionally loaded for at least two years and who attended follow-up sessions were included in the study. Full-mouth plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing, clinical attachment level (CAL), and peri-implant modified plaque index, modified bleeding index, PD, keratinized mucosal width (KMW), CAL and GR were recorded. According to the IDRA risk diagram, participants and dental implants were divided into low, moderate, and high-risk groups. Marginal bone level (MBL) was measured on periapical radiographs obtained at functional loading (T0) and at the last follow-up session (T1), and mesial and distal marginal bone level changes (ΔMBL) were calculated as T1-T0. Results: A statistically significant correlation was found between the periodontitis history and periodontitis susceptibility and IDRA classification at the patient-level. Full-mouth GI, PD, and BOP were found to be statistically higher in the high-risk IDRA group. No statistically significant result was found between the mesial and distal ΔMBL between the IDRA risk groups.Conclusions: In this study, IDRA risk level increased especially by periodontitis susceptibility and periodontitis history, but no significant difference was found between risk groups in terms of ΔMBL.

PMID:39172500 | DOI:10.11607/jomi.10956

Vasc Endovascular Surg. 2024 Aug 22:15385744241277053. doi: 10.1177/15385744241277053. Online ahead of print.

ABSTRACT

BACKGROUND: Cardiopulmonary exercise testing (CPET) is a preoperative risk stratification tool providing an objective measure of fitness and functional capacity. There is however little evidence on the use of this compared to non-physiological test in vascular surgery despite its current use. This study investigates whether CPET perioperatively has value alongside non-physiological testing for patients undergoing elective open abdominal aortic aneurysm (AAA) repair.

METHOD: Retrospective data was collected at 2 vascular centres between 2015-2019 in a CPET centre vs non-CPET centre in patients undergoing elective AAA repair. Outcomes measured included: length of stay in an intensive care unit (ICU); total length of stay; post-operative complications and acute kidney injury (AKI). Statistical analysis was performed using IBM SPSS software.

RESULTS: There were 38 patients at each centre. The mean duration of stay in ICU for patients in CPET centre was 2.5 ± 2.13 days whilst in non-CPET centre it was 3.68 ± 4.08 days (P = 0.05). The mean duration of stay in ICU and total length of stay was significantly shorter in CPET centre (P = 0.05 and P = 0.015 respectively). Mortality in CPET centre was 2.63% and 5.26% in non-CPET centre (not significant). The number of patients developing AKI post-operatively was 13.61% in CPET vs 28.95% in non-CPET centre.

CONCLUSION: CPET tested patients have statistically significant lower length of total and ICU stay compared to non-CPET patients. CPET is therefore a useful adjunct in selecting patients for open surgery compared to non-physiological testing. This study provides some evidence on the use of this routinely but not validated assessment tool in aortic aneurysm repair.

PMID:39172489 | DOI:10.1177/15385744241277053

Transl Vis Sci Technol. 2024 Aug 1;13(8):34. doi: 10.1167/tvst.13.8.34.

ABSTRACT

PURPOSE: Inflammatory and infectious eye diseases are an important cause of visual impairment in patients older than 65 years of age. Health care disparities for eye care are present for general eye care. However, there is lack of national data on health disparities regarding eye care use for inflammatory and infectious eye diseases. Our study examines the effect of gender and race on eye care in patients with inflammatory and infectious eye diseases who are equal or greater than 65 years of age.

METHODS: We have used Medicare data to examine the effect gender and race on use of eye care services in patients with inflammatory and infectious eye diseases for 2014 to 2018. Medicare is a national insurance program administered by the government of United States to insure people age 65 years or older. Owing to its high enrollment, those in Medicare are representative of the U.S. population aged 65 and older.

RESULTS: We found that females have higher use for Medicare for inflammatory and infectious eye diseases across all races from 2014 to 2018. On examining the effect of race, African Americans have lower use as compared with Whites. People of Asian descent have the highest use, followed by Hispanic people.

CONCLUSIONS: Health care disparities exist for eye care use for inflammatory and infectious eye diseases for patients 65 years of age and older. Future studies are required to address these disparities to provide equitable eye care.

TRANSLATIONAL RELEVANCE: Identification of eye care disparities is the first step to addressing these disparities.

PMID:39172483 | DOI:10.1167/tvst.13.8.34

J Vis. 2024 Aug 1;24(8):11. doi: 10.1167/jov.24.8.11.

ABSTRACT

The perception of the ambiguous image of #TheDress may be influenced by optical factors, such as macular pigments. Their accumulation during childhood could increase with age and the ingestion of carotenoid-containing foods. The purpose of this study was to investigate whether the visual perception of the dress in children would differ based on age and carotenoid preference. This was a cross-sectional, observational, and comparative study. A poll was administered to children aged 2 to 10 years. Parents were instructed to inquire about the color of #TheDress from their children. A carotenoid preference survey was also completed. A total of 413 poll responses were analyzed. Responses were categorized based on the perceived color of the dress: blue/black (BB) (n = 204) and white/gold (WG) (n = 209). The mean and median age of the WG group was higher than the BB group (mean 6.1, median 6.0 years, standard deviation [SD] 2.2; mean 5.5, median 5.0 years, SD 2.3; p = 0.007). Spearman correlation between age and group was 0.133 (p = 0.007). Green-leaf preference (GLP) showed a statistically significant difference between groups (Mann-Whitney U: p = 0.038). Spearman correlation between GLP and group was 0.102 (p = 0.037). Logistic regression for the perception of the dress as WG indicated that age and GLP were significant predictors (age: B weight 0.109, p = 0.012, odds ratio: 1.115; GLP: B weight 0.317, p = 0.033, odds ratio: 1.373). Older children and those with a higher GLP were more likely to perceive #TheDress as WG. These results suggest a potential relationship with the gradual accumulation of macular pigments throughout a child’s lifetime.

PMID:39172467 | DOI:10.1167/jov.24.8.11

JAMA Netw Open. 2024 Aug 1;7(8):e2427763. doi: 10.1001/jamanetworkopen.2024.27763.

ABSTRACT

IMPORTANCE: Identifying longitudinal changes in advanced airway management by emergency medical services (EMS) is crucial for understanding practice patterns and optimizing care.

OBJECTIVE: To examine the longitudinal trends in endotracheal intubation (ETI) and supraglottic airway (SGA) utilization in a national EMS cohort.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cross-sectional study analyzed 2011 to 2022 data from the ESO Data Collaborative, a national database of US prehospital electronic health records. The study included all 911 EMS events in which advanced airway management was attempted. Data were analyzed from November 2022 to January 2024.

EXPOSURES: Advanced airway management attempts, including ETI, SGA, and surgical airways.

MAIN OUTCOMES AND MEASURES: The annual percentage of ETI and SGA attempts, stratified by underlying condition (cardiac arrest, nonarrest medical, nonarrest trauma, pediatrics).

RESULTS: Among 47.5 million EMS activations, 444 041 (mean [SD] age, 60.6 [19.8] years; 273 296 [61.5%] men) involved advanced airway management, including 305 584 (68.8%) that used ETI and 200 437 (45.1%) that used SGA. The overall incidence was 9.3 per 1000 EMS events. In the cardiac arrest cohort from 2011 to 2022, EMS events with ETI attempts decreased from 2470 of 2831 (87.3%) to 40 083 of 72 793 (55.1%) and those with SGA attempts increased from 711 of 2831 (25.1%) to 44 386 of 72 793 (61.0%). In the pediatric subset, there were similarly large decreases in ETI attempts, from 117 of 182 EMS events (97.3%) to 1573 of 2307 EMS events (68.2%), and increases in SGA attempts, from 11 of 182 EMS events (6.6%) to 1058 of 2307 EMS events (45.9%). In the nonarrest medical and nonarrest trauma cohorts, ETI attempts decreased and SGA attempts increased but to a much lower extent.

CONCLUSIONS AND RELEVANCE: In this national cross-sectional study of EMS care episodes, there were marked shifts in advanced airway management practices, with the increased use of SGA and decreased use of ETI. These observations highlight current trends in EMS airway management practices.

PMID:39172452 | DOI:10.1001/jamanetworkopen.2024.27763

JAMA Netw Open. 2024 Aug 1;7(8):e2427781. doi: 10.1001/jamanetworkopen.2024.27781.

ABSTRACT

IMPORTANCE: With the rise in popularity of streaming platforms concerns about exposure to tobacco advertising and promotion have emerged. While tobacco marketing and promotion through traditional television (TV) media channels has been extensively studied, less is known about exposure to tobacco through TV or streaming platforms and its associated factors.

OBJECTIVE: To examine the prevalence and factors associated with exposure to tobacco products advertised, marketed, or promoted on TV or streaming platforms among US adults.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study used data from the National Cancer Institute’s Health Information National Trends Survey (HINTS 6), conducted from March 7 to November 8, 2022. The nationally representative survey included noninstitutionalized civilian US adults.

MAIN OUTCOMES AND MEASURES: The primary outcome was self-reported exposure to tobacco advertisements, marketing, or promotion on TV or streaming platforms in the past 3 months. Factors associated with exposure were explored using multivariable survey logistic regression.

RESULTS: The study included 5775 participants (3415 females [weighted percentage, 50.5%], 970 Hispanic individuals [weighted percentage, 16.9%], 872 non-Hispanic Black or African American individuals [11.1%], 3144 non-White individuals [61.5%], and 632 individuals who currently smoke [12.0%]). The estimated exposure to tobacco advertisements, marketing, or promotion on television or streaming platforms was 12.4% (95% CI, 10.8%-14.2%). Multivariable logistic regression analysis revealed that exposure odds were higher among those who had a level of education of high school or less (adjusted odds ratio [aOR], 1.60; 95% CI, 1.08-2.37), individuals who currently smoke (aOR, 1.85; 95% CI, 1.06-3.25), non-Hispanic Black or African American respondents (aOR, 2.20; 95% CI, 1.40-3.45) and Hispanic respondents (aOR, 1.58; 95% CI, 1.04-2.42).

CONCLUSIONS AND RELEVANCE: In this study of the prevalence of exposure to tobacco advertisements on TV or streaming platforms among US adults, disparities in exposure by race or ethnicity, education level, and smoking status were identified. These findings underscore the need for targeted public health interventions and regulation to address these disparities and reduce the impact of tobacco advertisements on vulnerable populations.

PMID:39172451 | DOI:10.1001/jamanetworkopen.2024.27781

JAMA Netw Open. 2024 Aug 1;7(8):e2429671. doi: 10.1001/jamanetworkopen.2024.29671.

ABSTRACT

IMPORTANCE: Reducing children’s exposure to advertisements promoting unhealthy foods and beverages has been recognized by the World Health Organization as a key strategy to improve children’s diets and reduce childhood obesity.

OBJECTIVE: To examine changes in children’s exposure to food-related (food, beverage, and restaurant) television advertising, including for products high in nutrients to limit (NTL; ie, saturated fat, trans fat, total sugars, and sodium) based on federal Interagency Working Group guidelines, following changes in the voluntary industry self-regulatory Children’s Food and Beverage Advertising Initiative (CFBAI).

DESIGN, SETTING, AND PARTICIPANTS: This repeated cross-sectional study used US television ratings data on advertising exposure from The Nielsen Company for 2013, 2014, 2015, 2018, and 2022. Food and beverage product advertisements were assessed for nutritional content. Participants included 2- to 5-year-old and 6-to 11-year-old children. Data analysis was performed from July 2023 to January 2024.

EXPOSURE: Changes in CFBAI standards in 2014 and 2020.

MAIN OUTCOMES AND MEASURES: The primary outcome was the number of food-related advertisements seen per year and percentage of food and beverage product advertisements high in NTL, on all programming and children’s programming (defined as ≥35% child audience share).

RESULTS: From 2013 to 2022, total advertisements seen per year declined by 77.6% (from 4611 to 1035) for 2- to 5-year-olds and by 78.5% (from 4860 to 1046) for 6- to 11-year-olds. Advertisements seen on children’s programming decreased by 95.1% (from 1703 to 84 per year) for 2- to 5-year-olds and by 97.0% (from 1745 to 52 per year) for 6- to 11-year-olds. The percentages of advertisements for products high in NTL decreased from 2013 to 2022 but were still high: 68.9% for all programming and 63.9% for children’s programming for 2- to 5-year-olds, and 68.4% for all programming and 60.6% for children’s programming for 6- to 11-year-olds. The majority (51%-52%) of CFBAI-member food and beverage advertisements on children’s programming remained high in NTL. Black children saw more food-related television advertisements than White children (58% more for 2- to 5-year-olds and 72% more for 6- to 11-year-olds); however, the percentage of advertisements for food and beverage products high in NTL seen was similar by race.

CONCLUSIONS AND RELEVANCE: In this repeated cross-sectional study of children’s exposure to food-related television advertisements, exposure via children’s programming decreased substantially. However, most advertisements seen were still for unhealthy products, and exposure from all programming remained substantial. Findings of more than 90% of advertising exposure not from children’s programming and more than 1000 food-related advertisements seen per year suggest the need for government regulations based on time of day rather than programming.

PMID:39172450 | DOI:10.1001/jamanetworkopen.2024.29671