Category: Statistics

Saudi J Anaesth. 2024 Jul-Sep;18(3):388-394. doi: 10.4103/sja.sja_142_24. Epub 2024 Jun 4.

ABSTRACT

INTRODUCTION: In the backdrop of escalating healthcare costs and an increasing focus on resource optimization, this audit study delves into the realm of anesthesia management, specifically exploring the application of low-flow anesthesia (LFA). The primary objective was to assess adherence to hospital standards and evaluate the economic implications of LFA (<1 L/min).

MATERIALS AND METHODS: This retrospective audit focused on 700 adult patients undergoing elective surgeries with general anesthesia. Data sources included anesthesia records, electronic recording systems, and audits by a dedicated team. Fresh gas flow rates (FGFRs), minimum alveolar concentration (MAC), and volatile anesthetic consumption were analyzed. Cost comparisons between low-flow and high-flow anesthesia were conducted, employing specific cost per milliliter metrics.

RESULTS: The average FGFR during the maintenance phase was found to be 0.45 ± 0.88 L/min. Adherence to hospital standards was notably high, with 94.29% of patients being maintained on low-flow gas rates. The differences in anesthetic consumption between low-flow and high-flow FGFR were statistically significant for both desflurane (12.17 ± 10.84 ml/MAC hour versus 43.12 ± 27.25 ml/MAC hour) and sevoflurane (3.48 ± 7.22 ml/MAC hour versus 5.20 ± 5.20 ml/MAC hour, P < 0.001). The calculated savings per patient with low-flow desflurane and sevoflurane anesthesia compared to high flow were found to be 109.25 AED and 6.74 AED, respectively.

CONCLUSION: This audit advocates for the widespread adoption of LFA as a standard practice. Beyond aligning with hospital standards, the study highlights the multi-faceted benefits of LFA, encompassing economic savings, environmental safety, and enhanced patient care.

PMID:39149724 | PMC:PMC11323908 | DOI:10.4103/sja.sja_142_24

Adv Pharmacol Pharm Sci. 2024 Aug 7;2024:6668480. doi: 10.1155/2024/6668480. eCollection 2024.

ABSTRACT

BACKGROUND: Self-medication practice is the use of medicine without consulting health professionals to treat self-recognized illness by the general population including pregnant women. Inappropriate self-medication practice during pregnancy may pose harmful consequences for the fetus as well as the mother. There is not given much attention on the practice of self-medication among pregnant women in our setting. Therefore, this study aimed to assess the prevalence of self-medication practice and associated factors among pregnant women who attended antenatal care at North Shewa Zone public hospitals.

METHODS: An institution-based cross-sectional study was conducted from June 01, 2022 to July 30, 2022, among 650 pregnant women who attended antenatal care at North Shewa Zone public hospitals. A multistage sampling technique was employed. The questionnaires were pretested. A structured interviewer-administered questionnaire and reviewed medical records were used for data collection. Epi-data version 4.6.2 and SPSS version 20 were utilized for data entry and analysis, respectively. Bivariate and multivariable logistic regression was done to identify associated factors, and P values less than 0.05 were considered statistically significant.

RESULTS: The prevalence of self-medication practice among pregnant women was 65.38%. Housewives (AOR = 0.097 95% CI 0.030, 0.310), farmers (AOR = 0.117, 95% CI 0.028, 0.493), people with health insurance (AOR = 0.507, 95% CI 0.300, 0.858), and people in preconception care (AOR = 0.038, 95% CI 0.011-0.135) were less likely to practice self-medication, while people with primary education (AOR = 3.00, 95% CI 1.217, 7.435), income less than 3,000 birr (AOR = 5.46, 95% CI 1.41, 21.1), participants in the first (AOR = 4.183, 95% CI 2.12, 8.24) and second trimesters (AOR = 2.05, 95% CI 1.18, 3.56), pregnant women who lived in rural areas (AOR = 1.579, 95% CI 1.103-2.260), and people who previously practiced self-medication (AOR = 8.2, 95% CI 5.04, 13.3) were more likely to practice self-medication.

CONCLUSION: From the present finding, it can be concluded that self-medication among pregnant women is high. Previous self-medication practice, gestation period, educational status, monthly income, no preconception care, no health insurance, being a housewife, farmer, and place of residence were significantly associated with self-medication practice. Therefore, preventive measures such as proper counseling during dispensing, awareness creation programs on preconception care, and enrolling in health insurance programs to minimize the practice of self-medication are necessary.

PMID:39149722 | PMC:PMC11325016 | DOI:10.1155/2024/6668480

Annu Rev Sociol. 2024 Aug;50:41-59. doi: 10.1146/annurev-soc-091523-013249. Epub 2024 Apr 17.

ABSTRACT

Experience sampling (ES) – also referred to as ecological momentary assessment (EMA) – is a data collection method that involves asking study participants to report on their thoughts, feelings, behaviors, activities, and environments in (or near) real time. ES/EMA is typically administered using an intensive longitudinal design (repeated assessments within and across days). Although use of ES/EMA is widespread in psychology and health sciences, uptake of the method among sociologists has been limited. We argue that ES/EMA offers key advantages for the investigation of sociologically relevant phenomena, particularly in light of recent disciplinary emphasis on investigating the everyday mechanisms through which social structures and micro (individual and relational) processes are mutually constitutive. We describe extant and potential research applications illustrating advantages of ES/EMA regarding enhanced validity, disentangling short-term dynamics, and the potential for linkage with spatially and temporally referenced data sources. We also consider methodological challenges facing sociological research using ES/EMA.

PMID:39149714 | PMC:PMC11326442 | DOI:10.1146/annurev-soc-091523-013249

Ophthalmol Sci. 2024 May 23;4(6):100557. doi: 10.1016/j.xops.2024.100557. eCollection 2024 Nov-Dec.

ABSTRACT

PURPOSE: Diabetic macular edema (DME), a leading cause of visual impairment, can occur regardless of diabetic retinopathy (DR) stage. Poor metabolic control is hypothesized to contribute to DME development, although large-scale studies have yet to identify such an association. This study aims to determine whether measurable markers of dysmetabolism are associated with DME development in persons with diabetes.

DESIGN: Retrospective cohort study.

PARTICIPANTS: Using data from the Sight Outcomes Research Collaborative (SOURCE) repository, patients with diabetes mellitus and no preexisting DME were identified and followed over time to see what factors associated with DME development.

METHODS: Cox proportional hazard modeling was used to assess the relationship between demographic variables, diabetes type, smoking history, baseline DR status, blood pressure (BP), lipid profile, body mass index (BMI), hemoglobin A1C (HbA1C), and new onset of DME.

MAIN OUTCOME MEASURES: Adjusted hazard ratio (HR) of developing DME with 95% confidence intervals (CIs).

RESULTS: Of 47 509 eligible patients from 10 SOURCE sites (mean age 63 ± 12 years, 58% female sex, 48% White race), 3633 (7.6%) developed DME in the study period. The mean ± standard deviation time to DME was 875 ± 684 days (∼2.4 years) with those with baseline nonproliferative DR (HR 3.67, 95% CI: 3.41-3.95) and proliferative DR (HR 5.19, 95% CI: 4.61-5.85) more likely to develop DME. There was no difference in DME risk between type 1 and type 2 patients; however, Black race was associated with a 40% increase in DME risk (HR 1.40, 95% CI: 1.30-1.51). Every 1 unit increase in HbA1C had a 15% increased risk of DME (HR 1.15, 95% CI: 1.13-1.17), and each 10 mmHg increase in systolic BP was associated with a 6% increased DME risk (HR 1.06, 95% CI: 1.02-1.09). No association was identified between DME development and BMI, triglyceride levels, or high-density lipoprotein levels.

CONCLUSIONS: These findings suggest that in patients with diabetes modifiable risk factors such as elevated HbA1C and BP confer a higher risk of DME development; however, other modifiable systemic markers of dysmetabolism such as obesity and dyslipidemia did not. Further work is needed to identify the underlying contributions of race in DME.

FINANCIAL DISCLOSURES: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

PMID:39149711 | PMC:PMC11324816 | DOI:10.1016/j.xops.2024.100557

eNeuro. 2024 Aug 15:ENEURO.0291-24.2024. doi: 10.1523/ENEURO.0291-24.2024. Online ahead of print.

ABSTRACT

Volatile anesthetics are currently believed to cause unconsciousness by acting on one or more molecular targets including neural ion channels, receptors, mitochondria, synaptic proteins, and cytoskeletal proteins. Anesthetic gases including isoflurane bind to cytoskeletal microtubules (MTs) and dampen their quantum optical effects, potentially contributing to causing unconsciousness. This possibility is supported by the finding that taxane chemotherapy consisting of microtubule-stabilizing drugs reduces the effectiveness of anesthesia during surgery in human cancer patients. In order to experimentally assess the contribution of MTs as functionally relevant targets of volatile anesthetics, we measured latencies to loss of righting reflex (LORR) under 4% isoflurane in male rats injected subcutaneously with vehicle or 0.75 mg/kg of the brain-penetrant microtubule-stabilizing drug epothilone B (epoB). EpoB-treated rats took an average of 69 seconds longer to become unconscious as measured by latency to LORR. This was a statistically significant difference corresponding to a standardized mean difference (Cohen’s d) of 1.9, indicating a “large” normalized effect size. The effect could not be accounted for by tolerance from repeated exposure to isoflurane. Our results suggest that binding of the anesthetic gas isoflurane to microtubules causes unconsciousness and loss of purposeful behavior in rats (and presumably humans and other animals). This finding is predicted by models that posit consciousness as a property of a quantum physical state of neural microtubules.Significance statement Our study establishes that action on intracellular microtubules is the mechanism, or one of the mechanisms, by which the inhalational anesthetic gas isoflurane induces unconsciousness in rats. This finding has potential clinical implications for understanding how taxane chemotherapy interferes with anesthesia in humans, and more broadly for avoiding anesthesia failures during surgery. Our results are also theoretically important because they provide support for microtubule-based theories of anesthetic action and consciousness.

PMID:39147581 | DOI:10.1523/ENEURO.0291-24.2024

Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2024 Aug 16;40:e20240021. doi: 10.62958/j.cjap.2024.021.

ABSTRACT

BACKGROUND AND OBJECTIVES: Nanosponges are one of the most innovative ways to use the newest developments in nanodrugs delivery. Nanosponges can catch drugs that dissolve in water or ones that don’t. This work uses statistical design to find the best nanosponges for drugs that don’t dissolve easily and make them.

MATERIAL AND METHODS: It was looked into how to statistically make the most of the effects of independent factors. The ethyl cellulose ratio and stirring rate were chosen based on how they affected the dependent variables, such as particle size and how well they were trapped. FTIR, SEM, zeta potential, entrapment efficiency, and particle size data were used to test the nanosponges that were made. Using carbopol, the best lot of nanosponges was added to the gel.

RESULTS: Using ethyl cellulose and polyvinyl alcohol as stabilizers in the emulsion liquid diffusion method, it was possible to make drug-loaded nanosponges. It was possible to make the nanosponges composition work better by using Central Composite Design. It has been seen that making drug-filled nanosponges improves stability.

CONCLUSION: The study showcased the enhanced capacity of a formulation with decreased particle size and high entrapment efficiency to disseminate effectively.

PMID:39147577 | DOI:10.62958/j.cjap.2024.021

Occup Environ Med. 2024 Aug 15:oemed-2023-109192. doi: 10.1136/oemed-2023-109192. Online ahead of print.

ABSTRACT

OBJECTIVE: This follow-up study of uranium processing workers at the Fernald Feed Materials Production Center examines the relationship between radiation exposure and cancer and non-cancer mortality among 6403 workers employed for at least 30 days between 1951 and 1985.

METHODS: We estimated cumulative, individual, annualised doses to 15 organs/tissues from external, internal and radon exposures. Vital status and cause of death were ascertained in 2017. The analysis employed standardised mortality ratios, Cox proportional hazards and Poisson regression models. Competing risk analysis was conducted for cardiovascular disease (CVD) mortality risk given several assumptions about risk independent of competing outcomes. Emphysema was examined to assess the potential for confounding by smoking.

RESULTS: Vital status was confirmed for 98.1% of workers, with 65.1% deceased. All-cause mortality was less than expected in salaried but not hourly workers when compared with the US population. A statistically significant dose response was observed between external (but not total or internal) lung dose and lung cancer mortality (HR at 100 mGy adjusted for internal dose=1.45; 95% CI=1.05 to 2.01). Significantly increased HRs at 100 mGy dose to heart were observed for CVD (1.27; 95% CI=1.07 to 1.50) and ischaemic heart disease (1.30; 95% CI=1.07 to 1.58). CVD risk remained elevated regardless of competing risk assumptions. Both external and internal radiation were associated with emphysema.

CONCLUSIONS: Lung cancer was associated with external dose, though positive dose responses for emphysema imply residual confounding by smoking. Novel use of competing risk analysis for CVD demonstrates leveraging retrospective data for future risk prediction.

PMID:39147576 | DOI:10.1136/oemed-2023-109192

Food Res Int. 2024 Sep;192:114838. doi: 10.1016/j.foodres.2024.114838. Epub 2024 Jul 27.

ABSTRACT

In this study, for the very first time, aqueous extracts obtained from flowers of spontaneously grown or cultivated Onopordum platylepis (Murb.) Murb. thistles were used as coagulating agents for the pilot-scale manufacture of Caciofiore, a traditional Italian raw ewe’s milk cheese. Cheese prototypes were compared to control cheeses curdled with a commercial thistle rennet obtained from flowers of Cynara cardunculus L. After 45 days of ripening under controlled conditions, both the experimental and control cheese prototypes were analyzed for: cheese yield, physico-chemical (pH, titratable acidity, a_w, proximate composition), morpho-textural (color and texture), and microbiological parameters (viable cell counts and species composition assessed by Illumina sequencing), as well as volatile profile by SPME-GC-MS. Slight variations in titratable acidity, color, and texture were observed among samples. Based on the results overall collected, neither the yield nor the proximate composition was apparently affected by the type of thistle coagulant. However, the experimental cheese prototypes curdled with extracts from flowers of both spontaneous or cultivated thistles showed 10 % higher values of water-soluble nitrogen compared to the control prototypes. On the other hand, these latter showed slightly higher loads of presumptive lactococci, thermophilic cocci, coliforms, and eumycetes, but lower counts of Escherichia coli. No statistically significant differences were revealed by the metataxonomic analysis of the bacterial and fungal biota. Though most volatile organic compounds (VOCs) were consistent among the prototypes, significant variability was observed in the abundance of some key aroma compounds, such as butanoic, hexanoic, and octanoic acids, ethanol, propan-2-ol, isobutyl acetate, 2-methyl butanoic acid, and 3-methyl butanal. However, further investigations are required to attribute these differences to either the type of coagulant or the metabolic activity of the microorganisms occurring in the analyzed cheese samples. The results overall collected support the potential exploitation of O. platylepis as a novel source of thistle coagulant to produce ewe’s milk cheeses.

PMID:39147526 | DOI:10.1016/j.foodres.2024.114838

Food Res Int. 2024 Sep;192:114816. doi: 10.1016/j.foodres.2024.114816. Epub 2024 Jul 24.

ABSTRACT

Lipids are the key matrix for the presence of odorants in meat products. The formation mechanism of odorants of air-fried (AF) pork at 230 °C was elucidated from the perspectives of lipids and heat transfer using physicochemical analyses and multidimensional statistics. Twenty-nine key aroma compounds were identified, with pyrazines predominantly contributing to the roasty aroma of air-fried roasted pork. Untargeted lipidomics revealed 1184 lipids in pork during roasting, with phosphatidylcholine (PC), phosphatidylethanolamine (PE), and triglyceride (TG) being the major lipids accounting for about 60 % of the total lipids. TG with C₁₈ acyl groups, such as TG 16:1_18:1_18:2 and TG 18:0_18:0_20:3, were particularly significant in forming the aroma of AF pork. The OPLS-DA model identified seven potential biomarkers that differentiate five roasting times, including PC 16:0_18:3 and 2-ethyl-3,5-dimethylpyrazine. Notably, a lower specific heat capacity and water activity accelerated heat transfer, promoting the formation and retention of odorants in AF pork.

PMID:39147509 | DOI:10.1016/j.foodres.2024.114816

Food Res Int. 2024 Sep;192:114771. doi: 10.1016/j.foodres.2024.114771. Epub 2024 Jul 15.

ABSTRACT

This comprehensive study explores the phytoconstituents of different parts of pumpkin (Cucurbita pepo) including flesh, peel, seeds, pumpkin juice, and pumpkin seed oil. Utilizing advanced analytical techniques including UPLC-QqQ-MS and GC-TSQ-MS combined with multivariate statistical analysis, 94 distinct chromatographic peaks from various chemical classes were annotated. Predominant classes included phenolic acids, flavonoids, cucurbitacins, amino acids, triterpenoids, fatty acids, sterols, carotenoids, and other compounds. For more comprehensive chemical profiling of the tested samples, fractionation of the different parts of the fruit was attempted through successive solvent extraction. The unsaponifiable part of the oils, analyzed by GC, showed that the phytosterols, namely ß-sitosterol, and stigmasterol are in the majority. All pumpkin extracts showed significant inhibition of carbohydrase enzymes and glucose uptake promotion by cells. Pumpkin flesh butanol fraction exhibited potent α-glucosidase inhibition, while pumpkin defatted seed methylene chloride fraction showed strong α-amylase inhibition. Additionally, pumpkin seed oil and defatted seed petroleum ether fraction demonstrated high glucose uptake activity. Bioactive metabolites including vaccenic acid, sinapic acid, kuguacin G, luteolin hexoside, delta-7-avenasterol, cucurbitosides and others were unveiled through OPLS multivariate models elucidating the anti-diabetic potential of pumpkin. These findings support the use of pumpkin as a functional food, offering insights into its mechanisms of action in diabetes management.

PMID:39147478 | DOI:10.1016/j.foodres.2024.114771