Category: Statistics

Water Sci Technol. 2024 Mar;89(5):1252-1263. doi: 10.2166/wst.2024.056.

ABSTRACT

A biochar from co-pyrolysis of a mixture of sawdust and biological sludge (70/30, w/w), providing a high environmental compatibility in terms of water leachable polycyclic aromatic hydrocarbons and inorganic elements, together with a remarkable surface area (389 m²/g), was integrated into laboratory-scale vertical-flow constructed wetlands (VF-CWs), planted with Phragmites australis and unplanted. Biochar-filled VF-CWs have been tested for 8 months for the refining of effluents from the tertiary clariflocculation stage of a wastewater treatment plant operating in a mixed domestic-industrial textile context, in comparison with systems filled with gravel. VF-CW influents and effluents were monitored for chemical oxygen demand (COD), nitrogen and phosphorus cycles, and absorbance values at 254 and 420 nm, the latter as rapid and reliable screening parameters of the removal of organic micropollutants containing aromatic moieties and/or chromophores. Biochar-based systems provided a statistically significant improvement in COD (Δ = 22%) and ammonia (Δ = 35%) removal, as well as in the reduction of UV-Vis absorbance values (Δ = 32-34% and Δ = 28% for 254 and 420 nm, respectively), compared to gravel-filled microcosms. The higher removal of organic was mainly attributed to the well-known adsorption properties of biochars, while for nitrogen the biological mechanisms seem to play a predominant role.

PMID:38483496 | DOI:10.2166/wst.2024.056

Water Sci Technol. 2024 Mar;89(5):1240-1251. doi: 10.2166/wst.2024.039.

ABSTRACT

The accelerated growth of cyanobacteria in water bodies is a global critical environmental issue caused by continuous discharges of effluents into the environment that are rich in phosphorus and nitrogen. So, cyanobacteria have found propitious conditions for proliferation, provoking significant ecological imbalances. Cyanobacteria produce cyanotoxins, which are harmful to life, and compounds like 2-methylisoborneol and geosmin that affect water’s taste and odor. This study analyzed a long-term database of important environmental parameters from a tropical reservoir in São Paulo State, Brazil. The statistical methods of correlation matrices and principal component analysis were used. Data analysis revealed a significant relationship between cyanobacteria growth and high levels of phosphate and nitrogen. Furthermore, positive correlations were found among concentrations of biocidal elements like antimony, arsenic, and selenium related to cyanobacterial bloomings. These correlations can be attributed to agricultural wastewaters and/or possible algicide used to control these microorganisms.

PMID:38483495 | DOI:10.2166/wst.2024.039

Psychol Serv. 2024 Mar 14. doi: 10.1037/ser0000851. Online ahead of print.

ABSTRACT

This article examines the feasibility of implementing patient-reported outcome (PRO) measures with adolescents on an inpatient psychiatry service. During the study period (March 8, 2021, to June 7, 2022), a total of 154 patient encounters were recorded for adolescents between 12 and 17 years of age. PROs were piloted during the first 3 months of the study period, with a focus on technical implementation. In the 12 months from June 8, 2021, through June 7, 2022, the PRO project moved to full implementation across all patient encounters. Fisher’s exact test and independent t tests were conducted to examine the differences between patients who completed the PROs and patients who did not complete them to determine the representativeness of the sample receiving them. During the 3-month pilot period, 31.8% of patients completed the PROs at admission and discharge, while during the 12-month full implementation, 74.5% of patients completed them at both time points. Statistical tests showed no significant diagnostic, sex, or race/ethnicity differences between patients who received and did not receive the outcome measures. Even without funding, small inpatient psychiatry services for adolescents can feasibly implement PROs with completion rates similar to other published studies and capture the majority of the patients served. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PMID:38483486 | DOI:10.1037/ser0000851

Microbiol Spectr. 2024 Mar 14:e0393123. doi: 10.1128/spectrum.03931-23. Online ahead of print.

ABSTRACT

Antimicrobial resistance is one of the greatest challenges to global health. While the development of new antimicrobials can combat resistance, low profitability reduces the number of new compounds brought to market. Elucidating the mechanism of action is crucial for developing new antimicrobials. This can become expensive as there are no universally applicable pipelines. Phenotypic heterogeneity of microbial populations resulting from antimicrobial treatment can be captured through flow cytometric fingerprinting. Since antimicrobials are classified into limited groups, the mechanism of action of known compounds can be used for predictive modeling. We demonstrate a cost-effective flow cytometry approach for determining the mechanism of action of new compounds. Cultures of Actinomyces viscosus and Fusobacterium nucleatum were treated with different antimicrobials and measured by flow cytometry. A Gaussian mixture mask was applied over the data to construct phenotypic fingerprints. Fingerprints were used to assess statistical differences between mechanism of action groups and to train random forest classifiers. Classifiers were then used to predict the mechanism of action of cephalothin. Statistical differences were found among the different mechanisms of action groups. Pairwise comparison showed statistical differences for 35 out of 45 pairs for A. viscosus and for 32 out of 45 pairs for F. nucleatum after 3.5 h of treatment. The best-performing random forest classifier yielded a Matthews correlation coefficient of 0.92 and the mechanism of action of cephalothin could be successfully predicted. These findings suggest that flow cytometry can be a cheap and fast alternative for determining the mechanism of action of new antimicrobials.IMPORTANCEIn the context of the emerging threat of antimicrobial resistance, the development of novel antimicrobials is a commonly employed strategy to combat resistance. Elucidating the mechanism of action of novel compounds is crucial in this development but can become expensive, as no universally applicable pipelines currently exist. We present a novel flow cytometry-based approach capable of determining the mechanism of action swiftly and cost-effectively. The workflow aims to accelerate drug discovery and could help facilitate a more targeted approach for antimicrobial treatment of patients.

PMID:38483479 | DOI:10.1128/spectrum.03931-23

J Particip Med. 2024 Mar 14;16:e50242. doi: 10.2196/50242.

ABSTRACT

BACKGROUND: Effective primary care necessitates follow-up actions by the patient beyond the visit. Prior research suggests room for improvement in patient adherence.

OBJECTIVE: This study sought to understand patients’ views on their primary care visits, the plans generated therein, and their self-reported adherence after 3 months.

METHODS: As part of a large multisite cluster randomized pragmatic trial in 3 health care organizations, patients completed 2 surveys-the first within 7 days after the index primary care visit and another 3 months later. For this analysis of secondary outcomes, we combined the results across all study participants to understand patient adherence to care plans. We recorded patient characteristics and survey responses. Cross-tabulation and chi-square statistics were used to examine bivariate associations, adjusting for multiple comparisons when appropriate. We used multivariable logistic regression to assess how patients’ intention to follow, agreement, and understanding of their plans impacted their plan adherence, allowing for differences in individual characteristics. Qualitative content analysis was conducted to characterize the patient’s self-reported plans and reasons for adhering (or not) to the plan 3 months later.

RESULTS: Of 2555 patients, most selected the top box option (9=definitely agree) that they felt they had a clear plan (n=2011, 78%), agreed with the plan (n=2049, 80%), and intended to follow the plan (n=2108, 83%) discussed with their provider at the primary care visit. The most common elements of the plans reported included reference to exercise (n=359, 14.1%), testing (laboratory, imaging, etc; n=328, 12.8%), diet (n=296, 11.6%), and initiation or adjustment of medications; (n=284, 11.1%). Patients who strongly agreed that they had a clear plan, agreed with the plan, and intended to follow the plan were all more likely to report plan completion 3 months later (P<.001) than those providing less positive ratings. Patients who reported plans related to following up with the primary care provider (P=.008) to initiate or adjust medications (P≤.001) and to have a specialist visit were more likely to report that they had completely followed the plan (P=.003). Adjusting for demographic variables, patients who indicated intent to follow their plan were more likely to follow-through 3 months later (P<.001). Patients’ reasons for completely following the plan were mainly that the plan was clear (n=1114, 69.5%), consistent with what mattered (n=1060, 66.1%), and they were determined to carry through with the plan (n=887, 53.3%). The most common reasons for not following the plan were lack of time (n=217, 22.8%), having decided to try a different approach (n=105, 11%), and the COVID-19 pandemic impacted the plan (n=105, 11%).

CONCLUSIONS: Patients’ initial assessment of their plan as clear, their agreement with the plan, and their initial willingness to follow the plan were all strongly related to their self-reported completion of the plan 3 months later. Patients whose plans involved lifestyle changes were less likely to report that they had “completely” followed their plan.

TRIAL REGISTRATION: ClinicalTrials.gov NCT03385512; https://clinicaltrials.gov/study/NCT03385512.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/30431.

PMID:38483458 | DOI:10.2196/50242

JMIR Form Res. 2024 Mar 14;8:e51331. doi: 10.2196/51331.

ABSTRACT

BACKGROUND: Misinformation in Spanish on social media platforms has contributed to COVID-19 vaccine hesitancy among Latino parents. Brigada Digital de Salud was established to disseminate credible, science-based information about COVID-19 in Spanish on social media.

OBJECTIVE: This study aims to assess participants’ reactions to and engagement with Brigada Digital content that sought to increase COVID-19 vaccine uptake among US Latino parents and their children.

METHODS: We conducted a 5-week intervention in a private, moderator-led Facebook (Meta Platforms, Inc) group with Spanish-speaking Latino parents of children aged ≤18 years (N=55). The intervention participants received 3 to 4 daily Brigada Digital posts and were encouraged to discuss the covered topics through comments and polls. To assess participants’ exposure, reactions, and engagement, we used participants’ responses to a web-based survey administered at 2 time points (baseline and after 5 weeks) and Facebook analytics to calculate the average number of participant views, reactions, and comments. Descriptive statistics were assessed for quantitative survey items, qualitative responses were thematically analyzed, and quotes were selected to illustrate the themes.

RESULTS: Overall, 101 posts were published. Most participants reported visiting the group 1 to 3 times (22/55, 40%) or 4 to 6 (18/55, 33%) times per week and viewing 1 to 2 (23/55, 42%) or 3 to 4 (16/55, 29%) posts per day. Facebook analytics validated this exposure, with 36 views per participant on average. The participants reacted positively to the intervention. Most participants found the content informative and trustworthy (49/55, 89%), easy to understand, and presented in an interesting manner. The participants thought that the moderators were well informed (51/55, 93%) and helpful (50/55, 91%) and praised them for being empathic and responsive. The participants viewed the group environment as welcoming and group members as friendly (45/55, 82%) and supportive (19/55, 35%). The 3 most useful topics for participants were the safety and efficacy of adult COVID-19 vaccines (29/55, 53%), understanding child risk levels (29/55, 53%), and the science behind COVID-19 (24/55, 44%). The preferred formats were educational posts that could be read (38/55, 69%) and videos, including expert (28/55, 51%) and instructional (26/55, 47%) interviews. Regarding engagement, most participants self-reported reacting to posts 1 to 2 (16/55, 29%) or 3 to 4 (15/55, 27%) times per week and commenting on posts 1 to 2 (16/55, 29%) or <1 (20/55, 36%) time per week. This engagement level was validated by analytics, with 10.6 reactions and 3 comments per participant, on average, during the 5 weeks. Participants recommended more opportunities for engagement, such as interacting with the moderators in real time.

CONCLUSIONS: With adequate intervention exposure and engagement and overall positive participant reactions, the findings highlight the promise of this digital approach for COVID-19 vaccine-related health promotion.

PMID:38483457 | DOI:10.2196/51331

J Med Internet Res. 2024 Mar 14;26:e50882. doi: 10.2196/50882.

ABSTRACT

BACKGROUND: The widespread use of artificial intelligence, such as ChatGPT (OpenAI), is transforming sectors, including health care, while separate advancements of the internet have enabled platforms such as China’s DingXiangYuan to offer remote medical services.

OBJECTIVE: This study evaluates ChatGPT-4’s responses against those of professional health care providers in telemedicine, assessing artificial intelligence’s capability to support the surge in remote medical consultations and its impact on health care delivery.

METHODS: We sourced remote orthopedic consultations from “Doctor DingXiang,” with responses from its certified physicians as the control and ChatGPT’s responses as the experimental group. In all, 3 blindfolded, experienced orthopedic surgeons assessed responses against 7 criteria: “logical reasoning,” “internal information,” “external information,” “guiding function,” “therapeutic effect,” “medical knowledge popularization education,” and “overall satisfaction.” We used Fleiss κ to measure agreement among multiple raters.

RESULTS: Initially, consultation records for a cumulative count of 8 maladies (equivalent to 800 cases) were gathered. We ultimately included 73 consultation records by May 2023, following primary and rescreening, in which no communication records containing private information, images, or voice messages were transmitted. After statistical scoring, we discovered that ChatGPT’s “internal information” score (mean 4.61, SD 0.52 points vs mean 4.66, SD 0.49 points; P=.43) and “therapeutic effect” score (mean 4.43, SD 0.75 points vs mean 4.55, SD 0.62 points; P=.32) were lower than those of the control group, but the differences were not statistically significant. ChatGPT showed better performance with a higher “logical reasoning” score (mean 4.81, SD 0.36 points vs mean 4.75, SD 0.39 points; P=.38), “external information” score (mean 4.06, SD 0.72 points vs mean 3.92, SD 0.77 points; P=.25), and “guiding function” score (mean 4.73, SD 0.51 points vs mean 4.72, SD 0.54 points; P=.96), although the differences were not statistically significant. Meanwhile, the “medical knowledge popularization education” score of ChatGPT was better than that of the control group (mean 4.49, SD 0.67 points vs mean 3.87, SD 1.01 points; P<.001), and the difference was statistically significant. In terms of “overall satisfaction,” the difference was not statistically significant between the groups (mean 8.35, SD 1.38 points vs mean 8.37, SD 1.24 points; P=.92). According to how Fleiss κ values were interpreted, 6 of the control group’s score points were classified as displaying “fair agreement” (P<.001), and 1 was classified as showing “substantial agreement” (P<.001). In the experimental group, 3 points were classified as indicating “fair agreement,” while 4 suggested “moderate agreement” (P<.001).

CONCLUSIONS: ChatGPT-4 matches the expertise found in DingXiangYuan forums’ paid consultations, excelling particularly in scientific education. It presents a promising alternative for remote health advice. For health care professionals, it could act as an aid in patient education, while patients may use it as a convenient tool for health inquiries.

PMID:38483451 | DOI:10.2196/50882

J Chem Inf Model. 2024 Mar 14. doi: 10.1021/acs.jcim.3c01925. Online ahead of print.

ABSTRACT

The lengthy and expensive process of developing new drugs from scratch, coupled with a high failure rate, has prompted the emergence of drug repurposing/repositioning as a more efficient and cost-effective approach. This approach involves identifying new therapeutic applications for existing approved drugs, leveraging the extensive drug-related data already gathered. However, the diversity and heterogeneity of data, along with the limited availability of known drug-disease interactions, pose significant challenges to computational drug design. To address these challenges, this study introduces EKGDR, an end-to-end knowledge graph-based approach for computational drug repurposing. EKGDR utilizes the power of a drug knowledge graph, a comprehensive repository of drug-related information that encompasses known drug interactions and various categorization information, as well as structural molecular descriptors of drugs. EKGDR employs graph neural networks, a cutting-edge graph representation learning technique, to embed the drug knowledge graph (nodes and relations) in an end-to-end manner. By doing so, EKGDR can effectively learn the underlying causes (intents) behind drug-disease interactions and recursively aggregate and combine relational messages between nodes along different multihop neighborhood paths (relational paths). This process generates representations of disease and drug nodes, enabling EKGDR to predict the interaction probability for each drug-disease pair in an end-to-end manner. The obtained results demonstrate that EKGDR outperforms previous models in all three evaluation metrics: area under the receiver operating characteristic curve (AUROC = 0.9475), area under the precision-recall curve (AUPRC = 0.9490), and recall at the top-200 recommendations (Recall@200 = 0.8315). To further validate EKGDR’s effectiveness, we evaluated the top-20 candidate drugs suggested for each of Alzheimer’s and Parkinson’s diseases.

PMID:38483449 | DOI:10.1021/acs.jcim.3c01925

J Emerg Nurs. 2024 Mar 13:S0099-1767(24)00021-7. doi: 10.1016/j.jen.2024.01.006. Online ahead of print.

ABSTRACT

INTRODUCTION: Pediatric convulsive status epilepticus is one of the most common neurologic emergencies and should be managed by health care professionals as soon as possible based on current guidelines. This study aimed to determine the nursing approaches and management of pediatric convulsive status epilepticus from the perspective of emergency nurses in Turkey.

METHODS: A cross-sectional, multicenter study was conducted with 162 emergency nurses working in emergency departments in 35 different provinces in Turkey. The data were collected via an online form. Descriptive statistical methods were used in data analysis.

RESULTS: Most emergency nurses (72.2%) attempted an intravenous access immediately to administer antiseizure medications during the stabilization phase. Approximately half the emergency nurses stated that rectal diazePAM was frequently administered in the initial therapy phase and intravenous diazePAM was administered in the second therapy phase. The emergency nurses had most difficulties attempting intravenous access, determining status epilepticus types, and calming the parents.

DISCUSSION: As health care professionals and important members of the health team, emergency nurses have the responsibility to manage pediatric convulsive status epilepticus in the fastest and the most appropriate way based on current practice guidelines in emergency departments. When intravenous access is not available, nonintravenous benzodiazepines should be considered in the first-line treatment of pediatric convulsive status epilepticus, followed by immediate intravenous access.

PMID:38483423 | DOI:10.1016/j.jen.2024.01.006

J Allergy Clin Immunol. 2024 Feb 28:S0091-6749(24)00126-X. doi: 10.1016/j.jaci.2024.01.023. Online ahead of print.

ABSTRACT

BACKGROUND: Long-standing health inequalities in Australian society that were exposed by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic were described as “fault lines” in a recent call to action by a consortium of philanthropic organizations. With asthma a major contributor to childhood disease burden, studies of its spatial epidemiology can provide valuable insights into the emergence of health inequalities early in life.

OBJECTIVE: The aims of this study were to characterize the spatial variation of asthma prevalence among children living within Australia’s 4 largest cities and quantify the relative contributions of climatic and environmental factors, outdoor air pollution, and socioeconomic status in determining this variation.

METHODS: A Bayesian model with spatial smoothing was developed to regress ecologic health status data from the 2021 Australian Census against groups of explanatory covariates intended to represent mechanistic pathways.

RESULTS: The prevalence of asthma in children aged 5 to 14 years averages 7.9%, 8.2%, 8.5%, and 7.6% in Sydney, Melbourne, Brisbane, and Perth, respectively. This small inter-city variation contrasts against marked intracity variation at the small-area level, which ranges from 6% to 12% between the least and most affected locations in each. Statistical variance decomposition on a subsample of Australian-born, nonindigenous children attributes 66% of the intracity spatial variation to the assembled covariates. Of these covariates, climatic and environmental factors contribute 30%, outdoor air pollution contributes 19%, and areal socioeconomic status contributes the remaining 51%.

CONCLUSION: Geographic health inequalities in the prevalence of childhood asthma within Australia’s largest cities reflect a complex interplay of factors, among which socioeconomic status is a principal determinant.

PMID:38483422 | DOI:10.1016/j.jaci.2024.01.023