Category: Statistics

Thorac Surg Clin. 2024 Aug;34(3):239-247. doi: 10.1016/j.thorsurg.2024.04.001. Epub 2024 May 4.

ABSTRACT

Abuse, bullying, harassment, and discrimination are prominent workplace occurrences within cardiothoracic (CT) surgery that cause burnout and threaten the well-being of surgeons. Under-represented and marginalized groups experience higher incidences of these negative events, and CT surgery is one of the least diverse specialties. The CT surgery workforce and institutional leadership must prioritize mentorship, sponsorship, and allyship to promote a diverse and healthy specialty for surgeon recruitment, growth, and job satisfaction.

PMID:38944451 | DOI:10.1016/j.thorsurg.2024.04.001

J Appl Microbiol. 2024 Jun 29:lxae163. doi: 10.1093/jambio/lxae163. Online ahead of print.

ABSTRACT

AIMS: Shellfish production areas are classified for suitability for human consumption using counts of E.coli in shellfish samples. Two alternative laboratory methods are approved in the EU and UK for measuring E. coli in shellfish samples; the MPN and pour plate methods. These methods have inherently different statistical uncertainty and may give different counts for the same sample. Using two approaches: simulated data and spiking experiments, we investigate the theoretical properties of the two methods to determine their reliability for shellfish waters classification.

METHODS AND RESULTS: Assuming a Poisson distribution of E. coli in shellfish samples, we simulate concentrations in 10,000 samples using the MPN and pour plate methods. We show that for higher concentrations of E. coli the pour plate method becomes increasingly more reliable than the MPN method. The MPN method has higher probabilities than pour plate of generating results exceeding shellfish classification thresholds, while conversely having higher probabilities of failing to detect counts that exceed regulatory thresholds. The theoretical analysis also demonstrates that the MPN method can produce genuine extreme outliers, even when E. coli are randomly distributed within the sampled material. A laboratory spiking experiment showed results consistent with the theoretical analysis, suggesting the Poisson assumption used in the theoretical analysis is reasonable.

CONCLUSION: The large differences in statistical properties between the pour plate and MPN methods should be taken into consideration in classifying shellfish beds, with the pour plate method being more reliable over the crucial range of E. coli concentrations used to determine class boundaries.

PMID:38944416 | DOI:10.1093/jambio/lxae163

J Allergy Clin Immunol. 2024 Jun 27:S0091-6749(24)00637-7. doi: 10.1016/j.jaci.2024.06.013. Online ahead of print.

ABSTRACT

BACKGROUND: Mesenchymal stem cells (MSCs) play important roles in therapeutic applications by regulating immune responses.

OBJECTIVE: To investigate the safety and efficacy of allogenic human bone marrow-derived clonal MSCs (hcMSCs) in subjects with moderate to severe atopic dermatitis (AD).

METHODS: The study included a phase I open-label trial followed by a phase II randomized, double-blind, placebo-controlled trial that involved 72 subjects with moderate to severe AD.

RESULTS: In phase I, intravenous (IV) administration of hcMSCs at two doses (1×10⁶ and 5×10⁵ cells/kg) was safe and well-tolerated in 20 subjects. Since there was no difference between the two dosage groups (P=0.9), it was decided to administer low-dose hcMSCs only for phase II. In phase II, subjects receiving three weekly IV infusions of hcMSCs at 5×10⁵ cells/kg showed a higher proportion of an eczema area and severity index (EASI)-50 response at week 12 compared to the placebo group (P=0.038). The differences between groups in the dermatology life quality index and pruritus numerical-rating scale scores were not statistically significant. Most adverse events were mild or moderate and resolved by the end of the study period.

CONCLUSIONS: Our findings demonstrate that hcMSCs treatment resulted in a significantly higher rate of achieving EASI-50 at 12 weeks compared to the control group in subjects with moderate to severe AD. The safety profile of hcMSCs treatment was acceptable. Further larger-scale studies are necessary to confirm these preliminary findings.

PMID:38944393 | DOI:10.1016/j.jaci.2024.06.013

Urology. 2024 Jun 27:S0090-4295(24)00512-0. doi: 10.1016/j.urology.2024.06.058. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify characteristics of published manuscripts following a regional American Urological Association (AUA) meeting and recognize trends of publication rates over a 13-year timeframe.

METHODS: Abstract submissions to the Mid-Atlantic AUA (MA-AUA) conference from 2008 to 2020 were collected. Manuscripts were searched using abstract titles and authors in a standard fashion using PubMed, Google Scholar, and Google. Characteristic data was collected, including abstract type (podium or poster), abstract category, first author gender, manuscript publication date, and journal of publication. Univariate and multivariate analysis determined association of these variables with manuscript publication.

RESULTS: 1257 abstracts were presented between 2008 and 2020, of which 458 (36%) were published as manuscripts and 799 (64%) were not published. Of the published manuscripts, 55 (12%) were published prior to the conference date and 403 (88%) were published after. Our analysis was limited to the 403 manuscripts published post-meeting and the 799 abstracts that were not published, with N=1202. Amongst the 403 published post-meeting, the mean time to publication was 14.8 months ± 13.2 months. Podium presentations had a higher proportion of publications than those of posters (39.4% vs 30.5%, p=0.002). There was a statistically significant difference in proportion of publications between years (p=0.002). No association was noted between abstract first author gender and publication (38.7% male vs. 39.2% female, p=0.899).

CONCLUSIONS: Approximately one-third of presented abstracts from a major urologic conference were published with an average time to publication of 15 months. Publication percentage varied significantly between different years. Podium presentations had a higher publication rate compared to non-podium abstracts.

PMID:38944386 | DOI:10.1016/j.urology.2024.06.058

J Infect Chemother. 2024 Jun 27:S1341-321X(24)00171-5. doi: 10.1016/j.jiac.2024.06.015. Online ahead of print.

ABSTRACT

BACKGROUND: Human cytomegalovirus (HCMV) infection occurs in immunosuppressed individuals and is known to increase mortality. Patients with coronavirus disease 2019 (COVID-19) are often treated with steroids, require intensive care unit (ICU) treatment, and may therefore be at risk for HCMV infection. However, which factors predispose severely ill patients with COVID-19 to HCMV infection and the prognostic value of such infections remain largely unexplored. This study aimed to examine the incidence and potential risk factors of HCMV infection in patients with severe or critical COVID-19 and evaluate the relationship between HCMV infection and mortality.

METHODS AND FINDINGS: We used administrative claims data from advanced treatment hospitals in Japan to identify and analyze patients with severe or critical COVID-19. We explored potential risk factors for HCMV infection using multivariable regression models and their contribution to mortality in patients with COVID-19. Overall, 33,151 patients who progressed to severe or critical COVID-19 illness were identified. The incidence of HCMV infection was 0.3-1.7% depending on the definition of HCMV infection. Steroids, immunosuppressants, ICU admission, and blood transfusion were strongly associated with HCMV infection. Furthermore, HCMV infection was associated with patient mortality independent of the observed risk factors for death.

CONCLUSIONS: HCMV infection is a notable complication in patients with severe or critical COVID-19 who are admitted to the ICU or receive steroids, immunosuppressants, and blood transfusion and can significantly increase mortality risk.

PMID:38944381 | DOI:10.1016/j.jiac.2024.06.015

Int J Biostat. 2024 Jul 1. doi: 10.1515/ijb-2023-0050. Online ahead of print.

ABSTRACT

Traditional methods for Sample Size Determination (SSD) based on power analysis exploit relevant fixed values or preliminary estimates for the unknown parameters. A hybrid classical-Bayesian approach can be used to formally incorporate information or model uncertainty on unknown quantities by using prior distributions according to the Bayesian approach, while still analysing the data in a frequentist framework. In this paper, we propose a hybrid procedure for SSD in two-arm superiority trials, that takes into account the different role played by the unknown parameters involved in the statistical power. Thus, different prior distributions are used to formalize design expectations and to model information or uncertainty on preliminary estimates involved at the analysis stage. To illustrate the method, we consider binary data and derive the proposed hybrid criteria using three possible parameters of interest, i.e. the difference between proportions of successes, the logarithm of the relative risk and the logarithm of the odds ratio. Numerical examples taken from the literature are presented to show how to implement the proposed procedure.

PMID:38943460 | DOI:10.1515/ijb-2023-0050

J Foot Ankle Res. 2024 Sep;17(3):e12018. doi: 10.1002/jfa2.12018.

ABSTRACT

BACKGROUND: Medical students face the challenge of learning vast amounts of complex information. Existing research suggests improved learning outcomes using multimedia resources but reports on their impact on podiatric education are scarce. To explore the potential of multimedia-based learning tools in enriching medical education, this study examined the impact of Osmosis, a platform featuring interactive videos, flashcards, and self-assessment quizzes on podiatric medical student outcomes.

METHODS: This quasi-experimental study examined the impact of Osmosis, a multimedia learning platform with videos, flashcards, and quizzes, on podiatric medical students’ learning outcomes. Two cohorts (T = Osmosis access, N = 86; C = no access, N = 87) took Pharmacology and Podiatric Medicine courses consecutively. Final exam scores, final course grades, platform usage metrics (median weekly videos watched, flashcards, and quizzes), and student experience surveys were analyzed.

RESULTS: Analyses revealed no statistically significant differences in final exam scores between the groups in Pharmacology and Podiatric Medicine. While the treatment group exhibited a slight upward trend, further research is required for conclusive evidence. Student perceptions of Osmosis were overwhelmingly positive, with 90.2% of students agreeing that it facilitated concept learning and understanding compared to 54.9% for the textbook. Similarly, 80.4% of the treatment group felt that Osmosis enhanced their test performance, exceeding the 54.9% recorded for the textbook. Correlation analysis indicates a plausible connection between platform usage and academic success, as reflected by moderate positive correlations (r = [0.14, 0.28]) with final grades. Logistic regression analysis revealed that students with Osmosis access were 2.88 times more likely to score 90% or higher on the Pharmacology final exam (p < 0.05) and exhibited increased odds of achieving high (90%+) final course grades in Podiatric Medicine (OR = 2.71).

CONCLUSIONS: These findings suggest that Osmosis holds promise as a tool to support podiatric medical student learning. While the lack of statistically significant differences in final exam scores warrants further investigation, the positive student perceptions, high engagement rates, and increased odds of high scores in specific areas indicate the potential for Osmosis to positively impact academic outcomes. Therefore, a multimedia-based resource like Osmosis appears to show promise as a tool to support podiatric medical education. The limitations inherent in the quasi-experimental design necessitate further studies to confirm its effectiveness and long-term impact on podiatric medical education.

PMID:38943458 | DOI:10.1002/jfa2.12018

Otolaryngol Head Neck Surg. 2024 Jun 29. doi: 10.1002/ohn.885. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate patients’ satisfaction with opioid versus opioid-sparing postoperative analgesia in patients undergoing outpatient head and neck surgery.

STUDY DESIGN: Prospective randomized trial.

SETTING: Tertiary care academic hospital.

METHODS: Adult patients undergoing outpatient head and neck surgery were randomly assigned to 1 of 3 analgesic regimens. First- and second-line medications were the following by group (1) Hydrocodone-acetaminophen with ibuprofen, (2) ibuprofen with hydrocodone-acetaminophen, and (3) ibuprofen with acetaminophen. Preoperative counseling was provided to patients regarding expected pain and proper medication use. Postoperative questionnaires were administered to assess satisfaction.

RESULTS: One hundred three patients were enrolled in the study (mean age, 56.5 years; women, 75 [73%]). The mean satisfaction score with the pain regimen assigned was similar between the 3 groups (scale 0-10, [7.7, 8.3, 8.5, P = .46]). A similar percentage of patients in each group reported that surgery was more painful than anticipated (25%, 32%, 26%, P = .978), and a similar percentage of patients reported willingness to utilize the same analgesic regimen following future surgeries (75%, 83%, 76%, P = .682). Additional questions evaluating the side effect profile, maximum and minimum pain scores, and difficulty of recovery were not statistically different between the 3 groups.

CONCLUSION: In the postoperative population for outpatient head and neck surgeries, there was no significant difference in patient satisfaction and pain control between the opioid and nonopioid arms. Providers should discuss opioid-sparing regimens preoperatively with patients and describe them as effective in providing adequate pain control without a significant impact on patient’s perception of care.

PMID:38943454 | DOI:10.1002/ohn.885

Otolaryngol Head Neck Surg. 2024 Jun 29. doi: 10.1002/ohn.876. Online ahead of print.

ABSTRACT

OBJECTIVE: Our study aims to assess if decreasing bottle cap size was associated with more ingestions and injuries nationally. STUDY DESIGN: Retrospective chart review.

SETTING: The National Electronic Injury Surveillance System (NEISS) database.

METHODS: The NEISS was queried for bottle cap ingestions in children 0 to 18 years old between 2002 and 2021. Demographic factors including age, race, and sex of the patient were recorded. The location where the ingestion took place and the disposition of the patient were also analyzed. Data were excluded if the narrative did not specify the ingestion of a cap of a drinking bottle.

RESULTS: A total of 415 bottle cap ingestion injuries were identified, for a national estimate of 11,683 injuries. The mean age at the time of ingestion was 10.3 ± 5.2 years and the majority of the injuries occurred in males (N = 9129, 78.4%). 46.4% (N = 5398) were Caucasian, 17.6% (N = 2046) were Black or African American, and 2.7% (N = 311) were Hispanic. 55.0% (N = 6405) of injuries occurred at an unknown location, 41.4% (N = 4781) occurred at home, and 2.8% (N = 326) occurred at school. 82.3% (N = 9584) of patients were treated in the emergency department and released, 6.9% (N = 808) were treated and admitted, 6.7% (N = 783) were treated and transferred, and 0.9% (N = 110) were held for observation. From 2002 (N = 6) to 2021 (N = 2291), there was a statistically significant increase in bottle cap ingestions (P < .001).

CONCLUSION: Plastic bottle cap ingestions have increased in children over the last 20 years, coincident with the change to smaller bottle caps.

PMID:38943452 | DOI:10.1002/ohn.876

Work. 2024 Jun 25. doi: 10.3233/WOR-230643. Online ahead of print.

ABSTRACT

BACKGROUND: In vehicles there is often limited space for seats. This might mean that reclining the back rest reduces the legroom. The second row in a cargo van has this problem and in this limited space an upright seat and a reclined seat with less legroom was developed and tested.

OBJECTIVE: The research question of this study is: Does a reclined backrest with less leg room result in the same comfort and/or discomfort as an upright backrest with more leg room?

METHODS: Twenty participants are asked to sit 45 minutes in the upright seat with 8 cm more legroom and 45 minutes in the reclined seat. Ten participants started in the upright seat and ten in the reclined. Participants had to complete a comfort and discomfort questionnaire every 15 minutes and a qualitative interview was conducted after experiencing both seats.

RESULTS: For comfort no statistically significant differences were found between both seats. For discomfort statistically significant differences were found where discomfort was lower in the reclined seat. Half of the participants preferred the upright and half the reclined seat. The interviews showed that the reclined position was more related to relaxation.

CONCLUSIONS: This study indicates that a more reclined back rest results in less discomfort, but that does not lead to a clear preference of participants. The reclined position is associated with relaxing, and this study indicates that for the relaxing state the more reclined seat is preferred. For more active situations the upright posture seems better.

PMID:38943420 | DOI:10.3233/WOR-230643