Category: Statistics

Ther Clin Risk Manag. 2024 Jun 17;20:373-379. doi: 10.2147/TCRM.S455332. eCollection 2024.

ABSTRACT

INTRODUCTION: The management of patients with COVID-19 infection has placed great pressure on the healthcare systems around the world. The aim of this study was to investigate the impact of the COVID-19 pandemic on the treatment outcomes of patients with rectal cancer by comparing them to those of patients with the same diagnosis in the pre-pandemic period.

METHODS: Retrospective data analysis of patients undergoing multimodal treatment for rectal cancer at the four university hospitals during the COVID-19 pandemic (2020-2021) and the 2-year pre-pandemic period (2018-2019).

RESULTS: A total of 693 patients (319 in the pre-pandemic period and 374 in the pandemic period) with rectal cancer were included in the study. The demographic and clinical characteristics of patients in both study periods were comparable, as was the spectrum of surgical procedures. Palliative surgery was more common in the pandemic period (18% vs 13%, p=0.084). The proportion of patients undergoing minimally invasive surgery was higher during the COVID-19 pandemic (p=0.025). There were no statistically significant differences between the study periods in the incidence/severity of post-operative complications, 30-day mortality and length of hospital stay. The number of positive resection margins was similar (5% vs 5%). Based on these results, COVID-19 had no effect on the postoperative morbidity and mortality in patients undergoing surgery for rectal cancer. Neoadjuvant treatment was more common in the pre-pandemic period (50% vs 45%). Long-course RT was predominantly offered in the pre-pandemic period, short-course RT during the pandemic. Significantly shorter “diagnosis-surgery” intervals were observed during the pandemic (23 days vs 33 days, p=0.0002). The “surgery-adjuvant therapy” interval was similar in both analysed study periods (p=0.219).

CONCLUSION: Our study showed, that despite concerns about the COVID-19 pandemic, multimodal treatment of rectal cancer was associated with unchanged postoperative morbidity rates, increased frequency of short-course neoadjuvant RT administration and shorter “diagnosis-surgery” intervals.

PMID:38912517 | PMC:PMC11192038 | DOI:10.2147/TCRM.S455332

Heliyon. 2024 May 27;10(11):e31618. doi: 10.1016/j.heliyon.2024.e31618. eCollection 2024 Jun 15.

ABSTRACT

The security of images is one of the predominant pivotal aspects in the mammoth and still expanding digital domain. Due to chaotic system properties i.e. randomness and unpredictability is very appropriate to encrypt the images. In this research article, we construct an encryption model via 6D hyperchaotic map and a symmetric matrix for both color and grayscale images. We utilize the 6D hyperchaotic map in the confusion stage to change the pixel location and the symmetric matrix is used for changing the pixel value in the diffusion step for each RGB channel extraction from plain or original image. The image encryption model is checked over differential attacks (NPCR and UACI). Histogram analysis, correlation coefficients, and entropy analysis are also performed as statistical attacks. In conclusion, the image pixels are uniformly distributed, and the average entropy value are 7.9992 and 7.9973 for color and grayscale images, subsequently. The average NPCR and UACI for color images are 99.5956 and 33.4061, correspondingly, while the values for grayscale images are 99.5934 and 33.3054, respectively. These values are in the vicinity of optimal ranges. The suggested scheme’s great efficiency and the proposed algorithm’s resilience to a wide range of cryptanalytic attacks are implied by experimental results, statistical analysis, and differential attacks.

PMID:38912513 | PMC:PMC11190540 | DOI:10.1016/j.heliyon.2024.e31618

Heliyon. 2024 Jun 7;10(11):e32663. doi: 10.1016/j.heliyon.2024.e32663. eCollection 2024 Jun 15.

ABSTRACT

BACKGROUND: Indiscriminate use of antibiotics leads to antibiotic resistance (AMR) and results in mortality, morbidity, and financial burden. Antibiotic stewardship programs (ASPs) with education can resolve a number of barriers recognized in the implementation of successful ASPs. The aim of this study was to assess health professionals’ perceptions and status of ASPs in hospitals in 2022.

METHODS: A cross-sectional study was conducted from September 1, 2022 to October 30, 2022. A total of 181 health professionals were included, and a self-administered questionnaire was used to collect data. The status of hospitals was assessed using a checklist. The data were analyzed using SPSS version 23, and descriptive statistics and Chi-square tests (X²) at a P-value of <0.05 were used.

RESULTS: Of the 181 respondents, 163 (90.1 %), and 161 (89.0 %) believed that AMR is a significant problem in Ethiopia and globally, respectively. Easy access to antibiotics 155 (85.6 %), and inappropriate use 137 (75.7 %) were perceived as key contributors to AMR. Antibiotics were believed to be prescribed/dispensed without laboratory results 86 (47.5 %), and antibiotic susceptibility patterns were not considered to guide empiric therapy 81 (44.8 %). ASP was believed to reduce the duration of hospital stays and associated costs 137 (75.7 %), and improve the quality of patient care 133 (73.5 %), whereas 151 (83.4 %), 143 (79 %), and 142 (78.5 %) suggested education, institutional guidelines, and prospective audits with feedback interventions to combat AMR in their hospitals, respectively. There were significant differences in perception among professionals based on professional category and attempts by hospitals to implement ASPs. Although ASPs were not functioning according to standard, there have been attempts to implement it in three hospitals. The issue of ASP had never been heard in general hospitals. Currently, it is feasible to implement ASPs in four hospitals.

CONCLUSION: The status of ASP in hospitals was very poor. Despite a lack of prior knowledge on ASPs, most respondents do have a positive perception of AMR and the implementation of ASPs. Pharmacist-led prospective audits and feedback with education and institutional guidelines for empiric antibiotic use can be better implemented in hospitals. Involvement of representatives from infection prevention and control, and collaboration among hospitals in ASP implementation will help establish a strong ASP in the area.

PMID:38912506 | PMC:PMC11193037 | DOI:10.1016/j.heliyon.2024.e32663

Heliyon. 2024 Jun 1;10(11):e32282. doi: 10.1016/j.heliyon.2024.e32282. eCollection 2024 Jun 15.

ABSTRACT

This present study investigated how heat treatment affects the mechanical properties of 3D-printed black carbon fiber HTPLA by manipulating two parameters: heating temperature and holding time. The mechanical properties of 3D-printed black carbon fiber HTPLA components are crucial for assessing their structural integrity and performance. The shrinkage and dimensional accuracy of the 3D-printed parts were also explored using a vernier caliper. The microstructure of both heat-treated and non-heat-treated HTPLA black carbon fiber 3D-printed parts was examined using scanning electron microscopy. Samples were prepared, printed, heat-treated, and mechanically tested, and their microstructure was observed and recorded. The results showed that heat treatment improved the material’s strength, hardness, and crystallinity, leading to better mechanical properties. However, statistical analysis indicates no clear evidence that the two factors, optimum heating temperature and holding time, affect the mechanical properties of heat-treated printed parts. Nonetheless, further study suggests that these factors might be important in optimizing the heat treatment process.

PMID:38912502 | PMC:PMC11190666 | DOI:10.1016/j.heliyon.2024.e32282

Heliyon. 2024 Jun 2;10(11):e32145. doi: 10.1016/j.heliyon.2024.e32145. eCollection 2024 Jun 15.

ABSTRACT

Fuzzy hybrid models are efficient mathematical tools for managing unclear and vague data in real-world scenarios. This research explores the q-rung orthopair fuzzy soft set (q-ROFSS), which presents incomplete and ambiguous details in decision-making problems. The main intention of this study is to describe and evaluate the characteristics of the correlation coefficient (CC) and weighted correlation coefficient (WCC) for q-ROFSS. Also, the technique for order preference should be enhanced by similarity to the ideal solution (TOPSIS) with extended measures in q-ROFSS settings. Furthermore, we integrated mathematical formulations of correlation obstructions to confirm the consistency of the planned technique. It helps handle difficulties involving multi-attribute group decision-making (MAGDM). Moreover, a numerical illustration is presented to clarify how the advocated decision-making methodology can be implemented in evaluating suppliers in green supply chain management (GSCM). As a result, each alternative is assessed using multiple criteria, such as quality and reliability, capacity and scalability, compliance and certifications, and sustainability practices. The technique proposed in this study retains the selected research’s specific structure more effectively than current techniques. A comparative analysis further substantiates the feasibility and effectiveness of the proposed approach over other decision-making techniques.

PMID:38912497 | PMC:PMC11190557 | DOI:10.1016/j.heliyon.2024.e32145

Heliyon. 2024 Jun 1;10(11):e32038. doi: 10.1016/j.heliyon.2024.e32038. eCollection 2024 Jun 15.

ABSTRACT

The cure models based on standard distributions like exponential, Weibull, lognormal, Gompertz, gamma, are often used to analyze survival data from cancer clinical trials with long-term survivors. Sometimes, the data is simple, and the standard cure models fit them very well, however, most often the data are complex and the standard cure models don’t fit them reasonably well. In this article, we offer a novel generalized Gompertz promotion time cure model and illustrate its fitness to gastric cancer data by three different methods. The generalized Gompertz distribution is as simple as the generalized Weibull distribution and is not computationally as intensive as the generalized F distribution. One detailed real data application is provided for illustration and comparison purposes.

PMID:38912437 | PMC:PMC11190554 | DOI:10.1016/j.heliyon.2024.e32038

Data Brief. 2024 May 22;54:110548. doi: 10.1016/j.dib.2024.110548. eCollection 2024 Jun.

ABSTRACT

This study evaluated the level of knowledge of effects, knowledge of safe use, information complexity of natural health products and consumers’ perceived safety and efficacy toward natural health products used to control or cure Covid-19 viruses in Malaysia. The validated questionnaires were used to survey randomly selected stakeholders in Malaysia, who were asked to participate voluntarily in an online survey from 1st September 2020 to 31st December 2020. 723 respondents of adults above 18 years old returned completed questionnaires. The survey used for data collection consisted of 5 questions on knowledge of effects, 4 questions on knowledge for safe-use, 9 questions on perception towards safety and efficacy and 4 questions on the information complexity of natural health products. Besides that, 8 questions are being asked on the demography of respondents at the very end of the survey. The Statistical Package for the Social Sciences (SPSS) version 26 was used to analyse the data. The mean score, correlation and regression values were the focus of this study. The findings provide various opportunities to investigate Malaysian consumers’ perceptions which facilitates the development of regulation and strategic plans related to health, and encourage additional research by other researchers interested in the measures and data given.

PMID:38912420 | PMC:PMC11190492 | DOI:10.1016/j.dib.2024.110548

Front Glob Womens Health. 2024 Jun 7;5:1236758. doi: 10.3389/fgwh.2024.1236758. eCollection 2024.

ABSTRACT

INTRODUCTION: Home delivery, which is the process of childbirth at one’s residence rather than in a health facility, is a major reason for maternal mortality caused by obstetric complications, such as sepsis, hypertensive disorders, and hemorrhage. Maternal and child mortality remains high in developing countries despite efforts made to reduce these outcomes. This is mainly due to poor utilization of institution-based healthcare services. Moreover, there is a limited number of studies that have addressed the determinants of home delivery in Ethiopia, including the study area. This study aims to identify the determinants of home delivery in Bore District, East Guji Zone, Southern Ethiopia, in 2022.

METHODS: A community-based unmatched case-control study was conducted from 18 May to 5 July 2022 among 498 women (249 cases and 249 controls) who gave birth in Bore District. The case group included women who gave birth at home, while the control group included those who gave their last birth at health institutions. A multistage sampling technique was employed to select the study participants. Data were collected using the KoboToolbox digital software and exported to SPSS Version 26.0 for analysis. A multivariable logistic regression analysis was done to declare the statistical significance of the association of the the independent variables and home delivery.

RESULTS: The study included a total of 496 respondents with a mean age of 32.5 (SD = ±5.5) for the case group and 33.7 (SD = ±5.2) for the control group. Among the assessed determinants of home delivery were not attending antenatal care (ANC) visits [adjusted odds ratio (AOR) = 5.6, 95% CI: 2.0-15.16], missing pregnant women’s conferences (AOR = 3.2, 95% CI: 1.65-8.32), not receiving health education on pregnancy-related complications (AOR = 2.2, 95% CI: 1.1-4.3), inadequate knowledge of pregnancy-related danger signs (AOR = 6.0, CI: 3.0-11.9), inadequate knowledge about pregnancy-related complications (AOR = 3.0, CI: 1.55-6.13), and unfavorable attitude (AOR = 6.9, 95% CI: 2.16-22.6).

CONCLUSION: In this study, not attending ANC visits, missing pregnant women’s conferences, not receiving health education on pregnancy-related complications, inadequate knowledge of pregnancy-related danger signs, inadequate knowledge about pregnancy-related complications, and unfavorable attitudes were identified as determinants of home delivery. The district health office and other stakeholders should work on strengthening maternal health service delivery through appropriate ANC visits and participation in pregnant women’s conferences and improving community awareness about pregnancy at all levels.

PMID:38912412 | PMC:PMC11190296 | DOI:10.3389/fgwh.2024.1236758

Med Pharm Rep. 2021 Nov;94(Suppl No 3):S6-S11. doi: 10.15386/mpr-2516. Epub 2021 Nov 29.

ABSTRACT

BACKGROUND AND AIM: Gastrointestinal manifestations in COVID-19 have been frequently acknowledged by clinicians and scientists. However, their clinical significance and potential influence on the disease outcome is not entirely elucidated. In this study we aim to evaluate gastrointestinal involvement, both digestive symptoms and liver-related changes in hospitalized COVID-19 patients in correlation to the presence or absence of underlying liver disease and rate of mortality.

METHODS: We performed a retrospective cohort study of COVID-19 patients, consecutively admitted in a hospital from Chisinau, between September 3, 2020 and May 31, 2021. Data on clinical symptoms and laboratory findings were collected from electronic clinical records. The cohort was divided into two groups, with and without pre-existing liver disease. The Fisher exact, Pearson Chi-square tests were used to compare groups.

RESULTS: A total of 1835 patients were included, 108 (5.9%) with pre-existing liver disease and 1727 (94.1%) without this comorbidity. Digestive symptoms were reported by 331(18%) of the patients, diarrhea being the most common symptom 11.8% (217) and being encountered more in patients with underlying chronic liver disease. No statistical difference was identified between the groups in regard to other symptoms, comorbidities and rate of mortality. But patients with chronic liver disease had significant (P < 0.001) lower ferritin, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in comparison with the other group. At admission, 341 (19.2%) had increased aspartate aminotransferase level (AST) and 317 (17.8%) alanine aminotransferase. The enzyme abnormalities were predominantly mild and transitory. Abnormal AST level at admission and during follow up, higher ESR, CRP, ferritin, lactate dehydrogenase (LDH) was found to correlate with higher rates of mortality.

CONCLUSION: Digestive implications, especially diarrhea in COVID-19 patients is frequent, but do not appear to be associated with mortality. Elevated liver enzymes during hospitalization, age, high ferritin, CRP, LDH might be interpreted as risk factors for mortality in COVID-19 but further studies are needed to address this topic.

PMID:38912406 | PMC:PMC11188023 | DOI:10.15386/mpr-2516

Environ Epidemiol. 2023 Nov 16;7(6):e280. doi: 10.1097/EE9.0000000000000280. eCollection 2023 Dec.

ABSTRACT

OBJECTIVE: We aimed to assess whether the influence of urban vegetation on asthma development in children (<13 years) varies by type (e.g., total vegetation, tree type, and grass) and season.

METHODS: We used a cohort of all children born in Montreal, Canada, between 2000 and 2015. Children and cases were identified from linked medico-administrative databases. Exposure to residential vegetation was estimated using the Normalized Difference Vegetation Index (NDVI) for total vegetation and using the total area covered by deciduous and evergreen crowns for trees in 250 m buffers centered on residential postal codes. Seasonal variations in vegetation were modeled by setting values to zero on days outside of pollen and leaf-on seasons. Cox models with vegetation exposures, age as a time axis, and adjusted for sex, material deprivation, and health region were used to estimate hazard ratios (HR) for asthma development.

RESULTS: We followed 352,946 children for a total of 1,732,064 person-years and identified 30,816 incident cases of asthma. While annual vegetation (total and trees) measures did not appear to be associated with asthma development, models for pollen and leaf-on seasons yielded significant nonlinear associations. The risk of developing asthma was lower in children exposed to high levels (>33,300 m²) of deciduous crown area for the leaf-on season (HR = 0.69; 95% confidence interval [CI] = 0.67, 0.72) and increased for the pollen season (HR = 1.07; 95% CI =1.02, 1.12), compared with unexposed children. Similar results were found with the Normalized Difference Vegetation Index.

CONCLUSION: The relationship between urban vegetation and childhood asthma development is nonlinear and influenced by vegetation characteristics, from protective during the leaf-on season to harmful during the pollen season.

PMID:38912389 | PMC:PMC11189683 | DOI:10.1097/EE9.0000000000000280