Category: Statistics

Prz Gastroenterol. 2023;18(4):421-429. doi: 10.5114/pg.2023.133223. Epub 2023 Nov 27.

ABSTRACT

INTRODUCTION: In heart pathology, abdominal pathology is often detected, but due attention has not been paid to this issue, and algorithms for predicting, preventing, and correcting the coefficient of endothelial dysfunction (CED) after coronary artery bypass grafting (CABG) with the use of artificial circulation (AC) have not been developed.

AIM: To substantiate the pathogenetic expediency of correction of postoperative intestinal paresis after coronary artery bypass grafting for the prevention of functional cardiac complications.

MATERIAL AND METHODS: 147 men were divided into 2 groups. Statistical processing of the obtained data was performed using Windows Microsoft Excel software and parametric methods of variational statistics, and the reliability of differences was determined using Student’s formula and table.

RESULTS: It was found that in group II, after coronary artery bypass grafting, the clinical symptoms of intestinal dysfunction were significantly less (p = 0.019), and the recovery of defecation was significantly faster (p = 0.033) than in group I. After coronary artery bypass grafting, the frequency of high-grade extrasystoles in group II was significantly lower than in group I (p = 0.033).

CONCLUSIONS: The application of the digestive tract dysfunction correction program is pathogenetically justified because it provides a reduction in the frequency of intestinal paresis and hence a reduction in the frequency of development of ventricular extrasystoles of high gradations after coronary artery bypass grafting.

PMID:38572465 | PMC:PMC10985738 | DOI:10.5114/pg.2023.133223

Infect Drug Resist. 2024 Mar 29;17:1267-1279. doi: 10.2147/IDR.S443574. eCollection 2024.

ABSTRACT

INTRODUCTION: The purpose of this study was to compare the viral shedding time in patients infected with the Omicron variant during Paxlovid therapy and conventional therapy and to analyze the effects of Paxlovid on patients infected with COVID-19.

METHODS: In this study, the demographic and clinical characteristics and laboratory data of 3159 patients infected with the SARS-CoV-2 Omicron variant treated at Jilin Province People’s Hospital were collected and analyzed. A total of 362 patients received Paxlovid therapy, and 2797 patients received conventional therapy. After propensity score matching (PSM), 1086 patients were obtained.

RESULTS: The difference in platelet (PLT) count between the two groups was statistically significant but within the normal range (P < 0.05). CT value revealed that the nucleic acid test results became negative more quickly in the Paxlovid therapy group. Analysis of the Paxlovid therapy group showed that IgG and IgM levels were increased after Paxlovid therapy administration.

CONCLUSION: The CT value of the Paxlovid therapy group became negative more quickly. This finding suggests that Paxlovid treatment after early diagnosis of the Omicron variant may achieve good therapeutic efficacy.

PMID:38572421 | PMC:PMC10987972 | DOI:10.2147/IDR.S443574

Clin Pediatr Endocrinol. 2024;33(2):43-49. doi: 10.1297/cpe.2023-0070. Epub 2024 Jan 28.

ABSTRACT

We conducted a randomized phase 3 study to investigate the efficacy and safety of GH treatment in prepubertal Japanese patients with short stature due to SHOX deficiency. The patients were randomly allocated to the GH-GH group (n = 10), in which the patients were treated with GH (0.35 mg/kg/wk) subcutaneously once daily for 24 mo, or the no-treatment (NT)-GH group (n = 9), in which the patients were untreated for the first 12 mo and then administered the same dosage of GH for the next 12 mo. At month 12, the ∆height standard deviation score (SDS) for chronological age (CA) and serum IGF-1 level were significantly higher in the GH-GH group than those in the NT-GH group. In contrast, bone age (BA) and ΔBA/ΔCA were numerically higher in the GH-GH group but were not statistically significant. At month 24, these parameters were comparable between the two groups. The height velocity was significantly larger in the GH-GH group during the first year and in the NT-GH group during the second year. No serious adverse drug reactions were observed; however, one patient in the GH-GH group exhibited increased insulin resistance at month 24. These results indicated that GH is a promising treatment option for short stature in patients with SHOX deficiency.

PMID:38572386 | PMC:PMC10985015 | DOI:10.1297/cpe.2023-0070

J Pharm Policy Pract. 2024 Apr 2;17(1):2323091. doi: 10.1080/20523211.2024.2323091. eCollection 2024.

ABSTRACT

BACKGROUND: The critical shortage of comprehensively trained healthcare staff in Tanzania affects the capacity to deliver essential health services, attain universal health coverage and compromises health outcomes. There is a specific lack of suitably trained pharmaceutical professionals, thus, an increase in the use of unqualified or poorly trained staff. Following the introduction of a one-year pharmacy dispenser course intervention, this study explored the impact that the new cadre of graduates had on pharmacy practice compared to healthcare facilities with non-pharmacy trained dispensers (NPTDs).

METHODS: A post intervention assessment was conducted in 2021 using questionnaires formulated to measure indicators of Good Pharmacy Practice, comparing 29 public health facilities employing pharmacy-trained dispensers (PTD) with 32 public health facilities with NPTDs in Dodoma, Shinyanga and Morogoro regions of Tanzania. Data were collected by experienced pharmacists or pharmaceutical technicians and subsequently aggregated and statistically analysed.

RESULTS: The dispensing times for medicines were found to be the same for PTDs and the NPTDs (2 min). There were no statistically significant differences in the adequacy of labelling elements between PTDs and NPTDs. Patients’ level of knowledge of the medicines dispensed to them, from both PTDs and NPTDs, showed no difference. Moreover, no differences were observed in storage practice and documentation performance, records of dispensed medicines, handling of medicines and the dispensing area cleanliness between both groups. Overall, facilities with PTDs averaged a higher availability of tracer medicines (77%) than those with NPTDs (70%), however, availability of health commodities in all health facilities in the three regions was low and there was no statistically significant difference between both groups.

CONCLUSION: The study showed no significant difference in performance of pharmacy practice between PTDs and NPTDs despite the former undertaking a one-year training course intended to improve knowledge and skills. Practice application not only depends on effective training but on the working environment. Clear job descriptions, appropriate tools and references to guide, Standard Operating Procedures, acceptance by management of the training undertaken to actively encourage recruits to apply these new skills could improve PTDs performance. Training and knowledge alone do not seem to lead to better practice and performance.

PMID:38572378 | PMC:PMC10989198 | DOI:10.1080/20523211.2024.2323091

Sci Total Environ. 2024 Apr 1:172118. doi: 10.1016/j.scitotenv.2024.172118. Online ahead of print.

ABSTRACT

Declines in insect pollinators have been linked to a range of causative factors such as disease, loss of habitats, the quality and availability of food, and exposure to pesticides. Here, we analysed an extensive dataset generated from pesticide screening of foraging insects, pollen-nectar stores/beebread, pollen and ingested nectar across three species of bees collected at 128 European sites set in two types of crop. In this paper, we aimed to (i) derive a new index to summarise key aspects of complex pesticide exposure data and (ii) understand the links between pesticide exposures depicted by the different matrices, bee species and apple orchards versus oilseed rape crops. We found that summary indices were highly correlated with the number of pesticides detected in the related matrix but not with which pesticides were present. Matrices collected from apple orchards generally contained a higher number of pesticides (7.6 pesticides per site) than matrices from sites collected from oilseed rape crops (3.5 pesticides), with fungicides being highly represented in apple crops. A greater number of pesticides were found in pollen-nectar stores/beebread and pollen matrices compared with nectar and bee body matrices. Our results show that for a complete assessment of pollinator pesticide exposure, it is necessary to consider several different exposure routes and multiple species of bees across different agricultural systems.

PMID:38569959 | DOI:10.1016/j.scitotenv.2024.172118

Sci Total Environ. 2024 Apr 1:172140. doi: 10.1016/j.scitotenv.2024.172140. Online ahead of print.

ABSTRACT

Despite their longstanding use in environmental remediation, constructed wetlands (CWs) are still topical due to their sustainable and nature-based approach. While research and review publications have grown annually by 7.5 % and 37.6 %, respectively, from 2018 to 2022, a quantitative meta-analysis employing advanced statistics and machine learning to assess CWs has not yet been conducted. Further, traditional statistics of mean ± standard deviation could not convey the extent of confidence or uncertainty in results from CW studies. This study employed a 95 % bootstrap-based confidence interval and out-of-bag Random Forest-based driver analysis on data from 55 studies, totaling 163 cases of pilot and full-scale CWs. The study recommends, with 95 % confidence, median surface hydraulic loading rates (HLR) of 0.14 [0.11, 0.17] m/d for vertical flow-CWs (VF) and 0.13 [0.07, 0.22] m/d for horizontal flow-CWs (HF), and hydraulic retention time (HRT) of 125.14 [48.0, 189.6] h for VF, 72.00 [42.00, 86.28] h for HF, as practical for new CW design. Permutation importance results indicate influent COD impacted primarily on COD removal rate at 21.58 %, followed by HLR (16.03 %), HRT (12.12 %), and substrate height (H) (10.90 %). For TN treatment, influent TN and COD were the most significant contributors at 12.89 % and 10.01 %, respectively, while H (9.76 %), HRT (9.72 %), and HLR (5.87 %) had lower impacts. Surprisingly, while HRT and H had a limited effect on COD removal, they substantially influenced TN. This study sheds light on CWs’ performance, design, and control factors, guiding their operation and optimization.

PMID:38569956 | DOI:10.1016/j.scitotenv.2024.172140

eNeuro. 2024 Apr 3;11(4):ENEURO.0153-23.2024. doi: 10.1523/ENEURO.0153-23.2024. Print 2024 Apr.

ABSTRACT

Most neuroeconomic research seeks to understand how value influences decision-making. The influence of reward type is less well understood. We used functional magnetic resonance imaging (fMRI) to investigate delay discounting of primary (i.e., food) and secondary rewards (i.e., money) in 28 healthy, normal-weighted participants (mean age = 26.77; 18 females). To decipher differences in discounting behavior between reward types, we compared how well-different option-based statistical models (exponential, hyperbolic discounting) and attribute-wise heuristic choice models (intertemporal choice heuristic, dual reasoning and implicit framework theory, trade-off model) captured the reward-specific discounting behavior. Contrary to our hypothesis of different strategies for different rewards, we observed comparable discounting behavior for money and food (i.e., exponential discounting). Higher k values for food discounting suggest that individuals decide more impulsive if confronted with food. The fMRI revealed that money discounting was associated with enhanced activity in the right dorsolateral prefrontal cortex, involved in executive control; the right dorsal striatum, associated with reward processing; and the left hippocampus, involved in memory encoding/retrieval. Food discounting, instead, was associated with higher activity in the left temporoparietal junction suggesting social reinforcement of food decisions. Although our findings do not confirm our hypothesis of different discounting strategies for different reward types, they are in line with the notion that reward types have a significant influence on impulsivity with primary rewards leading to more impulsive choices.

PMID:38569920 | DOI:10.1523/ENEURO.0153-23.2024

Stroke Vasc Neurol. 2024 Apr 3:svn-2023-003022. doi: 10.1136/svn-2023-003022. Online ahead of print.

ABSTRACT

Cerebral small vessel disease (cSVD) causes lacunar stroke (25% of ischaemic strokes), haemorrhage, dementia, physical frailty, or is ‘covert’, but has no specific treatment. Uncertainties about the design of clinical trials in cSVD, which patients to include or outcomes to assess, may have delayed progress. Based on experience in recent cSVD trials, we reviewed ways to facilitate future trials in patients with cSVD.We assessed the literature and the LACunar Intervention Trial 2 (LACI-2) for data to inform choice of Participant, Intervention, Comparator, Outcome, including clinical versus intermediary endpoints, potential interventions, effect of outcome on missing data, methods to aid retention and reduce data loss. We modelled risk of missing outcomes by baseline prognostic variables in LACI-2 using binary logistic regression.Imaging versus clinical outcomes led to larger proportions of missing data. We present reasons for and against broad versus narrow entry criteria. We identified numerous repurposable drugs with relevant modes of action to test in various cSVD subtypes. Cognitive impairment is the most common clinical outcome after lacunar ischaemic stroke but was missing more frequently than dependency, quality of life or vascular events in LACI-2. Assessing cognitive status using Diagnostic and Statistical Manual for Mental Disorders Fifth Edition can use cognitive data from multiple sources and may help reduce data losses.Trials in patients with all cSVD subtypes are urgently needed and should use broad entry criteria and clinical outcomes and focus on ways to maximise collection of cognitive outcomes to avoid missing data.

PMID:38569894 | DOI:10.1136/svn-2023-003022

BMJ Lead. 2024 Apr 3:leader-2023-000922. doi: 10.1136/leader-2023-000922. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: This article examines the relationships between workers’ hospital leadership status, hospital front-line status and patient safety culture in hospitals throughout the USA. By identifying possible disparities in perception, targeted interventions can aim at decreasing differences between the two groups to increase the quality of healthcare.

METHOD: Data from 1 739 083 individuals, spreading across 1810 hospitals between 2008 and 2017 were collected. 115 228 (6.63%) self-identified as leaders, and 772 505 (44.42%) self-identified as front-line workers. The participants also filled in information describing their demographics in reference to the hospital, such as how long they have worked at the facility, their working unit and their occupation.

RESULTS: Results showed that leaders responded more positively to items that are directly related to management, such as ‘my supervisor/manager says a good word when he/she sees a job done according to established patient safety procedures’ (0.33, p<0.01), where 0.33 signifies that leaders had an average response more positive by 0.33 compared with all other occupations on a Likert scale of 1-5. Based on multiple F-tests, all items have shown a statistical significance between leadership and front-line groups.

CONCLUSION: The findings highlight a compelling link between leadership roles and patient safety culture in hospitals, as well as between front-line worker status and patient safety culture. Moreover, a pronounced divergence in viewpoints regarding patient safety culture exists between hospital leaders and front-line staff. An in-depth investigation is necessary to comprehend the ramifications of these outcomes.

PMID:38569892 | DOI:10.1136/leader-2023-000922

J Natl Cancer Inst. 2024 Apr 3:djae074. doi: 10.1093/jnci/djae074. Online ahead of print.

ABSTRACT

BACKGROUND: A large well-annotated recent international cohort of Li-Fraumeni (LFS) patients with early-stage breast cancer (BC) was examined for shared features.

METHODS: This multicentre cohort study included females with a germline TP53 pathogenic or likely pathogenic variant and nonmetastatic BC diagnosed between 2002-2022. Clinical and genetic data were obtained from institutional registries and clinical charts. Descriptive statistics were utilized to summarize proportions and differences were assessed by Chi square or Wilcoxon rank sum tests. Metachronous contralateral breast cancer (CBC) risk, radiation-induced sarcoma risk, and recurrence-free survival (RFS) were analyzed by Kaplan-Meier methodology.

RESULTS: Among 227 females who met study criteria, the median age of first BC diagnosis was 37 years (range 21-71), 11.9% presented with bilateral synchronous BC and 18.1% had ductal carcinoma in situ (DCIS) only. In total, 166 (73.1%) underwent mastectomies including 67 bilateral mastectomies as first BC surgery. Among those with retained breast tissue, CBC rate was 25.3% at 5-years. Among 186 invasive tumors, 72.1% were stages I-II, 48.9% node-negative, and the most common subtypes were HR+/HER2- (40.9%) and HR+/HER2 + (34.4%). At a median follow-up of 69.9 months (IQR 32.6-125.9), invasive HR+/HER2- disease had the highest recurrence risk among the subtypes (5-year RFS 61.1%, p = .0012). Among those who received radiation therapy (n = 79), the 5-year radiation-induced sarcoma rate was 4.8%.

CONCLUSION: We observed high rates of DCIS, HR+ and HER2+ breast cancers, with a worse outcome in the HR+/HER2- luminal tumors despite appropriate treatment. Confirmation of these findings in further studies could have implications for BC care in LFS.

PMID:38569880 | DOI:10.1093/jnci/djae074