Category: Statistics

Eur Rev Med Pharmacol Sci. 2023 Nov;27(22):10935-10943. doi: 10.26355/eurrev_202311_34461.

ABSTRACT

OBJECTIVE: In this study, we aim to estimate the prevalence of adult ADHD among Saudi adults, determine its demographic correlates, the impact of the disorder on school/work, social life, and productivity, and describe its association with other psychiatric disorders such as depression and anxiety.

SUBJECTS AND METHODS: A cross-sectional study involving 993 adult participants was carried out utilizing a validated online questionnaire that was given to the Saudi population between January 2022 and March 2022. Socio-demographic information, the adult ADHD Self-Report Scale, the Sheehan Disability Scale (SDS), and the Hospital Anxiety and Depression Scale (HADS) are among the data gathered from the questionnaire.

RESULTS: Participants’ median age group was 21-30 years (48.4%), with 77.8% being females. The prevalence of participants who were positive for ADHD symptoms was 46.6%. In univariate analysis, age group, marital status, depression, anxiety, Sheehan scale domains, day lost, and unproductive days were all significant risk factors for ADHD. In a multivariate regression analysis, anxiety, depression, symptoms that disrupted work/school work, family life/home responsibilities, and days unproductive remained statistically significant and determined as the significant independent predictors of positive ADHD.

CONCLUSIONS: Morbidity of adult ADHD symptoms appreciably existed among younger adults of Saudi Arabia, mostly students with no favorable genders. Adult ADHD symptoms were found to affect the quality of social life and work/schoolwork performance as they decreased the productivity rate and increased the absenteeism rate. Moreover, symptoms of depression and anxiety were in a profound correlation with Adult ADHD symptoms.

PMID:38039023 | DOI:10.26355/eurrev_202311_34461

Eur Rev Med Pharmacol Sci. 2023 Nov;27(22):10909-10916. doi: 10.26355/eurrev_202311_34458.

ABSTRACT

OBJECTIVE: Prognostic models proposed for cirrhotic patients’ survival have not been satisfactorily investigated in the Vietnam population, especially in the medium-term period.

PATIENTS AND METHODS: In this prospective study, we enrolled a total of 904 patients admitted to Hepato-Gastroenterology Center, Bach Mai Hospital from December 2019 to November 2021 and calculated their CP, MELD, MELD-Na score, IMELD, Refit MELD, and Refit MELD-Na after 2-year follow-up to compare their survival prognosis.

RESULTS: The mean age of the patients was 53.8 ±10.8 years, and males constituted 91%. Compared with the surviving group, deceased patients had statistically significant lower albumin, higher INR, serum bilirubin, and creatinine levels with higher means of all prognostic scores. RefitMELD score had the highest AUC (0.768), followed by MELD (0.766), and the lowest belonged to RefitMELDNa (0.669).

CONCLUSIONS: In conclusion, deceased patients had significantly higher values of Child-Pugh score and all MELD-based scores than survival. RefitMELD is the most reliable scoring system to predict 2-year mortality in patients with decompensated liver cirrhosis.

PMID:38039020 | DOI:10.26355/eurrev_202311_34458

Eur Rev Med Pharmacol Sci. 2023 Nov;27(22):10839-10844. doi: 10.26355/eurrev_202311_34450.

ABSTRACT

OBJECTIVE: This study aimed to demonstrate the relationship between thorax computed tomography (CT) findings at the time of admission and prognosis using a semiquantitative CT severity scoring system in patients diagnosed with coronavirus disease 2019 (COVID-19) who tested positive for reverse transcriptase polymerase chain reaction (RT-PCR).

PATIENTS AND METHODS: A total of 305 patients aged 18 years and older who were diagnosed with COVID-19 confirmed by RT-PCR and underwent thorax CT at the time of admission, were included in the study between March and July 2020. The demographic data of the patients, their presenting complaints at the time of admission, RT-PCR results, and thorax CT images were scanned retrospectively from electronic medical records. Lesions on thorax CT were evaluated for the presence of ground glass opacity, consolidation, and septal thickening and scoring.

RESULTS: No significant relationship was found between mortality and CT score or other parameters. A significant relationship was found between admission to the intensive care unit and CT scoring (p=0.014), aortic diameter (p=0.032), chronic pulmonary disease (p=0.004), halo sign (p=0.031), mortality (p<0.001), fever (p=0.038), and dyspnea (p=0.031). A statistically significant difference was detected in the score parameter between discharged patients and intensive care unit patients who survived and those who died (p<0.001). In the parameter of the number of lobes, a statistically significant difference was found only between discharged patients and intensive care unit patients who survived (p=0.016).

CONCLUSIONS: Thorax CT is an advisor for early diagnosis, treatment, and prognosis assessment of the disease. Semiquantitative CT severity scoring can provide valuable information about the prognosis of the patient.

PMID:38039012 | DOI:10.26355/eurrev_202311_34450

JAMA Netw Open. 2023 Dec 1;6(12):e2340232. doi: 10.1001/jamanetworkopen.2023.40232.

ABSTRACT

IMPORTANCE: Optimizing insulin therapy for patients with type 2 diabetes can be challenging given the need for frequent dose adjustments. Most patients receive suboptimal doses and do not achieve glycemic control.

OBJECTIVE: To examine whether a voice-based conversational artificial intelligence (AI) application can help patients with type 2 diabetes titrate basal insulin at home to achieve rapid glycemic control.

DESIGN, SETTING, AND PARTICIPANTS: In this randomized clinical trial conducted at 4 primary care clinics at an academic medical center from March 1, 2021, to December 31, 2022, 32 adults with type 2 diabetes requiring initiation or adjustment of once-daily basal insulin were followed up for 8 weeks. Statistical analysis was performed from January to February 2023.

INTERVENTIONS: Participants were randomized in a 1:1 ratio to receive basal insulin management with a voice-based conversational AI application or standard of care.

MAIN OUTCOMES AND MEASURES: Primary outcomes were time to optimal insulin dose (number of days needed to achieve glycemic control), insulin adherence, and change in composite survey scores measuring diabetes-related emotional distress and attitudes toward health technology and medication adherence. Secondary outcomes were glycemic control and glycemic improvement. Analysis was performed on an intent-to-treat basis.

RESULTS: The study population included 32 patients (mean [SD] age, 55.1 [12.7] years; 19 women [59.4%]). Participants in the voice-based conversational AI group more quickly achieved optimal insulin dosing compared with the standard of care group (median, 15 days [IQR, 6-27 days] vs >56 days [IQR, >29.5 to >56 days]; a significant difference in time-to-event curves; P = .006) and had better insulin adherence (mean [SD], 82.9% [20.6%] vs 50.2% [43.0%]; difference, 32.7% [95% CI, 8.0%-57.4%]; P = .01). Participants in the voice-based conversational AI group were also more likely than those in the standard of care group to achieve glycemic control (13 of 16 [81.3%; 95% CI, 53.7%-95.0%] vs 4 of 16 [25.0%; 95% CI, 8.3%-52.6%]; difference, 56.3% [95% CI, 21.4%-91.1%]; P = .005) and glycemic improvement, as measured by change in mean (SD) fasting blood glucose level (-45.9 [45.9] mg/dL [95% CI, -70.4 to -21.5 mg/dL] vs 23.0 [54.7] mg/dL [95% CI, -8.6 to 54.6 mg/dL]; difference, -68.9 mg/dL [95% CI, -107.1 to -30.7 mg/dL]; P = .001). There was a significant difference between the voice-based conversational AI group and the standard of care group in change in composite survey scores measuring diabetes-related emotional distress (-1.9 points vs 1.7 points; difference, -3.6 points [95% CI, -6.8 to -0.4 points]; P = .03).

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial of a voice-based conversational AI application that provided autonomous basal insulin management for adults with type 2 diabetes, participants in the AI group had significantly improved time to optimal insulin dose, insulin adherence, glycemic control, and diabetes-related emotional distress compared with those in the standard of care group. These findings suggest that voice-based digital health solutions can be useful for medication titration.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05081011.

PMID:38039007 | DOI:10.1001/jamanetworkopen.2023.40232

Ann Neurol. 2023 Dec 1. doi: 10.1002/ana.26839. Online ahead of print.

ABSTRACT

BACKGROUND: Telestroke (TS) service has been shown to improve stroke diagnosis timing and accuracy, facilitate treatment decisions, and decrease inter-facility transfers. Expanding TS service to inpatient units at the community hospital provides an opportunity to follow up on stroke patients and optimize medical management. This study examines the outcome of expanding TS coverage from acute ER triage to incorporate inpatient consultation.

METHODS: We studied the effect of expanding TS to inpatient consultation service at 19 regional hospitals affiliated with Promedica Stroke Network. We analyzed data pre- and post-TS expansion. We reviewed changes in TS utilization, admission rate, thrombolytic therapy, patient transfer rate, and diagnosis accuracy.

RESULTS: Between Jan-2018 and June-2022, a total of 9,756 patients were evaluated in our stroke network (4,705 in pre and 5,051 in the post-TS expansion). In the post-TS expansion period, stroke patients’ admission at the spoke hospital increased from 18/month to 40/month and for TIA from 11/month to 16/month. TS cart use increased from 12% to 35.2%. Patient transfers to hub hospital decreased by 31%. TS service expansion did not affect IV thrombolytic therapy rate or door-to-needle time. There was no difference in length of stay or readmission rate, and the patients at the spoke hospitals had a higher rate of home discharge 57.38% compared to 52.58% at hub hospital.

INTERPRETATION: Telestroke service expansion to inpatient units helped decrease transfers and retain patients in their communities, increased stroke and TIA diagnosis accuracy, and did not compromise patients’ hospitalization or outcome. This article is protected by copyright. All rights reserved.

PMID:38038962 | DOI:10.1002/ana.26839

Disabil Rehabil Assist Technol. 2023 Dec 1:1-9. doi: 10.1080/17483107.2023.2289547. Online ahead of print.

ABSTRACT

PURPOSE: In the Faroe Islands, an Assistive Technology (AT) Centre allocates and finances AT for all AT users. This study aimed to provide a preliminary evaluation of the Faroese AT services from a user perspective by using recommendations from the Horizontal European Activity on Rehabilitation Technology (HEART) study.

METHOD: The study enrolled 101 persons aged 8-95 (mean 69 years) using a study-specific questionnaire. The AT service delivery process (AT-SDP) questions included questions about the application and the implementation. User satisfaction was assessed with KWAZO and the service subscale of QUEST with seven and four questions, respectively. The sample and the steps in the AT-SDP were described with frequency distribution. The KWAZO and QUEST results were analysed item-by-item and grouped in “Satisfied” and “Not fully satisfied”. A threshold of 33% was used to identify items rated “Not fully satisfied”. Associations between items rated “Not fully satisfied” and the AT-SDP were assessed with statistical analysis.

RESULTS: The participants were mostly satisfied, but Instruction, Professional services and Follow-up were rated “not fully satisfied”. The AT centre helped with application and implementation in 9.6% and 12% of the cases, respectively, and other institutions in 62.3% and 43.7% of the cases. No contact had been with professionals in 28.7% and 37.6% of the cases.

CONCLUSIONS: There was a low degree of satisfaction in different quality parameters. The role of the AT-center seemed reduced to delivering AT and the whole service delivery process appeared to be fragmented and not in line with HEART recommendations.

PMID:38038955 | DOI:10.1080/17483107.2023.2289547

Environ Sci Pollut Res Int. 2023 Dec 1. doi: 10.1007/s11356-023-30763-7. Online ahead of print.

ABSTRACT

This analysis explores the complicated relationship between oil price fluctuations, the oil industry’s finances, and the resulting increase or decrease in carbon emissions. Oil price changes have far-reaching effects on the global economy because of its dependence on fossil fuels; therefore, understanding these patterns is essential for effective policymaking and long-term energy planning. The study uses a dataset built from secondary data collected in China over 15 years, starting in 2008 and ending in 2022. This information comes from a wide range of authoritative places, including public records, trade journals, university studies, and the records of international organizations, and provides a solid foundation for study. Oil prices on a global and national scale, oil sector financial performance indicators (such as revenues, earnings, and investment levels), and carbon emission statistics are all significant factors under investigation. As one of the world’s largest oil consumers, China has been singled out in this study to allow for a more comprehensive analysis of reactions within this crucial subset of the energy industry. To understand the complex interplay between oil price shocks, the financial dynamics of the oil sector, and carbon emissions, the research utilizes statistical and econometric methods, most notably time-series analysis and regression models. The results are meant to shed light on how oil price shocks consistently affect the monetary aspects of the oil business and, by extension, the patterns in carbon emissions. This study helps us understand these vital interrelationships more completely and nuancedly.

PMID:38038915 | DOI:10.1007/s11356-023-30763-7

Environ Sci Pollut Res Int. 2023 Dec 1. doi: 10.1007/s11356-023-31225-w. Online ahead of print.

ABSTRACT

The impact of digital industrialization on regional pollution control and carbon reduction in China is an area that remains largely unexplored despite being a new driving force in promoting high-quality economic development. This study constructs a combined system synergy model to measure the synergistic governance effect of regional pollution and carbon reduction in China from 2011 to 2020 and then estimates the direct impact and spatial spillover effect using a spatial dual-weight model. Our findings indicate that digital industrialization has a greater impact on regional pollution reduction and carbon reduction as geographical distance decreases, with the spillover effect with close geographical relationships being higher than that of adjacent. Furthermore, the heterogeneity analysis reveals that the added value of digital technology and services has a significantly positive effect, while the spatial spillover effect of the added value of digital infrastructure is significantly negative. Finally, our mechanism judgements prove digital industrialization can impact the level of regional co-governance of pollution and carbon reduction through source prevention, process control, and end-treatment. Our study provides a factual basis for further promoting China’s environmental pollution control and carbon reduction behavior and offers a method to use different spatial weights in depth.

PMID:38038909 | DOI:10.1007/s11356-023-31225-w

Musculoskelet Surg. 2023 Dec 1. doi: 10.1007/s12306-023-00806-w. Online ahead of print.

ABSTRACT

According to the latest statistics of the American Cancer Society 2022, breast cancer is a leading cause of morbidity and death among women worldwide. As a result of oncological procedures, breast cancer survivors often complain of pain and disability to the ipsilateral arm and shoulder. Objective: we aimed to analyze the latest literature regarding the efficacy of different rehabilitation treatments in patients affected by shoulder impairment secondary to breast cancer care. A comprehensive literature search was conducted on PubMed, PEDRO and Scopus databases. All English studies, published in the last decade up to March 2023, reporting shoulder problems in adult women treated for breast cancer with partial or total mastectomy ± breast reconstruction, lymphadenectomy, radio-, chemo-, hormonal or biologic therapy were assessed for eligibility. The methodological quality of the included trials was evaluated using the Cochrane bias tool. Of 159 articles identified, 26 were included in qualitative synthesis. Data from 1974 participants with a wide heterogeneity of breast cancer treatments were analyzed in this review. The methodological quality for most included studies was moderate. Several physiotherapy and interventional protocols showed some evidence of efficacy in shoulder range of motion (ROM), upper limb function, strength, pain and quality of life recovery after breast cancer treatment. Both physiotherapy alone or in combination with other techniques significantly improves shoulder disability, pain, and quality of life of patients undergoing breast cancer treatment regardless of their baseline characteristics or the time passed from surgery. The optimal treatment protocol and dosage remain unclear, and more homogeneous studies are needed in order to perform a meta-analysis of the literature.

PMID:38038901 | DOI:10.1007/s12306-023-00806-w

Diabetes Ther. 2023 Dec 1. doi: 10.1007/s13300-023-01507-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Glycemic control is associated with better outcomes among individuals with type 2 diabetes (T2D). This research examines total US all-cause medical costs for adults with T2D with recommended glycemic control (HbA1c < 7%) compared to poor glycemic control (HbA1c ≥ 7%).

METHODS: The study used administrative claims data linked to HbA1c laboratory test results from January 1, 2015 through June 30, 2021 to identify adults with T2D with a recorded HbA1c test. Patients with recommended glycemic control at index date were propensity score matched to patients with poor glycemic control. General linear models and two-part models were used to compare all-cause outpatient, drug, acute care and total costs for 1 year post index date.

RESULTS: The study included 59,830 propensity-matched individuals. Results indicate that recommended glycemic control, compared to poor glycemic control, was associated with statistically significantly lower all-cause acute care ($23,868 ± $21,776 vs. $24,352 ± $22,223), drug ($10,277 ± $14,671 vs. $10,540 ± $14,928), and total medical costs ($41,381 ± $42,757 vs. $42,054 ± $43,422) but significantly higher outpatient costs ($7290 ± $12,028 vs. $7026 ± $11,587) (all p < 0.0001). Sensitivity analyses examined results based upon alternative HbA1c thresholds of ≤ 6.5% and < 8%. Results were generally robust to alternative HbA1c thresholds, with higher HbA1c thresholds associated with higher all-cause total costs as well as increased savings for having HbA1c below threshold.

CONCLUSIONS: Glycemic control was associated with significantly lower all-cause total, drug, and acute care medical costs. Given the high prevalence of T2D in the USA, our results suggest potential economic benefits associated with glycemic control for healthcare providers.

PMID:38038897 | DOI:10.1007/s13300-023-01507-0