Category: Statistics

J Med Imaging Radiat Sci. 2023 Jan 30:S1939-8654(23)00005-X. doi: 10.1016/j.jmir.2023.01.005. Online ahead of print.

ABSTRACT

BACKGROUND: Resilient health systems effectively respond to health crises and coordinate post-event recovery. Central to a resilient system is the willingness of its workforce to work in high-risk scenarios. This study explored traits that may affect Medical Radiation and Imaging Professionals (MRIPs) willingness to work during a pandemic. Specifically, intrapersonal traits of compassion, empathy, and resilience were examined. Understanding such relationships can inform interventions that enhance individuals’ willingness and health system resilience (HSR).

METHODS: In Fall 2020, a cross-sectional survey of Nova Scotian MRIPs was conducted. Witte’s Extended Parallel Process Model, Professional Quality of Life, Intrapersonal Reactivity Index and Adult Resilience Measures-17 tools were used to assess willingness, compassion, empathy, and resilience. Statistical tests included chi-square, binomial, and multinomial logistic regression.

RESULTS: MRIPs were willing to report to work during the SARS-CoV-2 pandemic if required (92%); asked but not required (89%); or regardless of severity (94%). Individuals with very high levels of willingness reported lower personal distress (a facet of empathy) compared to those with high (p=.018) or moderate levels (p=.005). MRIPs with < 10 years experience were more likely to report high personal distress (p≤.37). Job role was associated with willingness (p<.001). There were no significant associations between level of willingness, and gender, age, experience, education, or the intrapersonal traits resilience and compassion.

CONCLUSION: Willingness was associated with job role and levels of personal distress. Personal distress was higher in participants with less years of practice. Interventions to reduce personal distress in early career MRIPs may enhance willingness to work during crises and thereby support HSR.

PMID:36775684 | DOI:10.1016/j.jmir.2023.01.005

J Pediatr Surg. 2023 Jan 20:S0022-3468(23)00040-4. doi: 10.1016/j.jpedsurg.2023.01.021. Online ahead of print.

ABSTRACT

BACKGROUND: Global pandemics may limit access to specialized care, delaying diagnosis and treatment of common acute surgical diseases. We analyzed the impact of the novel coronavirus disease 2019 (COVID-19) pandemic on acute appendicitis at an urban tertiary care center. We hypothesize that pandemics are associated with delayed presentation and worsened clinical sequelae, specifically, higher incidences of perforation in children.

METHODS: We retrospectively assessed patients admitted to our institution with acute appendicitis in pre-pandemic control (February 2018-June 2019) and COVID-19 (February 2020-June 2021) cohorts. Primary outcomes included complicated appendicitis rates (perforation/abscess/bowel obstruction), COVID-19 status, complications and travel distance to our institution. 1107 patients met inclusion criteria: 491 (44.4%) during the control period and 616 (55.6%) in the COVID-19 cohort. Statistical analysis involved t-tests, contingency tables and logistic regression modelling for key variables.

RESULTS: A larger proportion of complicated appendicitis occurred during COVID-19 compared to controls (28.3% vs 38.8%, p < 0.001). Symptom duration at presentation and length of stay were not significantly different. Duration of antibiotic treatment, surgery length, readmission rate and travel distances were significantly higher during COVID-19. The pre-pandemic cohort had a significantly younger age distribution.

CONCLUSION: Pediatric appendicitis was significantly impacted during COVID-19, demonstrated by increased rates of complicated appendicitis, surgery duration and antibiotic duration. This may be an unintended secondary consequence of patients avoiding healthcare facilities for non-pandemic related illnesses or lockdown policies. Government policies directing all provincial pediatric appendicitis cases to pediatric institutions increased travel distances for our patients and had unanticipated consequences and resource requirements on tertiary healthcare.

LEVEL OF EVIDENCE: Level III for “Treatment Studies”.

PMID:36775681 | DOI:10.1016/j.jpedsurg.2023.01.021

Aust Crit Care. 2023 Feb 10:S1036-7314(22)00258-2. doi: 10.1016/j.aucc.2022.12.012. Online ahead of print.

ABSTRACT

OBJECTIVES: We aim to ascertain whether the benefit of early tracheostomy can be found in patients with severe traumatic brain injury (TBI) and stroke and if the benefit will remain considering distinct pathologies.

DATA SOURCES: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, a search through Lilacs, PubMed, and Cochrane databases was conducted.

REVIEW METHODS: Included studies were those written in English, French, Spanish, or Portuguese, with a formulated question, which compared outcomes between early and late trach (minimum of two outcomes), such as intensive care unit (ICU) length of stay (LOS), duration of mechanical ventilation (MV), hospital LOS, mortality rates, or ventilator-associated pneumonia (VAP). Likewise, patients presented exclusively with head injury or stroke had minimum hospital stay follow-up, and as for severe TBI patients, they presented Glasgow Coma Scale ≤8 at admission. Evaluated outcomes were the risk ratio (RR) of VAP, risk difference (RD) of mortality, and mean difference (MD) of the duration of MV, ICU LOS, and hospital LOS.

RESULTS: The early and late tracheostomy cohorts were composed of 6211 and 8140 patients, respectively. The meta-analysis demonstrated that the early tracheostomy cohort had a lower risk for VAP (RR: 0.73 [95% confidence interval {CI}, 0.66, 0.81] p < 0.00001), shorter duration of MV (MD: -4.40 days [95% CI, -8.28, -0.53] p = 0.03), and shorter ICU (MD: -6.93 days [95% CI, -8.75, -5.11] p < 0.00001) and hospital LOS (MD: -7.05 days [95% CI, -8.27, -5.84] p < 0.00001). The mortality rate did not demonstrate a statistical difference.

CONCLUSION: Early tracheostomy could optimise patient outcomes by patients’ risk for VAP and decreasing MV durationand ICU and hospital LOS.

PMID:36775675 | DOI:10.1016/j.aucc.2022.12.012

Acad Radiol. 2023 Feb 10:S1076-6332(23)00027-2. doi: 10.1016/j.acra.2023.01.011. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: Work-life experience of physicians is a driver of work engagement vs. burnout. We aimed to determine individual and institutional factors affecting work-life experience of the clinical faculty at a large tertiary care academic medical center.

MATERIALS AND METHODS: The Department of Radiology clinical faculty (n = 62) were surveyed electronically in October 2022. Twenty-three questions, consisting of multiple choice, Yes/No, and Likert scale ratings were administered to obtain demographic information and data for life outside of work, life at work, and work-life integration for the prior 12 months. Work engagements in terms of clinical, research, administrative, and education; work practices including engagement in extra work and remote work; life responsibilities; and utilization of work-life balance strategies were analyzed for percentages and differences in seniority levels and genders. Ratings of faculty work engagement and life integration strategies were assessed utilizing a 1-5 Likert scale. Descriptive statistics were utilized to report mean, standard deviation, median, Q1 and Q3 for continuous measurements, while count and percentage for categories measurements. Comparisons between seniority and gender categories were conducted using independent t-test or Wilcoxon rank sum test depending on data normality assessed through histogram analysis. Chi-square test was used to make comparisons for categorical data. When encountered with small cell (category with <5 count), Fisher’s exact test was used for 2 × 2 table analysis and Freeman-Halton test was used for comparisons with more than two categories. SAS 9.4 was used for the data analysis.

RESULTS: Twenty-eight faculty (M:F = 17:11) responded to the survey (survey response rate 45%). The vast majority of faculty reported working extra hours, with 40% working at least 10 hours extra per week. Total of 42.9% reported performing clinical work in the extra hours worked. Total 70.4% of faculty had caregiver responsibilities and 64.3% reported other individual stresses (e.g., financial, family/social, health-related), which required consistent demand of time and effort. A total of 35.7% of faculty reported not being able to balance competing life and work demands. A total of 21.4% respondents reported not utilizing any individual healthy lifestyle choices on a consistent basis over the prior 12 months. Protected time off work and remote work were perceived as effective strategies to provide adequate work-life balance; however, remote work engagement was relatively minor and 35.7% bought back vacation. Total 53.6% respondents reported a level 4 (out of 5) rating for work being meaningful and being positively engaged in their work.

CONCLUSION: Institutions should invest in providing the infrastructure for physician work-life balance and in facilitating healthy lifestyle choices for physicians.

PMID:36775667 | DOI:10.1016/j.acra.2023.01.011

J Biomol Struct Dyn. 2023 Feb 12:1-22. doi: 10.1080/07391102.2023.2178510. Online ahead of print.

ABSTRACT

Currently, numerous potent chemotherapeutic agents are available in the market but most of them show poor pharmacokinetics, lethal effects and drug resistance during their enduring use. The increased cancer cases, deaths and need of better treatment stimulates us to give newer lifesaving anticancer drugs. The phthalimide derivatives are structurally diverse and exert potential anticancer activity. In this regard, the 3D QSAR Pharmacophore model was developed and validated using fifty-eight phthalimide derivatives. The validation parameters corroborated the reliability and statistical robustness of CEASER Hypo 1. Three databases-NCI Open, Drug Bank, and Asinex were submitted to ADMET and drug-like filtering; 117893 drug-like compounds were mapped on CEASER Hypo 1; and 362 hits with IC₅₀ <1 µM were discovered. These hits were docked on VEGFR2-TK, and in the form of results fifteen hits exhibited greater affinity than sorafenib. The top lead ASN 03206926 was subjected for MD simulation (100 ns) and RMSD, Rg, RMSF, number of hydrogen bonds, and SASA verified that the complex was stable, rigid and highly compact. Results demonstrated GLU885, PHE918, CYS919, LYS920, HIS1026, CYS1045, ASP1046 are the essential residues for favourable interactions. The binding free energy calculations support the affinity and stability revealed by docking and MD simulation. The DFT calculations, negative binding energy and lower HOMO-LUMO band gap revealed that the process is spontaneous and ASN 03206926 is very reactive. Following extensive analysis we suggest that the ASN 03206926 might be employed as a new VEGFR2-TK inhibitor for the treatment of breast and VEGFR2-TK associated cancers.Communicated by Ramaswamy H. Sarma.

PMID:36775656 | DOI:10.1080/07391102.2023.2178510

Huan Jing Ke Xue. 2023 Feb 8;44(2):807-815. doi: 10.13227/j.hjkx.202204212.

ABSTRACT

Polycyclic aromatic hydrocarbons (PAHs), as a highly toxic persistent organic pollutant, are commonly found in soil and water environments. In recent years, the pollution of PAHs in groundwater has attracted wide attention from scientists. To study the pollution characteristics and sources of polycyclic aromatic hydrocarbon in groundwater of the coking site, 16 PAHs priorly controlled by the US EPA were analyzed and discussed. In this study, we identified the contamination characteristics of PAHs in groundwater, analyzed the pollution sources of PAHs, and evaluated the ecological risk of PAHs in the coking site by combining statistical techniques, the positive matrix factorization (PMF) model, and risk quotient (RQ) methods. The results indicated that the total detection rate of PAHs in groundwater of the coking plant was 46.7%. The concentrations of PAHs in groundwater of the coking plant ranged from below the detection limit to 444.9 μg·L^-1, with the average value of 1.88 μg·L^-1. The concentration of PAHs in the groundwater of different production workshops was significantly different. The most polluted workshop was in the tar-refining area, and the concentration of 16 PAHs was 444.9 μg·L^-1. Based on the PMF model, we identified the two primary contamination sources of PAHs in groundwater of the coking plant:① oil combustion and ② coal and biomass combustion and oil leakage. The contribution ratios of the two sources to PAHs of groundwater were 38.6% and 61.4%, respectively. The results of the ecological risk assessment indicated that Σ₁₆PAHs in groundwater of the coking plant had high ecological risk, and the ecological risk of single PAHs in 53.4% of the groundwater sampling site was at a high ecological risk level. In conclusion, it is urgent to carry out the treatment and restoration of the groundwater environment in the coking plant site.

PMID:36775604 | DOI:10.13227/j.hjkx.202204212

Huan Jing Ke Xue. 2023 Feb 8;44(2):796-806. doi: 10.13227/j.hjkx.202203144.

ABSTRACT

In order to explore the sources of pollution and health risk profile of heavy metal elements in groundwater, 41 sets of representative groundwater samples from the southwest sub-basin of the Shiqi River were examined for 10 heavy metal elements (As, Cr, Cd, Al, Cu, Zn, Ni, Co, Mn, and Hg), and correlation analysis and principal component analysis were used to resolve the possible sources of heavy metal contamination in groundwater in the study area. The concentration characteristics and health risk levels of the 10 heavy metals were assessed using the single-factor contamination index (P_i), the Nemerow comprehensive contamination index (P_N), and the health risk model. The results showed that:① the average values of heavy metal elements of the groundwater in the study area all met the limit of the class Ⅲ water standard in the quality standard for groundwater (GB/T 14848-2017); only the maximum value of Al was exceeded, followed by a large variation in the concentrations of Al, Mn, and Cr. The heavy metal element with the largest average contribution was Al (65.74%). ② The results of the single-factor contamination index evaluation showed that only the heavy metal element Al exceeded the cleaning level, and the results of the Nemerow comprehensive contamination index evaluation showed that the study area was basically at low pollution levels, and the quality of groundwater was good. ③ The results of the multivariate statistical analysis showed that Zn, Co, and Mn were from mixed sources consisting of geological formation and domestic waste; Al, As, and Cu were from agricultural sources; Cd, Cr, and Ni were from industrial sources; and Hg came from long-range atmospheric transport. ④ The health risk values for all heavy metals in the study area were within acceptable limits, with higher health risk values for children than for adults from the drinking water route, lower health risk values than in adults from the dermal route, and higher health risk values for heavy metals from the drinking water route than those from the dermal route, indicating that the drinking water route was the main route of exposure to heavy metals.

PMID:36775603 | DOI:10.13227/j.hjkx.202203144

Huan Jing Ke Xue. 2023 Feb 8;44(2):752-760. doi: 10.13227/j.hjkx.202204232.

ABSTRACT

Global warming and regional extreme climates will lead to unbalanced rainfall, melting glaciers, and permafrost degradation in alpine and arid mountain plains, thereby changing the regional hydrological cycle. The relationship between surface water and groundwater conversion is one of the important scientific issues of hydrological cycle climate response in alpine arid areas. Taking the Datong River Basin at the southern foot of the Qilian Mountains as the study area, based on 119 sets of basic hydrochemical parameters and deuterium-oxygen isotope data, using multivariate statistical analysis and isotopic techniques, the hydrochemical characteristics of surface water and groundwater in the basin and their mutual transformation process were studied. The results showed that the surface water was HCO₃-Mg·Ca type, which was mainly controlled by rock weathering, whereas the groundwater was HCO₃-Mg·Ca type and Cl·SO₄-Na type, which was controlled by rock weathering and evaporation concentration. There was a small amount of calcium and magnesium feldspar dissolved in the upstream groundwater, and the chemical components of the midstream groundwater were mainly the weathering and dissolution of carbonate rocks. The contribution rates of weathering filtration, anthropogenic activities, native sedimentary environment, alternating adsorption of cations, and other factors to the chemical components of surface water and groundwater in the study area were 39.1%, 15.0%, 12.6%, 13.8%, and 19.5%, respectively. The deuterium and oxygen isotope contents of Datong River water showed a trend of enrichment to depletion along the groundwater flow direction. The δD and δ¹⁸O isotope test results showed that the deuterium and oxygen isotope content in the Datong River along the groundwater flow showed a trend of enrichment to depletion. The upper and middle reaches of the Datong River were mainly recharged by atmospheric precipitation, whereas the lower reaches were affected by geological structure and influenced by hydrogeological conditions, which was mainly due to diving and spring water overflow to supply river water, as the discharge area of groundwater.

PMID:36775599 | DOI:10.13227/j.hjkx.202204232

Huan Jing Ke Xue. 2023 Feb 8;44(2):740-751. doi: 10.13227/j.hjkx.202204313.

ABSTRACT

Tuochangjiang River is a typical mining-type watershed in the karst mountainous area of western Guizhou province. The study of its hydrochemical evolution characteristics and driving factors is of great significance to the local economic development and the scientific management of water resources. The samples of river water, spring water, and mine water in the Tuochangjiang River Basin were collected, and the sources of solutes and their contribution to the chemical components of river water were discussed by means of hydrochemical diagrams, mathematical statistics, and the absolute principal component scores-multivariate linear regression model (APCS-MLR). The results showed that the pH of the river water ranged between 7.30 to 8.31, and the TDS value ranged between 40 to 520 mg·L^-1, which was mainly contributed by Ca²⁺, Na⁺, HCO₃^–, and SO₄^2-. The dominant cations in river water were Ca²⁺ and Na⁺, the dominant anions were HCO₃^– and SO₄^2-, and the main water chemistry transitioned from HCO₃-Ca to HCO₃-Ca·Na and HCO₃·SO₄-Ca·Na type, whereas that of the mine water was mainly the HCO₃-Na and HCO₃·SO₄-Na types. The chemical composition of river water was affected by rock weathering, exchange adsorption of anions, mineral dissolution and precipitation, and human activities, in which Ca²⁺, Mg²⁺, and HCO₃^– were mainly derived from the weathering and dissolution of carbonate and silicate rocks, Na⁺and SO₄^2- were mainly from the discharge of mining wastewater, and Cl^– and NO₃^– were affected by domestic sewage and agricultural activities, respectively. APCS-MLR analysis further showed that the river water solutes mainly included five sources:discharge of mining wastewater, dissolution of soil minerals, geological background, agricultural activities, and unknown sources, and their contribution rates to river water were 23.49%, 35.04%, 13.87%, 7.96%, and 20.63%, respectively. Mining factors and soil factors were the most important sources of solutes in the river water, and they were the main driving factors for the hydrochemical evolution of the Tuochangjiang River Basin.

PMID:36775598 | DOI:10.13227/j.hjkx.202204313

J Bodyw Mov Ther. 2023 Jan;33:8-13. doi: 10.1016/j.jbmt.2022.09.005. Epub 2022 Sep 23.

ABSTRACT

INTRODUCTION: Core strengthening, balance, and flexibility programs such as Pilates have been advocated to positively impact running mechanics and prevent lower extremity injuries. The purpose of this study was to assess the effects of a 12-week mat-based Pilates exercise program on dynamic knee valgus alignment in runners.

METHODS: Thirty-four novice runners, including young male and female adults performed a running protocol at baseline. The protocol consisted of the participants running on a treadmill at a constant five miles per hour (mph) for 4 min. Post-examination, participants were randomly assigned to a Pilates or control group (n = 16 and n = 18, respectively). A certified Pilates instructor gave the Pilates group a 12-week home-based program. To ensure participants in the Pilates group performed exercises correctly, the Pilates instructor conducted the first session, and provided feedback to each participant. Participants in both groups performed the same running testing protocol every four weeks. Knee valgus was measured as the medial displacement of the knee joint center during the running stance phase. Repeated measures Analysis of Variance (RepANOVA) was calculated at baseline and 4-, 8-, and 12-weeks post examinations to compare knee valgus during running.

RESULTS: Although a reduction in dynamic knee valgus was observed within the Pilates group, the RepANOVA analysis revealed this change was not statistically significant.

CONCLUSIONS: Pilates mat-based exercises may improve knee valgus after 12 weeks but a larger sample size, longer intervention duration, or a supervised program should be considered for future research to evaluate its effectiveness.

PMID:36775530 | DOI:10.1016/j.jbmt.2022.09.005