Category: Statistics

Home Healthc Now. 2021 Mar-Apr 01;39(2):91-98. doi: 10.1097/NHH.0000000000000948.

ABSTRACT

Home visiting programs provide families with an array of services that contribute to decreased infant and maternal morbidity and mortality. However, little is known as to how mothers perceive participation in home visiting programs, and questions remain regarding what improvements can be made to better serve these families. The purpose of this program evaluation was to assess mothers’ perceived benefits and barriers to participation in established home visiting and outreach programs at Child Developmental Resources (CDR) in Williamsburg, Virginia. The program evaluation was a descriptive project consisting of 30-minute telephone interviews. Participants included 23 English-speaking mothers enrolled in CDR programs. Maternal demographics and perception of benefits/barriers were measured. Descriptive statistics were performed to describe sample demographics and outcome variables. Overall, most mothers perceived CDR programs as beneficial and were very satisfied with the services; however, a few changes could be made to improve programs and combat barriers to participation. Potential alternatives to supplement programs were suggested including the use of mobile technology in the participant’s home.

PMID:33662967 | DOI:10.1097/NHH.0000000000000948

Homeopathy. 2021 Mar 4. doi: 10.1055/s-0040-1722234. Online ahead of print.

ABSTRACT

BACKGROUND: Artesunate (ATS) is a semi-synthetic compound derived from artemisinin, which is widely accepted in the treatment of malaria. However, there is evidence that ATS, under certain in vitro conditions, induces several impairments to normal cell functions. Canova (CA) is a Brazilian homeopathic formulation indicated for patients with depressed immune system. CA shows both in vitro and in vivo protective effects against mutagenic/carcinogenic compounds. Therefore, we aimed to assess in vitro the cytoprotective effects of CA against the cytotoxicity of ATS in Vero cells.

METHODS: Viability of Vero cells exposed to ATS was assessed by MTT assay, whereas the anti-cytotoxic effect of CA was evaluated by apoptosis and necrosis quantification with fluorescent dyes.

RESULTS: After 24 hours of ATS treatment, a reduction in cell viability was observed at 32 and 64 µg/mL, the latter being statistically significant (p < 0.05) in relation to the negative control. The concentration of 64 µg/mL was chosen for the subsequent experiments. ATS significantly induced both apoptosis and necrosis in Vero cells in relation to controls (p < 0.01). We also observed a statistically significant decrease in the number of apoptotic cells observed in the CA 16% + ATS co-treatment compared with ATS treatment (p < 0.01). Treatment with CA alone also had no influence on either type of cell death.

CONCLUSION: Our results demonstrated that ATS is cytotoxic in the assessed conditions. However, such cytotoxicity was attenuated when the cells were treated simultaneously with ATS and CA.

PMID:33662994 | DOI:10.1055/s-0040-1722234

Phys Med. 2021 Mar 1;82:185-191. doi: 10.1016/j.ejmp.2021.01.080. Online ahead of print.

NO ABSTRACT

PMID:33662882 | DOI:10.1016/j.ejmp.2021.01.080

Environ Int. 2021 Mar 1;151:106456. doi: 10.1016/j.envint.2021.106456. Online ahead of print.

ABSTRACT

The understanding of sources and controlling factors of potentially toxic elements (PTEs) in soils plays an important role in the improvement of environmental management. With the rapid growth of data volume, effective methods are required for data analytics for the large geochemical data sets. In recent years, spatial machine learning technologies have been proven to have the potential to reveal hidden spatial patterns in order to extract geochemical information. In this study, two spatial clustering techniques of Getis-Ord G_i* statistic and K-means clustering analysis were performed on 15 PTEs in 6,862 topsoil samples from the Tellus datasets of Northern Ireland to investigate the hidden spatial patterns and association with their controlling factors. The spatial clustering patterns of hot spots (high values) and cold spots (low values) for the 15 PTEs were revealed, showing clear association with geological features, especially peat and basalt. Peat was associated with high concentrations of Bi, Pb, Sb and Sn, while basalt was associated with high concentrations of Co, Cr, Cu, Mn, Ni, V and Zn. The high concentrations of As, Ba, Mo and U were associated with mixture of various lithologies, indicating the complicated influences on them. In addition, three hidden patterns in the 6,862 soil samples were revealed by K-means clustering analysis. The soil samples in the first and second clusters were overlaid on the peatland and basalt formation, respectively, while the samples in the third cluster were overlaid on the mixture of the other lithologies. These hidden patterns of soil samples were consistent with the spatial clustering patterns for PTEs, highlighting the dominant control of peat and basalt in the topsoil of Northern Ireland. This study demonstrates the power of spatial machine learning techniques in identifying hidden spatial patterns, providing evidences to extract geochemical knowledge in environmental studies.

PMID:33662887 | DOI:10.1016/j.envint.2021.106456

Forensic Sci Int. 2021 Feb 20;321:110739. doi: 10.1016/j.forsciint.2021.110739. Online ahead of print.

ABSTRACT

Sex estimation is a crucial component of the biological profile. Stull et al. (2017) have proposed a promising juvenile sex estimation method using long bone measurements taken from a South African sample, providing relatively high classification accuracies and made easy to use via the KidStats web-based app. In this study, we test the models developed by Stull et al. (2017) on an external historic population from Lisbon, Portugal, in order to determine whether the models can be reliably applied to archeological and forensic populations outside of the original population sample. The study sample consisted of 102 individuals (45 females and 57 males) aged under 13 years at death from the Lisbon identified skeletal collection. Measurements from these individuals were used to test the flexible discriminant analysis (FDA) models given by Stull et al. (2017). Allocation accuracies were calculated for boys and girls and children over and under 2 years separately and combined. Our findings show that the models developed by Stull et al. (2017) yield poor accuracy when applied to our external population and thus can potentially be misapplied on archeological skeletal remains or forensic remains of unknown origin. A number of statistical issues may explain why models fail to be transportable or even generalizable, namely multicollinearity, model overfitting and overly optimist bootstrapped cross-validation rates. It is also likely that population differences in size and sexual size dimorphism also affected the applicability of the models. We emphasize the importance of externally validating prediction models, particularly if they are intended to be applied across populations. Our study addresses Stull and co-worker’s request for further validation of the method on populations outside of South Africa, as the models cannot be confidently applied in the field until it has been externally validated.

PMID:33662898 | DOI:10.1016/j.forsciint.2021.110739

J Sport Rehabil. 2021 Mar 3:1-4. doi: 10.1123/jsr.2020-0275. Online ahead of print.

ABSTRACT

CONTEXT: Total Motion Release® (TMR®) is a novel treatment paradigm used to restore asymmetries in the body (eg, pain, tightness, limited range of motion). Six primary movements, known as the Fab 6, are performed by the patient and scored using a 0 to 100 scale. Clinicians currently utilize the TMR® scale to modify treatment, assess patient progress, and measure treatment effectiveness; however, the reliability of the TMR® scale has not been determined. It is imperative to assess scale reliability and establish minimal detectable change (MDC) values to guide clinical practice.

OBJECTIVE: To assess the reliability of the TMR® scale and establish MDC values for each motion in healthy individuals in a group setting.

DESIGN: Retrospective analysis of group TMR® assessments.

SETTING: University classroom.

PARTICIPANTS: A convenience sample of 61 students (23 males and 38 females; 25.48 [5.73] y), with (n = 31) and without (n = 30) previous exposure to TMR®.

INTERVENTION: The TMR® Fab 6 movements were tested at 2 time points, 2 hours apart. A clinician with previous training in TMR® led participant groups through both sessions while participants recorded individual motion scores using the 0 to 100 TMR® scale. Test-retest reliability was calculated using an intraclass correlation coefficient (2,1) for inexperienced, experienced, and combined student groups. Standard error of measurement and MDC values were also assessed for each intraclass correlation coefficient.

OUTCOME MEASURE: Self-reported scores on the TMR® scale.

RESULTS: Test-retest reliability ranged from 0.57 to 0.95 across the Fab 6 movements, standard error of measurement values ranged from 4.85 to 11.77, and MDC values ranged from 13.45 to 32.62.

CONCLUSION: The results indicate moderate to excellent reliability across the Fab 6 movements and a range of MDC values. Although this study is the first step in assessing the reliability of the TMR® scale for clinical practice, caution is warranted until further research is completed to establish reliability and MDC values of the TMR® scale in various settings to better guide patient care.

PMID:33662931 | DOI:10.1123/jsr.2020-0275

Value Health Reg Issues. 2021 Mar 1;24:157-166. doi: 10.1016/j.vhri.2020.10.006. Online ahead of print.

ABSTRACT

OBJECTIVES: The objective of this study was to investigate predictors and develop risk equations for stage-3 chronic kidney disease (CKD) in Thai patients with type 2 diabetes mellitus (DM).

METHODS: A retrospective cohort study was conducted in patients with type 2 DM. The outcome was the development of stage-3 CKD. The data set was randomly split into training and validation data sets. Cox proportional hazard regression was used for model development. Discrimination (Harrell’s C statistic) and calibration (the Hosmer-Lemeshow chi-square test and survival probability curve) were applied to evaluate model performance.

RESULTS: In total, 2178 type 2 DM patients without stage-3 CKD, visiting the hospital from January 1, 2008, to December 31, 2017, were recruited, with median follow-up time of 1.29 years (interquartile range, 0.5-2.5 years); 385 (17.68%) subjects had developed stage-3 CKD. The final predictors included age, male sex, urinary albumin to creatinine ratio, estimated glomerular filtration rate, and hemoglobin A1c. Two 3-year stage-3 CKD risk models, model 1 (laboratory model) and model 2 (simplified model), had the C statistic in validation data sets of 0.890 and 0.812, respectively.

CONCLUSIONS: Two 3-year stage-3 CKD risk models were developed for Thai patients with type 2 DM. Both models have good discrimination and calibration. These stage-3 CKD prediction models could equip health providers with tools for clinical management and supporting patient education.

PMID:33662821 | DOI:10.1016/j.vhri.2020.10.006

Psychiatry Res. 2021 Feb 23;298:113821. doi: 10.1016/j.psychres.2021.113821. Online ahead of print.

ABSTRACT

The Coronavirus disease 2019 (COVID-19) pandemic has contributed to over 500,000 deaths, and hospitalization of thousands of individuals worldwide. Cross-sectional data indicate that anxiety and depression levels are greater during the pandemic, yet no known prospective studies have tested this assertion. Further, individuals with elevated trait anxiety prior to a global pandemic may theoretically be more apt to experience greater pandemic-related anxiety and/or impairment. The current study tested whether anxiety and depression increased from the month before the state’s Stay-At-Home order to the period of the Stay-At-Home order among 120 young adults in Louisiana, a state with especially high rates of COVID-19 related infections and deaths. We also tested whether pre-pandemic social anxiety was related to greater pandemic related anxiety, depression, and COVID-related worry and impairment. Depression but not anxiety increased during the Stay-At-Home order. Further, pre-pandemic trait anxiety, social anxiety, and depression were statistically significant predictors of anxiety and depression during the Stay-At-Home order, although only social anxiety was robustly related to COVID-related worry and impairment. Emotional distress increased during the COVID-19 pandemic Stay-At-Home order and this is especially the case among individuals with pre-pandemic elevations in trait anxiety (especially social anxiety) and depression.

PMID:33662840 | DOI:10.1016/j.psychres.2021.113821

Nurse Educ Today. 2021 Feb 11;99:104816. doi: 10.1016/j.nedt.2021.104816. Online ahead of print.

ABSTRACT

BACKGROUND: Collaboration and teamwork are vitally important for safe patient care. Experiential learning through interprofessional simulation helps prepare students for the expansive requirements of today’s complex healthcare environment.

PURPOSE: To develop and evaluate an interprofessional simulation educational activity to promote teamwork and communication between respiratory therapy and nursing students.

DESIGN: A mixed method design employing surveys, observation, and focus groups with educators and students was used. Thirty-six students from two institutions in Western Canada participated in this study. Data was analyzed using descriptive statistics and content analysis.

RESULTS: Baseline assessment revealed students were most familiar and comfortable with team functioning and communication interprofessional competencies, familiar but uncomfortable with collaborative leadership, conflict resolution, patient-centered care, and role clarification competencies. Correlation between communication and teamwork and collaborative leadership suggests these competencies play an important role in students’ ability to enact more complex skills, such as conflict resolution competency. Overall, participants were highly satisfied and shared invaluable insights for improving this simulation experience in the future.

CONCLUSION: This evaluation study demonstrated feasibility of interprofessional simulation and its potential to enhance acquisition of interprofessional competencies. A future study will incorporate additional disciplines, such as medicine and pharmacy, applying a controlled evaluation design.

PMID:33662866 | DOI:10.1016/j.nedt.2021.104816

Clin Res Hepatol Gastroenterol. 2021 Mar 1;45(6):101623. doi: 10.1016/j.clinre.2021.101623. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Few studies have focused on the treatment failure of zinc monotherapy for oligosymptomatic Wilson disease (WD) patients. Therefore, we aimed to evaluate the long-term efficacy of zinc monotherapy in oligosymptomatic patients and to analyze the possible factors that may influence the outcome of this treatment.

METHODS: We retrospectively reviewed the medical records of oligosymptomatic WD patients who received zinc monotherapy from the time of diagnosis. Then, the characteristics of patients who were treated with zinc monotherapy successfully and those who experienced treatment failure were investigated.

RESULTS: Forty oligosymptomatic WD patients were identified that have received zinc monotherapy as initial treatment, with a median age of 3.83 years at the time of diagnosis. 36 (90%) patients had abnormal alanine transaminase/aspartate transaminase levels at baseline. None of the patients became symptomatic during zinc monotherapy. 28 (70%, Group 1) patients were treated with zinc monotherapy successfully for a median period of 2.4 years. In Group 1, serum aminotransferase levels significantly decreased 6 and 12 months after zinc therapy compared to the baseline levels (P < 0.05). 12 (30%, Group 2) patients experienced treatment failure with zinc monotherapy due to uncontrolled serum liver enzyme levels, and d-penicillamine was combined. The baseline 24-hour urine copper levels before treatment were significantly higher in Group 2 compared to that in Group 1 (182.5 vs 90.92 μg /day, P = 0.018). Comparing the age at onset; ceruloplasmin, serum copper, ALT, and AST levels; and proportions of abdominal ultrasonography abnormality at baseline between Group 1 and 2 revealed no statistically significant differences.

CONCLUSIONS: We found that high initial 24 -h urinary copper levels may lead to treatment failure of zinc monotherapy in oligosymptomatic WD patients. It might be reasonable to follow up liver function tests more closely during zinc monotherapy and to begin combination treatment with chelators early in patients with high level of 24 -h urinary copper.

PMID:33662781 | DOI:10.1016/j.clinre.2021.101623