Category: Statistics

Health Secur. 2022 May 24. doi: 10.1089/hs.2021.0214. Online ahead of print.

ABSTRACT

A disaster overwhelms the normal operating capacity of a health service. Minimal research exists regarding Australian hospitals’ capacity to respond to chemical, biological, radiological, or nuclear (CBRN) disasters. This article, and the research supporting it, begins to fill that research gap. We conducted a descriptive quantitative study with 5 tertiary hospitals and 1 rural hospital in Queensland, Australia. The study population was the hospitals’ clinical leaders for disaster preparedness. The 25-item survey consisted of questions relating to each hospital’s current response capacity, physical surge capacity, and human surge capacity in response to a CBRN disaster. Data were analyzed using descriptive statistics. The survey data indicated that over the previous 12 months, each site reached operational capacity on average 66 times and that capacity to respond and create additional emergency, intensive care, or surgical beds varied greatly across the sites. In the previous 12 months, only 2 sites reported undertaking specific hospital-wide training to manage a CBRN disaster, and 3 sites reported having suitable personal protective equipment required for hazardous materials. There was a noted shortfall in all the hospitals’ capacity to respond to a radiological disaster in particular. Queensland hospitals are crucial to CBRN disaster response, and they have areas for improvement in their response and capacity to surge when compared with international preparedness benchmarks. CBRN-focused education and training must be prioritized using evidence-based training approaches to better prepare hospitals to respond following a disaster event.

PMID:35612425 | DOI:10.1089/hs.2021.0214

Clin Ter. 2022 May 25;173(3):249-256. doi: 10.7417/CT.2022.2428.

ABSTRACT

CONTEXT: In Europe, during an era of globalization in which traveling and studying abroad is becoming easier and more affordable, an open question remains on whether different European medical schools educate students with a dissimilar level of preparedness and/or satisfaction.

OBJECTIVE: To develop and validate the EUropean Students’ Preparedness and Satisfaction Questionnaire (EUSPSQ), a standardized European tool to assess preparedness and satisfaction in medical education.

MATERIALS AND METHODS: 30 participants belonging to the 5th and 6th year of two different European medical schools (Sapienza University of Rome and Universidad Complutense de Madrid) participated in the validation of the study. A standard validation protocol that included item development, test-retesting, and a series of statistical validation analyses, was used. Feasibility, test-retest reliability, inter-item reliability were assessed quantitatively. Face validity was evaluated qualitatively by an expert professor in the field.

RESULTS: Test-retest and inter-item reliability were considered satisfactory for all the parts of the questionnaire. Part III and IV presented lower Cohen’s kappa values, probably as a consequence of their inherent subjectivity. When one item in Part III was removed, the Cronbach’s alpha values of both initial and 48h answers consider-ably increased (-0.355 to 0.713 and -0.202 to 0.808 respectively). We therefore decided to eliminate the question from the EUSPSQ. Internal and external validity were considered appropriate. The questionnaire was also feasible and viable to complete.

DISCUSSION: Preliminary findings indicate that the EUSPSQ can be a valid, viable and reliable questionnaire to measure preparedness and satisfaction of 5th and 6th year medical students across different European Universities.

PMID:35612340 | DOI:10.7417/CT.2022.2428

Clin Ter. 2022 May 25;173(3):274-279. doi: 10.7417/CT.2022.2431.

ABSTRACT

PURPOSE: To evaluate safety and efficacy of customized central corneal regularization (CCR), together with simultaneous accelerated corneal collagen cross-linking (A-CXL) – CCR-CXL protocol, to treat keratoconus-related corneal ectasia.

DESIGN: Retrospective, comparative observational case series.

METHODS: Patients that had undergone combined CCR-CXL protocol. Main inclusion criteria were keratoconus visual acuity deterioration and contact lens intolerance. All patients underwent complete ophthalmological evaluation, corrected distance visual acuity (CDVA) and Scheimpflug-corneal tomography. Central corneal regularization was performed by ablation using flying spot laser. Subsequently, the stroma was saturated with 0.17% riboflavin-5-phosphate added every 2 minutes, followed by A-CXL 9 mW/cm2 for 10 minutes. CDVA, medium keratometry value (Kmed), and total corneal morphological irregularity index (CMI) of patients were analyzed before surgery and after 1, 3 and 12 months. A P value of .05 or less was considered statistically significant.

RESULTS: 46 eyes of 39 keratoconus patients were treated. At 1 month, the mean CDVA (LogMar) increased from 0.19 ± 0.02 to 0.12 ± 0.02 (P < .05), and the difference remained stable at month 12. Kmax decrease was statistically significant from 57.02 ± 5.65 to 50.21 ± 4.48 (P < .05). CMI decreased significantly from 47.8 ± 2.84 to 30.1 ± 2.4 (P < .01).

CONCLUSIONS: CCR-CXL protocol is safe and effective in arresting keratectasia progression and increasing corneal optic regularity in keratoconus. These findings showed a significant improvement in CDVA, keratometry values and corneal optical aberrations after being treated with the CCR-CXL protocol.

PMID:35612343 | DOI:10.7417/CT.2022.2431

Endocr Metab Immune Disord Drug Targets. 2022 May 24. doi: 10.2174/1871530322666220524104929. Online ahead of print.

ABSTRACT

BACKGROUND: Hypovitaminosis D and low testosterone levels are common in men with T2DM, and vitamin D has been proposed to regulate pituitary-testicular function.

OBJECTIVE: We investigated the association between testosterone levels and the circulating vitamin D among type 2 diabetic males.

METHODOLOGY: We recruited 95 type 2 diabetic males in this cross-sectional study, and investigated the circulating form of vitamin D which is 25-hydroxyvitamin D (25(OH) D). 25(OH) D level <30 ng/mL was used to define vitamin D insufficiency and 25(OH) D level <20 ng/ml defined deficiency. Testosterone deficiency was defined as a total testosterone level less than300 ng/dl.

RESULT: Testosterone deficiency prevalence in type 2 diabetic males was 46.3%. Testosterone deficient diabetics had significantly lower 25(OH) D levels than patients with normal testosterone. We observed a higher prevalence of vitamin D deficiency in testosterone deficient diabetics compared with testosterone sufficient patients. Furthermore, significantly lower total testosterone but not LH levels were observed in diabetic males with vitamin D deficiency in comparison to non-deficient patients. We observed that 25(OH) D significantly predicted total testosterone levels in diabetic males evaluated by linear regression analysis. However this association was no longer statistically significant after exclusion of macro-albuminuric patients. Moreover, Vitamin D deficiency was a significant risk factor for testosterone deficiency in logistic regression analysis.

CONCLUSION: Testosterone deficient diabetic males had significantly lower 25(OH)D levels and a higher prevalence of vitamin D deficiency in comparison with normal testosterone diabetic males. Likewise, vitamin D deficient patients had lower testosterone levels. Overall, 25(OH) D significantly predicted total testosterone levels. The vitamin D deficiency was thus a significant risk factor for testosterone deficiency in diabetic males.

PMID:35611781 | DOI:10.2174/1871530322666220524104929

Clin Exp Hypertens. 2022 May 25:1-9. doi: 10.1080/10641963.2022.2079666. Online ahead of print.

ABSTRACT

OBJECTIVE: Excessive salt intake is currently the foremost universal risk factor for controllable chronic disease. This study evaluated the short-term effects of a modest salt intake reduction combined with the Chinese Modified Dietary Approaches to Stop Hypertension (CM-DASH) diet on sodium and potassium intake, mean arterial pressure (MAP), and pulse pressure (PP) in hypertensive patients with type II diabetes.

METHODS: Sixty-one participants were randomized to the intervention group (52% low-sodium salt and DASH) and control group (normal salt and DASH). An 8-week dietary intervention was applied. Daily salt intake, blood pressure (BP), and drug use were recorded every week. Twenty-four-hour urine, casual urine, and blood samples were measured at baseline, the 4th week, and the end of the intervention.

RESULTS: Fifty-nine patients (25 men) completed the entire study. Sodium intake decreased by 1259.66 (792.76, 1726.56)/705.80 (149.21, 1262.39) mg/day after 4 weeks (intervention: P < .001; control: P = .015). Potassium intake increased by 641.14 (73.31, 1208.96)/43.43 (-259.66, 346.53) mg/day (intervention: P = .028); MAP decreased by 9.06 (6.69, 11.43)/7.16 (4.03, 10.28) mmHg (both: P < .001); PP decreased by 7.97 (3.05, 12.88)/5.74 (2.55,8.94) mmHg (intervention: P = .002; control: P = .001) after 8 weeks. However, the difference between the two groups was not statistically significant.

CONCLUSION: Modest salt reduction and the CM-DASH diet for hypertensive patients with type II diabetes can achieve short-term salt reduction effects. The effect on changing salt-eating habits needs to be investigated with an extended follow-up.

PMID:35611762 | DOI:10.1080/10641963.2022.2079666

Orthop Surg. 2022 May 25. doi: 10.1111/os.13311. Online ahead of print.

ABSTRACT

As more high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are performed, orthopaedic surgeons realize that more HTO and UKA failures will require revision to total knee arthroplasty (TKA) in the future. To systematically evaluate the clinical outcomes of TKA after HTO and TKA after UKA, the Embase, PubMed, Ovid, Web of Science, and Cochrane Library databases were searched for studies investigating revision TKA after HTO and UKA published up to June 2021. RevMan version 5.3 was used to perform the meta-analysis. The revision TKA after HTO and revision TKA after UKA groups were compared in terms of operative time, range of motion (ROM), knee score, postoperative complications, postoperative infection, revision, and revision implants used. Nine studies were ultimately included in the meta-analysis. Results revealed that the knee score for the revision TKA after HTO group was better than that of the revision TKA after UKA group (MD 4.50 [95% CI 0.80-8.20]; p = 0.02). The revision TKA after HTO group had a lower revision rate (OR 0.65 [95% CI 0.55-0.78]; p < 0.00001) and fewer revision implants used (OR 0.11 [95% CI 0.05-0.23]; p < 0.00001). There were no statistical differences in operation time (MD -2.00 [95% CI -11.22 to 7.21]; p = 0.67), ROM (MD -0.04 [95% CI -3.69-3.61]; p = 0.98), postoperative complications (OR 1.41 [95% CI 0.77-2.60]; p = 0.27), or postoperative infections (OR 0.89 [95% CI 0.61-1.29]; p = 0.53). To conclude, the revision rate of revision TKA after UKA was greater, and more revision implants were required. It is important for orthopaedic surgeons to preserve bone during primary UKA.

PMID:35611758 | DOI:10.1111/os.13311

Oral Dis. 2022 May 25. doi: 10.1111/odi.14264. Online ahead of print.

ABSTRACT

OBJECTIVE: One third of the Hungarian population suffers from xerostomia. Since there is no evidence on the actual prevalence of Sjögren’s syndrome (SS) in Hungary, this study aimed to evaluate the same.

MATERIALS AND METHODS: Data were collected from the Faculty of Dentistry, Semmelweis University from 2008 to 2015. A diagnosis of SS was established based on the American College of Rheumatology and European League Against Rheumatism criteria.

RESULTS: Of the 1,076 patients examined with sicca symptoms, 188 patients, had confirmed SS. Primary SS (pSS) was diagnosed in 135 patients, secondary SS (sSS) was confirmed in 53 patients. According to the available statistical records of the public health service of Hungary, there were an average of 16 (0.0014%, 5-26) newly diagnosed SS cases in the entire population and 141 SS patient-practitioner consultations (49-232) per 100,000 inhabitants in the country over the past 10 years (based on the past 10 years: 2011-2020).

CONCLUSION: Results revealed that approximately 1/5th-1/6th of patients with sicca symptoms have SS, among whom 72% and 285 have pSS and sSS, respectively. Global Hungarian records simultaneously revealed that the number of both new diagnoses and doctor-SS patient encounters has significantly decreased (by 50%) yearly over the last decade.

PMID:35611648 | DOI:10.1111/odi.14264

Eur J Contracept Reprod Health Care. 2022 May 25:1-8. doi: 10.1080/13625187.2022.2067329. Online ahead of print.

ABSTRACT

PURPOSE: To collect real-world safety and clinical outcome data on the levonorgestrel-releasing intrauterine system (LNG-IUS) for functional/organic heavy menstrual bleeding (HMB) and dysmenorrhoea in Japanese women (J-MIRAI).

MATERIALS AND METHODS: In this prospective, multicentre, single-cohort, open-label, post-authorisation study, we assessed menstrual blood loss after LNG-IUS insertion by changes from baseline in pictorial blood loss assessment chart (PBAC) scores. Scores for the menorrhagia multi-attribute scale (MMAS) were collected for 12 months to assess quality of life.

RESULTS: We included 47 patients with complete PBAC score and patient diary data. The median PBAC score before LNG-IUS insertion was 159.0, which decreased significantly to 6.0 at 12 months post-insertion; for patients with adenomyosis (n = 20), PBAC score decreased from 174.5 pre-insertion to 19.5 at 12 months. The number of patient-reported bleeding days was correlated with PBAC score ≥5. The proportion of women with prolonged bleeding decreased from 85.7% to 34.6% by the study’s end. Some women reported no bleeding after the first 90-day reference period. The mean MMAS overall score significantly increased from 50.50 before insertion to 88.67 at 12 months.

CONCLUSIONS: Japanese women with functional/organic HMB experienced substantial reductions in bleeding symptoms and improvements in quality of life after 12-month use of the LNG-IUS.

PMID:35611632 | DOI:10.1080/13625187.2022.2067329

J R Soc Interface. 2022 May;19(190):20220019. doi: 10.1098/rsif.2022.0019. Epub 2022 May 25.

ABSTRACT

Biological heterogeneity is a primary contributor to the variation observed in experiments that probe dynamical processes, such as the internalization of material by cells. Given that internalization is a critical process by which many therapeutics and viruses reach their intracellular site of action, quantifying cell-to-cell variability in internalization is of high biological interest. Yet, it is common for studies of internalization to neglect cell-to-cell variability. We develop a simple mathematical model of internalization that captures the dynamical behaviour, cell-to-cell variation, and extrinsic noise introduced by flow cytometry. We calibrate our model through a novel distribution-matching approximate Bayesian computation algorithm to flow cytometry data of internalization of anti-transferrin receptor antibody in a human B-cell lymphoblastoid cell line. This approach provides information relating to the region of the parameter space, and consequentially the nature of cell-to-cell variability, that produces model realizations consistent with the experimental data. Given that our approach is agnostic to sample size and signal-to-noise ratio, our modelling framework is broadly applicable to identify biological variability in single-cell data from internalization assays and similar experiments that probe cellular dynamical processes.

PMID:35611619 | DOI:10.1098/rsif.2022.0019

Clin Obes. 2022 May 25:e12529. doi: 10.1111/cob.12529. Online ahead of print.

ABSTRACT

To investigate what are the effects of pre-surgical aerobic dance-based exercise programme (PSADBE) and physical activity counselling (PAC) programme on lower extremity functions after surgery in people with morbid obesity awaiting bariatric surgery (PMOABS). This study was a single-blind, randomized controlled study. Groups were divided into Group I (PSADBE and PAC) and Group II (PAC). Both groups received PAC, Group I completed the PSADBE programme accompanied by music for 60 min/2 days/8 weeks. Thirty-four PMOABS were included in the study. The 6-Minute Walking Test, as primary outcomes, and The Stair Climbing Up-Down Test for evaluating functional capacity, Biodex Isokinetic Test and Exercise System® for evaluating muscle strength were used. Besides, muscle endurance, physical activity (PA) level, fatigue and quality of life (QoL) were also assessed. All measurements were repeated three times; pre-treatment, post-treatment and the fifth-month post-surgery. After 8 weeks, significant changes were found in functional capacity, muscle strength and endurance, PA level, fatigue and QoL in both groups (p < .05). Comparing the groups, the changes in functional capacity, muscle strength and endurance, PA and fatigue scores after treatment and the fifth-month post-surgery were statistically superior in Group I (p < .05). Adding an 8-week PSADBE programme to PAC is an effective treatment option for improving postoperative functional capacity, muscle strength and endurance, PA level and fatigue in PMOABS.

PMID:35611581 | DOI:10.1111/cob.12529