Category: Statistics

PLoS Negl Trop Dis. 2022 Jan 14;16(1):e0010136. doi: 10.1371/journal.pntd.0010136. Online ahead of print.

ABSTRACT

BACKGROUND: As China is moving onto schistosomiasis elimination/eradication, diagnostic methods with both high sensitivity and specificity for Schistosoma japonicum infections in humans are urgently needed. Microscopic identification of eggs in stool is proven to have poor sensitivity in low endemic regions, and antibody tests are unable to distinguish between current and previous infections. Polymerase chain reaction (PCR) technologies for the detection of parasite DNA have been theoretically assumed to show high diagnostic sensitivity and specificity. However, the reported performance of PCR for detecting S. japonicum infection varied greatly among studies. Therefore, we performed a meta-analysis to evaluate the overall diagnostic performance of variable-temperature PCR technologies, based on stool or blood, for detecting S. japonicum infections in humans from endemic areas.

METHODS: We searched literatures in eight electronic databases, published up to 20 January 2021. The heterogeneity and publication bias of included studies were assessed statistically. The risk of bias and applicability of each eligible study were assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool (QUADAS-2). The bivariate mixed-effects model was applied to obtain the summary estimates of diagnostic performance. The hierarchical summary receiver operating characteristic (HSROC) curve was applied to visually display the results. Subgroup analyses and multivariate regression were performed to explore the source of heterogeneity. This research was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and was registered prospectively in PROSPERO (CRD42021233165).

RESULTS: A total of 2791 papers were retrieved. After assessing for duplications and eligilibity a total of thirteen publications were retained for inclusion. These included eligible data from 4268 participants across sixteen studies. High heterogeneity existed among studies, but no publication bias was found. The pooled analyses of PCR data from all included studies resulted in a sensitivity of 0.91 (95% CI: 0.83 to 0.96), specificity of 0.85 (95% CI: 0.65 to 0.94), positive likelihood ratio of 5.90 (95% CI: 2.40 to 14.60), negative likelihood ratio of 0.10 (95% CI: 0.05 to 0.20) and a diagnostics odds ratio of 58 (95% CI: 19 to 179). Case-control studies showed significantly better performances for PCR diagnostics than cross-sectional studies. This was further evidenced by multivariate analyses. The four types of PCR approaches identified (convention PCR, qPCR, Digital droplet PCR and nested PCR) differed significantly, with nested PCRs showing the best performance.

CONCLUSIONS: Variable-temperature PCR has a satisfactory performance for diagnosing S. japonicum infections in humans in endemic areas. More high quality studies on S. japonicum diagnostic techniques, especially in low endemic areas and for the detection of dual-sex and single-sex infections are required. These will likely need to optimise a nested PCR alongside a highly sensitive gene target. They will contribute to successfully monitoring endemic areas as they move towards the WHO 2030 targets, as well as ultimately helping areas to achieve these goals.

PMID:35030167 | DOI:10.1371/journal.pntd.0010136

Ophthalmic Plast Reconstr Surg. 2022 Jan 13. doi: 10.1097/IOP.0000000000002120. Online ahead of print.

ABSTRACT

PURPOSE: To characterize chronic orbital pain in patients who benefitted from peripheral trigeminal nerve blocks and to explore the relationship between pain etiologies and phenotypes, injection attributes, and positive response to treatment.

METHODS: In this single-center retrospective descriptive study, patients who underwent peripheral trigeminal nerve blocks for chronic orbital pain from November 2016 to May 2021 were selected. Data reviewed included inciting factors, neuropathic symptoms of orbital pain, injection composition (anesthetic alone versus anesthetic + dexamethasone), and corneal epitheliopathy grades. Primary outcomes assessed were response to injection, duration of injection effectiveness, and overall treatment efficacy. Associations between subgroups of chronic orbital pain, injection attributes, and treatment outcomes were examined.

RESULTS: Nineteen patients who underwent a total of 94 peripheral trigeminal nerve blocks for chronic orbital pain were included. During a mean follow-up period of 2.4 years after initial injection (range 7 days-4.6 years), 16 (84.2%) patients achieved either partial or complete improvement. Ocular versus nonocular origin of orbital pain or the presence of neuropathic sensory characteristics was not associated with a treatment outcome. Injections containing dexamethasone had a lower positive efficacy (relative risk, 0.88; 95% CI, 0.81-0.97) and no statistically significant association with prolonged effect. Twenty-nine (50.9%) of the 57 injections for which effect duration was recorded produced a response lasting greater than 6 weeks.

CONCLUSIONS: Modulation of trigeminal afferent nerve activity with peripheral trigeminal nerve blocks containing anesthetic with or without dexamethasone may be a promising treatment strategy for chronic orbital pain of diverse etiologies and phenotypes.

PMID:35030151 | DOI:10.1097/IOP.0000000000002120

PLoS Comput Biol. 2022 Jan 14;18(1):e1009733. doi: 10.1371/journal.pcbi.1009733. Online ahead of print.

ABSTRACT

The rates of cell growth, division, and carbon loss of microbial populations are key parameters for understanding how organisms interact with their environment and how they contribute to the carbon cycle. However, the invasive nature of current analytical methods has hindered efforts to reliably quantify these parameters. In recent years, size-structured matrix population models (MPMs) have gained popularity for estimating division rates of microbial populations by mechanistically describing changes in microbial cell size distributions over time. Motivated by the mechanistic structure of these models, we employ a Bayesian approach to extend size-structured MPMs to capture additional biological processes describing the dynamics of a marine phytoplankton population over the day-night cycle. Our Bayesian framework is able to take prior scientific knowledge into account and generate biologically interpretable results. Using data from an exponentially growing laboratory culture of the cyanobacterium Prochlorococcus, we isolate respiratory and exudative carbon losses as critical parameters for the modeling of their population dynamics. The results suggest that this modeling framework can provide deeper insights into microbial population dynamics provided by size distribution time-series data.

PMID:35030163 | DOI:10.1371/journal.pcbi.1009733

J Nurses Prof Dev. 2022 Jan 13. doi: 10.1097/NND.0000000000000844. Online ahead of print.

ABSTRACT

Perceived knowledge deficits in disaster preparedness are widespread among hospital-based nurses and healthcare professionals. Experiential learning programs provide enhanced disaster preparedness familiarity among hospital-based healthcare staff. A disaster preparedness education class was offered at a midwestern suburban hospital to promote increased knowledge perception. The Emergency Preparedness Information Questionnaire was administered to assess disaster preparedness familiarity. The posttest scores after the experiential learning yielded statistically significant results (t = 46.90, p < .001) for increased disaster preparedness familiarity.

PMID:35030112 | DOI:10.1097/NND.0000000000000844

Retina. 2022 Jan 10. doi: 10.1097/IAE.0000000000003407. Online ahead of print.

ABSTRACT

PURPOSE: To analyze the retino-choroidal vascular characteristics of patients affected by pigmented paravenous chorio-retinal atrophy (PPCRA) by means of optical coherence tomography angiography (OCTA).

METHODS: The study was designed as an observational, cross-sectional case series. Multimodal imaging included fundus autofluorescence (FAF), structural optical coherence tomography (OCT) and OCT angiography (OCTA). The quantitative OCTA analyses included the calculation of the vessel density (VD) and choriocapillaris porosity.

RESULTS: Overall, 12 patients (24 eyes) affected by PPCRA were recruited. Structural OCT of the areas involved by PPCRA as visualized on FAF showed a complete EZ and ELM absence, with thinning of ganglion cell complex (GCC), outer nuclear layer (ONL), and outer plexiform layer, but associated with the optical partial preservation of the retinal pigment epithelium (RPE). OCTA quantitative assessment of the retinal regions affected by PPRCA, as visualized by FAF, were characterized by normal VD at the level of superficial capillary plexus, but significantly altered VD of deep capillary plexus (DCP) and choriocapillaris, with higher choriocapillaris porosity.The presence of macular atrophy was significantly correlated with worse DCP and choriocapillaris VD values. Furthermore, a statistically significant correlation between the FAF patterns and the retinal vascular status was found.

CONCLUSIONS: OCTA quantitative analyses in PPCRA demonstrate a specific impairment at the level of the DCP, which could in turn bring about a thinning of GCC and ONL. The alterations at the level of the choriocapillaris and the choroid in general, could then represent a secondary effect.

PMID:35030147 | DOI:10.1097/IAE.0000000000003407

Wound Manag Prev. 2021 Nov;67(11):26-32.

ABSTRACT

BACKGROUND: Medical devices can cause pressure injuries.

PURPOSE: This study was conducted to determine the prevalence of and factors associated with medical device-related pressure injury (MDRPI) in an intensive care unit (ICU).

METHODS: A cross-sectional study was performed among adult patients (at least 18 years of age) admitted to an ICU in a referral hospital in Brazil between December 2019 and February 2020. The skin of patients who consented to participate was assessed for the presence of an MDRPI, and the use of all medical devices was noted. Other independent variables (sociodemographic variables, medical history, pressure injury risk factors, medications, and length of hospitalization) were abstracted from the medical records. Bivariate data analysis included Pearson’s chi-square test or Fisher’s exact test; odds ratio and a confidence interval of 95% also were established. Correlation among independent variables and MDRPI was determined using the ρ Spearman correlation test, and a hierarchical binary logistic regression analysis was performed using statistically significant variables from the bivariate analysis. P < .05 was considered statistically significant.

RESULTS: The 125 study participants ranged in age from 15 to 97 years (mean, 63.02 ± 19.2), 76 (60.8%) were men, and 76 (60.8%) were White. Of the 125 participants, 43 (34%) experienced MDRPI; the total number of MDRPIs was 58 (3 patients had 3 injuries, and 7 patients had 2 injuries). Of those 58 MDRPIs, 46 were stage 1, and 12 were stage 2. Polypharmacy (> 4 medications) was a significant risk factor for MDRPI. Use of a nasal catheter, cord for orotracheal tube fixation, oximeter, intra-abdominal pressure equipment, and indwelling urinary catheter was significantly associated with the presence of MDRPI. Renal and respiratory diseases and the presence of infection were positively related to the presence of MDRPI.

CONCLUSION: Medical device-related pressure injury was prevalent in this patient population. Most of these injuries were stage 1, which suggests that frequent monitoring and device repositioning (when possible) may help prevent more serious injuries. Additional research involving other hospitals in Brazil is needed to increase the understanding of the prevalence and risk factors of MDRPIs in patients in the ICU.

PMID:35030095

Wound Manag Prev. 2021 Nov;67(11):12-25.

ABSTRACT

BACKGROUND: Turning nursing home residents every 2 hours has been a long-held standard for pressure injury (PrI) prevention in individuals with mobility impairments although evidence to substantiate this practice is limited. New guidelines recommend personalizing turning schedules to support person-centered care but lack specific recommendations about which turning frequencies are appropriate for various risk levels.

PURPOSE: This quality improvement program aimed to determine the feasibility and outcomes of using individualized turn schedules for newly admitted nursing home residents.

METHODS: An expert panel of wound clinicians developed, tested, and implemented a turn frequency tool that allowed staff in 2 nursing homes to select a turning schedule of 1, 2, 3, or 4 hours based on resident risk factors. Turning schedules were operationalized using a wearable sensor-based visual cueing technology that alerted staff to resident repositioning needs. Nonparticipating resident data were collected for comparison of PrI incidence. Descriptive statistics were calculated for all covariates. Significance of differences tests were performed as appropriate.

RESULTS: Over 7 months, 154 residents had their turn period individualized, with 56% qualifying for 3-hour (Q3H) or 4-hour (Q4H) schedules. Facility-acquired PrI incidence was 94% lower in participants than in nonparticipants (P < .0001). Use of 3-hour and 4-hour intervals saved roughly 21 and 35 minutes of staff time, respectively, per resident per shift.

CONCLUSION: Individualizing turning schedules is feasible. Residents with longer turning intervals did not develop PrIs, supporting previous studies about safely extending turning periods for most residents.

PMID:35030094

J Med Life. 2021 Sep-Oct;14(5):710-715. doi: 10.25122/jml-2021-0304.

ABSTRACT

Cancer testis antigens have been discovered in various cancers, and several studies have suggested that since they exhibit such distinct patterns of expression, these antigens might be attractive targets for cancer detection and immunotherapy. Our work attempted to clarify the function played by cancer-testis antigens in ovarian cancers, notably in the XAGE1 gene. The investigation was conducted on 74 tissue samples from newly diagnosed patients with ovarian cancer. The control group included twenty-eight benign ovarian tumors. The expression of XAGE1 mRNA was assessed using RT-PCR. Compared to benign tumors, cancer samples exhibited higher levels of XAGE1 gene expression, which was statistically significant (P0.01). There were no statistically significant differences between menopausal status and family history. Gene expression was substantially connected with age groups as the higher level of gene expression in patients 50-74 years of age (P 0.01) was seen. Mucinous tumors exhibited significant correlations (P0.01) across histopathological tumor types. In correlation with tumor stages, stage III was substantially linked compared to stage I (P0.01). In conclusion, we referred to the potential to use XAGE1 to discriminate malignant ovarian tumors as a diagnostic biomarker. The connection of high XAGE 1 level with advanced ovarian cancer stages has also been established, supporting XAGE 1’s proposed role in poor prognosis. Finally, finding the specific involvement of this gene in ovarian cancer and other kinds of malignancies may require further investigations.

PMID:35027975 | PMC:PMC8742904 | DOI:10.25122/jml-2021-0304

J Med Life. 2021 Sep-Oct;14(5):695-699. doi: 10.25122/jml-2021-0052.

ABSTRACT

Over the last ten years, the incidence of the pathology of the bronchus-pulmonary system in children has increased 3.6 times, mainly due to acute and recurrent inflammatory diseases of the upper and lower respiratory tract. Thus, the problem of identifying children with recurrent episodes of acute obstructive bronchitis and an increased risk of developing asthma is relevant and promising. The goal of this study was to find molecular genetic markers associated with increased susceptibility of children to repeated episodes of acute obstructive bronchitis. The molecular genetic testing of the IL4 gene of a single nucleotide polymorphism C-33T was performed in 35 children with recurrent episodes of acute obstructive bronchitis and 35 children with acute bronchitis. The results were statistically processed on a personal computer with the calculation of values the arithmetic mean (M), of the errors arithmetic mean (m), Student criterion (t), the degree of probability (p), Pearson criterion (χ²), and the odds ratio (OR). Statistically significant differences were figured at p<0.01 and p<0.05. It has been proved that the presence of a child’s genotype 33CT IL4 increases the risk of recurrent acute obstructive bronchitis four times.

PMID:35027973 | PMC:PMC8742891 | DOI:10.25122/jml-2021-0052

J Med Life. 2021 Sep-Oct;14(5):700-709. doi: 10.25122/jml-2021-0362.

ABSTRACT

The main aim of this study is to systematically record Cerebrolysin treatment modalities and concomitant medication, according to local standards, in patients with moderate to severe neurological deficits after acute ischemic stroke and to assess the impact of these parameters on therapy outcome during early rehabilitation (day 21) and on day 90. An open observational treatment design based on the principles of high-quality comparative effectiveness research (HQCER) has been chosen to capture the therapies as applied in real-world clinical practice. HQCER opens a new horizon for strengthening the validity of the results from observational trials, thereby enhancing the associated level of evidence. Rigorous pre-specification of analytical procedures and tight risk-based centralized monitoring were additional measures to improve the impact of the observational approach. The value for real-world studies has become obvious, and such studies based on comparative effectiveness designs supplement the classical study designs by enabling the inclusion of larger proband numbers and more statistical reliability for practical use.

PMID:35027974 | PMC:PMC8742899 | DOI:10.25122/jml-2021-0362