Category: Statistics

PLoS One. 2021 Dec 16;16(12):e0261264. doi: 10.1371/journal.pone.0261264. eCollection 2021.

ABSTRACT

BACKGROUND: The objectives of this study were; (I) to determine the proportion of pathogens isolated from patients with infected chronic wounds in the surgical ward of MRRH that are resistant to the third-generation cephalosporins and (II) to determine the factors associated with resistance to third-generation cephalosporins in the surgical ward of MRRH.

METHOD(S): This study was a descriptive analytical survey of bacterial isolates from infected chronic wounds among patients admitted in the surgical ward of MRRH, Uganda. Seventy five (75) study participants were recruited in the study using convenient sampling technique. Bacterial culture and identification was performed using standard microbiology laboratory procedures whereas broth microdilution method was used to establish the susceptibility of the identified pathogens. Data for objective one (1) was summarized as proportions while the categorized variables were analyzed using logistic regression to determine whether they were associated with the resistance patterns. The level of significance was preset at 5% and p-values less than 0.05 were considered statistically significant.

RESULTS: Generally, all isolates had complete susceptibility (100%) to Cefoperazone+Sulbactam 2g except 7.1% of proteus spp that were resistant. Of all the bacterial isolates studied, Staphylococcus aureus, Enterobacter agglomerans, providencia spp and pseudomonas earuginosa had complete resistance (100%) to Cefopodoxime 200mg while providencia spp and pseudomomas earuginosa had complete resistance (100%) to Cefixime 400mg and cefotaxime 1g. Finally, higher odds of bacterial resistance to more 2 brands of the third generation cephalosporins were observed among participants who had prior exposure to the third generation cephalosporins (OR, 2.22, 95% CI, 0.80-6.14), comorbidities (OR, 1.76, 95% CI, 0.62-4.96) and those who had more than two hospitalizations in a year (OR, 1.39, 95% CI 0.46-4.25). However, multivariate logistic regression was not performed since no factor was significantly associated with resistance to more than two brands of third generation cephalosporins (p >0.05).

CONCLUSION: This study found that cefixime and cefpodoixme had high rates of resistance and should not be used in routine management of infected chronic wounds. In addition, the factors investigated in this study were not significantly associated with bacterial resistance to more than two brands of third generation cephalosporins.

PMID:34914757 | DOI:10.1371/journal.pone.0261264

PLoS One. 2021 Dec 16;16(12):e0260567. doi: 10.1371/journal.pone.0260567. eCollection 2021.

ABSTRACT

We propose a framework of Resources, Achievement, Status, and Events (RASE) that allows the many disparate but well-documented phenomena affecting underrepresented groups in STEM to be assembled into a story of career trajectories, illuminating the possible cumulative impact of many small inequities. Our framework contains a three-component deterministic cycle of (1) production of Achievements from Resources, (2) updated community Status due to Achievements, and (3) accrual of additional Resources based on community Status. A fourth component, stochastic Events, can influence an individual’s level of Resources or Achievements at each time step of the cycle. We build a specific mathematical model within the RASE framework and use it to investigate the impact of accumulated disadvantages from multiple compounding variables. We demonstrate that the model can reproduce data of observed disparities in academia. Finally, we use a publicly available visualization and networking tool to provide a sandbox for exploring career outcomes within the model. The modeling exercise, results, and visualization tool may be useful in the context of training STEM faculty to recognize and reduce effects of bias.

PMID:34914741 | DOI:10.1371/journal.pone.0260567

PLoS One. 2021 Dec 16;16(12):e0261223. doi: 10.1371/journal.pone.0261223. eCollection 2021.

ABSTRACT

In this paper, the algebraic topological characteristics of brain networks composed of electroencephalogram(EEG) signals induced by different quality images were studied, and on that basis, a neurophysiological image quality assessment approach was proposed. Our approach acquired quality perception-related neural information via integrating the EEG collection with conventional image assessment procedures, and the physiologically meaningful brain responses to different distortion-level images were obtained by topological data analysis. According to the validation experiment results, statistically significant discrepancies of the algebraic topological characteristics of EEG data evoked by a clear image compared to that of an unclear image are observed in several frequency bands, especially in the beta band. Furthermore, the phase transition difference of brain network caused by JPEG compression is more significant, indicating that humans are more sensitive to JPEG compression other than Gaussian blur. In general, the algebraic topological characteristics of EEG signals evoked by distorted images were investigated in this paper, which contributes to the study of neurophysiological assessment of image quality.

PMID:34914746 | DOI:10.1371/journal.pone.0261223

PLoS One. 2021 Dec 16;16(12):e0257407. doi: 10.1371/journal.pone.0257407. eCollection 2021.

ABSTRACT

Salmonid fish raised in hatcheries often have lower fitness (number of returning adult offspring) than wild fish when both spawn in the wild. Body size at release from hatcheries is positively correlated with survival at sea. So one explanation for reduced fitness is that hatcheries inadvertently select for trait values that enhance growth rate under the unnatural environment of a hatchery, but that are maladaptive in the wild environment. A simple prediction of this hypothesis is that juveniles of hatchery origin should grow more quickly than fish of wild origin under hatchery conditions, but should have lower survival under wild conditions. We tested that hypothesis using multiple full sibling families of steelhead (Oncorhynchus mykiss) that were spawned using either two wild parents (WxW) or two first-generation hatchery (HxH) parents. Offspring from all the families were grown together under hatchery conditions and under semi-natural conditions in artificial streams. HxH families grew significantly faster in the hatchery, but had significantly lower survival in the streams. That we see this tradeoff after only a single generation of selection suggests that the traits involved are under very strong selection. We also considered one possible alteration to the hatchery environment that might reduce the intensity of selection among families in size at release. Here we tested whether reducing the fat content of hatchery feed would reduce the variance among families in body size. Although fish raised under a low-fat diet were slightly smaller, the variation among families in final size was unchanged. Thus, there is no evidence that reducing the fat content of hatchery feed would reduce the opportunity for selection among families on size at release.

PMID:34914737 | DOI:10.1371/journal.pone.0257407

PLoS One. 2021 Dec 16;16(12):e0260891. doi: 10.1371/journal.pone.0260891. eCollection 2021.

ABSTRACT

BACKGROUND: Parent mental health and wellbeing may have implications for understanding attachment transmission. In this systematic review, we synthesise the published literature to determine the nature of the relationship between parent mental health and wellbeing and the intergenerational transmission of attachment and to provide recommendations for future research, clinical practice and intervention.

METHOD: Using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach, five electronic databases were searched for peer-reviewed empirical studies, published in English. Articles were considered for inclusion if data was collected on adult attachment, child attachment, and a domain of parent mental health/wellbeing. No date parameters were applied to the search strategy. The review was registered with PROPSERO (registration number: CRD42020157247).

RESULTS: Eleven studies examining the impact on parent mental health and wellbeing on the intergenerational transmission of attachment were identified for inclusion in this review. Our review found preliminary evidence that parent mental health and wellbeing play a role in the intergenerational transmission of attachment. Other key findings from the review were: evidence quality is mixed due to variable measurement of attachment and mental health; studies have mostly included correlational analysis or do not utilise contemporary methodological approaches to testing mediating or moderating relationships; and literature is largely focused on psychopathology and negative factors of mental health.

CONCLUSIONS: The limited scope of parent mental health and wellbeing constructs examined in the literature, the sparse use of robust statistical analyses, and the lack of literature in general makes it difficult to draw conclusions on how and why parent mental health impacts attachment transmission. Addressing these limitations will further progress attachment-related literature and may have particular implications for attachment-informed interventions with clinical populations.

PMID:34914730 | DOI:10.1371/journal.pone.0260891

Disabil Rehabil. 2021 Dec 16:1-12. doi: 10.1080/09638288.2021.2013961. Online ahead of print.

ABSTRACT

PURPOSE: To systematically review the effectiveness of psychosocial interventions developed for informal caregivers of hemodialysis patients.

METHODS: Relevant studies were identified through five electronic databases: PubMed, Scopus, Web of Science, ProQuest, and the CENTRAL. Randomized controlled trials (RCTs) and quasi-experimental studies describing interventions for informal caregivers of adult in-center hemodialysis patients (≥18 years old) were included and independently appraised by two reviewers using the Joanna Briggs Institute Statistics Assessment and Review Instruments critical appraisal checklists.

RESULTS: Eleven articles evaluating eight intervention programs were included in this review, covering a total of 729 informal caregivers. Most studies implemented educational or psycho-educational interventions (n = 6). Psycho-educational interventions designed to promote caregivers’ ability to care and to cope with the caregiving role had positive effects on burden and/or quality of life. Psychological interventions also had large effects on reducing the burden over time.

CONCLUSIONS: There are still few interventions available to caregivers of hemodialysis patients. Psychosocial interventions showed great potential in improving the caregiver burden and quality of life. Further research with rigorous designs is needed to achieve stronger evidence on the extent of the current findings.

TRIAL REGISTRATION NUMBER: CRD42021247916.Implications for rehabilitationPatients with end-stage renal disease (ESRD) undergoing in-center hemodialysis often require emotional and/or practical support from family members or friends.Research has consistently shown that informal caregivers of hemodialysis patients may experience significant burden and a negative impact on their quality of life as a result of their caregiving role during the disease trajectory.This review evidenced that intervention programs involving education and psychological strategies had large positive effects on reducing caregiver burden and improving quality of life.The findings provide valuable evidence to recommend the inclusion of psychosocial programs to family caregivers as part of comprehensive renal care.

PMID:34913777 | DOI:10.1080/09638288.2021.2013961

Percept Mot Skills. 2021 Dec 16:315125211060953. doi: 10.1177/00315125211060953. Online ahead of print.

ABSTRACT

The underlying mechanism(s) of the Bilateral Deficit (BLD) phenomenon is without consensus. Methodological inconsistencies across prior works may be an important source of equivocal results and interpretations. Based on repeatability problems with the BLD measure and maximal force definition, the presence or absence of the BLD phenomenon is altered, shifting conclusions of its mechanistic cause. Our purpose in this study was to examine methodological inconsistencies in applying the BLD measure to establish optimal methods for evaluating the underlying mechanism. Eleven healthy participants engaged in one familiarity and five test sessions, completing bilateral and unilateral elbow maximal voluntary isometric contractions. We defined maximal force by averaged and absolute peak and plateau values. BLD was evident if the bilateral index (BI), the ratio of the bilateral over summed unilateral forces, was statistically different from zero. We addressed interclass correlations (ICC), Chronbach’s α, standard error of the mean, and minimal detectable change between and within sessions for all force measures and BI. We evaluated all combinations of sessions (i.e., 1-2, 3-5, 5-6) and maximal forces to establish the optimal number of sessions to achieve reliability. BLD was present for test sessions, but not for familiarization. All measures of maximal force were highly reliable between and within sessions (ICC(2,1) ≥ .895). BI was only considered significantly reliable in sessions 3-5 (p < .027), defined by absolute and average plateau forces, but reliability was still quantifiably poor (absolute: ICC(2,1) = .392; average: ICC(2,1) = .375). These results demonstrate that high force reliability within and between sessions does not translate to stable and reliable BI, potentially exposing the lack of any defined BLD mechanism.

PMID:34913749 | DOI:10.1177/00315125211060953

Technol Cancer Res Treat. 2021 Jan-Dec;20:15330338211051808. doi: 10.1177/15330338211051808.

ABSTRACT

Objective: To compare the effects of 2 techniques of semi-hepatic alternating radiotherapy on diffuse hepatic metastasis in patients with breast cancer. Methodology: A total of 68 breast cancer patients with diffuse liver metastasis were randomly divided into Group A (semi-hepatic alternating radiotherapy) and Group B (semi-hepatic sequential radiotherapy). In Group A (semi-hepatic sequential radiotherapy), the liver was divided into the first semi-liver and second semi-liver and alternatively treated with semi-hepatic intensity-modulated radiation therapy (IMRT). The interval between the 2 instances of semi-hepatic radiotherapy was 6 h. The average radiotherapy dose to the semi-livers was both 2 Gy/fraction, once a day, 5 times per week, with a total dose of 30 Gy for 15 days. The total radiation therapy time in Group A was 15 days in Group B (semi-hepatic sequential radiotherapy), the livers were divided into the first semi-liver and second semi-liver and treated with semi-hepatic sequential IMRT, The first semi-liver was first treated in the initial stage of radiation therapy, the average radiotherapy dose to the semi-liver was 2 Gy/fraction, once a day, 5 times per week, with a total dose of 30 Gy for 15 days. The second semi-liver was treated next in the second stage of radiation therapy, the average radiotherapy dose to the semi-liver was 2 Gy/fraction, once a day, 5 times per week, with a total dose of 30 Gy for 15 days. The total radiation therapy time in group B was 30 days. Results: The objective response rate (complete response + partial response) of Group A and Group B were 50.0% and 48.5%, respectively (p = .903). The median survival time after metastasis (median survival of recurrence) of Group A and Group B was 16.7 months and 16.2 months, respectively (p = .411). The cumulative survival rates of 6 months, 1 year, 2 years, and 3 years of Group A and Group B were 90.6% (29 of 32) and 84.8% (28 of 33) (p = .478), 65.6% (21 of 32) and 60.6% (20 of 33) (p = .675), 31.2% (10 of 32) and 27.3% (9 of 33) (p = .725), and 15.6% (5 of 32) and 0 (0 of 33) (p = .018), respectively. The differences between the 2 groups showed no statistical significance in terms of cumulative survival rates in 1 year, 2 years, however, the 3-year survival rate was significantly different. The main toxic reactions were digestive tract reactions, abnormal liver functions, and myelosuppression. The incidence of I to II degree gastrointestinal reactions was 78.13% (25 of 32) in Group A and 72.73% (24 of 33) in Group B (p = .614). The incidence of I to II abnormal liver function was 53.13% (17 of 32) in Group A and 48.48% (16 of 33) in Group B (p = .708). The differences between the 2 groups showed no statistical significance. The incidence of I to II myelosuppression was 59.38% (19 of 32) in Group A and 51.52% (17 of 33) in Group B (p = .524), respectively. The differences between the 2 groups showed no statistical significance in terms of adverse effects. Conclusion: Semi-hepatic alternating IMRT was an effective palliative treatment for diffuse liver metastasis in patients with breast cancer. Semi-hepatic alternating radiotherapy showed a trend of prolonged survival time when compared with semi-hepatic sequential radiotherapy. Compared with the former, the latter showed a trend of lower incidences of side effects without any statistical differences. Moreover, the side effects from the 2 radiotherapy techniques can be controlled through appropriate management, which is worthy of further exploration and applications.

PMID:34913767 | DOI:10.1177/15330338211051808

Rev Environ Health. 2021 Dec 17. doi: 10.1515/reveh-2021-0148. Online ahead of print.

ABSTRACT

OBJECTIVES: Health care workers (HCWs) are exposed to needle needles daily. Despite individual studies, there is no statistics on the prevalence of unreported needle stick injuries (NSIs) have been reported. This study was performed to determine the prevalence and causes of unreported NSIs among HCWs.

CONTENT: In present systematic review and meta-analysis study, three international databases (Web of Science, Scopus, PubMed) were searched from January 1, 2000 to December 31, 2018. The random model was used to determine the prevalence of unreported needle stick among HCWs.

SUMMARY AND OUTLOOK: Forty-one studies performed on 19,635 health care workers entered the final stage. Based-on random effect model, pooled prevalence of unreported needle stick injuries was 59.9% (95% CI: 52.0, 67.7; I2=98.9%). The most common cause of unreported NSIs was: They were not worried about NSIs (n=12). The high prevalence of unreported needle sticks injuries indicates the urgency and necessity of paying attention to strategies to improve reporting among health workers.

PMID:34913621 | DOI:10.1515/reveh-2021-0148

J Manag Care Spec Pharm. 2021 Dec 16:1-10. doi: 10.18553/jmcp.2021.21310. Online ahead of print.

ABSTRACT

BACKGROUND: Lung cancer is the leading cause of cancer-related deaths in the United States. Several anaplastic lymphoma kinase (ALK) rearrangement inhibitors have been approved for the treatment of metastatic ALK-positive nonsmall cell lung cancer (NSCLC). Effective disease management requires an understanding of how these treatments are used in clinical practice, since low treatment adherence and/or early discontinuation have been associated with poor patient outcomes. Owing to the recency of approvals, real-world data on the use of ALK inhibitors in patients with ALKpositive NSCLC are currently limited; this represents a notable gap in our understanding of ALK treatment use. OBJECTIVE: To assess real-world adherence and persistence with ALK inhibitors in patients with ALK-positive NSCLC. METHODS: This retrospective observational study used US commercial claims for patients aged at least 18 years with lung cancer receiving ALK inhibitors (alectinib, brigatinib, ceritinib, crizotinib) between July 1, 2015, and December 31, 2018. Patients’ first and any subsequent ALK inhibitor uses were categorized into ALK inhibitor-naive and ALK inhibitor-pretreated cohorts, respectively. Adherence was measured by medication possession ratio and persistence by time from treatment initiation to discontinuation (earliest of a treatment switch or greater than a 60-day gap). Descriptive statistics were used to summarize patient characteristics. Cohort comparisons were made using chi-square tests and t-tests. Persistence and time to next ALK inhibitor were analyzed using Kaplan-Meier methods and the log-rank test. Poisson and Cox regression models of adherence and persistence, respectively, were applied to compare ALK inhibitors. RESULTS: We identified 1,482 patients treated with alectinib (n = 445) or crizotinib (n = 1,037) in the ALK inhibitor-naive cohort; 604, 142, and 134 patients received alectinib, brigatinib, or ceritinib in the ALK inhibitor-pretreated cohort. Adherence during the treatment period (95%-97%) and the proportion of patients with a medication possession ratio of at least 0.8 (92%-95%) were similar for all ALK inhibitors. In the ALK inhibitor-naive cohort, median time to treatment discontinuation with alectinib and crizotinib was 27.1 and 8.8 months, respectively; patients receiving alectinib were 46% less likely to discontinue than patients receiving crizotinib (adjusted hazard ratio [aHR] [95% CI]: 0.54 [0.44-0.65]; P < 0.0001). In the ALK inhibitor-pretreated cohort, the discontinuation risk for alectinib was 64% lower than for ceritinib (aHR [95% CI]: 0.36 [0.27-0.49]; P < 0.0001) and 34% lower than for brigatinib (aHR [95% CI]: 0.66 [0.42-1.02]; P = 0.062). CONCLUSIONS: To our knowledge, this study is the first to address a current research gap by assessing real-world adherence and persistence with ALK inhibitors among patients with ALK-positive NSCLC in real-world clinical practice. Alectinib was associated with longer real-world persistence than other ALK inhibitors, despite similar adherence. Further research with more patients and longer follow-up is needed to link persistence to real-world clinical outcomes. DISCLOSURES: This study was funded by Genentech Inc. Ganti has received research support from Takeda and has provided consulting services to Genentech Inc., AstraZeneca, Flagship Biosciences, Cardinal Health, BioGene, Mirati Therapeutics, Blueprint Medicines, and G1 Therapeutics. Lin, Wong, and Ogale are employees of Genentech Inc. and may own stock in F. Hoffmann-La Roche. Yang was employed by Genentech Inc. at the time of this study. Part of the study findings were presented as a poster at the NCCN 2020 Virtual Annual Conference, April 9, 2020.

PMID:34913728 | DOI:10.18553/jmcp.2021.21310