Category: Statistics

Diabetes Metab Syndr. 2021 Dec 13;16(1):102369. doi: 10.1016/j.dsx.2021.102369. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Classification of wound severity is important in medical care decisions specially in diabetic patients. The Wagner Scale provides a structure to determine the severity of a wound by examining its depth and extent. The adequate reliability of this instrument, like other instruments for measuring health status, is important. So, the aim of this review is to report evidence on the reliability of the Wagner scale.

METHOD: A comprehensive search was performed in databases. Observational studies that assessed the reliability of the Wagner scale, with statistical measures, were included. Methodological quality of studies was evaluated with the COSMIN checklist. Finally, we report the reliability measurements, narratively.

RESULTS: We assessed 7 studies. In all studies 1873 subjects participated. Methodological quality was good only in one study. In two studies used of weighted kappa (Inter Observer Reliability) that reliability was in median level in both studies. The relation between Wagner score and amputation were report in two studies that measured by X²_trend and regression analysis. In four measurements, reported the correlation between Wagner with ulcer healing by X²_trend, Log Rank, Kaplan-Meier, and inter quartile range.

CONCLUSION: It can be confirmed that the reliability of the Wagner scale is appropriate and this tool is recommended to evaluate the severity of the wounds specially in diabetic patients. It should also be noted that the user of the scale must be trained. In future studies, it is recommended to use appropriate methodology and complete reports for the reliability of Wagner scale.

PMID:34929620 | DOI:10.1016/j.dsx.2021.102369

Pathol Res Pract. 2021 Dec 7;229:153733. doi: 10.1016/j.prp.2021.153733. Online ahead of print.

ABSTRACT

BACKGROUND: Spindle Cell Carcinoma (SpCC) is a rare type of squamous cell carcinoma (SCC) with prominent malignant spindle cell component. This unique biphasic feature on histopathological examination makes its diagnosis problematic. Detection of p63 antigens in SpCC can be helpful however its expression in variousb proliferating soft tissue lesions demands for better marker.

METHODS: In this study, histopathologically diagnosed SpCC of head and neck region were considered as cases, and 22 soft tissue sarcomas, reactive lesions and spindle cell lesions of the body were taken as controls. Immunohistochemistry (IHC) was done using Anti-p63 and p40 clone and the results were compared. CK was done for negative cases to prove their epithelial origin. P. value < 0.05 considered statistically significant.

RESULTS: Among 22 cases of SpCC, 19 cases showed positive immunoreactivity to p63, and 18 cases for p40. IHC of controls showed no immunoreactivity in any of the sarcomas, reactive lesions or spindle cell lesions. The sensitivity of p63 is 86% while that of p40 is 82%. Specificity of both the markers was 100% CONCLUSION: Though p63 is a slightly (4%) more sensitive marker than p40, percentage of cell positivity for p40 is higher compared to p63. Both of these markers are 100% specific for SpCC.

PMID:34929597 | DOI:10.1016/j.prp.2021.153733

Accid Anal Prev. 2021 Dec 17;165:106501. doi: 10.1016/j.aap.2021.106501. Online ahead of print.

ABSTRACT

In the last fifty years, researchers have developed statistical, data-driven, analytical, and algorithmic approaches for designing and improving emergency response management (ERM) systems. The problem has been noted as inherently difficult and constitutes spatio-temporal decision making under uncertainty, which has been addressed in the literature with varying assumptions and approaches. This survey provides a detailed review of these approaches, focusing on the key challenges and issues regarding four sub-processes: (a) incident prediction, (b) incident detection, (c) resource allocation, and (c) computer-aided dispatch for emergency response. We highlight the strengths and weaknesses of prior work in this domain and explore the similarities and differences between different modeling paradigms. We conclude by illustrating open challenges and opportunities for future research in this complex domain.

PMID:34929574 | DOI:10.1016/j.aap.2021.106501

Phytomedicine. 2021 Dec 3;95:153868. doi: 10.1016/j.phymed.2021.153868. Online ahead of print.

ABSTRACT

BACKGROUND: Huashibaidu Formula (HSBD) for the COVID-19 treatment has been supported by the China’s Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia. However, it is not clear whether HSBD can improve blood oxygen saturation and when it should be used with conventional therapies.

PURPOSE: To access the effect of HSBD combined with conventional treatment on blood oxygen saturation of COVID-19 patients.

METHODS: A single-center retrospective cohort study was conducted to collect the confirmed severe COVID-19 patients’ information, treated by the National Traditional Chinese Medicine Medical Team at the Jinyintan hospital between January 24 and March 31, 2020. According to whether HSBD was used during hospitalization, participants were separated into the conventional treatment group and the HSBD group (HSBD and conventional treatment). The primary observation indicators included the time for relieving blood oxygen saturation and the improvement ratio of blood oxygen saturation in each group.

RESULTS: Of 111 patients with severe COVID-19, 53.2% (59/111) received HSBD, and 46.8% (52/111) only received conventional treatment, respectively. No statistically significant difference was found in image, clinical symptoms, and past medical history between the two groups (p > 0.05). Notably, the median time for relieving blood oxygen saturation in the conventional treatment group was 11 days (IQR, 8-14.25), while that in the HSBD group was only 6 days (IQR, 3.25-10.75), which was significantly shortened by 4.09 days (95%CI, 2.07-6.13; p= 0.0001), compared with the conventional treatment group. After repeated measurement design analysis, the main effect within times (p< 0.001) and the main effect were significantly different under the oxygen saturation dimension between two groups (p= 0.004). However, time and group interaction were observed no significant difference (p= 0.094). After 14 days of treatment, the improvement ratio of the HSBD group over the conventional treatment group was 1.20 (95%CI, 0.89-1.61).

CONCLUSION: For severe COVID-19 patients, the HSBD has a tendency to shorten the time for relieving blood oxygen saturation. After taking a course of HSBD, the effect can be more obvious.

PMID:34929564 | DOI:10.1016/j.phymed.2021.153868

Nurse Educ Pract. 2021 Dec 15;58:103277. doi: 10.1016/j.nepr.2021.103277. Online ahead of print.

ABSTRACT

AIM: To explore nurses’ knowledge, skills and personal attributes for competent health education practice and their association with potential influencing factors.

BACKGROUND: Clinical nurses are expected to perform effective health education interventions, but they do not feel competent. The self-assessment of the health education competence and its conditional factors is paramount for professional development.

DESIGN: A cross-sectional study.

METHODS: A total of 458 clinical nurses from two health specialized centers in Spain participated in this study. Data were collected using the Nurse Health Education Competence Instrument and a second self-report questionnaire from January to February 2019. Descriptive statistics, t-test, analysis of variance, Pearson’s and Spearman’s correlation and multiple linear regression were used to analyse the data. The STROBE guideline was used RESULTS: The mean scores of the knowledge (70.10 ± 15.11), skills (92.14 ± 15.18) and personal attributes scales (32.32 ± 5.89) were found to be low to moderate. The main influencing factors for the health education implementation were lack of education and training (71.4%), lack of time (67.5%) and high workload (67.3%). Nurses with higher educational level and perceived self-efficacy for competently providing health education, more extensive professional experience and previous training in health education rated higher in knowledge, skills and personal attributes. Age and years of experience were negatively correlated with knowledge scores, but positively with the rest of domains of the competence and self-efficacy. The regression models for the overall health education competence’s domains were significant (p < 0.001) with R2 values ranging from 28.0% to 49.3%. Self-efficacy, previous health education training and working in intensive care units were found to be significant in all cognitive, psychomotor and attitudinal scales.

CONCLUSION: Clinical nurses reported on some skills and personal attributes for health education practice, but they seem to lack health education knowledge necessary for a competent practice. This study suggested that effective education and training and supportive organizational cultures are key to enhance nurses’ health education competence. Identifying nurses’ educational needs on the main domains of the competence and its intrinsic/extrinsic influential factors may assist in both planning and organizing tailored training strategies and in promoting appropriate environments to support a high-quality health education practice TWEETABLE ABSTRACT: Nurses’ knowledge, skills and attitudes about health education competence are low to moderate. Training and organizational support are key.

PMID:34929565 | DOI:10.1016/j.nepr.2021.103277

Psychoneuroendocrinology. 2021 Dec 16;137:105631. doi: 10.1016/j.psyneuen.2021.105631. Online ahead of print.

ABSTRACT

BACKGROUND: Alterations in cognitive performance have been described in patients with major depressive disorder (MDD). However, the specific risk factors of these changes are not yet known. This study aimed to explore whether inmunometabolic parameters are related to cognitive performance in MDD in comparison to healthy controls (HC) METHODS: Sample consisted of 84 MDD patients and 78 HC. Both groups were compared on the results of cognitive performance measured with the Cambridge Neuropsychological Test Automated Battery (CANTAB), the presence of metabolic syndrome (MetS) and an inflammatory/oxidative index calculated by a principal component analysis of peripheral biomarkers (tumor necrosis factor, C-reactive protein and 4-hydroxynonenal). A multiple linear regression was carried out, to study the relationship between inmunometabolic variables and the global cognitive performance, being the latter the dependent variable.

RESULTS: Significant differences were obtained in the inflammatory/oxidative index between both groups (F₍₁₁₅₇₎= 12.93; p < .001), also in cognitive performance (F₍₁₁₅₇₎= 56.75; p < .001). The inmunometabolic covariate regression model (i.e., condition (HC/MDD), sex, age and medication loading, MetS, inflammatory/oxidative index and the interaction between MetS and inflammatory/oxidative index) was statistically significant (F₍₇₁₅₇₎= 11.24; p < .01) and explained 31% of variance. The condition, being either MDD or HD, (B=-0.97; p < .001), age (B=-0.28; p < .001) and the interaction between inflammatory/oxidative index and MetS (B=-0.38; p = .02) were factors associated to cognitive performance.

LIMITATIONS: Sample size was relatively small. The cross-sectional design of the study limits the possibilities of analysis.

CONCLUSIONS: Our results provide evidence on the conjoint influence of metabolic and inflammatory dysregulation on cognitive dysfunction in MDD patients. In this way, our study opens a line of research in immunometabolic agents to deal with cognitive decline associated with MDD.

PMID:34929555 | DOI:10.1016/j.psyneuen.2021.105631

Health Place. 2021 Dec 17;73:102731. doi: 10.1016/j.healthplace.2021.102731. Online ahead of print.

ABSTRACT

A scoping review was performed to identify how Organisation for Economic Co-operation and Development (OECD) countries measure overall health for sub-national geographies within each country. Sixty publications were selected from MEDLINE, Scopus and Google Scholar, plus information extracted from 37 of 38 OECD countries statistical agency and/or public health institute websites that were available in English. Data sources varied by categorisation into national statistical agency mortality (n = 7) or population-level survey morbidity (n = 5) health indicators. Region was the most common geographic scale (e.g., eight indicators for 26 countries), slightly fewer indicators for urban areas (max countries per most frequent indicator = 24), followed by municipality (range of 1-14 countries per indicator). Other geographies, particularly those at smaller granularity, were infrequently available across health indicators and countries. Wider availability of health indicators at smaller, and non-administrative, geographies is needed to explore the best way to measure comparative population health in local areas.

PMID:34929525 | DOI:10.1016/j.healthplace.2021.102731

Curr Opin Pharmacol. 2021 Dec 17;62:74-81. doi: 10.1016/j.coph.2021.11.005. Online ahead of print.

ABSTRACT

Hypertension is a global disease that is extremely harmful to humans. Timely lowering of blood pressure is necessary in order to avoid the occurrence of corresponding complications. This review shows that soy peptides are beneficial in resisting hypertension. One of the advantages is the abundance of raw materials for producing soybean peptides. Secondly, there are no reports of adverse reactions due to soy peptides. Moreover, they exert protective effect against hypertension-induced complications such as long-term memory impairment and kidney damage. However, there are still some obstacles associated with the development of soybean peptides. Therefore, this review is focused on statistical analysis of peptide sequences, amino acid residues, and possible targets of anti-hypertensive soybean peptides. Eventually, it proposes that application of genetic engineering technology to specifically modify the N- and C-terminal of the soybean peptides, and possible targets in identifying the likely drug targets involved in the antihypertensive effects of these peptides.

PMID:34929528 | DOI:10.1016/j.coph.2021.11.005

Ecotoxicol Environ Saf. 2021 Dec 17;229:113086. doi: 10.1016/j.ecoenv.2021.113086. Online ahead of print.

ABSTRACT

An attempt has been made in this study to evaluate the factors favoring the uranium mobilization into the groundwater of Northwest India using uranium isotope activity ratio (²³⁴U/²³⁸U), radon (²²²Rn) and environmental isotopes of water (²H, ¹⁸O and ³H). The values range from 23 – 597 µg/L for total uranium and 634-3210 Bq/m³ for radon and the corresponding annual effective dose is estimated to be 18.9-490 µSv/a and 6.2-31.5 μSv/a respectively. Uranium activity ratio (UAR) varies from 0.68 – 1.17 and maximum samples indicate secular equilibrium. Environmental isotopic data indicates that the source to groundwater is vertical percolation of rainwater in the case of shallow zone while regional flows from outcrop areas recharge the deep groundwater. A wide scatter is noticed in environmental ³H content (0.23-6.62 TU) indicating both fast and sluggish water flows. The UAR phase diagram suggests that leaching process controls the uranium mobilization into the groundwater. The correlations among UAR, uranium and U_excess further indicate oxidative nature of leaching process. Statistical treatment of the obtained data along with available geochemical and isotope evidences suggest that source of uranium is common but the driving processes are different for shallow and deep zone. Influences of root zone CO₂, oxic species from irrigation return flows and water level fluctuations are also evaluated. Low uranium, low UAR, low ³H and high ²²²Rn activity in deep zone suggest uranium being released from the roll front as well as transported from outcrop regions. This study highlights the application of uranium isotope ratio, radon and environmental isotopes in assessing vulnerability of alluvial aquifers towards uranium contamination.

PMID:34929505 | DOI:10.1016/j.ecoenv.2021.113086

Lymphology. 2021;54(3):154-163.

ABSTRACT

Surgical intervention and subsequent wound healing process are known to induce neo-lymphangiogenesis, but few studies have been reported to utilize this mechanism for lymphedema treatment. The aim of this study was to evaluate feasibility of subdermal dissection for neo-lymphangiogenesis induction (SDN) to treat lower extremity lymphedema (LEL). Medical records of secondary LEL patients who had undergone ICG lymphography and SDN procedure were reviewed. SDN was performed by dissecting fat tissues just below the dermis from the most proximal area showing dermal backflow through abdominal-toaxillary lymphatic pathways. Perioperative lymphedematous conditions were evaluated with lymphedema quality of life score (LeQOLiS) and LEL index. Seventeen female patients were included. SDN could be performed in 10 minutes on average without postoperative complication. Postoperative ICG lymphography showed new lymphatic pathways in 6 (35.3%) cases. Postoperative LeQOLiS ranged from 9 to 66, which was statistically lower than preoperative LeQOLiS (32.9 ± 19.2 vs. 36.6 ± 19.3, p = 0.048), whereas there was no statistically significant difference between pre- and post-operative LEL index (275.2 ± 23.3 vs. 270.5 ± 20.8, P = 0.073). Subdermal dissection, although its probability is not high, has a potential to induce neo-lymphangiogenesis. Further studies are required to improve and demonstrate efficacy of the procedure for new lymphatic pathway creation.

PMID:34929076