Category: Statistics

Trends Psychiatry Psychother. 2021 Apr-Jun;43(2):126-133. doi: 10.47626/2237-6089-2020-0022.

ABSTRACT

OBJECTIVE: Breast cancer is the most common cancer in women worldwide. Many of these patients suffer from multiple psychological symptoms. The present study aimed to investigate the impact of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer.

METHODS: The present study was a pre- and post-test clinical trial with intervention and control groups. The research population consisted of women with breast cancer referred to the Ayatollah Yasrebi and Shahid Beheshti Hospitals in Kashan in 2018. Through a purposive sampling method, 40 women were selected and randomly divided into two groups, namely, intervention (n = 20) and control (n = 20). The applied tools included the Depression, Anxiety and Stress Scale (DASS-21), Chronic Pain Acceptance Questionnaire 8 (CPAQ-8), and Acceptance and Action Questionnaire – II (AAQ-II). Data were analyzed by SPSS 16 using descriptive statistics and analysis of variance (ANOVA).

RESULTS: The results showed that ACT treatment significantly reduced the mean scores of depression compared to the control group (F = 107.72, p < 0.001). The mean scores of pain acceptance (F = 9.58, p < 0.05) and psychological flexibility (F = 10.61, p < 0 .05) significantly increased in comparison with the control group.

CONCLUSION: ACT can be considered as an effective therapeutic approach to reduce depression and increase pain acceptance and psychological flexibility in women with breast cancer. These changes appear to be due to improved acceptance of thoughts and feelings associated with cancer and increased psychological flexibility, which is the primary goal of ACT treatment.

CLINICAL TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT), IRCT20190518043620N1.

PMID:34392667 | DOI:10.47626/2237-6089-2020-0022

Int J Biostat. 2021 Aug 16. doi: 10.1515/ijb-2020-0144. Online ahead of print.

ABSTRACT

The timings of visits in observational longitudinal data may depend on the study outcome, and this can result in bias if ignored. Assessing the extent of visit irregularity is important because it can help determine whether visits can be treated as repeated measures or as irregular data. We propose plotting the mean proportions of individuals with 0 visits per bin against the mean proportions of individuals with >1 visit per bin as bin width is varied and using the area under the curve (AUC) to assess the extent of irregularity. The AUC is a single score which can be used to quantify the extent of irregularity and assess how closely visits resemble repeated measures. Simulation results confirm that the AUC increases with increasing irregularity while being invariant to sample size and the number of scheduled measurement occasions. A demonstration of the AUC was performed on the TARGet Kids! study which enrolls healthy children aged 0-5 years with the aim of investigating the relationship between early life exposures and later health problems. The quality of statistical analyses can be improved by using the AUC as a guide to select the appropriate analytic outcome approach and minimize the potential for biased results.

PMID:34392639 | DOI:10.1515/ijb-2020-0144

J Tradit Chin Med. 2021 Aug;41(4):507-514. doi: 10.19852/j.cnki.jtcm.2021.03.002.

ABSTRACT

OBJECTIVE: To use evidence-based medicine to systematically evaluate the effectiveness and safety of acupuncture therapy for improving anorexia in tumor patients.

METHODS: We queried the China National Knowledge Infrastructure Database (CNKI), China Science and Technology Journal Database (VIP), Wanfang Data, PubMed, Cochrane Library, and Embase databases to identify reports of randomized controlled trials (RCTs) that applied acupuncture therapy to improve anorexia in tumor patients, and used Rev Man 5.3 software to conduct a Meta-analysis of the effective rate, appetite score, Karnofsky Performance Status (KPS) score, Functional Assessment of Anorexia/Cachexia Therapy (FAACT) appetite scale, and body weight in each study. Subgroup analysis was conducted based on whether radiotherapy or chemotherapy were also administered.

RESULTS: A total of 10 RCTs were included with a total of 648 patients, including 343 patients in the treatment group and 305 patients in the control group. The Meta-analysis results showed that the clinical efficacy, appetite score, KPS score, and FAACT score of the treatment group (which received acupuncture to improve appetite) were better than those of the control group, and the difference was statistically significant (P < 0.05); however, there was no statistically significant difference in body weight between the treatment group and the control group (P > 0.05). The results of the subgroup analysis showed that the effective rate and appetite score for patients with long-term and chronic loss of appetite who underwent acupuncture were better than those of the control group, and the difference was statistically significant (P < 0.05).

CONCLUSIONS: Acupuncture therapy has good efficacy and safety in the treatment of anorexia in tumor patients, and it also has good efficacy and safety for long-term and chronic loss of appetite. The reliability and stability of the above results need to be confirmed by high-quality RCTs with larger sample sizes.

PMID:34392642 | DOI:10.19852/j.cnki.jtcm.2021.03.002

Isr Med Assoc J. 2021 Aug;23(8):510-515.

ABSTRACT

BACKGROUND: In recent years, treatment for Achilles tendon rupture (ATR) went through radical changes: from the conservative non-weight bearing approach to a functional protocol. This functional protocol allows complete weight bearing after only 2 weeks by placing the foot in a plastic boot in tapered down equines and using interchangeable wedges under the heel. This change of approach has dramatically lowered the rate of re-rupture.

OBJECTIVES: To describe our preliminary results with this functional protocol and to assess outcome measures in the functional conservative treatment.

METHODS: The study comprised 15 people who were evaluated clinically and by sonograph. We measured calf circumference, ankle joint range of motion (ROM), and single-leg heel-rise test (SLHRT). In addition, standard scoring methods (Achilles Tendon Rupture Score and Physical Activity Scale) were examined.

RESULTS: In our cohort 14 people successfully gained SLHRT. The mean Achilles Tendon Rupture Score functional questionnaire and Physical Activity Scale physical activity questionnaire score was 85.6 of 100, and 4.7 of 6, respectively. There were no significant differences in ankle ROM compared to the uninjured limb. There was statistically significant reduction in the calf circumference and soleus muscle thickness sonographically.

CONCLUSIONS: It seems that the conservative functional treatment of ATR demonstrates good functional outcomes, with the patients returning to close to normal activity, although noted muscle wasting and weakness. This protocol presents a true alternative to surgery and should be considered for most non-insertional Achilles tendon tears.

PMID:34392629

Plant Genome. 2021 Aug 15:e20129. doi: 10.1002/tpg2.20129. Online ahead of print.

ABSTRACT

Powdery mildew isa major disease of barley (Hordeum vulgare L.) for which breeders have traditionally relied on dominant, pathogen race-specific resistance genes for genetic control. Directional selection pressures in extensive monocultures invariably result in such genes being overcome as the pathogen mutates to evade recognition. This has led to a widespread reliance on fungicides and a single broad-spectrum recessive resistance provided by the mlo gene. The range of resistance genes and alleles found in wild crop relatives and landraces has been reduced in agricultural cultivars through an erosion of genetic diversity during domestication and selective breeding. Three novel major-effect adult plant resistance (APR) genes from landraces, designated Resistance to Blumeria graminis f. sp. hordei (Rbgh1 to Rbgh3), were identified in the terminal regions of barley chromosomes 5HL, 7HS, and 1HS, respectively. The phenotype of the new APR genes showed neither pronounced penetration resistance, nor the spontaneous necrosis and mesophyll cell death typical of mlo resistance, nor a whole epidermal cell hypersensitive response, typical of race-specific resistance. Instead, resistance was localized to the site of attempted penetration in an epidermal cell and was associated with cell wall appositions and cytosolic vesicle-like bodies, and lacked strong induction of reactive oxygen species. The APR genes exhibited differences in vesicle-like body sizes, their distribution, and the extent of localized 3,3-diaminobenzidine staining in individual doubled haploid lines. The results revealed a set of unique basal penetration resistance genes that offer opportunities for combining different resistance mechanisms in breeding programs for robust mildew resistance.

PMID:34392613 | DOI:10.1002/tpg2.20129

Isr Med Assoc J. 2021 Aug;23(8):484-489.

ABSTRACT

BACKGROUND: Surgery for hip fractures within 48 hours of admission is considered standard. During the lockdown period due to the coronavirus disease-2019 (COVID-19) epidemic, our medical staff was reduced.

OBJECTIVES: To compare the demographics, treatment pathways, and outcomes of patients with hip fractures during the COVID-19 epidemic and lockdown with the standard at routine times.

METHODS: A retrospective study was conducted of all patients who were treated surgically for hip fracture in a tertiary center during the COVID-19 lockdown period between 01 March and 01 June 2020 and the equivalent period in 2019. Demographic characteristics, time to surgery, surgery type, hospitalization time, discharge destination, postoperative complications, and 30- and 90-day mortality rates were collected for all patients.

RESULTS: During the COVID-19 period, 105 patients were operated due to hip fractures compared to 136 in the equivalent period with no statistical difference in demographics. The rate of surgeries within 48 hours of admission was significantly higher in the COVID-19 period (92% vs. 76%, respectively; P = 0.0006). Mean hospitalization time was significantly shorter (10 vs. 12 days, P = 0.037) with diversion of patient discharge destinations from institutional to home rehabilitation (P < 0.001). There was a significant correlation between the COVID-19 period and lower 90-day mortality rates (P = 0.034). No statistically significant differences in postoperative complications or 30-day mortality rates were noted.

CONCLUSIONS: During the COVID-19 epidemic, despite the limited staff and the lack of therapeutic sequence, there was no impairment in the quality of treatment and a decrease in 90-day mortality was noted.

PMID:34392622

Int J Clin Pract. 2021 Aug 15:e14736. doi: 10.1111/ijcp.14736. Online ahead of print.

ABSTRACT

PURPOSE: To observe and describe the stiffness changes of the optic nerve in the patients with multiple sclerosis (MS) with or without optic neuritis and healthy adults via shear wave elastography (SWE).

METHODS: Seventy optic nerves from thirty-five patients with MS and sixty optic nerves from thirty healthy subjects were included prospectively in the study. The optic nerve (ON), optic disc (OD), and perineural area were evaluated with SWE and optic nerve sheat diameter (ONSD) was measured by ultrasound.

RESULTS: The mean age of patients was 39.68 ± 9.99 years. There was no statistically significant difference between the groups in terms of ONSD, SWE ON, SWE OD, and SWE perineural area levels (p> 0.05). In the MS group; No statistically significant difference was found between patients with and without optic neuritis for the mean age, gender distribution, duration of MS, types of MS, ONSD, SWE ON, SWE OD, SWE perineural area, and Expanded Disability Status Scale (EDSS) scores (p> 0.05). No statistically significant difference in terms of ONSD, SWE ON, SWE OD, and SWE perineural area between the MS patients with or without optic neuritis and the control group (p> 0.05).

CONCLUSION: Shear wave elastography measurements of the optic nerve, optic disc, and perineural area do not contribute to the evaluation of optic neuritis in a patient with MS.

PMID:34392588 | DOI:10.1111/ijcp.14736

Vet Comp Oncol. 2021 Aug 15. doi: 10.1111/vco.12761. Online ahead of print.

ABSTRACT

Prognosis of canine oral malignant melanoma encompasses clinical, histological and immunohistochemical parameters. The aim of this study was to evaluate the prognostic impact of bone invasion in oral canine melanoma. Sixty-eight dogs bearing oral melanoma staged II and III that underwent surgery and anti-CSPG4 electrovaccination, with available histological data and a minimum follow up of minimum 1 year, were retrospectively selected. Bone invasion was detected on imaging and/or histology. Median survival time of dogs with evidence of bone invasion (group 1) was 397 days and significantly shorter compared with dogs with oral melanomas not invading the bone (group 2, 1063 days). Dogs with tumours localized at the level of the cheek, lip, tongue and soft palate (soft tissue – group 3) lived significantly longer compared with dogs having tumours within the gingiva of the maxilla or mandible (hard tissue – group 4) with a median survival time of 1063 and 470 days, respectively. Within group 4, the subgroup of dogs with tumours not invading the bone (group 5) showed a significant prolonged survival time (972 days) in comparison with dogs of group 1 (bone invasion group). Similar results were obtained for the disease-free intervals among the different groups. Statistical analysis showed that Ki67 and mitotic count were correlated with shorter survival in patients of group 1 (with bone invasion). Bone invasion should always be assessed since it appears to be a negative prognostic factor. This article is protected by copyright. All rights reserved.

PMID:34392602 | DOI:10.1111/vco.12761

Nurs Open. 2021 Aug 15. doi: 10.1002/nop2.1038. Online ahead of print.

ABSTRACT

AIM: To analyse medication error data from a hospital’s electronic reporting system and identify the factors affecting error types and harmfulness.

DESIGN: A retrospective study.

METHODS: The 805 near misses and adverse events reported to the hospital’s electronic reporting system between January 2014 and December 2018 were analysed using descriptive statistics, chi-square tests and logistic regression analyses.

RESULTS: A total of 632 near misses and 173 adverse events were reported. Near misses and adverse events were the most common error type during the dispensing stage and medication administration, respectively. The odds of medication errors reported by nurses with 1-9 years of clinical experience were relatively low. After adjusting for confounders, the odds of medication errors directly observed by nurses were 65% lower than the odds of medication errors not directly detected. In clinical practice, nurses must be educated about errors in reporting depending on their degree of clinical experience.

PMID:34392612 | DOI:10.1002/nop2.1038

Am J Disaster Med. 2021 Spring;16(2):95-104. doi: 10.5055/ajdm.2021.0392.

ABSTRACT

OBJECTIVE: The aim of this study is to determine if a specific tablet-based training module can be used as an effective tool for independently training novice sonographers in the components of the focused assessment for sonography in trauma (FAST) exam.

DESIGN: Participants attended a 15-minute orientation presentation followed by a 2-hour ultrasound scanning workshop where they used a novel tablet-based training module to learn the components of the FAST exam independently.

SETTING: This study took place at an accredited United States college of osteopathic medicine.

PARTICIPANTS: Thirty-two first-year medical student volunteers without any prior ultrasound training in abdominal scanning.

INTERVENTIONS: Training activities included brief didactic training and participation in an independent learning FAST exam workshop.

MAIN OUTCOME MEASURES: Participants filled out subjective pre- and post-training self-confidence questionnaires and were objectively assessed and scored on their scanning skills.

RESULTS: Comparison of the pre- and post-training subjective questionnaires showed a statistically significant (p < 0.001) increase in participant confidence in performing all components of the FAST exam. During skill evaluation, participants collectively demonstrated correct technique in 366 (82 percent) of the 448 total FAST exam scanning tasks they attempted.

CONCLUSIONS: Based on these findings, the authors believe that learning to perform the FAST exam with this digital training module is an effective means of independently acquiring ultrasound skill. Digital ultrasound training modules like this one could have several useful applications, such as serving as an educational resource, or functioning as a point-of-care scanning adjunct to medical professionals in underdeveloped and rural areas where formal ultrasound training is not available.

PMID:34392522 | DOI:10.5055/ajdm.2021.0392