Category: Statistics

Dermatol Ther. 2021 Apr 11:e14957. doi: 10.1111/dth.14957. Online ahead of print.

ABSTRACT

Keratinizing skin cancers including actinic keratoses (AK), in situ squamous cell carcinoma/Bowen’s disease/intraepidermal carcinoma (IEC), invasive cutaneous squamous cell carcinoma (cSCC) and keratoacanthoma share similar dermatoscopic features and also reveal different patterns that asist in their diagnosis. Recently epidemiological studies reveal the association between antihypertensive drugs and skin cancer risk, especially cSCC. This study aims to determine the dermatoscopic features of keratinizing skin cancer in patients using antihypertensive drug and compare with non-users. A total of 46 patient with 64 keratinizing skin cancer lesions were included in the study. The demographic, clinical characteristic of patients, the number, duration, localization and dermatoscopic features from each lesion were collected. First, we evaluated the dermatoscopic features according to the histopathologic diagnosis. Then, all patients were divided into two groups as users of antihypertensive drugs and non-users. The dermatoscopic features were compared in terms of antihypertensive drug usage and histopathologic diagnosis in antihypertensive drug users and non-users, separately. The users of anti-hypertensive drugs were 22 (47,8%) and non-users 24 (52,2%). Of the total 64 lesions including 47 AK, 5 IEC, 10 cSCC and 2 keratoacanthoma were evaluated. White structureless area was found statistically significant in cSCC lesions of patients using antihypertensive drugs (p=0.004). This finding in cSCC may be a clue for antihypertensive drug usage and these drugs may be a predisposan factor for dermal fibrosis. Regardless of histopathology, dermatoscopic features show no statistically difference between antihypertensive drug users and non-users (p>0.05). Clearer results can be obtained by conducting more detailed and long-term studies. This article is protected by copyright. All rights reserved.

PMID:33843141 | DOI:10.1111/dth.14957

J Texture Stud. 2021 Apr 12. doi: 10.1111/jtxs.12600. Online ahead of print.

ABSTRACT

OBJECTIVES: Due to the importance of providing the appropriate fluid consistency for effective management of swallowing problems (dysphagia) in infants, this project sought to determine the effect of three commercially available thickening agents on the resulting thickened consistencies of commonly prescribed, ready to feed infant formulas.

METHODS: Nine ready-to-feed infant formulas were thickened with three different thickening agents to nectar and honey consistencies following manufacturer’s instructions and their resulting thickness was measured via line spread test. The nine formulas with nothing added to them (thin liquids) and the 27 target-nectar and 27 target-honey samples together created 63 unique samples for comparison. A series of one-way ANOVA analyses were conducted to determine if the resulting thickness (as measured by line spread test values) for target categories of nectar and honey consistencies was significantly influenced by the type of thickening agent used.

RESULTS: The achieved thickness of the formula samples as measured by line spread test values was statistically significantly different for the three different types of thickening agents used to achieve a target nectar consistency, F (2, 24) = 15.55, p < .001, partial eta squared = .709. Additionally, the achieved thickness of the formula samples was statistically significantly different for the three different types of thickening agents used to achieve a target honey consistency, F (2, 24) = 16.18, p < .001, partial eta squared = .709.

CONCLUSIONS: The results of this study reveal that the choice of thickening agent impacts the resulting thickness of ready to feed infant formula.

PMID:33843078 | DOI:10.1111/jtxs.12600

J Sch Health. 2021 Apr 11. doi: 10.1111/josh.13025. Online ahead of print.

ABSTRACT

BACKGROUND: Determination of adequate school nurse staffing is a complex process. School nurse-to-student ratios and the health services school nurses provide to students should be considered. The purpose of this study was to examine the impact of North Carolina school nurse-to-student ratios and school nurse health services on the health and education outcomes (eg, absences, grades, self-management) of students receiving services for asthma and diabetes.

METHODS: This study of all 115 school districts in North Carolina used the Annual School Health Services Report Survey from 2011 to 2016. Descriptive statistics for health services, programs and outcomes, and generalized linear modeling were used to estimate the association of ratios and health services with asthma and diabetes outcomes.

RESULTS: By the 2015-2016 school year, the average ratio decreased to 1:1086 in North Carolina public schools. Annually, 100,187 students received services for asthma, 3832 students received services for type 1 diabetes, and 913 students received services for type 2 diabetes. Lower ratios and nurse health services were associated with improved student outcomes, including decreased absences (p = .05), improved grades (p = .05), and student self-management of their health condition (p = .05).

CONCLUSIONS: Lower school nurse-to-student ratios and services were associated with improvements in students’ health and education outcomes.

PMID:33843082 | DOI:10.1111/josh.13025

J Clin Apher. 2021 Apr 12. doi: 10.1002/jca.21900. Online ahead of print.

ABSTRACT

BACKGROUND: Peripheral venous access has been promoted as the safest, quickest, and most easily achievable route for performing apheresis procedures by the American Society for Apheresis’ Choosing Wisely campaign. The current literature regarding catheter size and selection for both draw and return access is limited. Furthermore, the Infusion Nurses Society recommends using the smallest gauge catheter possible for the prescribed therapy in order to limit vein trauma and phlebitis. Since there is a lack of evidence to guide selection of catheter size for return access during therapeutic apheresis procedures (TAPs) for patients with chronic conditions, this pilot study seeks to compare the performance of a 20-gauge fenestrated (20G) catheter to a standard 18-gauge (18G) intravenous catheter.

METHODS: This non-inferiority pilot study randomized 26 subjects during 74 TAPs to either 20G fenestrated catheter or 18G standard catheter.

RESULTS: There were no statistically significant differences for variables associated with the efficiency of the TAPs comparing 20G to 18G catheter for inlet rate (P = .8666), return pressure (P = .9427), blood processed (P = .4318), or total procedure time (P = .3184).

CONCLUSION: The results from this pilot study suggest that 20G fenestrated catheter is non-inferior to 18G standard catheters. Additional studies with increased power are warranted to confirm these findings.

PMID:33843086 | DOI:10.1002/jca.21900

Atten Percept Psychophys. 2021 Apr 11. doi: 10.3758/s13414-021-02252-x. Online ahead of print.

ABSTRACT

The occupancy model (OM) was proposed to explain how the spatial arrangement of dots in sparse random patterns affects their perceived numerosity. The model’s central thesis maintained that each dot seemingly fills or occupies its surrounding area within a fixed radius r_o and the total area collectively occupied by all the dots determines their apparent number. Because the perceptual system is not adapted for the precise estimation of area, it looks likely that the OM is just a convenient computational algorithm that does not necessarily correspond to the processes that actually take place in the perceptual system. As an alternative, the proximity model (PM) was proposed, which instead relies on a binomial function with the probability β characterizing the perceptual salience with which each element can be registered by the perceptual system. It was also assumed that the magnitude of β is proportional to the distance between a dot and its nearest neighbor. A simulation experiment demonstrated that the occupancy area computed according to the OM can almost perfectly be replicated by the mean nearest neighbor distance. It was concluded that proximity between elements is a critical factor in determining their perceived numerosity, but the exact algorithm that is used for the measure of proximities is yet to be established.

PMID:33843029 | DOI:10.3758/s13414-021-02252-x

Cardiol J. 2021 Apr 12. doi: 10.5603/CJ.a2021.0038. Online ahead of print.

NO ABSTRACT

PMID:33843038 | DOI:10.5603/CJ.a2021.0038

Stat Med. 2021 Apr 11. doi: 10.1002/sim.8950. Online ahead of print.

ABSTRACT

We consider the non-trivial problem of estimating a health cost repartition among diseases from patients’ hospital stays’ global costs in the presence of multimorbidity, that is, when the patients may suffer from more than one disease. The problem is even harder in the presence of interactions among the disease costs, that is, when the costs of having, for example, two diseases simultaneously do not match the sum of the basic costs of having each disease alone, generating an extra cost which might be either positive or negative. In such a situation, there might be no “true solution” and the choice of the method to be used to solve the problem will depend on how one wishes to allocate the extra costs among the diseases. In this article, we study mathematically how different methods proceed in this regard, namely ordinary least squares (OLS), generalized linear models (GLM), and an iterative proportional repartition (IPR) algorithm, in a simple case with only two diseases. It turned out that only IPR allowed to retrieve the total costs and the unambiguous solution that one would have in a setting without interaction, that is, when no extra cost has to be allocated, while OLS and GLM may produce some negative health costs. Also, contrary to OLS, IPR is taking into account the basic costs of the diseases for the allocation of the extra cost. We conclude that IPR seems to be the most natural method to solve the problem, at least among those considered.

PMID:33843071 | DOI:10.1002/sim.8950

Health Care Manag Sci. 2021 Apr 12. doi: 10.1007/s10729-021-09561-5. Online ahead of print.

ABSTRACT

Demand for Personal Protective Equipment (PPE) such as surgical masks, gloves, and gowns has increased significantly since the onset of the COVID-19 pandemic. In hospital settings, both medical staff and patients are required to wear PPE. As these facilities resume regular operations, staff will be required to wear PPE at all times while additional PPE will be mandated during medical procedures. This will put increased pressure on hospitals which have had problems predicting PPE usage and sourcing its supply. To meet this challenge, we propose an approach to predict demand for PPE. Specifically, we model the admission of patients to a medical department using multiple independent [Formula: see text] queues. Each queue represents a class of patients with similar treatment plans and hospital length-of-stay. By estimating the total workload of each class, we derive closed-form estimates for the expected amount of PPE required over a specified time horizon using current PPE guidelines. We apply our approach to a data set of 22,039 patients admitted to the general internal medicine department at St. Michael’s hospital in Toronto, Canada from April 2010 to November 2019. We find that gloves and surgical masks represent approximately 90% of predicted PPE usage. We also find that while demand for gloves is driven entirely by patient-practitioner interactions, 86% of the predicted demand for surgical masks can be attributed to the requirement that medical practitioners will need to wear them when not interacting with patients.

PMID:33843005 | DOI:10.1007/s10729-021-09561-5

Virchows Arch. 2021 Apr 12. doi: 10.1007/s00428-021-03090-w. Online ahead of print.

ABSTRACT

Tumor budding scoring guidelines from the International Tumor Budding Consensus Conference (ITBCC) for colorectal cancer propose three groups: BD1 (0-4 buds/0.785 mm²), BD2 (5-9 buds/0.785 mm²), and BD3 (10 or more buds/0.785 mm²). Here, we investigate whether a fourth scoring category, namely zero buds, may have additional clinical relevance. The number of tumor buds/0.785 mm² was scored in 959 cases. Those with zero tumor buds were considered BD0, while a new BD1 category of 1-4 buds was proposed. Associations of both scoring approaches with clinicopathological features were analyzed. Conventional ITBCC scoring showed expected associations with unfavorable histopathological prognostic factors. In total, 111/959 (11.6%) were BD0. A significant difference was found when BD0 was compared statistically to BD1 (1-4 buds) for pT, TNM, tumor grade, and lymphatic, venous, and perineural invasion (p < 0.01, all). Tumors with BD0 occur relatively frequently and contribute additional information on tumor behavior. BD0 should be considered for subsequent ITBCC guidelines.

PMID:33843013 | DOI:10.1007/s00428-021-03090-w

Int J Implant Dent. 2021 Apr 12;7(1):27. doi: 10.1186/s40729-021-00310-5.

ABSTRACT

BACKGROUND: This study aimed to investigate the effects of systemic omeprazole treatment on the osseointegration of titanium implants.

MATERIAL AND METHODS: After surgical insertion of titanium implants into the metaphyseal part of rats’ both right and left tibial bones, the animals were randomly divided into three equal groups: control (n = 8), omeprazole dosage-1 (n = 8) (OME-1), and omeprazole dosage-2 (n = 8) (OME-2) and totally 48 implants were surgically integrated. The rats in the control group received no treatment during the four-week postoperative experimental period. In the OME-1 and OME-2 groups, the rats received omeprazole in doses of 5 and 10 mg/kg, respectively, every 3 days for 4 weeks. After the experimental period, the rats were euthanized. One rat died in each group and the study was completed with seven rats in each group. Blood serum was collected for biochemical analysis, and the implants and surrounding bone tissue were used for biomechanical reverse-torque analysis. In the biomechanical analysis, implants that were not properly placed and were not osseointegrated were excluded from the evaluation.

RESULTS: One-way analysis of variance and Tukey’s honestly significant difference test and Student’s t test were used for statistical analysis. The reverse-torque test (control (n = 9), OME-1 (N = 7), and OME-2 (n = 7)) analysis of biochemical parameters (alkaline phosphatase, calcium, phosphorus, aspartate aminotransferase, alanine amino transferase, urea, and creatinine) revealed no significant differences between the groups (control (n = 7), OME-1 (N = 7), and OME-2 (n = 7)) (P > 0.05).

CONCLUSIONS: Omeprazole had no biomechanical or biochemical effects on the osseointegration process of titanium implants.

PMID:33843027 | DOI:10.1186/s40729-021-00310-5