Category: Statistics

Sleep. 2021 May 6:zsab101. doi: 10.1093/sleep/zsab101. Online ahead of print.

ABSTRACT

STUDY OBJECTIVES: This study aims to assess whether the nocturnal wear of dentures has an effect on the quality of sleep and oral-health-related quality of life of the edentulous elderly with untreated sleep apnea.

METHODS: A single-blind randomized cross-over design with two sequences and two periods was used. Participants (n = 77) were randomly assigned either to sequence 1 (nocturnal wear followed by nocturnal nonwear of the denture for 30-30 days) or sequence 2 (nocturnal nonwear followed by nocturnal wear of denture for 30-30 days). The primary sleep outcome was the quality of sleep, assessed through sleep fragmentation measured as Apnea-Hypopnea Index (AHI) and respiratory arousal from portable polysomnography. Secondary outcomes were daytime sleepiness, sleep quality (Pittsburgh Sleep Quality Index, PSQI) and oral-health-related quality of life measured by validated questionnaires.

RESULTS: The mean paired difference in AHI scores for the period of wearing versus not wearing dentures at night was small 1.0 event per hour (p = 0.50; 95% confidence interval (CI) = -2.0 to 4.1). The mean respiratory arousal index was higher when wearing dentures at night than when not wearing dentures at night, with a mean paired difference of 2.3 events per hour (p = 0.05; 95% CI = 0.0 to 4.6). No difference in sleepiness and PSQI were noted. Wearing dentures at night resulted in a statistically significantly higher mean score of psychological discomfort when compared to not wearing dentures at night.

CONCLUSIONS: The results provide some support to usual practice guidelines to remove dentures at night in edentulous elders suffering from sleep apnea.

CLINICAL TRIAL REGISTRATION: NCT01868295.

PMID:33955479 | DOI:10.1093/sleep/zsab101

East Mediterr Health J. 2021 Apr 27;27(4):336-343. doi: 10.26719/emhj.20.113.

ABSTRACT

BACKGROUND: Research linking awareness of health effects of alcohol and harmful alcohol drinking status is limited.

AIMS: To investigate the association between awareness of long-term alcohol effects and alcohol use disorders.

METHODS: University students aged 18-25 years (n = 1155) completed a self-filled survey. Participants were asked if they knew that alcohol causes: (1) problems in the liver; (2) cancers of the mouth, throat, oesophagus and breast; (3) damage to the heart; and (4) weakening of the immune system. Multinomial regression analyses were conducted to assess the association between awareness of long-term alcohol effects and alcohol drinking status, including Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) alcohol use disorders.

RESULTS: One third (32.8%) were past-year drinkers and 18% screened positive for DSM-5 alcohol use disorders. Compared to past-year drinkers with no alcohol use disorders, non-past-year ever drinkers were twice as likely to know about the link between alcohol and cancers of the mouth, throat, oesophagus and breast. Past-year drinkers with an alcohol use disorders were less likely to know about this association. Non-past-year ever drinkers (vs past-year drinkers with no alcohol use disorders) were also 2.6 times more likely to know the alcohol liver risks.

CONCLUSIONS: There is a strong inverse relationship between awareness of the effects of alcohol and harmful consumption among young people, providing preliminary support for the protective nature of knowledge on alcohol drinking status. Efforts to increase public awareness of the long-term health effects of alcohol may be useful in reducing alcohol-related harm.

PMID:33955529 | DOI:10.26719/emhj.20.113

Prostate. 2021 May 6. doi: 10.1002/pros.24135. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical outcomes may differ among patients presenting with primary (de novo) metastatic hormone-sensitive prostate cancer (mHSPC) versus secondary (metachronous) mHSPC occurring after local therapy. It is unknown what molecular features distinguish these potentially distinct presentations.

METHODS: A single-center retrospective study of mHSPC patients classified as primary mHSPC (n = 121) or secondary mHSPC (n = 106). A targeted set of genes was analyzed: BRCA2, PTEN, RB1, TP53, SPOP, CDK12, any two out of PTEN/RB1/TP53 alterations, and homologous recombination deficiency mutations. TP53 mutations were categorized as loss-of-function (LOF) versus dominant-negative (DN). The impacts of genetic features on progression-free survival (PFS) and overall survival (OS) were assessed using univariate and multivariate Cox proportional hazards regression.

RESULTS: Median PFS was 15 and 30 months for men with primary and secondary mHSPC, respectively (hazard ratio: 0.57, 95% confidence interval: 0.41-0.78; p < .01). OS did not show a significant difference between groups. There were more men with Gleason 8-10 disease in the primary versus secondary mHSPC groups (83% vs. 68%; p < .01). In univariate and multivariate analyses, TP53 DN mutations showed a statistically significant association with OS for the entire mHSPC population. Conversely, SPOP mutations were associated with improved OS. Additionally, TP53 mutations (DN and LOF) were associated with worse OS for secondary mHSPC. A combination of PTEN/RB1/TP53 mutations was associated with worse OS and PFS for secondary mHSPC, while no genomic alteration affected outcomes for primary mHSPC.

CONCLUSIONS: TP53 DN mutations, but not all TP53 alterations, were the strongest predictor of negative outcomes in men with mHSPC, while SPOP mutations were associated with improved outcomes. In subgroup analyses, specific alterations were prognostic of outcomes in secondary, but not primary, mHSPC.

PMID:33955569 | DOI:10.1002/pros.24135

Adv Emerg Nurs J. 2021 Jan-Mar 01;43(1):79-85. doi: 10.1097/TME.0000000000000335.

ABSTRACT

The most common site for hospital sentinel events due to care delays, secondary to waiting and/or inefficient processes, occurs in the emergency department (ED). Decreasing patient length of stay in an ED is a key initiative for many hospitals in order to maximize both quality and efficiency. The purpose of this practice improvement project was to (1) standardize front-end processes across a 6-hospital health system, (2) move non-sorting-related clinical questions out of triage, and (3) improve door-to-triage and door-to-provider times. The project occurred within a 6-hospital East Coast health system. This was a continuous quality improvement initiative utilizing the Donabedian theoretical model, plus the DMAIC method, for process improvement. A system-wide performance work team was formed including ED leaders and staff; site-specific implementation teams were also formed. Rapid triage implementation was effective in producing statistically significant improvement in door-to-triage, door-to-provider, and ED length of stay for discharged patients at 3 of the 6 sites. Further performance improvement projects in this area are needed to better understand the generalizability of this process in other EDs. Furthermore, from a leadership perspective, additional investigation is needed into the cost savings as well as shared labor opportunities that may exist when policies and processes are standardized across a system’s service line.

PMID:33952880 | DOI:10.1097/TME.0000000000000335

Holist Nurs Pract. 2020 Sep-Oct 01;34(5):274-281. doi: 10.1097/HNP.0000000000000402.

ABSTRACT

This study shows that breathing mindfully for 3 minutes over a period of 4 weeks, positively affects compassion fatigue in nurses. A nonrandomized, pre/postintervention study was conducted using a 3-minute attentional breathing intervention. Thirty-two nurses participated over 4 weeks. The intervention demonstrated statistically significant reductions in compassion fatigue measures.

PMID:33953010 | DOI:10.1097/HNP.0000000000000402

Jpn J Infect Dis. 2021 Apr 30. doi: 10.7883/yoken.JJID.2021.046. Online ahead of print.

ABSTRACT

SARS-CoV-2 (COVID-19) has infected over 100 million people since it appeared in Wuhan, China just 1 year ago. This study aimed to evaluate the relationship between interleukin-6 (IL-6)gene polymorphisms -174G/C and -597G/A and COVID-19 course. The study included a total of 70 patients aged 18-45 years who were hospitalized in our hospital and diagnosed with COVID-19 in Turkey between March and November 2020. Of these, 40 patients required intensive care admission due to macrophage activation syndrome (MAS) and 30 patients did not develop MAS or acute respiratory distress syndrome. The frequency of IL-6-174G/C -and 597G/A polymorphisms was determined. There were statistically significant differences between the groups in terms of -174G/C allele and genotype frequency and comparison with Hardy-Weinberg distribution (χ²=10.029, df=1, p=0.002 and χ²=9.998, df=1, p=0.002, respectively). The frequency of the GG genotype was significantly higher in the MAS group compared to the non-MAS group (p=0.002). The G allele was also significantly more frequent in the MAS group compared to the non-MAS group (p=0.032). Analysis of the -174G/C polymorphism in patients with MAS showed that the G allele may be a risk factor for increased serum IL-6 levels and progression to MAS.

PMID:33952771 | DOI:10.7883/yoken.JJID.2021.046

Int Heart J. 2021 May 1. doi: 10.1536/ihj.20-726. Online ahead of print.

ABSTRACT

The efficacy of anticoagulation for isolated distal DVT (id-DVT) is still uncertain and controversial. The aim of this study was to elucidate the risk of pulmonary embolism (PE) from id-DVT and to investigate the need for anticoagulants.We identified hospitalized patients with id-DVT diagnosed by lower-extremity ultrasonography (LEUS) from January 2013 to December 2013 in our institute. The exclusion criteria were the simultaneous detection of PE, a history of PE and/or DVT, and administration of anticoagulants before DVT detection. We retrospectively investigated the patient characteristics, treatments, occurrence of PE, and bleeding events between the groups with and without anticoagulation.A total of 151 patients met the criteria. The median (IQR) age was 74 (67, 80) years old, and there were 60 (39.7%) men. The median (IQR) observation period was 571 (160, 721) days. Significant differences in patient characteristics were observed for hypertension, operation time, consultation with experts, and follow-up LEUS. During the observation period, only one patient in the no-anticoagulation group who had traumatic cerebral hemorrhaging and was bedridden developed PE (non-massive type). However, there was no statistically significant difference in the occurrence of PE between the groups (log-rank P = 0.569). Bleeding episodes were observed in 9 of 151 (6.0%) patients, and all patients with bleeding events were taking anticoagulants (log-rank P < 0.001).The present retrospective single center study suggests that anticoagulation for id-DVT in inpatients with various backgrounds has a low efficacy to prevent the occurrence of PE and may increase bleeding events.

PMID:33952809 | DOI:10.1536/ihj.20-726

Adv Emerg Nurs J. 2021 Jan-Mar 01;43(1):39-47. doi: 10.1097/TME.0000000000000330.

ABSTRACT

This study was conducted to evaluate the effect of ShotBlocker on the intramuscular injection pain and satisfaction in emergency adult patients. This research was designed as a randomized controlled, double-blind, experimental study. The study was conducted with 74 patients who applied to the adult emergency department. Patients were randomized to ShotBlocker and control groups. Patient Assessment Form, Visual Analog Scale, and Visual Analog Patient Satisfaction Scale were used. The mean scores of postinjection pain and satisfaction level were analyzed between the groups; it was determined that while postinjection pain mean score of the experimental group was statistically significantly lower than that of the control group (p = 0.0001), satisfaction scores were statistically significantly higher in the experimental group than in the control group (p = 0.004). When the correlation between the intragroup Pain Scores (VAS) and the Satisfaction Scores (VAS) of the groups after injection was examined, a statistically significant and inverse correlation was found (p < 0.05). It was determined that ShotBlocker was effective in reducing intramuscular injection pain and increasing satisfaction levels.

PMID:33952876 | DOI:10.1097/TME.0000000000000330

J Biosci. 2021;46:35.

ABSTRACT

Among all the proteins of Periplasmic C type Cytochrome family obtained from cytochrome C₇ found in Geobacter sulfurreducens, only the Periplasmic C type Cytochrome A (PPCA) protein can recognize the deoxycholate (DXCA), while its other paralogs do not, as observed from the crystal structures. Though some existing works have used graph-theoretic approaches to realize the 3-D structural properties of proteins, its usage in the rationalisation of the physiochemical behavior of proteins has been very limited. To understand the driving force towards the recognition of DXCA exclusively by PPCA among its paralogs, in this work, we propose two graph theoretic models based on the combinatorial properties, namely, base-pair-type and impact, of the nucleotide bases and the amino acid residues, respectively. Combinatorial analysis of the binding sequences using the proposed base-pair type based graph theoretic model reveals the differential behaviour of PPCA among its other paralogs. Further, to investigate the underlying chemical phenomenon, another graph theoretic model has been developed based on impact. Analysis of the results obtained from impact-based model clearly indicates towards the helix formation of PPCA which is essential for the recognition of DXCA, making PPCA a completely different entity from its paralogs.

PMID:33952726

J Nutr Sci Vitaminol (Tokyo). 2021;67(2):111-117. doi: 10.3177/jnsv.67.111.

ABSTRACT

To demonstrate that fortified crystal salt enriched with iron, iodine, vitamin B12, folic acid and zinc can combat multi-micronutrient deficiencies. A randomized controlled study was conducted in 6 villages in Tiruvallur district, in Tamilnadu, South India. All the women and children aged 5-17 y in households in the experimental villages (n=117) were provided the fortified salt for 8 mo. Similar demographic group in the control villages (n=95) used regular non-fortified salts for the same time period. Blood from study subjects were analysed for hemoglobin, serum ferritin, serum transferrin receptor, AGP, CRP, and serum zinc, at the beginning and end of the study. Urine was analyzed for iodine at the same times. The experimental group showed a statistically significant increase in hemoglobin (>1.05 g/dL), serum zinc (>12.23 μg/dL), ferritin (>6.97 μg/L) and body iron stores (>0.73 mg/kg body weight), compared to the control group. A significant decrease in the prevalence of anaemia from 67.5% to 29.1% and zinc deficiency from 32.7% to 12.4% was observed in the experimental group relative to control group, using Binary logistic regression. There was no change in urinary iodine in the experimental group while it decreased significantly in the control. The fortified crystal salt was effective in decreasing multi-micronutrient deficiencies.

PMID:33952731 | DOI:10.3177/jnsv.67.111