Category: Statistics

Saudi J Kidney Dis Transpl. 2021 Jul-Aug;32(4):1065-1072. doi: 10.4103/1319-2442.338280.

ABSTRACT

Kidney transplant remains the definitive treatment for patients with end-stage renal disease. A retrospective cohort was conducted in Dr. Selma Center for Kidney Diseases (DSCKD) to determine the pattern of follow-up and outcomes of adult kidney transplant recipients (KTRs) on long-term follow-up. Patients presented for follow-up during the period from January to June 2018 were studied regarding their demographic features, kidney transplant surgery, immunosuppressive therapy, graft function, and post-transplant complications. Data analysis was done using the Statistical Package for the Social Sciences version 16.0. During the study period, a total of 941 adult and pediatric KTR presented to DSCKD for follow-up. Only 792 KTRs were included in the study; those were adults, with their first kidney transplant, completed one year post-transplant, and agreed for enrollment. The mean age of the studied population was 47 ± 4.3 years. The majority were males, 74.2%. The median duration of follow-up was 7.4 years (interquartile range 3-11). Most transplants were through living-related donations, 78.8%. The combination of prednisolone, tacrolimus, and azathioprine remains the most common immunosuppressive regimen prescribed; delivered to 47.5% of recipients. Post-transplant complications were predominantly recurrent infections, diabetes mellitus, and hyperlipidemia seen in 54.5%, 42.4%, and 24.7% of recipients, respectively. On cross-comparisons living unrelated donor transplant recipients were found to have increased post-transplant complications, with a reduced kidney graft function at the end of the 1^st year and throughout follow-up, when compared to living related donor transplant recipients. A prospective multi-center study with long-term follow-up remains essential for further evaluation of the long-term outcomes of the KTR in Sudan.

PMID:35229806 | DOI:10.4103/1319-2442.338280

Saudi J Kidney Dis Transpl. 2021 Jul-Aug;32(4):1054-1064. doi: 10.4103/1319-2442.338279.

ABSTRACT

Renal transplantation is the ideal therapeutic implement for end-stage renal disease patients. However, late kidney graft defeat remains a main challenge. Torque teno virus (TTV) is a small DNA virus whose replication is strictly related to person immune status besides TTV Antigens could prevent organ rejection by regulating both adaptive and innate immunity through interfering with NF-κB pathway which decrease interleukin-6 (IL-6) levels in renal transplanted patients. This cross-sectional study was conducted eighty serum samples were collected renal transplant recipients, DNA was extracted and the viral DNA was detected and quantified by quantitative polymerase chain reaction (PCR) for human cytomegalovirus (CMV) and real-time PCR for TTV. In addition, enzyme-linked immunosorbent assays (ELISA) were used for the detection of TTV antigen and IL-6 levels were also done. Result of PCR showed that 25% and 56.25% of renal transplantation patients had positive for CMV and TTV viremia. CMV viremia was positive in 20% of patients who have positive result to TTV-DNA, which was statistically nonsignificant. Results of ELISA presented that TTV-Ag was positive in 10% of renal transplantation patients, while IL-6 level was very low in patients who have positive results to present of TTV-Ag which was significantly lower in those patients (P = 0.008). In conclusion, TTV could have not an association with reactivation of CMV in renal transplant patients and the presence of TTV-Ag reduce renal rejection by decreasing of IL-6 levels which might be an indicator of allograft status.

PMID:35229805 | DOI:10.4103/1319-2442.338279

Pest Manag Sci. 2022 Mar 1. doi: 10.1002/ps.6852. Online ahead of print.

NO ABSTRACT

PMID:35229453 | DOI:10.1002/ps.6852

J Clin Hypertens (Greenwich). 2022 Mar 1. doi: 10.1111/jch.14445. Online ahead of print.

ABSTRACT

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) both inhibit the renin-angiotensin system (RAS) but have different sites of action. Whether clinically meaningful differences exist is still debated. The authors set up a population-based nationwide retrospective cohort study with at least 5 years of follow-up based on the comprehensive French Health Insurance Database linked to the French hospital discharge database. Patients aged 50 or above, identified as ARB or ACE inhibitor new users in 2009 (at least one delivery during the year and no such delivery in 2008) were eligible. Exclusion criteria included history of cancer, cardiovascular disease, or chronic renal insufficiency. Main outcome measure was overall mortality. Secondary outcomes were cardiovascular deaths, major cardiovascular events, and major or other cardiovascular events. Out of 407 815 eligible patients, 233 682 (57%) were ARB users; two-third had no previous exposure to antihypertensive drug. Based on propensity-score based Cox model, ARB new user group had a better overall (HR: .878, 95%CI, .854 to .902), and cardiovascular (HR: .841, 95%CI, .800 to .84) survival and had a lower risk for major cardiovascular events (HR: .886, 95%CI, .868 to .905). Statistically significant quantitative interactions were detected with diabetes. Considering subgroup analyses, ARBs had a better survival than ACE inhibitors in nondiabetic patients.

PMID:35229448 | DOI:10.1111/jch.14445

Health Econ. 2022 Feb 28. doi: 10.1002/hec.4487. Online ahead of print.

ABSTRACT

EQ-5D is a 5-item questionnaire instrument designed to measure health-related quality of life. It is extremely important, since it is used to measure health benefits in many studies providing evidence for reimbursement decisions by the National Institute for Health and Care Excellence in England and similar policy bodies in other countries. EQ-5D has been redesigned in a more detailed form (EQ-5D-5L), but much existing cost-effectiveness evidence is based on the older version (EQ-5D-3L). Statistical mapping from one version to another is widely used, exploiting data from multi-instrument surveys incorporating both variants. However, little is known about the robustness of data from such multi-instrument surveys. We design a randomized experiment to investigate whether inclusion of both versions at different stages in a single interview gives a reliable picture of the relationship between health measures from the two instruments and embed it in individual interviews from the UK Understanding Society household panel. We find that sequencing of the two versions of EQ-5D within an interview has a significant impact not only on the resulting data but also on the estimated mapping models. We illustrate the non-negligible effects in two real-world cost-effectiveness examples and discuss the implications for future multi-instrument survey design.

PMID:35229404 | DOI:10.1002/hec.4487

Oral Dis. 2022 Mar 1. doi: 10.1111/odi.14175. Online ahead of print.

ABSTRACT

OBJECTIVES: The current study aims in evaluating the prevalence of Epstein-barr virus (EBV), Cytomegalovirus (CMV) and Herpes simplex virus (HSV) in periodontitis and/or Coronary artery disease (CAD) patients to compare with their healthy controls and insist their significance in the same.

METHODOLOGY: Two hundred and forty patients were divided into 4 groups. Non-periodontitis+non-cardiac (NP+NC) =60 patients, periodontitis+non-cardiac patients (P+NC)=60 patients, non-periodontitis+cardiac patients (NP+C)=60 patients and periodontitis+cardiac (P+C)=60 patients. Demographic variables, cardiac and periodontal parameters were recorded. EBV, CMV and HSV were evaluated in the sub- gingival plaque samples using RT-PCR (Real time polymerase chain reaction) and compared between the groups. The results were statistically analysed using Students t test, Pearson’s chi square, Turkey post hoc analysis and multiple logistic regression analysis.

RESULTS: The demographic variables did not differ significantly between the groups, except for age. Systolic blood pressure, Diastolic blood pressure, Low density lipoprotein, Random blood sugar were significantly higher in NP+C and P+C (p≤0.05). The Plaque Index, Probing Pocket Depth and Clinical Attachment Loss (p≤0.05) were significantly higher in P+NC and P+C. EBV and CMV was significantly higher in the two periodontitis groups P+NC and P+C (p-value=0.000). HSV was significantly higher in the two cardiac groups (NP+C and P+C) (p≤0.05). Multiple logistic regression analysis revealed a significant association between EBV and CAL (p≤0.05).

CONCLUSION: The study concluded that higher prevalence of EBV and CMV were found in groups with periodontitis patients. This indicates the significant role of the viruses in periodontitis as confirmed by association of EBV and CAL. The viruses were said to be highest in periodontitis patients with CAD. This could pave a new link in the risk of CAD in periodontitis patients.

PMID:35229412 | DOI:10.1111/odi.14175

Int J Nurs Pract. 2022 Feb 28:e13043. doi: 10.1111/ijn.13043. Online ahead of print.

ABSTRACT

AIM: To examine the diagnostic reasoning skills of two nurse practitioner student cohorts.

INTRODUCTION: Nurse practitioners continue to play a pivotal role in health care provision. Diagnostic reasoning is a core skill of advanced practice. A comparative diagnostic reasoning study between two student cohorts was undertaken between 2018 and 2019.

METHODS: A validated diagnostic reasoning scale was completed by nurse practitioner students in the United Kingdom and the United States of America at the beginning and end of their clinical placements. The study utilized descriptive quantitative statistics from the data submitted by 22 survey respondents from an online survey.

RESULTS: Analysis of the diagnostic reasoning skills suggested there was a difference in the structural memory scores when compared with the beginning of their clinical placements and the final semester of their clinical placements.

CONCLUSION: Diagnostic reasoning skills are a core skill of advanced practice. As students progress through their training, these skills improve. Despite the statistical difference in diagnostic reasoning scores, caution should be made in determining any larger implications due to the small number of participants in this study. Further study is needed in this area.

PMID:35229403 | DOI:10.1111/ijn.13043

Magn Reson Chem. 2022 Feb 28. doi: 10.1002/mrc.5261. Online ahead of print.

ABSTRACT

The combination of computational methods and experimental data from Nuclear Magnetic Resonance (NMR) is a considerably valuable tool in the elucidation of new natural product structures and, also, in the structural revision of previously reported compounds. Until recently, only classical statistical parameters were used, e.g., linear correlation coefficient (R2), mean absolute error (MAE) or root mean square deviation (RMSD), as a way to statistically “validate” the structure pointed out by experimental NMR spectra. Regarding the resolution of the relative configuration of organic molecules, novel tools were available in the last few years to assist in the NMR elucidation process. The most relevant are DP4+, which is based on a Bayesian probability, and ANN-PRA, which is based on artificial neural networks. The combined application of these tools, has become the most accurate and important alternative to solve structural and stereochemical problems in natural product chemistry. Therefore, herein, in this case study, we intended to promote these novel tools, exploring the strengths and limitations of each approach in resolving the relative configuration of the sesquiterpene alpha-bisabol. We also highlighted the advantages of the complementary use of H- and C-DP4+ to obtain optimal results in the differentiation of the stereoisomers, validating the proposal with ANN-PRA method.

PMID:35229358 | DOI:10.1002/mrc.5261

Int J Health Plann Manage. 2022 Feb 28. doi: 10.1002/hpm.3449. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: The COVID-19 pandemic has significantly impacted human lives across the world. In a country like India, with the second highest population in the world, impact of COVID-19 has been diverse and multidimensional. Under such circumstances, vaccination against COVID-19 infection is claimed to be one of the major solutions to contain the pandemic. Understanding of Knowledge, Attitude and Practice (KAP) measures are essential prerequisites to design suitable intervention programs. This paper examines the different KAP factors in Indians towards their decision of vaccine uptake.

METHOD: An online questionnaire was administered to Indian respondents. (Pilot study: n = 100, Main study: n = 221) to assess their existing knowledge on COVID-19 infections and vaccination, attitude and intentions towards COVID-19 vaccines and their decision towards COVID-19 vaccine uptake.

RESULT: The findings highlighted that existing knowledge on COVID-19 infections and vaccination directly impacted their attitude and intention towards vaccination. The attitude and intention towards COVID-19 vaccines directly impacted their practice of undergoing COVID-19 vaccination. Further, there was a statistically significant and considerably large indirect effect of existing knowledge on COVID-19 infections and vaccination on the practice of undergoing COVID-19 vaccination through attitude and intention towards the vaccine. There was no direct effect of Knowledge (existing knowledge on COVID-19 infections and vaccination) on Practice (decision to undergo COVID-19 vaccination). Therefore, Attitude and intention towards COVID-19 vaccine is the primary mediator between Knowledge (existing knowledge on COVID-19 infections and vaccination) and Practice (decision to undergo COVID-19 vaccination).

CONCLUSION: Participants decision towards COVID-19 vaccination decisions are strongly related to their attitude and intentions that confirms the strong role of attitude towards success of COVID-19 vaccination programme. Therefore, ‘person-centric’ attitude based positive intervention strategies that links their prior knowledge on COVID-19 infections and vaccination must be designed for greater vaccine acceptance amongst Indians.

PMID:35229357 | DOI:10.1002/hpm.3449

J Trauma Stress. 2022 Feb 28. doi: 10.1002/jts.22810. Online ahead of print.

ABSTRACT

In the forensic field, most studies employing virtual reality (VR) interventions have focused on offenders. The validity and safety of VR applications for victims of crime are still unclear. Following PRISMA guidelines, a systematic review on VR interventions for crime victims was performed to assess the efficacy, acceptability by patients, and cost-effectiveness of these interventions compared to in-person care. We identified 34 potentially eligible studies from 188 records obtained from database searches (Medline/Pubmed, CINAHL, PsycINFO, Web of Science, and Scopus); four additional articles were identified via alternative sources. In total, nine articles were included for the qualitative synthesis. Patient satisfaction with VR interventions was found to be equivalent to face-to-face interventions. Both VR exposure and control groups found relief from posttraumatic symptoms, with differences either statistically insignificant or in favor of VR. Despite the increased costs linked to the technology required, VR appears to be a promising alternative to in vivo exposure, but further research is needed. Limitations of the review include the varied experimental protocols, which did not allow us to conduct a quantitative analysis and comparison of findings across different studies, and the generally poor quality of the studies included. Further research, preferably in larger groups, is needed to shed more light on the effectiveness of VR interventions for traumatized victims of crime.

PMID:35229354 | DOI:10.1002/jts.22810