Category: Statistics

Biomed Chromatogr. 2022 Jan 9:e5331. doi: 10.1002/bmc.5331. Online ahead of print.

ABSTRACT

Gleditsiae spina, the thorn of Gleditsia sinensis Lam., has a long history of being used as a traditional medicine in East Asian countries. However, only a few biologically active substances have been identified from Gleditsiae spina. In this study, the epidermis, xylem and pith of Gleditsiae spina, respectively, namely Gs-E, Gs-X and Gs-P, were studied. We used a widely targeted metabolomics method to investigate the chemical composition in Gs-E, Gs-X and Gs-P. A total of 728 putative metabolites were identified from Gleditsiae spina, including 211 primary metabolites and 517 secondary metabolites. These primary and secondary metabolites could be categorized into more than 10 different classes. Flavonoids, phenolic acids, lipids, and amino acids and derivatives, and organic acids constituted the main metabolite groups. Multivariate statistical analysis showed that the Gs-E, Gs-X and Gs-P samples could be clearly separated. Differential accumulated metabolite (DAM) analysis revealed that more than half of the DAMs exhibited the highest relative concentrations in Gs-E, and most of the DAMs showed the lowest relative concentrations in Gs-X. Moreover, 11 common differential primary metabolites and 79 common differential secondary metabolites were detected in all comparison groups. These results further our understanding of chemical composition and metabolite accumulation of Gleditsiae spina.

PMID:35000209 | DOI:10.1002/bmc.5331

Pacing Clin Electrophysiol. 2022 Jan 9. doi: 10.1111/pace.14441. Online ahead of print.

ABSTRACT

BACKGROUND: QRS area, a three-dimensional QRS complex, is a novel vectorcardiography method of measuring the magnitude of electrical forces in the heart. Hypothetically, a greater QRS area denotes higher dyssynchrony and indicates potential benefits from cardiac resynchronization therapy (CRT). Previous studies suggest a positive correlation between QRS area and the degree of response to CRT, but its clinical use remains unclear. We performed a meta-analysis of the relationship between QRS area and survival benefit following CRT.

METHODS: We comprehensively searched the MEDLINE, EMBASE, and Cochrane databases from inception to August 2021. We included studies with prospective and retrospective cohort designs that reported QRS area before CRT and total mortality. Data from each study were analyzed using a random-effects model. The results were reported as a hazard ratio (HR) and 95% confidence intervals.

RESULTS: Five observational studies including 4,931 patients were identified. The cut-off values between large and small QRS areas ranged from 102-116 μVs. Our analysis showed a larger QRS area was statistically associated with increased 5-year survival in patients implanted with CRT (HR pooled 0.48, 95% CI 0.46-0.51, I² = 54%, P < 0.0001). Greater QRS area reduction (pre- and post-implantation) were associated with a lower total mortality rate (HR pooled 0.45, 95% CI 0.38-0.52, I² = 0%, P < 0.0001).

CONCLUSION: Larger pre-implantation QRS area was associated with increased survival after CRT. QRS area reduction following CRT implantation was also associated with lower mortality. QRS area may potentially become an additional selection criterion for CRT implantations. This article is protected by copyright. All rights reserved.

PMID:35000207 | DOI:10.1111/pace.14441

J Zoo Wildl Med. 2021 Dec;52(4):1247-1256. doi: 10.1638/2020-0184.

ABSTRACT

Diagnostic hematology can prove challenging to the exotic animal practitioner presented with a nonhuman primate patient. Few point-of-care automated cell counters are calibrated for primate samples. Twenty-one samples from 17 nonhuman primates presented to an exotic animal practice were analyzed. Samples were run on both canine and feline settings on each of two veterinary point-of-care analyzers: one that assays by impedance technology, and one that assays by laser flow cytometry. Samples were also sent to a reference laboratory to be assayed on an analyzer that performs simultaneous impedance and laser measurements of blood cells and has been calibrated for use in nonhuman primates. Fourteen analytes were assessed for each sample on each machine. Manual hematocrits and total white blood cell counts were also performed on 16 of the samples. Statistical analysis indicated some variance between individual parameters, but overall correlation was acceptable.

PMID:34998296 | DOI:10.1638/2020-0184

J Zoo Wildl Med. 2021 Dec;52(4):1241-1246. doi: 10.1638/2021-0039.

ABSTRACT

Plasma separator tubes (PSTs) are a variant of lithium heparin blood tube containing a polymer gel, which, when centrifuged, creates a physical barrier between plasma and blood cells. Their use is common in laboratory procedures of reptilian species. This study aimed to determine whether the use of plasma separator tubes impacts plasma biochemistry data in green sea turtles (Chelonia mydas) at time of collection and after 24 hr of contact time with the separator gel after centrifugation at refrigerator temperature. A single blood sample was collected from 42 rehabilitating green sea turtles at the Sea Turtle Healing Center, Brevard Zoo, Melbourne, Florida, USA and divided into one lithium heparin tube [LHT (0 hr)] and two PSTs. After immediate centrifugation of all three tubes, plasma was transferred from the LHT (0 hr) and one PST (0 hr) into tubes without additive. The plasma was left in contact with the separator gel in the second PST (24 hr). After 24 hr of refrigeration, all three plasma aliquots were analyzed for the following 23 analytes: sodium, potassium, chloride, carbon dioxide, calcium, phosphorus, magnesium, iron, total protein, albumin, globulin (calculated), aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, gamma-glutamyltransferase, creatine kinase, glucose, urea nitrogen, creatinine, uric acid, triglyceride, and cholesterol. No statistically significant differences were found for any biochemical analytes between LHT (0 hr), PST (0 hr), and PST (24 hr). The use of PST does not appear to impact routine plasma biochemical analytes in green sea turtles and analytes appear stable in refrigerated plasma for up to 24 hr after centrifugation when using PSTs.

PMID:34998295 | DOI:10.1638/2021-0039

J Zoo Wildl Med. 2021 Dec;52(4):1195-1204. doi: 10.1638/2021-0029.

ABSTRACT

Sea turtles are often restrained manually for brief periods during veterinary evaluation and care in rescue, rehabilitation, research, and aquarium settings. Blood gas values and lactate are routinely evaluated during triage of sea turtles, and lactate clearance is of prognostic significance in cold-stunned individuals. Although increases in blood lactate have been associated with muscle exertion, experimental forced submergence, trawl and pound net capture, and general anesthesia, changes in blood lactate associated with short periods of manual restraint have not been evaluated. Venous blood gas and lactate values were tested in 16 juvenile loggerhead sea turtles (Caretta caretta) before and after manual restraint for a 15-min routine veterinary examination. The agreement of blood lactate values between two point-of care analyzers (i-STAT and Lactate Plus) was also compared. Blood pH and bicarbonate (HCO₃^–) decreased significantly (P < 0.001), and partial pressure of carbon dioxide (pCO₂) increased significantly (P < 0.0001) after 15 min. Lactate increased significantly between time points for both analyzers (P < 0.0001). Linear regression analysis showed excellent correlation for lactate measurements obtained on both analyzers (r = 0.998). The mean difference in lactate concentrations between the analyzers was statistically significant, indicating that the methods cannot be used interchangeably (P < 0.0001). Deming regression and Bland-Altman plots identified a slight negative proportional bias for lactate measurement by the Lactate Plus compared with the i-STAT. These results suggest that clinicians should evaluate blood gas values and lactate at the beginning of health evaluations and interpret serial lactate values in sea turtles with caution, because even short periods of manual restraint can induce lactic acidosis and considerably influence these values.

PMID:34998289 | DOI:10.1638/2021-0029

J Zoo Wildl Med. 2021 Dec;52(4):1217-1223. doi: 10.1638/2020-0222.

ABSTRACT

Ocular disease in pinnipeds under human care is well described, and intraocular pressure (IOP) can be impacted by a variety of ophthalmic conditions. Species-specific reference parameters from clinically normal animals are instrumental for understanding how ophthalmic diseases may impact ocular pressures. IOP measurements were obtained using rebound tonometry from free-ranging Peruvian fur seals (Arctocephalus australis unnamed subspecies) at Punta San Juan, Peru, over a 6-yr period (2010-2016). Retrospective data obtained from 108 (81 adults and 27 neonates comprising 69 females and 39 males) anesthetized fur seals with normal anterior segment ophthalmic examinations was included in the analysis. Differences in IOP from each eye were compared to categorical variables (age, year, sex, restraint) using an independent-samples t test. All univariate results with a significance of P < 0.05 were included in multivariate analysis. Of the 13 general linear models evaluated, the top two for both the right and the left eye included age class when all variables were evaluated simultaneously. Neonates had significantly lower IOP values than adults in both the right eye (17.5 mm Hg; 95% confidence interval [CI]: 14.0-21.1 mm Hg compared to 33.5 mm Hg; 95% CI: 31.0-36.1 mm Hg, respectively) and the left eye (18.4 mm Hg; 95% CI: 14.4-22.5 mm Hg compared to 32.3 mm Hg; 95% CI: 29.3-35.3 mm Hg, respectively). Anesthesia method was not statistically significant (P > 0.05). This is the first report of normal IOP measurements for any fur seal species. Described data can be used to improve diagnosis and management of ocular alterations in pinnipeds.

PMID:34998291 | DOI:10.1638/2020-0222

Drug Alcohol Depend. 2021 Dec 30;231:109245. doi: 10.1016/j.drugalcdep.2021.109245. Online ahead of print.

ABSTRACT

BACKGROUND: Prescription drug misuse remains a persistent problem in the United States. Residents living in disadvantaged neighborhoods are at greater risk of substance abuse such as alcohol, tobacco, or drugs. However, whether neighborhood disadvantage affects prescription drug misuse remains underexplored.

METHODS: This study uses data on 3444 mothers from the Fragile Families and Child Wellbeing Study to examine the role of neighborhood disadvantage in prescription drug misuse. In addition, we examine whether social support and neighborhood collective efficacy (social cohesion and social control) explain this relationship. The analysis uses multivariate logistic regression and delineated between the following neighborhoods: affluent (3% poverty), low poverty (3-10%), moderate poverty (10-20%), and high poverty neighborhoods (20% or more).

RESULTS: Mothers living in moderately poor neighborhoods were more than twice as likely (odds = 2.17, 95% CI: 1.43-3.27) to misuse prescription drugs than mothers living in neighborhoods with high poverty. Mothers living in neighborhoods with high poverty did not have a statistically significant difference in prescription drug misuse than those living in affluent or low poverty neighborhoods. Social support and neighborhood collective efficacy did not explain these associations. The association between moderate poverty and prescription drug misuse was mostly direct and there was no indirect association.

CONCLUSION: The study highlights the higher risk of prescription drug misuse among mothers living in neighborhoods with moderate poverty. Interventions aimed at reducing opioid misuse should focus on demographic groups that are more vulnerable such as low-income mothers living in disadvantaged neighborhoods.

PMID:34998251 | DOI:10.1016/j.drugalcdep.2021.109245

Int J Pharm Pract. 2022 Jan 6:riab079. doi: 10.1093/ijpp/riab079. Online ahead of print.

ABSTRACT

OBJECTIVES: The main objective of this study was to assess community pharmacists’ thoughts regarding the role they can play in effectively integrating deprescribing into clinical practice in Ireland. The aim was to assess pharmacists’ (1) knowledge of deprescribing, (2) confidence in deprescribing, (3) attitudes towards deprescribing and (iv) barriers and facilitators to deprescribing in a community pharmacy setting.

METHODS: An online questionnaire was disseminated to pharmacists currently registered with the Pharmaceutical Society of Ireland, with instruction only to complete if working in community pharmacy. Statistical analysis was conducted on the quantitative data, whereas thematic analysis was carried out on the open-ended responses.

KEY FINDINGS: Results indicate good knowledge scores and positive attitudes surrounding deprescribing, with demographic factors having no significant effect on results. Although deprescribing knowledge is high, willingness to engage is hindered by obstacles such as time. Remuneration was identified as an enabler for deprescribing. Interdisciplinary educational opportunities and bidirectional communication channels with prescribers are viewed as the major facilitators of deprescribing.

CONCLUSIONS: Community pharmacists demonstrate that they possess sufficient knowledge, confidence and willingness to play a greater role in facilitating deprescribing. To enable this role expansion, enablers such as education and funding need to be implemented, to overcome barriers such as insufficient time. Further studies are required to assess community pharmacists’ deprescribing competence, to demonstrate their ability to fulfil this role in clinical practice in Ireland.

PMID:34998277 | DOI:10.1093/ijpp/riab079

J Clin Neurosci. 2022 Jan 5;96:74-79. doi: 10.1016/j.jocn.2021.11.037. Online ahead of print.

ABSTRACT

It is challenging to predict neurological outcomes of acute spinal cord injury (SCI) considering issues such as spinal shock and injury heterogeneity. Deep learning-based radiomics (DLR) were developed to quantify the radiographic characteristics automatically using a convolutional neural network (CNN), and to potentially allow the prognostic stratification of patients. We aimed to determine the functional prognosis of patients with cervical SCI using machine learning approach based on MRI and to assess the ability to predict the neurological outcomes. We retrospectively analyzed the medical records of SCI patients (n=215) who had undergone MRI and had an American Spinal cord Injury Association Impairment Scale (AIS) assessment at 1 month after injury, enrolled with a total of 294 MR images. Sagittal T2-weighted MR images were used for the CNN training and validation. The deep learning framework TensorFlow was used to construct the CNN architecture. After we calculated the probability of the AIS grade using the DLR, we built the identification model based upon the random forest using 3 features: the probability of each AIS grade obtained by the DLR method, age, and the initial AIS grade at admission. We performed a statistical evaluation between the actual and predicted AIS. The accuracy, precision, recall and f1 score of the ensemble model based on the DLR and RF were 0.714, 0.590, 0.565 and 0.567, respectively. The present study demonstrates that prediction of the short-term neurological outcomes for acute cervical spinal cord injury based on MRI using machine learning is feasible.

PMID:34998207 | DOI:10.1016/j.jocn.2021.11.037

Comput Biol Med. 2021 Dec 17;141:105148. doi: 10.1016/j.compbiomed.2021.105148. Online ahead of print.

ABSTRACT

Operating rooms are among the most high-risk and vital parts of a hospital. Therefore, one of the most fundamental tasks of risk management is maintaining the safety of operating rooms. Resilience engineering (RE) can be introduced as a model for overcoming problems, and it seeks ways to raise success rates by focusing on and addressing complexities. To this end, an RE-based framework is presented to evaluate the performance of operating rooms. First, the RE indicators are identified, and the relative importance of each is calculated via the best-worst method (BWM). Subsequently, the required data are collected from operating room experts using a standard questionnaire. Next, a data envelopment analysis (DEA) method is employed to evaluate the performance of operating rooms in the study case. Lastly, drawing upon the sensitivity analysis and statistical tests, the effect of each RE indicator is examined on the surgical department. Accordingly, some improvement approaches are proposed. Besides, SWOT (strengths, weaknesses, opportunities, and threats) analysis is used to extract appropriate strategies to improve performance. To the best of our knowledge, this paper is the first to evaluate the performance of operating rooms quantitatively in terms of RE indicators, and the framework presented in this paper can have practical applications in different operating rooms.

PMID:34998085 | DOI:10.1016/j.compbiomed.2021.105148