Category: Statistics

Epilepsy Res. 2021 Dec 6;179:106841. doi: 10.1016/j.eplepsyres.2021.106841. Online ahead of print.

ABSTRACT

INTRODUCTION: Epileptic discharges occurring during seizure may affect many systems in the ictal, postictal, and interictal periods. Autonomic dysfunction and its negative impacts on the heart may cause life-threatening clinical manifestations, cardiac arrhythmias, and sudden cardiac death in epileptic patients. This study investigated the impact of levetiracetam (LEV) therapy on cardiac electrical activity in children with epilepsy.

MATERIAL AND METHODS: Our study included a total of 120 cases, comprising 40 newly diagnosed epilepsy patients, 40 epilepsy patients who had been receiving LEV therapy for at least 6 months, and 40 healthy individuals. Age at diagnosis, duration of LEV treatment, and familial history of cardiac disease were recorded in a standardized form. Electrocardiogram (ECG) parameters were calculated for all cases, echocardiography (ECHO) findings were noted, and the obtained data were compared using statistical methods.

RESULTS: A comparison of the ECG parameters showed that the Tpeak-Tend (Tp-e) interval, and the Tp-e/QT dispersion (QTd) and Tp-e/QTc dispersion (QTcd) ratios, of the newly diagnosed epilepsy patients were statistically significantly increased compared with the other two groups (p = <0.001, p = 0.001, and p = 0.007, respectively). There were no statistically significant differences between the three groups in terms of QTd and QTcd.

DISCUSSION: The repolarization differences in children with newly diagnosed epilepsy may have reflected early subclinical findings associated with the disease. We concluded that LEV monotherapy may make a positive contribution to early repolarization differences.

PMID:34894618 | DOI:10.1016/j.eplepsyres.2021.106841

Phys Ther Sport. 2021 Dec 3;53:105-114. doi: 10.1016/j.ptsp.2021.11.012. Online ahead of print.

ABSTRACT

OBJECTIVES: To present a new knee isokinetic assessment procedure linked to noncontact knee injury mechanisms and examine correlations between variables relevant to noncontact knee injury prevention screening (peak torque [PT, Nm], time-to-peak torque [TTPT, ms], angle-of-peak torque [APT, °], mean PT [MPT, Nm]).

DESIGN: Cross-sectional.

SETTING: Sports medicine laboratory.

PARTICIPANTS: Thirty-four agility-sport athletes (male/female n = 18/16, age 24.1 ± 3.5yr, height 171.8 ± 9.6 cm, mass 70.6 ± 12 kg).

MAIN OUTCOME MEASURES: Pearson’s/Spearman’s correlation (r/r_s), coefficient of determination (r²/r_s²).

RESULTS: Most correlations were statistically non-significant or statistically-significant with only weak-to-moderate coefficients. For both knee extension and flexion, PT and MPT were significantly and strongly correlated (r = 0.99, r² = 0.98, p = 0.001). Graphical analyses revealed two datapoint clusters for knee flexion TTPT and APT. One cluster indicated some participants could generate knee flexor PT rapidly (<150 ms) at low knee flexion angles (<45°) and the other cluster indicated that other participants could not (>200 ms, >50°).

CONCLUSIONS: In this study, most isokinetic variables represented distinct knee neuromuscular characteristics. For both knee extension and flexion, only PT or MPT need be used to represent isokinetic maximal strength. Knee flexion TTPT and APT may have utility in noncontact knee injury prevention screening with amateur adult agility-sport athletes.

PMID:34894616 | DOI:10.1016/j.ptsp.2021.11.012

Phys Ther Sport. 2021 Dec 5;53:97-104. doi: 10.1016/j.ptsp.2021.12.001. Online ahead of print.

ABSTRACT

This study aimed to compare the angle-specific (AS) and non-angle-specific (NAS) hamstring to quadriceps conventional and functional ratios between healthy, hamstring- and ACL-injured elite soccer players. One hundred and eleven players (27.42 ± 8.01 years, 182.11 ± 6.79 cm, 75.93 ± 7.25 kg) completed a series of concentric knee flexor and extensor strength in addition to eccentric knee flexor strength was measured at an angular velocity of 60°.s^-1. Normalized and raw peak torque values, and the torque-angle profiles were extracted for analysis. Conventional and functional NAS (peak values) and AS (waveform ratios) hamstring to quadriceps ratios were calculated and compared between the groups. Healthy players produced greater functional and conventional ratios compared to players with either ACL or hamstring injury. Players with hamstring injury produced a lower AS functional ratios between 46° and 54° of knee flexion. Players suffering from ACL injury depicted a lower value for the AS functional ratio between 33° and 56° of knee flexion. Although NAS can identify soccer players with previous hamstring or ACL injury, the range where there is a strength deficiency is eluded. With the use of AS the range where the deficiency is present can be identified, and clinicians can benefit from this analysis to design robust rehabilitation protocols.

PMID:34894617 | DOI:10.1016/j.ptsp.2021.12.001

Forensic Sci Int. 2021 Dec 2;331:111127. doi: 10.1016/j.forsciint.2021.111127. Online ahead of print.

ABSTRACT

In the context of forensic tool paint analysis, the development of analytical strategies to distinguish between different tools is of great interest in order to form a better opinion on whether or not a trace of paint seized at a crime scene originates from a tool found, for example, during a search of a house. A study was therefore conducted on the potential of using X-ray mapping to discriminate red tools that are not otherwise distinguished by standard analytical techniques (i.e. optical microscopy, infra-red spectroscopy, Raman spectroscopy). In this study, the presence of trace amounts of strontium – revealed by X-ray mapping – in the main mineral filler, namely barium sulphate, allowed the discrimination of different tools using a statistical approach. This study is one example among others of the potential of X-ray mapping for a better characterisation of tool paints in a forensic context.

PMID:34894612 | DOI:10.1016/j.forsciint.2021.111127

Forensic Sci Int. 2021 Nov 27;330:111125. doi: 10.1016/j.forsciint.2021.111125. Online ahead of print.

ABSTRACT

This article presents key factors affecting the analysis of particle profiles as used for discrimination and classification among items commonly collected at crime scenes. Identification of these factors is a necessary step to enable systematic improvement, optimization, and transition to practice. Prior research, employing reasonable initial choices of analytical and statistical parameters, has (1) demonstrated the presence of highly discriminating sets of very small particles (VSP) on the surfaces of items commonly collected at crime scenes, (2) developed statistically rigorous measurements of correspondence between VSP profiles, and (3) produced objective measures for the resulting probative value. In the present work the analytical and statistical parameters were examined more critically, identifying key factors affecting method performance. Experiments were conducted using scanning electron microscopy (SEM) with energy dispersive x-ray elemental analysis (EDS) to characterize the elemental composition of thousands of individual particles within each specimen. The experiments studied: Reproducibility of VSP analyses at given parameters Effects of the SEM/EDS parameters used for the detection of each particle Effects of SEM/EDS x-ray analysis parameters used for elemental analysis of each particle Effects of the number and choice of elements used in the elemental analysis Effects of particle size on the strength of correspondence between particle sets Effects of data filtration parameters on the strength of correspondence between particle sets The experiments confirmed the presence of abundant, highly discriminating VSP on items commonly collected at crime scenes. The numbers of particles available for analysis was not a limiting factor: many more particles (usually greater than 50 times more) were present than were used for the analysis. A very high level of reproducibility was observed. Many of the parameters tested had no measurable effect on particle combination analysis performance and others had minor or interactive effects. Four factors were identified as having significant impact on the strength of correspondence between particle profiles, three factors were identified as having a significant impact on the numbers of particles detected and nine factors were identified as having a significant impact on analytical time and costs. The approach in its current state of development offers crime laboratories an additional capability suitable for high priority cases. The identification of key factors affecting performance of the VSP analytical protocol allows existing methods to be further developed and systematically improved to facilitate transition to routine practice.

PMID:34894614 | DOI:10.1016/j.forsciint.2021.111125

J Surg Res. 2021 Dec 8;271:117-124. doi: 10.1016/j.jss.2021.09.042. Online ahead of print.

ABSTRACT

BACKGROUND: Considerable gaps in knowledge remain regarding the intersectionality between race, insurance status, rurality, and community-level socioeconomic status that contribute in concert to disparities in breast cancer care delivery.

METHODS: Women age 18-64 y old with either private, Medicaid, or no insurance coverage and a diagnosis of breast cancer from the North Carolina Central Cancer Registry (2010-2015) were identified and reviewed. Logistic regression models examined the impact of race, insurance status, rurality, and the Social Deprivation Index (SDI) on advanced stage disease at diagnosis (III, IV) and receipt of cancer directed surgery (CDS). Models tested two-way interactions between race, insurance status, rurality, and SDI.

RESULTS: Of the study population (n = 23,529), 14.6% were diagnosed with advanced stage disease (III, IV), and 97.1% of women with non-metastatic breast cancer (n = 22,438) received cancer directed surgery (CDS). Twenty percent of women were non-Hispanic Black (NHB), 3.0% Hispanic, 10.9% Medicaid insured, 5.9% uninsured, 20.0% of women resided in rural areas, and 20.0% resided in communities of the highest quartile SDI. NHB race, Medicaid or uninsured status, and residence in rural or socially deprived areas were associated with advanced stage breast cancer at diagnosis. NHB and Medicaid or uninsured women were significantly less likely to receive CDS. There were no statistically significant interactions found influencing stage at diagnosis or receipt of cancer directed surgery.

CONCLUSIONS: In a heterogeneous population across the state of North Carolina, non-Hispanic Black race, Medicaid or uninsured status, and residence in rural or high social deprivation communities are independently associated with advanced stage breast cancer at diagnosis, while non-Hispanic Black race and Medicaid or uninsured status are associated with lower odds to receive cancer directed surgery.

PMID:34894544 | DOI:10.1016/j.jss.2021.09.042

Nurse Educ Pract. 2021 Nov 30;58:103272. doi: 10.1016/j.nepr.2021.103272. Online ahead of print.

ABSTRACT

AIM: To examine the effectiveness of a Humanoid Diagram Teaching Strategy (HDTS) on care capabilities and retention of novice nurses.

BACKGROUND: Guiding novice nurses in clinical practice is a matter of concern and the use of diagrams in assisting the learning process and to promote learning efficiency has been acknowledged.

DESIGN: This is a quasi-experimental study with asynchronous repeated measurements for the experimental and control groups.

METHODS: The study was conducted in a medical centre in southern Taiwan with 24 novice nurses. The intervention, Humanoid Diagrams Teaching Strategy, contained three parts: the head and neck; trunk; and limbs. The HDTS was applied three time weekly. Each session lasted approximately 30 min and the training lasted 4 weeks. The effectiveness of HDTS was measured using Mini-CEX, CbD and retention rates in the 3rd and 6th months of novice nurses’ experience.

RESULTS: After the HDTS, although increases in mini-CEX and CbD scores in the experimental group were greater than the control group, these differences were not statistically significant after considering the time interaction. But the 3rd month and 6th month novice nurses’ retention rates were statistically significantly different by comparing the differences under the time interaction effects in both groups.

CONCLUSIONS: The Humanoid Diagram Teaching Strategy is an effective tool for preceptors to use in assisting novice nurses in learning, improving their nursing care knowledge and technical skills and to increase their retention rate.

PMID:34894604 | DOI:10.1016/j.nepr.2021.103272

Int J Pediatr Otorhinolaryngol. 2021 Dec 5;152:111002. doi: 10.1016/j.ijporl.2021.111002. Online ahead of print.

ABSTRACT

BACKGROUND: When to order an echocardiogram in children with obstructive sleep apnea (OSA) is debated. Studies evaluating the utility of pre-operative standard echocardiography are inconsistent. Tissue Doppler imaging (TDI) is an additional technique that quantifies the velocity of myocardial motion to assess cardiac function. The utility of TDI in pediatric OSA remains unclear.

METHODS: A systematic review and meta-analysis were performed in accordance with PRISMA guidelines using PubMed, Scopus, CINAHL, and Cochrane Library databases. Studies of echocardiographic findings using TDI in children with polysomnogram confirmed OSA before and after tonsillectomy and adenoidectomy (T&A) were included. 1,423 studies were screened, and 4 studies met inclusion criteria. Meta-analysis of echocardiographic findings was performed.

RESULTS: Data from 560 children were analyzed. Study groups included pre- and post-T&A children with OSA and non OSA controls. Pre-T&A S’ wave at the tricuspid annulus (S’ RV) was decreased with a mean difference of -1.04 [95% CI -1.57, -0.52, p < 0.001] and E’/A’ ratio at the mitral annulus (E’/A’ LV) was decreased with a mean difference of -0.74 [95% CI -0.85, -0.64, p < 0.001] when compared to controls. These variables were not statistically different when comparing post-T&A to controls.

CONCLUSIONS: TDI appears to successfully detect subclinical changes in cardiac function in children with OSA. However, echocardiography parameters of post-T&A and non OSA control children were similar. Further prospective studies stratified by OSA severity are needed with both TDI and standard echocardiography to define the utility of pre-operative cardiac imaging.

PMID:34894539 | DOI:10.1016/j.ijporl.2021.111002

Public Health. 2021 Dec 8;202:58-64. doi: 10.1016/j.puhe.2021.10.017. Online ahead of print.

ABSTRACT

OBJECTIVES: There is growing evidence of an association between social participation and improved physical and mental health among older individuals. The aims of this study were to explore the relationship between self-reported participation in groups, clubs, or organizations and all-cause mortality among older adults and examine the role of physical activity as a potential modifier of the health effects of social participation.

STUDY DESIGN: EPIC-Norfolk is a prospective cohort study that recruited 25,639 individuals between the ages of 40 and 79 in Norfolk County, England. This study involved a retrospective analysis of 8623 participants who had returned for the third health check between 2004 and 2011.

METHODS: Participants were categorized into those who reported participating socially and those who did not and were stratified by involvement in 0, 1, or 2 or more groups. Cox Proportional Hazards models were constructed to compare all-cause mortality between the groups. Stratum-specific hazard ratios were calculated by physical activity level to assess for effect modification.

RESULTS: Of the participants, 861 (9.98%) died during the follow-up period. After adjustment for confounding, social participation was associated with lower all-cause mortality (HR 0.84, 95% CI 0.73-0.97). Involvement in 2 or more groups was associated with lower all-cause mortality (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.70-0.97), but the association was not statistically significant for people involved in only 1 group (HR 0.86, 95% CI 0.73-1.03). Physical activity appeared to modify the effect of social participation on mortality.

CONCLUSIONS: This study’s findings provide evidence of an association between social participation and lower all-cause mortality for older adults. They also suggest that the effect of social participation on health is greater for people who are more physically active. Population-level interventions to facilitate social participation may contribute to improving health and wellbeing among older individuals.

PMID:34894534 | DOI:10.1016/j.puhe.2021.10.017

Eur J Obstet Gynecol Reprod Biol. 2021 Aug 28;268:100-109. doi: 10.1016/j.ejogrb.2021.08.028. Online ahead of print.

ABSTRACT

BACKGROUND: Significant risk of bias and limitations in outcome selections in trials evaluating conservative treatments for the management of Pelvic Organ Prolapse (POP) have been highlighted and preclude comparability of outcomes, synthesis of primary studies and high quality evidence.

OBJECTIVES: As systematic review of the reported outcomes is the first step in the process of development of a Core Outcome Set (COS), we aimed to systematically review reporting of outcomes and outcome measures in Randomised Control Trials (RCTs) on conservative treatments for POP and develop an inventory of them for consideration as core outcome and outcome measures sets. We evaluated methodological quality, outcome reporting quality and publication characteristics and their associations among published RCTs.

STUDY DESIGN: Systematic review of RCTs identified from the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and MEDLINE (Pubmed). RCTs evaluating the effectiveness of conservative interventions for the management of POP were considered for inclusion. Outcomes and outcome measures were obtained from the RCTs and an inventory was created. Outcomes were grouped in domains and themes. Methodological quality, outcome reporting quality and publication characteristics were evaluated and statistically analysed.

RESULTS: Twenty-five trials (3179 women) were included and reported 31 outcomes and 50 outcome measures. Reporting rates of the outcomes investigated ranged between 4% and 56%. The most commonly reported outcome domains were patient reported symptoms, stage of POP expressed as POP-Q stage, and quality of life. Univariate analysis demonstrated no significant correlations of methodological and outcome reporting parameters.

CONCLUSIONS: There is a need to increase comparability of RCTs. Reporting standardized outcomes included in a COS for conservative interventions for POP will facilitate the comparability across RCTs. While the process of developing COS is in progress, we propose the interim use of the three most commonly reported outcomes in each domain: patient-reported outcomes (symptom distress including bowel and urinary symptoms, sexual function), stage of prolapse and quality of life parameters using validated questionnaires (Pelvic Floor Distress Inventory 20 (PFDI-20), Pelvic Floor Impact Questionnaire/Health related quality of life (PFIQ-7/HRQOL) and Pelvic Organ Prolapse Impact Questionnaire (POPIQ-7).

PMID:34894536 | DOI:10.1016/j.ejogrb.2021.08.028