Nevin Manimala

Biom J. 2022 May 20. doi: 10.1002/bimj.202200002. Online ahead of print.

ABSTRACT

For multicenter randomized trials or multilevel observational studies, the Cox regression model has long been the primary approach to study the effects of covariates on time-to-event outcomes. A critical assumption of the Cox model is the proportionality of the hazard functions for modeled covariates, violations of which can result in ambiguous interpretations of the hazard ratio estimates. To address this issue, the restricted mean survival time (RMST), defined as the mean survival time up to a fixed time in a target population, has been recommended as a model-free target parameter. In this article, we generalize the RMST regression model to clustered data by directly modeling the RMST as a continuous function of restriction times with covariates while properly accounting for within-cluster correlations to achieve valid inference. The proposed method estimates regression coefficients via weighted generalized estimating equations, coupled with a cluster-robust sandwich variance estimator to achieve asymptotically valid inference with a sufficient number of clusters. In small-sample scenarios where a limited number of clusters are available, however, the proposed sandwich variance estimator can exhibit negative bias in capturing the variability of regression coefficient estimates. To overcome this limitation, we further propose and examine bias-corrected sandwich variance estimators to reduce the negative bias of the cluster-robust sandwich variance estimator. We study the finite-sample operating characteristics of proposed methods through simulations and reanalyze two multicenter randomized trials.

PMID:35593026 | DOI:10.1002/bimj.202200002

Int J Occup Saf Ergon. 2022 May 20:1-18. doi: 10.1080/10803548.2022.2079830. Online ahead of print.

ABSTRACT

The workers of fireworks industry are affected mentally because of hazards that occurred in and around the working environment which caused injuries/fire accidents due to carelessness of workers and poor maintenance of rules and regulations by management. The primary data was collected from 451 workers aiming twenty-five fireworks industries randomly. A structured questionnaire is developed to measure safety culture in the fireworks industry in terms of dimensions like work environment, worker awareness, process, governance and safety satisfaction. This instrument is tested for purification of items in terms of stability by various statistical tests like reliability and validity in statistical software like Statistical Package for Social Science (SPSS) and Analysis Moment Structure (AMOS). This field based study examines safety culture among workers of fireworks industry to find real scenario in the workplace and give recommendations for the management to control accidents and fire or explosions to save the lives of workers.

PMID:35593024 | DOI:10.1080/10803548.2022.2079830

Adv Wound Care (New Rochelle). 2022 May 20. doi: 10.1089/wound.2022.0041. Online ahead of print.

ABSTRACT

OBJECTIVE: To conduct a systematic review and meta-analysis of recently published randomized controlled trials (RCTs) that employed the use of topical oxygen therapy as an adjunct therapy in the treatment of Wagner 1 and 2 diabetic foot ulcers Approach: Following a literature search of eligible studies from 2010 onward, 4 RCTs were included. Studies were analyzed for patient and wound characteristics, outcomes, risk of bias, and quality of the evidence assessed using the GRADE methodology. A random effects meta-analysis for complete wound healing was carried out due to statistical heterogeneity of included studies.

RESULTS: Risk of bias judgment (Rob2 analysis) resulted in 1 low-risk trial and 3 trials with some risk. One study was determined to be the origin of the statistical heterogeneity. Pooled results showed statistical significance with a risk ratio (RR) of 1.59 (95% CI: 1.07-2.37); p = .021. Sensitivity analysis, based on imputed values for missing outcomes, demonstrated that both the RR and 95% confidence intervals changed little. The GRADE ratings for each domain were: (a) risk of bias: moderate (3); (b) imprecision: moderate (2), high (1); (c) inconsistency: low (2), high (1); (d) indirectness: moderate (2), high (1); and (e) publication bias: moderate (1), high (2). Overall, the evidence was moderate.

INNOVATION: Our study shows that topical oxygen therapy is a viable diabetic foot ulcer therapy.

CONCLUSIONS: This data supports the use of topical oxygen therapy for the treatment of chronic Wagner 1 or 2 diabetic foot ulcers in the absence of infection and ischemia.

PMID:35593010 | DOI:10.1089/wound.2022.0041

Neurourol Urodyn. 2022 May 20. doi: 10.1002/nau.24957. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the efficacy of magnetic stimulation (MStim) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB).

MATERIAL AND METHODS: Seventy-six women with idiopathic OAB were randomized into two groups using the random numbers generator as follows: Group 1 received BT alone (n: 38), and Group 2 received BT + MStim (n: 38). MStim was performed with MStim therapy armchair (Novamag NT60), 2 days a week, 20 min a day, a total of 12 sessions for 6 weeks. Women were evaluated in terms of incontinence severity (24-h pad test), 3-day voiding diary (frequency of voiding, incontinence episodes, nocturia, and number of pads), symptom severity (OAB-V8), QoL (IIQ-7), positive response and cure-improvement rates, and treatment satisfaction (Likert scale) at the baseline and the end of treatment (sixth week).

RESULTS: A statistically significant improvement was found in incontinence severity, frequency of voiding, incontinence episodes, nocturia, number of pads, symptom severity, and QoL parameters for two groups at the end of the treatment compared to the baseline values (p < 0.05). At the end of treatment; incontinence severity, incontinence episodes, nocturia, number of pads, symptom severity, and QoL were significantly improved in Group 2 compared to Group 1 (p < 0.05). No difference was found between the two groups in terms of frequency of voiding (p > 0.05). The positive response and cure-improvement rates, and treatment satisfaction were significantly higher in Group 2 than in Group 1 (p < 0.05).

CONCLUSION: MStim added to BT is more effective than BT alone in women with idiopathic OAB.

PMID:35593007 | DOI:10.1002/nau.24957

Stud Health Technol Inform. 2022 May 16;293:242-249. doi: 10.3233/SHTI220376.

ABSTRACT

BACKGROUND: It is feasible to collect data rapidly and online using IT solutions.

OBJECTIVES: To present a data collection platform for COVID-19 suspected patients in private offices and clinics without a standard software.

METHODS: The proposed system for collecting and sharing data of patients with respiratory symptoms was designed to be simple to use, without the need for special technology, and with proper security to authenticate reporters.

RESULTS: Two methods were developed to collect data from private physicians and offices. Finally, the data collected by both approaches is integrated and provided to primary healthcare staff to arrange appropriate healthcare measures.

CONCLUSION: Our platform can provide an easy-to-use case reporting system for private physicians.

PMID:35592989 | DOI:10.3233/SHTI220376

Stud Health Technol Inform. 2022 May 16;293:234-241. doi: 10.3233/SHTI220375.

ABSTRACT

BACKGROUND: Todays, smartphone technologies and applications are used in the medical and nursing fields. Medical and nursing students are among the groups in which the use of these tools is observed.

OBJECTIVES: To investigate their views on the barriers and facilitators of the use of these technologies.

METHODS: Four hundred people (200 people from each group) were invited randomly. A questionnaire was used to collect data. To collect data, hospitals were referred and the questionnaires were provided to students and after completion, they were collected. Data analysis was performed using SPSS software and descriptive and inferential statistics.

RESULTS: The most important barriers from the students’ view included internet problems in the university or hospital, lack of technical support for this technology in the hospital or university, the quality of existing applications, lack of appropriate Apps in the local language, non-introduction of appropriate Apps and not knowing the right Apps. The most important facilitators were the appropriate support services in the university or hospital, placing the appropriate Apps on the department or university website, designing native Apps with the participation of experts, and introducing the appropriate Apps by professors or universities.

CONCLUSION: The use of Apps is increasing among medical and nursing students. In this regard, attention to the existing barriers and their elimination and strengthening the facilitators, and providing the necessary technical and educational infrastructure to facilitate the useful applications should be considered by decision-makers.

PMID:35592988 | DOI:10.3233/SHTI220375

Stud Health Technol Inform. 2022 May 16;293:187-188. doi: 10.3233/SHTI220367.

ABSTRACT

BACKGROUND: The Open Source Registry System for Rare Diseases (OSSE), a web-based tool to create rare disease patient registries, currently offers no possibility to view aggregated registry data within the system. Here, we present the development and implementation of a dashboard for the registry of the German NEOCYST (Network for early onset cystic kidney diseases) consortium.

METHODS: Based on user requirements from NEOCYST, we developed a general dashboard for all OSSE registries, which was extended with NEOCYST-specific statistics.

RESULTS: The dashboard now allows users to gain a quick overview of key data, such as patient counts or the availability of biospecimens.

CONCLUSION: This work represents a first prototypical approach for an OSSE dashboard, demonstrated in an existing rare disease registry, to be further evaluated and enhanced in the future.

PMID:35592980 | DOI:10.3233/SHTI220367

Stud Health Technol Inform. 2022 May 16;293:1-8. doi: 10.3233/SHTI220339.

ABSTRACT

Patient summaries grant healthcare providers a concise overview of a patient’s status. This paper showcases to which degree International Patient Summaries (IPS) represented in HL7 FHIR format can be generated using data from the nationwide Austrian Electronic Health Record system ELGA. A solution is presented which enables the automated software-assembled generation of an IPS using the FHIR Mapping Language. The generated document successfully validates against the IPS profiles. Our results show that all required IPS sections can be supplied from ELGA data.

PMID:35592952 | DOI:10.3233/SHTI220339

Future Oncol. 2022 May 20. doi: 10.2217/fon-2022-0212. Online ahead of print.

ABSTRACT

Purpose: The predictive significance of the Naples prognostic score (NPS) in HER2-positive breast cancer is unclear. Hence we sought to evaluate the relationship between NPS and the clinical outcomes in HER2-positive breast cancer patients. Methods: This study retrospectively collected and analyzed data from 173 HER2-positive breast cancer patients between August 2004 and February 2014. The Cox regression model was applied in univariate and multivariate statistical analysis. Results: In multivariate analysis, increased NPS score correlated significantly with poor overall survival (p = 0.001) and disease-free survival (p < 0.001). Conclusion: Our findings may point to NPS being a novel and reliable prognostic score system with favorable predictive ability for HER2-positive breast cancer patients.

PMID:35592939 | DOI:10.2217/fon-2022-0212

Geospat Health. 2022 May 18;17(1). doi: 10.4081/gh.2022.1048.

ABSTRACT

Malaria remains one of the essential public health problems in Indonesia. The year 2015 was originally set as the elimination target in Java Island, but there are still several regencies on Java reporting malaria cases. Spatial technology helps determine local variations in malaria transmission, control risk areas and assess the outcome of interventions. Information on distribution patterns of malaria at the sub-district level, presented as spatial, temporal, and spatiotemporal data, is vital in planning control interventions. Information on malaria transmission at the sub-district level in three regencies in Java (Banyumas, Kebumen, and Purbalingga) was collected from the Agency for Regional Development (Bappeda), the Population and Civil Registration Agency (Disdukcapil) and Statistics Indonesia (BPS). Global spatial autocorrelation and space-time clustering was investigated together with purely spatial and purely temporal analyses using geographical information systems (GIS) by ArcGis 10.2 and SaTScan 8.0 to detect areas at high risk of malaria. Our results show that malaria was spatially clustered in the study area in central Java, in particular in the Banyumas and Purbalingga regencies. The temporal analysis revealed that malaria clusters predominantly appeared in the period January-April. The results of the spatiotemporal analysis showed that there was one most likely malaria cluster and three secondary clusters in southern central Java. The most likely cluster was located in Purbalingga Regency covering one sub-district and remaining from the beginning of 2016 to the end of 2018. The approach used can assist the setting of resource priorities to control and eliminate malaria.

PMID:35592925 | DOI:10.4081/gh.2022.1048