Tag: nevin manimala

Biometrics. 2023 Mar 25. doi: 10.1111/biom.13861. Online ahead of print.

ABSTRACT

Detecting the spatial clustering of the exposure-response relationship (ERR) between environmental risk factors and health-related outcomes plays important roles in disease control and prevention, such as identifying highly sensitive regions, exploring the causes of heterogeneous ERRs, and designing region-specific health intervention measures. However, few studies have focused on this issue. A possible reason is that the commonly used cluster-detecting tool, spatial scan statistics, cannot be used for multivariate spatial datasets with estimation error, such as the ERR, which is often defined by a vector with its covariance estimated by a regression model. Such spatial datasets have been produced in abundance in the last decade, which suggests the importance of developing a novel cluster-detecting tool applicable for multivariate datasets with estimation error. In this work, by extending the classic scan statistic, we developed a novel spatial scan statistic called the estimation-error-based scan statistic (EESS), which is applicable for both univariate and multivariate datasets with estimation error. Then, a two-stage analytic process was proposed to detect the spatial clustering of ERRs in practical studies. A published motivating example and a simulation study were used to validate the performance of EESS. The results show that the clusters detected by EESS can efficiently reflect the clustering heterogeneity and yield more accurate ERR estimates by adjusting for such heterogeneity. This article is protected by copyright. All rights reserved.

PMID:36964947 | DOI:10.1111/biom.13861

Ophthalmic Physiol Opt. 2023 Mar 25. doi: 10.1111/opo.13129. Online ahead of print.

ABSTRACT

PURPOSE: To determine whether there are quantifiable structural or functional differences that can distinguish between high-tension glaucoma (HTG; intraocular pressure [IOP] > 21 mm Hg) and low-tension glaucoma (LTG; IOP ≤ 21 mm Hg) at diagnosis.

METHOD: This was a retrospective, cross-sectional study. Clinical results of one eye from 90 newly diagnosed HTG and 319 newly diagnosed LTG patients (117 with very-low-tension glaucoma [vLTG; ≤15 mm Hg] and 202 with middling LTG [mLTG; >15 mm Hg, ≤21 mm Hg]) were extracted, which included relevant demographic covariates of glaucoma, quantitative optical coherence tomography (including the optic nerve head, retinal nerve fibre layer and ganglion cell-inner plexiform layer) measurements and standard automated perimetry global metrics. We used binary logistic regression analysis to identify statistically significant clinical parameters distinguishing between phenotypic groups for inclusion in principal component (PC) (factor) analysis (PCA). The separability between each centroid for each cohort was calculated using the Euclidean distance (d(x,y)).

RESULTS: The binary logistic regression comparing HTG and all LTG identified eight statistically significant clinical parameters. Subsequent PCA results included three PCs with an eigenvalue >1. PCs 1 and 2 accounted for 21.2% and 20.2% of the model, respectively, with a d(x,y) = 0.468, indicating low separability between HTG and LTG. The analysis comparing vLTG, mLTG and HTG identified 15 significant clinical parameters, which were subsequently grouped into five PCs. PCs 1 and 2 accounted for 24.1% and 17.8%, respectively. The largest separation was observed between vLTG and HTG (d(x,y) = 0.581), followed by vLTG and mLTG (d(x,y) = 0.435) and lastly mLTG and HTG (d(x,y) = 0.210).

CONCLUSION: Conventional quantitative structural or functional parameters could not distinguish between pressure-defined glaucoma phenotypes at the point of diagnosis and are therefore not contributory to separating cohorts. The overlap in findings highlights the heterogeneity of the primary open-angle glaucoma clinical presentations among pressure-defined groups at the cohort level.

PMID:36964934 | DOI:10.1111/opo.13129

Prof Inferm. 2022 Jul 1;75(2):123-126. doi: 10.7429/pi.2022.752123.

ABSTRACT

INTRODUCTION: Digital and technological solutions (DTS) might have an impact on people’s personal and professional lives. These types of solutions, according to studies, have the potential to revolutionize and improve the quality and long-term sustainability of healthcare activities, with nurses playing a significant role. Although DTS appears to be intimately linked to the future of nursing, technology must be utilized as an active rather than passive tool. Nonetheless, understanding DTS appears to be difficult, and a scoping study can provide a thorough overview of such a complicated topic. As a result, the scoping study on this topic will map all of the important aspects of DTS and synthesize studies on the nursing workforce, as well as analyze and clarify knowledge gaps and aid future research and development. This article presents the study protocol.

METHODS: The Joanna Briggs Institute (JBI) scoping review methodology will be used for the proposed scoping review. It will include both quantitative and qualitative scientific research as well as grey literature on DTS in nursing. Only English-language works will be considered for inclusion. Two independent reviewers will take part in an iterative process of evaluating literature, choosing papers, and extracting data. Disagreements among reviewers will be resolved through debate until a consensus is reached or through consultation with the study team if necessary. Results will be presented using descriptive statistics, diagrammatic or tabular displayed information, and narrative summaries, as specified in the JBI guidelines.

DISCUSSION: This scoping review protocol explained why it is important to describe the literature on embracing DTS in the nursing field, how to approach the research process, and what the study’s key implications will be. The protocol itself may be helpful to increase transparency in the research process, attract interested researchers to work with the group that developed the protocol and offer a practical methodological benchmark for researchers interested in performing scoping reviews by serving as an example of a scoping review protocol.

PMID:36964923 | DOI:10.7429/pi.2022.752123

J Burn Care Res. 2023 Mar 25:irad043. doi: 10.1093/jbcr/irad043. Online ahead of print.

ABSTRACT

The primary goal of the rehabilitation services offered to patients with lower limb burns is to enhance gait function. Exercise on a treadmill and conventional overground gait training are the two most widespread gait-training methods. Numerous studies have been published in the literature that claim treadmill training helps people walk more easily. Therefore, it would be intriguing to investigate whether treadmill gait training affects the progress made by post-lower limb burn patients compared to traditional overground gait training. The goal of the current study was to compare the effectiveness of treadmill training and traditional physical therapy therapies for improving gait after lower limb burn injury. A comparative study, was conducted between January to August 2022 at a burns care unit,in Islamabad. All the participants were informed about the study procedure and consent was taken before initiating the study. All the participants received the set standard of Burn Rehabilitation by the American Burn Association (ABA). The program consists of ROM exercises, mobilization, functional mobility, stretching, balance training,and resisted exercises for enhancing muscle power. Statistical analyses were performed using IBM SPSS 24.0 software. The study subjects selected were 30 burn patients, aged above 18 years, vitally stable and had lower limb burn injuries with an average TBSA (total burn surface area) of 20-30%.The mean for Experimental is 18.86 and control group is 21.13. Patients were randomly either assigned to an experimental group or a control group. The Experimental group had a lower Time Up and Go test score of 11.86±3.58 (9.50-24.07)as compared to the control group’s TUG score(of 12.78±4.41(6.30-24.07). Functional mobility significantly improved as the p<0.05. The total mean scores calculated on the Tampa Kinesiophobia scale for the Experimental group were 35.66±6.32 which was less compared with those of the control group 37.93± 6.36. It demonstrates that fear of movement was reduced for treadmill training participants. Comparison of pre-distance (350.9±86.82) , pre-velocity (62.78±20.20) and post distance (385.02±32.29), post-velocity 40.48±21.91 of the experimental group with the control group pre-distance (339.26±98.17, pre-velocity (55.07±22.63) and post-distance (383.07±36.914) post-velocity (40.57±21.95) showed significant changes in results. In contrast to traditional gait training, treadmill training significantly improves walking ability in burn patients with lower limb damage.

PMID:36964917 | DOI:10.1093/jbcr/irad043

Int Health. 2023 Mar 25:ihad021. doi: 10.1093/inthealth/ihad021. Online ahead of print.

ABSTRACT

BACKGROUND: In Kenya, long-distance truck drivers (LDTDs) using the Northern Corridor highway have a high prevalence of HIV and other sexually transmitted infections (STIs) due to their risky sexual networks. However, the spatial distribution of the sexual network locations used by LDTDs is not well understood. Consequently, healthcare stakeholders have found it difficult to provide spatially targeted HIV/STI interventions among LDTDs. Thus, the study sought to establish the spatial distribution of sexual network locations used by LDTDs along the Northern Corridor highway, to inform efficient distribution and use of limited HIV/STI-prevention resources.

METHODS: A cross-sectional study design was used. The study adopted a systematic sampling technique. 296 LDTDs were interviewed using interviewer-administered questionnaires at the Mlolongo weighbridge in Kenya. The LDTDs listed their history of sexual interactions and highway stopovers used during the week preceding data collection. Geospatial modelling techniques, using R statistical software packages for spatial mapping, were employed. Shapefiles were created and overlaid over a map of Kenya using R statistical software to create maps of sexual networks.

RESULTS: Forty-two highway stopovers used by LDTDs were spatially distributed along the highway, from the Kenya coast to the Kenya-Uganda border. In general, LDTDs’ sexual network hotspots were restricted to the outskirts of major cities along the Northern Corridor highway (Nairobi, Mombasa and Nakuru) as well as the Kenya-Uganda international border.

CONCLUSIONS: On the Northern Corridor highway, stopovers situated proximal to major urban areas, as well as those at international border points, frequently serve as sexual network hotspots among LDTDs and their sexual partners. Thus, healthcare stakeholders should improve access to HIV/STI-prevention services targeted for LDTDs at the sexual network hotspots identified in this study.

PMID:36964695 | DOI:10.1093/inthealth/ihad021

Hum Fertil (Camb). 2023 Mar 25:1-10. doi: 10.1080/14647273.2023.2190040. Online ahead of print.

ABSTRACT

It is estimated that one in seven couples in the UK experience infertility, though just over half of those affected by it seek professional help. Previous studies pointed to potential socioeconomic barriers in accessing assisted reproduction; however, less is known about geographic accessibility to fertility treatment and the way it is associated with measures of deprivation. In this study, we used publicly available data on fertility clinics, combined with official statistics for 315 local authorities in England, to create a standardized measure of geographic accessibility to fertility services. In addition, using a negative binomial regression model, we estimated the link between socioeconomic measures at the local authority level and availability of fertility services. We found that geographic accessibility to assisted reproduction is significantly higher in the most advantaged local authorities in terms of average household income and level of deprivation. This may lead to reduced opportunities for realizing fertility aspirations among those suffering from infertility in more deprived areas. Taking into account both socioeconomic and geographic barriers to accessing fertility treatment can contribute to a better understanding of help-seeking patterns for infertility, likelihood of achieving a live birth and inform policy to equalise opportunities in access to infertility treatment.

PMID:36964684 | DOI:10.1080/14647273.2023.2190040

Health Informatics J. 2023 Jan-Mar;29(1):14604582221146709. doi: 10.1177/14604582221146709.

ABSTRACT

Defining profiles of patients that could benefit from relevant anti-cancer treatments is essential. An increasing number of specific criteria are necessary to be eligible to specific anti-cancer therapies. This study aimed to develop an automated algorithm able to detect patient and tumor characteristics to reduce the time-consuming prescreening for trial inclusions without delay. Hence, 640 anonymized multidisciplinary team meetings (MTM) reports concerning lung cancers from one French teaching hospital data warehouse between 2018 and 2020 were annotated. To automate the extraction of eight major eligibility criteria, corresponding to 52 classes, regular expressions were implemented. The RegEx’s evaluation gave a F1-score of 93% in average, a positive predictive value (precision) of 98% and sensitivity (recall) of 92%. However, in MTM, fill rates variabilities among patient and tumor information remained important (from 31% to 100%). Genetic mutations and rearrangement test results were the least reported characteristics and also the hardest to automatically extract. To ease prescreening in clinical trials, the PreScIOUs study demonstrated the additional value of rule based and machine learning based methods applied on lung cancer MTM reports.

PMID:36964666 | DOI:10.1177/14604582221146709

Med Sci Monit. 2023 Mar 25;29:e939452. doi: 10.12659/MSM.939452.

ABSTRACT

BACKGROUND The increasing number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfections has opened a new research direction related to analyzing long-term immune response and accurately characterizing individual cases of reinfection to understand its mechanism and estimate the risk of widespread reinfection both locally and globally. This retrospective study from the Gyncentrum Genetic Laboratory in Sosnowiec, Poland aimed to evaluate reinfections from SARS-CoV-2 between April 2020 and July 2022. MATERIAL AND METHODS The study extended the previously published report on SARS-CoV-2 infection cases in Poland by analyzing 8041 reinfections diagnosed with real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. Data were collected on the amount of time elapsed from the first infection to the next and, based on these data, all results were divided into several groups for statistical analysis: 0-44, 45-90, 91-200, 201-310, 311-420, and >420 (days). RESULTS The study showed that of the 8041 patients who experienced reinfection, the vast majority (5505) became reinfected more than 310 days after the original infection, even though the average time between infections was 354.3 days. Statistical analysis revealed that the risk of SARS-CoV-2 reinfection increases with time and that this relationship becomes statistically significant after the 200th day following the initial infection (p<0.01). CONCLUSIONS We have shown that acquired immunity to SARS-CoV-2 infection is relatively short-lived – it starts diminishing about 6 months after the initial positive test. Moreover, the risk of reinfection is very high more than 1 year after the initial infection.

PMID:36964642 | DOI:10.12659/MSM.939452

Int J STD AIDS. 2023 Mar 24:9564624231152804. doi: 10.1177/09564624231152804. Online ahead of print.

ABSTRACT

BACKGROUND: Youth are a high-risk group for sexually transmitted infections (STIs). To increase access to STI testing, convenient approaches for sampling and testing are needed. We assessed the acceptability of self-collected vaginal swabs (SCVS) for STI testing among young women (16-24 years) attending a community-based sexual and reproductive health service in Zimbabwe.

METHODS: A SCVS was used for point-of-care testing for Trichomonas vaginalis and a urine sample for testing for Chlamydia trachomatis and Neisseria gonorrhoeae. A questionnaire was administered to investigate the acceptability of SCVS versus self-collected urine samples. In-depth interviews (IDIs) explored the experience of SCVS and reasons for sample collection preference. Qualitative analysis was predominantly deductive.

RESULTS: We recruited 129 women who took up STI testing (median age 20 years, IQR 18-22 years) and conducted 12 IDIs. Most participants reported that they understood the instructions (93.0%) and found SCVS easy (90.7%). Many participants felt relaxed (93.0%), in control (88.4%) and that they had enough privacy (90.7%). Pain or discomfort were reported by 16.3% and embarrassment by 15.5%. Among the 92 (71.3%) participants who provided both a SCVS and urine sample, 60.9% preferred SCVS. Sample collection method preferences were similar between 16-19 and 20-24year-olds. In IDIs, clear instructions, privacy, trust in the service and same-day results were perceived as important facilitators to taking up SCVS. Participants frequently described feeling relaxed and confident whilst taking a SCVS. Pain and discomfort were uncommon experiences.

CONCLUSIONS: SCVS for STI testing are acceptable to young women and a feasible method of sample collection in community-based settings.

PMID:36964640 | DOI:10.1177/09564624231152804

Arthritis Res Ther. 2023 Mar 25;25(1):47. doi: 10.1186/s13075-023-03023-9.

ABSTRACT

BACKGROUND: Optical spectral transmission (OST) is a modern diagnostic modality, able to assess the blood-specific absorption of light transmitted through a tissue, promising quantification of inflammation in the finger and wrist joints of patients with arthritis. To date, there are no adequate data regarding the diagnostic value of OST in the evaluation of inflammatory activity changes, during arthritis follow-up. Objectives of this study were therefore to examine the performance of OST in assessing response to anti-inflammatory therapy in patients with active arthritis and to explore OST associations with clinical, laboratory, and ultrasonographic (US) activity markers.

METHODS: 1173 joints of 54 patients with arthritides of the wrist and finger joints were examined by OST before and after oral administration of glucocorticoids (GC), during a disease flare. For the same time-points patients underwent clinical, laboratory, and joint US [grayscale (GSUS), power-Doppler (PDUS)] examinations. The distribution of ΔOST-values between the two time-points was compared with the respective distributions of ΔPDUS and ΔGSUS by Bayesian statistical analyses. Moreover, the diagnostic performance of OST compared to a control group (2508 joints of 114 subjects) was examined by receiver operating characteristics and associations of OST values with clinical, laboratory, and arthrosonographic parameters were evaluated by correlation analyses.

RESULTS: OST and US performed similarly in the assessment of inflammatory changes caused by GC (same value-change tendency in 83.2% of the cases). Bayesian statistics revealed no significant differences between ΔOST and ΔPDUS for all 3 examined joint categories (accuracy: metacarpophalangeal (MCP): 68.1%; proximal interphalangeal (PIP): 60.4%; wrists: 50.4%) and between ΔOST and ΔGSUS for MCP and PIP joints (accuracy: 51.1% and 78.7%, respectively). OST diagnostic performance (patients vs. controls) was excellent in both time-points [area under the curve (AUC) before GC=0.883(95%CI=0.83-0.94) and after GC=0.811(95%CI=0.74-0.881); p<0.001]. Furthermore, OST correlated significantly with all examined sonographic activity scores (all; p<0.001) and with swollen joint counts (p<0.01).

CONCLUSIONS: OST was able to assess response to therapy in a similar way to joint US and correlated significantly with arthritis activity markers. Therefore, OST has proved to be a valuable tool to assist disease activity monitoring in the examined cohort.

TRIAL REGISTRATION: German Registry of Clinical Trials, DRKS00016752.

PMID:36964628 | DOI:10.1186/s13075-023-03023-9