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Nevin Manimala Statistics

Evaluation of effectiveness of pathology reports in active surveillance of tuberculosis

Cent Eur J Public Health. 2021 Jun;29(2):96-101. doi: 10.21101/cejph.a6124.

ABSTRACT

OBJECTIVE: Despite advancing technology, national TB surveillance systems are still inadequate in terms of patient detection around the world. It was aimed to investigate suspicious cases detected by active surveillance method in pathology laboratories and to evaluate the effectiveness of this method in terms of finding new TB cases.

METHODS: This is a descriptive cross-sectional study. It was administrated in Samsun, Turkey, between January 2012-December 2017. Within the scope of active surveillance, pathology laboratories were regularly visited and reported cases with granulomatous inflammation were assessed. The obtained patient list was compared with the records of the Electronic Tuberculosis Management System (ETMS). Patients who were not included in these records were invited to the dispensary and evaluated for TB. They were also referred to the relevant hospitals for diagnosis if necessary. Frequency values and descriptive statistics were calculated using SPSS method.

RESULTS: It was found that 35.6% of 703 patients with the diagnosis of granulomatous inflammation were previously diagnosed, treated or currently undergoing treatment in the ETMS registry. As a result of the assessment of remaining 453 cases, 46 patients (10.1%) were newly diagnosed with TB. Newly diagnosed TB patients were reported, and their treatment started.

CONCLUSION: As a result, active surveillance method conducted in pathology laboratories are used to detect unknown or late reported TB cases and allows to start treatment without further delay.

PMID:34245548 | DOI:10.21101/cejph.a6124

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Evaluation of estimated direct health expenses on tobacco- and alcohol-related diseases in context of excise taxes revenues in the Czech Republic

Cent Eur J Public Health. 2021 Jun;29(2):143-152. doi: 10.21101/cejph.a5538.

ABSTRACT

OBJECTIVES: This article deals with the comparison of excise tax revenues from alcoholic beverages and tobacco products with public spending that are spent on treating diseases occurring in consumers of these commodities.

METHODS: Based on available data, the study estimates direct public expenditures on the treatment of tobacco-related diseases and very frequent alcohol consumption-related diseases in the Czech Republic. These partial results are evaluated in the context of tax revenues from consumption of the mentioned commodities. The analysis works with the data from 1998-2017, which was obtained from the Ministry of Health of the Czech Republic, the National Institute of Public Health, the Customs Administration of the Czech Republic, the Ministry of Finance of the Czech Republic, and the Czech Statistical Office.

RESULTS: Medical treatment costs of smoking-related diseases were 18.35-48.19 billion CZK per year in the analysed period. These expenditures in the period 1998-2011 exceeded the annual revenues from the tax on tobacco products (in 2002 by 12.08 billion CZK). Since 2012, the balance has been positive in favour of public spending. Expenditures on the treatment of alcohol-related diseases amounted to 9.66-25.36 billion CZK per year in the given period, the expenditures, except the year 1998, exceeded the revenues from alcoholic beverages taxes (by 14.63 billion CZK in 2009).

CONCLUSIONS: The study shows that the excise tax revenues for tobacco products do not reach the level of healthcare spending for tobacco-related disease in the most of the analysed period, and this difference increases with the length of consumption, which can be interpreted in such a way that current excise tax revenues potentially mean public healthcare expenditures, which cumulatively exceed revenues from the relevant excise duties.

PMID:34245555 | DOI:10.21101/cejph.a5538

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Nevin Manimala Statistics

Quality improvement initiative to decrease extrauterine growth restriction in preterm neonates

Nutr Clin Pract. 2021 Jul 10. doi: 10.1002/ncp.10735. Online ahead of print.

ABSTRACT

BACKGROUND: Prevention of extrauterine growth restriction (EUGR) in preterm neonates is one of the biggest challenges to neonatologists. Lack of uniformity and inconsistency in nutrition practices are the most common causes. We started a quality improvement (QI) initiative with an intention to decrease the proportion of EUGR.

METHODS: We performed prospective nonrandomized QI from May 2018 to July 2019. Ninety-six neonates (born at <32 weeks and/or <1.2 kg) were compared with 111 historical controls. A continuous feedback loop was maintained, and changes were analyzed as plan-do-study-actcycle.

RESULTS: Although EUGR was lower after the intervention (93.7% vs 87.5%), this change was not statistically significant. However, other measures of in-hospital neonatal growth showed improvement, including median discharge weight percentile from 1% to 3% (P = .003). Median difference in the z-score for weight from birth to discharge also improved significantly from -1.84 to -1.65 (P = .04). Babies in the intervention group regained birth weight earlier (P = .005) and had better growth velocity (P = .0005). The feeding was started early (P < .0001), and these babies reached full feeds (P < .0001) earlier than the control cohort.

CONCLUSION: Although our QI initiative failed to achieve a significant reduction in EUGR, it did achieve a significant improvement in discharge weight percentile and difference in the z-score for weight at birth and during discharge from hospital. There was a significant improvement in growth velocity and an early regaining of birth weight. The implementation of written nutrition practice guidelines facilitated improved outcomes.

PMID:34245467 | DOI:10.1002/ncp.10735

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Frequency of albuminuria in patients with bronchial obstructive diseases.

Adv Gerontol. 2021;34(2):272-276.

ABSTRACT

The aim of the study was to study the frequency and features of albuminuria in patients with chronic bronchoobstructive lung diseases. The prospective study involved 219 patients with COPD (GOLD 1-4) and 201 patients with persistent bronchial asthma (BA) of varying severity, who were examined in 2018-2019. The control group consisted of 48 volunteers, comparable in age and gender. In addition to General clinical studies, all patients were calculated BMI and visceral obesity detection based on the waist-hip ratio (WHR), and the Smoking index (HCI) was calculated. Albuminuria was determined based on the calculation of the albumin / creatinine ratio in a single morning portion of urine. The frequency of optimal / slightly elevated AU (A1) was 28,7% (63) among COPD patients and 9% (18) of BA patients. The number of COPD patients with clinically significant AU (A2, A3) was 24,2% (53) of patients, which is statistically significantly higher than among BA patients (5,5% of patients; χ2=22,3, p=0,01). The factors that make a statistically significant contribution to the development of AU in patients with COPD were the frequency of exacerbations over the previous 12 months, ICP, fibrinogen and CRP levels, FEV1; in BA patients – WHR, ICP. Smoking contributes to the development and potentiation of renal dysfunction in patients with bronchial obstructive diseases. The issue of considering BA as a risk factor for renal dysfunction remains controversial, given the diversity of BA both in terms of disease phenotypes, severity, and variety of therapeutic approaches.

PMID:34245511

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From statistics to clinics: the visual feedback of PROMIS CATs

J Patient Rep Outcomes. 2021 Jul 10;5(1):55. doi: 10.1186/s41687-021-00324-y.

ABSTRACT

BACKGROUND: To reduce the burden of completing Patient-Reported Outcome Measures (PROMs), PROMIS® Computerized Adaptive Tests (CATs) are being implemented in pediatric clinical practice. We aimed to develop recommendations for visual feedback options for PROMIS CATs on individual item and domain score level as an evidence-based feedback recommendation for PROMIS CATs is lacking.

METHODS: Focus groups were held with clinicians who use the KLIK PROM portal. Literature-based feedback options were provided to initiate group discussion. Data was analyzed using thematic coding method. Additionally, a questionnaire was sent out to assess patients’ (12-18y) and parents’ (child 0-18y) preference for individual item feedback. Data was analyzed using descriptive statistics.

RESULTS: Six focus groups were held (N = 28 clinicians). Regarding individual item feedback, showing the complete item bank, with only responses to administered items in traffic light colors was preferred. For domain scores, line graphs were preferred, including numerical (T-)scores, reference and cut-off lines, and traffic light colors. Separate graphs per domain, ranked in order of importance and harmonization of directionality (‘higher = better’) were considered important. Questionnaire results (N = 31 patients/N = 131 parents) showed that viewing their own item responses was preferred above receiving no item feedback by 58.1% of the patients and 77.1% of the parents.

CONCLUSIONS: Based on the outcomes and after discussion with the Dutch-Flemish PROMIS National Center, recommendations for PROMIS CAT feedback options were developed. PROMIS CATs can now be used in clinical practice to help clinicians monitor patient outcomes, while reducing the burden of completing PROMs for patients significantly.

PMID:34245390 | DOI:10.1186/s41687-021-00324-y

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Physicochemical assessment of anionic dye adsorption on bone char using a multilayer statistical physics model

Environ Sci Pollut Res Int. 2021 Jul 10. doi: 10.1007/s11356-021-15264-9. Online ahead of print.

ABSTRACT

The statistical physics modeling is a reliable approach to interpret and understand the adsorption mechanism of both organic and inorganic adsorbates. Herein, a theoretical study of the adsorption mechanism of anionic dyes, namely reactive blue 4 (RB4), acid blue 74 (AB74), and acid blue 25 (AB25), on bone char was performed with a multilayer statistical physics model. This model was applied to fit the equilibrium adsorption data of these dyes at 298-313 K and pH 4. Results indicated that the global number of formed dye layers on the bone char varied from 1.62 to 2.24 for RB4, AB74, and AB25 dyes depending on the solution temperature where the saturation adsorption capacities ranged from 0.08 to 0.12 mmol/g. Dye molecular aggregation was also identified for these dyes where dimers and trimers prevailed at different operating conditions especially for adsorbates RB4 and AB74. Adsorption mechanism of these dyes was multimolecular and endothermic with adsorption energies from 10.6 to 20.8 kJ/mol where van der Waals interactions and hydrogen bonding could be present. This investigation contributes to understand the physicochemical variables associated to dye adsorption using low-cost adsorbents as bone char.

PMID:34245418 | DOI:10.1007/s11356-021-15264-9

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The Relationship Between International Students’ Health Perceptions and Their Healthy Lifestyle Behaviors

J Relig Health. 2021 Jul 10. doi: 10.1007/s10943-021-01336-0. Online ahead of print.

ABSTRACT

This study was carried out to examine the relationship between international students’ health perceptions and their healthy lifestyle behaviors. This descriptive and relational study was conducted with 216 international students studying at a university in Turkey. Study data were collected using the descriptive information form, the Perception of Health Scale (PHS) and the Health-Promoting Lifestyle Profile II (HPLP-II). Data were evaluated using descriptive statistics and Pearson correlation analysis. It was determined that the health perception and healthy lifestyle behaviors of the international students involved in this study were moderately positive. The study found a weak and positive relationship between PHS and the physical activity, nutrition and stress management subdimensions of HPLP, while a moderate positive relationship was identified between PHS and the spiritual growth and interpersonal relations subdimensions of HPLP. No relationship was observed between PHS and the health responsibility subdimension of HPLP. The fact that students have a positive perception of health reflects positively on their healthy lifestyle behaviors. It is important to disseminate education programs aimed at improving the health perception and healthy lifestyle behaviors of international students within the university.

PMID:34245435 | DOI:10.1007/s10943-021-01336-0

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Nevin Manimala Statistics

Simultaneous changes in visual acuity, cortical population receptive field size, visual field map size, and retinal thickness in healthy human aging

Brain Struct Funct. 2021 Jul 10. doi: 10.1007/s00429-021-02338-0. Online ahead of print.

ABSTRACT

Healthy human aging is associated with a deterioration of visual acuity, retinal thinning, visual field map shrinkage and increasing population receptive field sizes. Here we ask how these changes are related to each other in a cross-sectional sample of fifty healthy adults aged 20-80 years. We hypothesized that age-related loss of macular retinal ganglion cells may lead to decreased visual field map sizes, and both may lead to increased pRF sizes in the cortical central visual field representation. We measured our participants’ perceptual corrected visual acuity using standard ophthalmological letter charts. We then measured their early visual field map (V1, V2 and V3) functional population receptive field (pRF) sizes and structural surface areas using fMRI, and their retinal structure using high-definition optical coherence tomography. With increasing age visual acuity decreased, pRF sizes increased, visual field maps surface areas (but not whole-brain surface areas) decreased, and retinal thickness decreased. Among these measures, only functional pRF sizes predicted perceptual visual acuity, and Bayesian statistics support a null relationship between visual acuity and cortical or retinal structure. However, pRF sizes were in turn predicted by cortical structure only (visual field map surface areas), which were only predicted by retinal structure (thickness). These results suggest that simultaneous disruptions of neural structure and function throughout the early visual system may underlie the deterioration of perceptual visual acuity in healthy aging.

PMID:34245381 | DOI:10.1007/s00429-021-02338-0

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Metabolic syndrome and anthropometric indices in CTS hands: an electrophysiological study

Neurol Sci. 2021 Jul 10. doi: 10.1007/s10072-021-05430-9. Online ahead of print.

ABSTRACT

INTRODUCTION: This study aims to evaluate the effect of metabolic syndrome (MetS) and anthropometric indices on carpal tunnel syndrome (CTS).

METHODS: Forty-three healthy controls and 41 CTS patients were enrolled. Complaints of patients were assessed by Boston Questionnaire (BQ). MetS components were investigated. Wrist circumference, wrist depth, wrist width, palm width, and palm length were measured. Routine nerve conduction studies of median and ulnar nerves as well as the “sensitive” comparison tests were performed. Cutaneous silent period (CuSP) was studied by stimulating both second and fifth digital nerves while recording over thenar muscles.

RESULTS: The vast majority of the participants were female and right-handed. CTS was bilateral in 61% of patients. Data of 109 hands were analyzed. MetS was more frequent in CTS patients. BQ scores were not related to MetS. Waist circumference, serum TG, and fasting glucose levels were higher in CTS patients. CTS hands with MetS had lower median CMAP amplitudes and increased sensory thresholds. Sensory thresholds were increased with both median and ulnar nerve stimulations suggesting a wider spread of peripheral nerve excitability changes in MetS presence. CuSPs were recorded from all 109 hands. CuSP latencies and durations were similar between controls and CTS patients. Wrist ratio was the only anthropometric index that was a statistically significant predictor for CTS development.

CONCLUSION: MetS was more prevalent in CTS patients. Some clinical and electrophysiological features (mainly sensory thresholds) may worsen in presence of MetS, but not the wrist ratio.

PMID:34245382 | DOI:10.1007/s10072-021-05430-9

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Nevin Manimala Statistics

Survival bias may explain the appearance of the obesity paradox in hip fracture patients

Osteoporos Int. 2021 Jul 10. doi: 10.1007/s00198-021-06046-7. Online ahead of print.

ABSTRACT

Patients with low-energy hip fractures do not follow the obesity paradox as previously reported. In datasets where injury mechanism is not available, the use of age >50 years (as opposed to commonly used >65 years) as a surrogate for a low-energy hip fracture patients may be a more robust inclusion criterion. PURPOSE: In elderly patients with a hip fracture, limited data suggests that obese patients counterintuitively have improved survival compared to normal-weight patients. This “obesity paradox” may be the byproduct of selection bias. We hypothesized that the obesity paradox would not apply to elderly hip fracture patients.

METHODS: The National Surgical Quality Improvement Project dataset identified 71,685 hip fracture patients ≥50 years-of-age with complete body mass index (BMI) data that underwent surgery. Patients were stratified into under and over 75-year-old cohorts (n=18,956 and 52,729, respectively). Within each age group, patients were stratified by BMI class and compared with respect to preoperative characteristics and 30-day mortality. Significant univariate characteristics (p<0.1) were included in multivariate analysis to determine the independent effect of obesity class on 30-day mortality (p<0.05).

RESULTS: Multivariate analysis of <75-year-old patients with class-III obesity were more likely to die within 30-days than similarly aged normal-weight patients (OR 1.91, CI 1.06-3.42, p=0.030). Multivariate analysis of ≥75-year-old overweight (OR 0.69, CI 0.62-0.77, p<0.001), class-I obese (OR 0.62, CI 0.51-0.74, p<0.001), or class-II obese (OR=0.69, CI 0.50-0.95, p=0.022) patients were less likely to die within 30-days when compared to similarly aged normal-weight patients.

CONCLUSIONS: Our data suggest that obesity is a risk factor for mortality in low-energy hip fracture patients, but the appearance of the “obesity paradox” in elderly hip fracture patients results from statistical bias that is only evident upon subgroup analysis.

PMID:34245343 | DOI:10.1007/s00198-021-06046-7