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Nevin Manimala Statistics

Efficacy and safety of traditional Chinese medicine decoction in the treatment of adolescent myopia: A protocol for systematic review and network meta-analysis

Medicine (Baltimore). 2022 Feb 11;101(6):e28733. doi: 10.1097/MD.0000000000028733.

ABSTRACT

BACKGROUND: Adolescent myopia has become a major public health problem in Asian countries and even the world. Due to its unstable prognosis and numerous complications, it has caused serious social and economic burden. As a common treatment in Asia, Chinese medicine has been shown to be effective in controlling the development of myopia, but its evidence-based medical evidence is not sufficient. Therefore, the purpose of this study is to evaluate the efficacy and safety of traditional Chinese medicine (TCM) in the treatment of adolescent myopia through network meta-analysis, and to provide evidence for clinical and scientific research.

METHODS: We searched seven databases for randomized controlled trials of TCM decoction for adolescent myopia, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chinese Scientific Journals Database, and wan-fang databases, from the date of the establishment of each database to January 31, 2022. The network meta-analysis will be implemented through Aggregate Data Drug Information System 1.16.8 and Stata 13.0 software. Primary outcomes include distant vision, intraocular pressure, and diopter. Mean differences or odds ratios will be used for statistical analysis. We will ensure the reliability of the results through node-split model and heterogeneity analysis. In addition, the Cochrane Collaboration’s tool and Grading of Recommendations Assessment, Development and Evaluation system will be used for the methodological quality and the evidence quality.

RESULTS: This study will provide reliable evidence for the clinical selection of TCM decoction in the treatment of adolescent myopia.

CONCLUSION: The results of this study will evaluate the efficacy and safety of TCM decoction in the treatment of adolescent myopia, and provide decision-making references for future clinical and scientific research.

ETHICS AND DISSEMINATION: This study did not require ethical approval. We will disseminate our findings by publishing results in a peer-reviewed journal.

OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/VXQUP.

PMID:35147096 | DOI:10.1097/MD.0000000000028733

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Nevin Manimala Statistics

Barcoded Bulk QTL mapping reveals highly polygenic and epistatic architecture of complex traits in yeast

Elife. 2022 Feb 11;11:e73983. doi: 10.7554/eLife.73983. Online ahead of print.

ABSTRACT

Mapping the genetic basis of complex traits is critical to uncovering the biological mechanisms that underlie disease and other phenotypes. Genome-wide association studies (GWAS) in humans and quantitative trait locus (QTL) mapping in model organisms can now explain much of the observed heritability in many traits, allowing us to predict phenotype from genotype. However, constraints on power due to statistical confounders in large GWAS and smaller sample sizes in QTL studies still limit our ability to resolve numerous small-effect variants, map them to causal genes, identify pleiotropic effects across multiple traits, and infer non-additive interactions between loci (epistasis). Here, we introduce barcoded bulk quantitative trait locus (BB-QTL) mapping, which allows us to construct, genotype, and phenotype 100,000 offspring of a budding yeast cross, two orders of magnitude larger than the previous state of the art. We use this panel to map the genetic basis of eighteen complex traits, finding that the genetic architecture of these traits involves hundreds of small-effect loci densely spaced throughout the genome, many with widespread pleiotropic effects across multiple traits. Epistasis plays a central role, with thousands of interactions that provide insight into genetic networks. By dramatically increasing sample size, BB-QTL mapping demonstrates the potential of natural variants in high-powered QTL studies to reveal the highly polygenic, pleiotropic, and epistatic architecture of complex traits.

PMID:35147078 | DOI:10.7554/eLife.73983

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The training needs of critical care nurses: A psychometric analysis

Sci Prog. 2022 Jan-Mar;105(1):368504221076823. doi: 10.1177/00368504221076823.

ABSTRACT

BACKGROUND/OBJECTIVE: Nurses develop the care methods they learn through specific training and this enables them to provide care in a safe, effective and efficient manner. Intensive Care Units (ICU), as complex areas in terms of care, require nurses with specific training. Due to this fact, we set ourselves the objective to validate a questionnaire that detects the training needs of intensive care nurses in Spain.

METHODS: A cross-sectional descriptive study, using an electronic questionnaire, adapted and validated through the Delphi technique, in 85 ICUs in Spain, for which a psychometric analysis is conducted. To explore the dimensions and determine the factorial structure, an Exploratory Factor Analysis (EFA) and a Confirmatory Factor Analysis (CFA) were carried out. Internal consistency was determined through ordinal alpha. The statistical treatment was carried out using the statistical programmes Factor Analysis 10.9.02 and IBM AMOS version 24.

RESULTS: A total of 568 Spanish intensive care nurses, randomly divided into two samples, participated in the study. The EFA presented a factorial solution with suitable values for both the Kaiser-Meyer-Olsen Index and Bartlett’s Sphericity. In the CFA, the model fit achieved close to ideal values with a Comparative Fit Index (CFI) and Tucker-Lewis Index (TLI) close to values of 0.9. The values of individual reliability, internal consistency and average variance extracted were appropriate for this type of analysis.

CONCLUSION: The dimensions detected are close to the construct that encompasses the training needs of ICU nurses. The analyses carried out indicate that there are reasonable realities for incorporating these dimensions into the field of nursing training. This study opens the possibility of incorporating new items to adjust the model to improve the explanatory variables. Our findings help us to understand the dimensions that the training programmes should incorporate.

PMID:35147050 | DOI:10.1177/00368504221076823

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Nevin Manimala Statistics

COVID-19 vaccine prioritization based on district classification in Yogyakarta Province, Indonesia

Geospat Health. 2022 Jan 14;17(s1). doi: 10.4081/gh.2022.1010.

ABSTRACT

Due to limited availability, Indonesia’s coronavirus disease 2019 (COVID-19) vaccination will be done in 4 stages until herd immunity has been reached. Yogyakarta, an education and tourist destination, needs to get a specific, spatial estimation of the exact need for COVID-19 vaccination without delay. This study sheds light on identifying which districts should be prioritized at each vaccination phase. Secondary data collected from provincial, and county-level statistical agencies were quantitatively calculated by the Z-Score method. The results indicate that the first phase of vaccination should prioritize Pengasih and Sentolo districts in Kulon Progo Regency, which have a large number of health workers; the districts of Depok, Banguntapan, Piyungan, Sewon, Wonosari, Gamping, Mlati and Ngaglik should be done in the second phase based on the fact that these districts have many public service officials as well as elderly people; Umbulharjo and Depok districts will be approached in the third phase since they have more vulnerable groups and facilities that may promote COVID- 19 transmission during their daily activities; while the fourth phase should focus on the districts of Banguntapan, Sewon, Kasihan, Gamping, Mlati, Depok, and Ngaglik due to the intensity of COVID-19 clusters discovered there. Overall, vaccination would be given the priority in the districts with the largest number of people in need, i.e., public service officers, elderly people and those likely to be exposed to the coronavirus causing COVID-19.

PMID:35147013 | DOI:10.4081/gh.2022.1010

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Postoperative pancreatitis after pancreatoduodenectomy

Khirurgiia (Mosk). 2022;(2):11-16. doi: 10.17116/hirurgia202202111.

ABSTRACT

OBJECTIVE: Retrospective assessment of the influence of postoperative pancreatitis in development of pancreatic fistula.

MATERIAL AND METHODS: The study included 173 patients after pancreatoduodenectomy performed between 2016 and 2019. Postoperative pancreatitis within the 1st postoperative day was verified considering blood amylase > 125 U/L. Patients with postoperative pancreatitis (n=36) were included in the main group, the control group consisted of 137 patients without pancreatitis. Postoperative pancreatic fistula was determined according to the ISGPS 2016 classification. Statistical analysis of the effect of postoperative pancreatitis on development of pancreatic fistula was carried out using relative risk and odds ratio with 95% confidence interval in both groups.

RESULTS: Postoperative pancreatitis occurred in 36 (20.8%) out of 173 patients after pancreatoduodenectomy. Pancreatic fistula occurred in 18 (50%) cases. Among 137 patients without postoperative pancreatitis, only 18 (13.1%) patients developed severe pancreatic fistula. Relative risk was 3.8 (95% CI 2.22-6.51, p<0.0001), odds ratio – 6.6 (95% CI 2.91-15.01, p<0.0001).

CONCLUSION: Postoperative pancreatitis significantly influences development of severe pancreatic fistula.

PMID:35146994 | DOI:10.17116/hirurgia202202111

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The use of dermoscopy in distinguishing the histopathological subtypes of basal cell carcinoma: A retrospective, morphological study

Indian J Dermatol Venereol Leprol. 2022 Jan 31:1-10. doi: 10.25259/IJDVL_1276_20. Online ahead of print.

ABSTRACT

BACKGROUND: The role of dermoscopy in distinguishing the histopathological subtypes of basal cell carcinoma (BCC) is not fully elucidated.

AIMS: To determine the accuracy of dermoscopy in diagnosing different BCC subtypes.

METHODS: The dermoscopic features of 102 histopathologically verified BCCs were studied retrospectively. The tumours were classified as superficial (n=33,32.3%), nodular (n=46,45.1%) and aggressive (n=23,22.6%) BCCs by histopathology. Statistical analysis included Cohen’s kappa test, proportion of correlation, measures of diagnostic accuracy, diagnostic odds ratio and the credibility ratio of positive (LR+) and negative (LR-) tests.

RESULTS: The highest value in all performed tests was seen in superficial BCCs (kappa 0.85; proportion of correlation 93%; diagnostic accuracy 93.1%), good correlation was noted in nodular BCCs (kappa 0.62, proportion of correlation 80%; diagnostic accuracy 80.4%) but dermoscopic correlation with histopathology was low for aggressive BCCs (kappa 0.13; proportion of correlation 79%; diagnostic accuracy 78.4%). Short, fine telangiectasias (83.3%) showed the greatest importance for the diagnosis of superficial BCCs, blue-grey ovoid nests (61.8%) had the highest diagnostic accuracy in nodular BCCs, while arborising vessels (79.4%) was the most significant dermoscopic feature for the diagnosis of aggressive BCCs.

LIMITATIONS: This was a retrospective analysis and included only Caucasian patients from a single centre.

CONCLUSION: The highest agreement of dermoscopic features with the histologic type was found in superficial BCCs. We did not find any specific dermoscopic structure that could indicate a diagnosis of aggressive BCC. The presence of relevant dermoscopic features in the evaluated cases was determined by the depth of tumour invasion and not by its histology.

PMID:35146979 | DOI:10.25259/IJDVL_1276_20

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Hyperbaric oxygen therapy for the treatment of perianal fistulas in 20 patients with Crohn’s disease: Results of the HOT-TOPIC trial after 1-year follow-up

United European Gastroenterol J. 2022 Feb 10. doi: 10.1002/ueg2.12189. Online ahead of print.

ABSTRACT

BACKGROUND: Previously published short-term results (week 16) of this trial showed a significant improvement in clinical, radiologic and biochemical outcomes in Crohn’s disease patients with therapy-refractory perianal fistulas after treatment with hyperbaric oxygen therapy.

OBJECTIVE: To assess the long-term (week 60) efficacy, safety and feasibility of hyperbaric oxygen therapy in perianal fistula in Crohn’s disease.

METHODS: Crohn’s disease patients with high perianal fistula(s) failing conventional treatment >6 months were included. Exclusion criteria were presence of a stoma, rectovaginal fistula(s) and recent changes in treatment regimens. Patients received 40 hyperbaric oxygen sessions and outcomes were assessed at week 16 and week 60.

RESULTS: Twenty patients were included (median age 34 years). At week 16, median scores of the perianal disease activity index and modified Van Assche index (co-primary outcomes) decreased from 7.5 (95% CI 6-9) to 4 (95% CI 3-6, p < 0.001) and 9.2 (95% CI 7.3-11.2) to 7.3 (95% CI 6.9-9.7, p = 0.004), respectively. At week 60, the respective scores remained significantly lower than baseline: 4 (95% CI 3-7, p < 0.001) and 7.7 (95% CI 5.2-10.2, p = 0.003). Perianal disease activity index score of 4 or less (representing inactive perianal disease) was observed in 13 patients at week 16 and 12 patients at week 60. Using fistula drainage assessment, 12 and 13 patients showed a clinical response at week 16 and 60, respectively, and clinical remission was achieved in four patients for both time points. At week 16, a statistically significant biochemical improvement (C-reactive protein and faecal calprotectin levels) was found, but this effect was no longer significant at week 60.

CONCLUSIONS: The clinical and radiologic improvement of perianal fistula in Crohn’s disease, that was found at week 16 after treatment with hyperbaric oxygen therapy, is maintained at 1-year follow-up.

PMID:35146959 | DOI:10.1002/ueg2.12189

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Characteristics and age-related injury patterns of maxillofacial fractures in children and adolescents: A multicentric and prospective study

Dent Traumatol. 2022 Feb 11. doi: 10.1111/edt.12735. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Paediatric maxillofacial trauma accounts for 15% of all maxillofacial trauma but remains a leading cause of mortality. The aim of this prospective, multicentric epidemiological study was to analyse the characteristics of maxillofacial fractures in paediatric patients managed in 14 maxillofacial surgery departments on five continents over a 1-year period.

METHODS: The following data were collected: age (preschool [0-6 years], school age [7-12 years], and adolescent [13-18 years]), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injuries, day of the maxillofacial trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software.

RESULTS: Between 30 September 2019 and 4 October 2020, 322 patients (male:female ratio, 2.3:1) aged 0-18 years (median age, 15 years) were hospitalized with maxillofacial trauma. The most frequent causes of the trauma were road traffic accidents (36%; median age, 15 years), followed by falls (24%; median age, 8 years) and sports (21%; median age, 14 years). Alcohol and/or drug abuse was significantly associated with males (p < .001) and older age (p < .001). Overall, 474 fractures were observed (1.47 per capita). The most affected site was the mandibular condyle in children <13 years old and the nose in adolescents. The proportion of patients who underwent open reduction and internal fixation increased with age (p < .001).

CONCLUSION: The main cause of paediatric maxillofacial fractures was road traffic accidents, with the highest rates seen in African and Asian centres, and the frequency of such fractures increased with age. Falls showed an inverse association with age and were the leading cause of trauma in children 0-6 years of age. The choice of treatment varies with age, reflecting anatomical and etiological changes towards patterns more similar to those seen in adulthood.

PMID:35146900 | DOI:10.1111/edt.12735

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Factors influencing intention to stay of male nurses: A descriptive predictive study

Nurs Health Sci. 2022 Feb 10. doi: 10.1111/nhs.12928. Online ahead of print.

ABSTRACT

Nurse shortages and nurse attrition are high in many countries, and there is also a dearth of male nurses in the profession. This study aimed to examine the level of intention to stay and ten predictors of this among male nurses in China. A descriptive, predictive study was administered to 480 registered male nurses. Eight research instruments were used to collect data. Descriptive statistics and binary logistic regression were employed to analyze the data. The overall intention to stay in the nursing profession as perceived by male nurses was at a moderate level. Binary logistic regression demonstrated that work group cohesion, transformational leadership, career growth, and job satisfaction were significant predictors, explaining 32.2% of the total variance for intention to stay. The findings of this study provide suggestions for nursing administrators and policymakers to develop appropriate strategies or interventions to increase the intention to stay for male nurses to stay in the profession, based on the four predictors.

PMID:35146863 | DOI:10.1111/nhs.12928

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Bullying and burnout in critical care nurses: A cross-sectional descriptive study

Nurs Crit Care. 2022 Feb 10. doi: 10.1111/nicc.12744. Online ahead of print.

ABSTRACT

BACKGROUND: Employee bullying and burnout are two crucial, prevalent and challenging concepts that adversely affect organizational staff behaviours. Also, adverse patient care is associated with nurse bullying and burnout.

AIM/S: This study aimed to assess the incidence and association between workplace bullying and occupational burnout among nurses in critical care units in Iran.

STUDY DESIGN: A cross-sectional descriptive study.

METHODS: The subjects were 184 nurses from critical care units in 6 teaching hospitals in Iran. Three questionnaires were distributed among the study population; (a) demographic characteristics questionnaire, (b) Maslach Burnout Inventory (MBI) and (c) bullying at Workplace Questionnaire. Descriptive statistics were used to present the workplace bullying and occupational burnout status among nurses. Linear and logistic regression analyses were conducted to estimate the relationship between workplace bullying with MBI and nurses’ demographic characteristics, respectively.

RESULTS: 62% of the nurses had moderate emotional exhaustion, 59.8% had moderate depersonalization and 46.2% had a moderate individual achievement. 75.5% faced workplace bullying. There was a positive and significant association between bullying scores and burnout in total (Pearson’s r = 0.598, p < 0.001). Linear regression test showed a positive and significant relationship between bullying with MBI dimensions (R = 0.613, p < 0.001) for emotional exhaustion, (R = 0.679, p < 0.001) for depersonalization and (R = -0.417, p < 0.001) for individual achievement.

CONCLUSIONS: Among Iranian nurses, bullying is a prominent and substantial issue that significantly correlates with their negative performance by enhancing job burnout.

RELEVANCE TO CLINICAL PRACTICE: It is suggested that some measures are adopted to avoid workplace bullying and to reduce occupational burnout for nurses. Managers should create an environment that encourages nurses to voice their concerns – informing nurses about their rights and creating a positive atmosphere in the hospital.

PMID:35146848 | DOI:10.1111/nicc.12744