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Nevin Manimala Statistics

Brainstem auditory evoked potential combined with high resolution cranial base CT can optimize the diagnosis of auditory nerve injury

Chin J Traumatol. 2021 Dec 13:S1008-1275(21)00189-9. doi: 10.1016/j.cjtee.2021.12.003. Online ahead of print.

ABSTRACT

PURPOSE: Auditory nerve injury is one of the most common nerve injury complications of skull base fractures. However, there is currently a lack of auxiliary examination methods for its direct diagnosis. The purpose of this study was to find a more efficient and accurate means of diagnosis for auditory nerve injury.

METHODS: Through retrospectively analyzing the results of brainstem auditory evoked potential (BAEP) and high-resolution CT (HRCT) in 37 patients with hearing impairment following trauma from January 1, 2018 to July 31, 2020, the role of the two inspection methods in the diagnosis of auditory nerve injury was studied. Inclusion criteria were patient had a clear history of trauma and unilateral hearing impairment after the trauma; while exclusion criteria were: (1) severe patient with a Glasgow coma scale score ≤5 because these patients were classified as severe head injury and admitted to the intensive care unit, (2) patient in the subacute stage admitted 72 h after trauma, and (3) patient with prior hearing impairment before trauma. According to Goodman’s classification of hearing impairment, the patients were divided into low/medium/severe injury groups. In addition, patients were divided into HRCT-positive and negative groups for further investigation with their BAEP results. The positive rates of BEAP for each group were observed, and the results were analyzed by Chi-square test (p < 0.05, regarded as statistical difference).

RESULTS: A total of 37 patients were included, including 21 males and 16 females. All of them were hospitalized patients with GCS score of 6-15 at the time of admission. The BAEP positive rate in the medium and severe injury group was 100%, which was significantly higher than that in the low injury group (27.27%) (p < 0.01). The rate of BEAP positivitywas significantly higher in the HRCT-positive group (20/30, 66.7%) than in the negative group (1/7, 14.3%) (p < 0.05). Twenty patients (54.05%) were both positive for BEAP and HRCT test, and considered to have auditory nerve damage. Six patients (16.22%) were both negative for BEAP and HRCT test, and 10 patients (27.03%) were BAEP-negative but HRCT-positive: all the 16 patients were considered as non-neurological injury. The rest 1 case (2.70%) was BAEP-positive but HRCT-negative, which we speculate may have auditory nerve concussion.

CONCLUSION: By way of BAEP combining with skull base HRCT, we may improve the accuracy of the diagnosis of auditory nerve injury. Such a diagnostic strategy may be beneficial to guiding treatment plans and evaluating prognosis.

PMID:35042629 | DOI:10.1016/j.cjtee.2021.12.003

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Nevin Manimala Statistics

Analysis of Prognostic Factors for Patients Undergoing Renal Replacement Therapy With Acute Kidney Injury Prior to Living Donor Liver Transplantation

Transplant Proc. 2022 Jan 14:S0041-1345(21)00930-1. doi: 10.1016/j.transproceed.2021.10.025. Online ahead of print.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is a common complication in patients undergoing liver transplantation (LT) for end-stage liver disease (ESLD), and renal replacement therapy (RRT) is required in many cases. This study was performed to identify the prognostic factors for patients undergoing RRT owing to AKI before living donor liver transplantation (LDLT).

MATERIALS AND METHODS: From January 2010 to December 2018, LDLT was performed in 464 adult patients in our center. We reviewed 33 patients who underwent RRT before LDLT among 464 consecutive cases. Patients who continued to RRT after LDLT or who underwent subsequent kidney transplantation were considered to have not recovered from renal impairment.

RESULTS: Among 33 patients, there were 23 patients in the recovery group and 10 patients in the nonrecovery group. The preoperative duration of RRT was shorter in the recovery group, but it was not statistically significant. In the nonrecovery group, diabetes mellitus was found to have a higher prevalence and ischemic time was longer. Other perioperative factors were not significantly different between the 2 groups. After LDLT, the peak total bilirubin level was higher, and the intensive care unit stay was longer in the nonrecovery group. The overall survival rate was higher in the recovery group.

CONCLUSIONS: Liver transplant recipients who maintain RRT after LDLT have poor outcome. It is necessary to know the risk factors and manage them well, perioperatively.

PMID:35042598 | DOI:10.1016/j.transproceed.2021.10.025

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Nevin Manimala Statistics

How does circumcision performed under regional anesthesia affect sleep, feeding, and maternal attachment in babies aged 0-4 months?

J Pediatr Surg. 2022 Jan 7:S0022-3468(22)00003-3. doi: 10.1016/j.jpedsurg.2021.12.026. Online ahead of print.

ABSTRACT

BACKGROUND: There is no consensus whether circumcision performed in the first months of life has negative effects on feeding, sleep, and maternal attachment in babies. This prospective study aimed to investigate this relation in the first months of life. This study is the first to investigate the effects of circumcision on feeding, sleep, and maternal attachment simultaneously.

METHODS: The study group consisted of 75 families with their babies aged 0-4 months. Surgical circumcision procedure under regional anesthesia was applied to all patients. The questionnaires were used to evaluate the babies’ feeding and sleeping habits, and the Maternal Attachment Inventory (MAI) was used to assess mother-baby attachment level. All assessments were performed before and one month after the circumcision.

RESULTS: The mean age of the patients when circumcision was performed was 75 (74.52 ± 37.03) (3-120) days. The mean ages of mothers were 32 (32.51 ± 4.05) years. There was no statistically significant change in the sleep habits and feeding status of babies before and after circumcision. The mean maternal attachment value before circumcision was 101 (98.89 ± 6.77) points, while it was 103 (101.36 ± 4.21) points after circumcision. This result indicates that the maternal attachment score increased significantly after circumcision (p < 0.001).

CONCLUSIONS: The circumcision performed under regional anesthesia between 0 and 4 months did not have any negative effect on sleep, feeding, and maternal attachment in babies.

PMID:35042606 | DOI:10.1016/j.jpedsurg.2021.12.026

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Nevin Manimala Statistics

Academic Success of Online Learning in Undergraduate Nursing Education Programs in the COVID-19 Pandemic Era

J Prof Nurs. 2022 Jan-Feb;38:6-16. doi: 10.1016/j.profnurs.2021.10.005. Epub 2021 Oct 22.

ABSTRACT

BACKGROUND: This study aimed to investigate predictors for academic success, including satisfaction with online class and academic achievement, in the coronavirus disease 19 (COVID-19) pandemic era.

PURPOSE: To obtain basic data needed to improve the quality and outcomes of online learning in lectures for nursing students.

METHOD: A cross-sectional, descriptive, nationwide online survey in South Korea was performed using structured questionnaires. Participants were 200 nursing students taking online-based learning at universities in 2020. Data were analyzed using descriptive statistics and hierarchical multiple regression with SPSS WIN 26.0 program.

RESULTS: Cyber-class flow (β = 0.65, p < 0.001) was a significant predictor of satisfaction with online class. Self-directed learning (β = 0.18, p = 0.014) and satisfaction with online class (β = 0.19, p = 0.035) were significant predictors of academic achievement.

CONCLUSION: To achieve academic success from online learning, self-directed learning should be prioritized and satisfaction with online class needs to be managed by nursing educators. To improve satisfaction with online class, cyber-class flow should be considered when designing teaching and learning methods for undergraduate nursing education programs.

PMID:35042591 | DOI:10.1016/j.profnurs.2021.10.005

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Nevin Manimala Statistics

Comparison and evaluation of statistical error models for scRNA-seq

Genome Biol. 2022 Jan 18;23(1):27. doi: 10.1186/s13059-021-02584-9.

ABSTRACT

BACKGROUND: Heterogeneity in single-cell RNA-seq (scRNA-seq) data is driven by multiple sources, including biological variation in cellular state as well as technical variation introduced during experimental processing. Deconvolving these effects is a key challenge for preprocessing workflows. Recent work has demonstrated the importance and utility of count models for scRNA-seq analysis, but there is a lack of consensus on which statistical distributions and parameter settings are appropriate.

RESULTS: Here, we analyze 59 scRNA-seq datasets that span a wide range of technologies, systems, and sequencing depths in order to evaluate the performance of different error models. We find that while a Poisson error model appears appropriate for sparse datasets, we observe clear evidence of overdispersion for genes with sufficient sequencing depth in all biological systems, necessitating the use of a negative binomial model. Moreover, we find that the degree of overdispersion varies widely across datasets, systems, and gene abundances, and argues for a data-driven approach for parameter estimation.

CONCLUSIONS: Based on these analyses, we provide a set of recommendations for modeling variation in scRNA-seq data, particularly when using generalized linear models or likelihood-based approaches for preprocessing and downstream analysis.

PMID:35042561 | DOI:10.1186/s13059-021-02584-9

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Nevin Manimala Statistics

Automated SEM Image Analysis of the Sphere Diameter, Sphere-Sphere Separation, and Opening Size Distributions of Nanosphere Lithography Masks

Microsc Microanal. 2021 Dec 27:1-11. doi: 10.1017/S1431927621013866. Online ahead of print.

ABSTRACT

Colloidal nanosphere monolayers—used as a lithography mask for site-controlled material deposition or removal—offer the possibility of cost-effective patterning of large surface areas. In the present study, an automated analysis of scanning electron microscopy (SEM) images is described, which enables the recognition of the individual nanospheres in densely packed monolayers in order to perform a statistical quantification of the sphere size, mask opening size, and sphere-sphere separation distributions. Search algorithms based on Fourier transformation, cross-correlation, multiple-angle intensity profiling, and sphere edge point detection techniques allow for a sphere detection efficiency of at least 99.8%, even in the case of considerable sphere size variations. While the sphere positions and diameters are determined by fitting circles to the spheres edge points, the openings between sphere triples are detected by intensity thresholding. For the analyzed polystyrene sphere monolayers with sphere sizes between 220 and 600 nm and a diameter spread of around 3% coefficients of variation of 6.8–8.1% for the opening size are found. By correlating the mentioned size distributions, it is shown that, in this case, the dominant contribution to the opening size variation stems from nanometer-scale positional variations of the spheres.

PMID:35042572 | DOI:10.1017/S1431927621013866

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Nevin Manimala Statistics

Statistical analysis plan for Better Evidence for Selecting Transplant Fluids (BEST-Fluids): a randomised controlled trial of the effect of intravenous fluid therapy with balanced crystalloid versus saline on the incidence of delayed graft function in deceased donor kidney transplantation

Trials. 2022 Jan 18;23(1):52. doi: 10.1186/s13063-021-05989-w.

ABSTRACT

BACKGROUND: Delayed graft function, or the requirement for dialysis due to poor kidney function, is a frequent complication of deceased donor kidney transplantation that is associated with inferior outcomes. Intravenous fluids with a high chloride content, such as isotonic sodium chloride (0.9% saline), are widely used in transplantation but may increase the risk of poor kidney function. The primary objective of the BEST-Fluids trial is to compare the effect of a balanced low-chloride crystalloid, Plasma-Lyte 148 (Plasmalyte), versus 0.9% saline on the incidence of DGF in deceased donor kidney transplant recipients. This article describes the statistical analysis plan for the trial.

METHODS AND DESIGN: BEST-Fluids is an investigator-initiated, pragmatic, registry-based, multi-centre, double-blind, randomised controlled trial. Eight hundred patients (adults and children) in Australia and New Zealand with end-stage kidney disease admitted for a deceased donor kidney transplant were randomised to intravenous fluid therapy with Plasmalyte or 0.9% saline in a 1:1 ratio using minimization. The primary outcome is delayed graft function (dialysis within seven days post-transplant), which will be modelled using a log-binomial generalised linear mixed model with fixed effects for treatment group, minimization variables, and ischaemic time and a random intercept for study centre. Secondary outcomes including early kidney transplant function (a ranked composite of dialysis duration and the rate of graft function recovery), treatment for hyperkalaemia, and graft survival and will be analysed using a similar modelling approach appropriate for the type of outcome.

DISCUSSION: BEST-Fluids will determine whether Plasmalyte reduces the incidence of DGF and has a beneficial effect on early kidney transplant outcomes relative to 0.9% saline and will inform clinical guidelines on intravenous fluids for deceased donor kidney transplantation. The statistical analysis plan describes the analyses to be undertaken and specified before completion of follow-up and locking the trial databases.

TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12617000358347 . Prospectively registered on 8 March 2017 ClinicalTrials.gov identifier NCT03829488 . Registered on 4 February 2019.

PMID:35042554 | DOI:10.1186/s13063-021-05989-w

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Nevin Manimala Statistics

Morbimortality assessment in abdominal surgery: are we predicting or overreacting?

BMC Surg. 2022 Jan 18;22(1):19. doi: 10.1186/s12893-021-01455-1.

ABSTRACT

BACKGROUND: High-risk surgical procedures represent a fundamental part of general surgery practice due to its significant rates of morbidity and mortality. Different predictive tools have been created in order to quantify perioperative morbidity and mortality risk. POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and morbidity) is one of the most widely validated predictive scores considering physiological and operative variables to precisely define morbimortality risk. Nevertheless, seeking greater accuracy in predictions P-POSSUM was proposed. We aimed to compare POSSUM and P-POSSUM for patients undergoing abdominal surgery.

METHODS: A retrospective observational study with a prospective database was conducted. Patients over 18 years old who complied with inclusion criteria between 2015 and 2016 were included. Variables included in the POSSUM and P-POSSUM Scores were analyzed. Descriptive statistics of all study parameters were provided. The analysis included socio-demographic data, laboratory values ​​, and imaging. Bivariate analysis was performed.

RESULTS: 350 Patients were included in the analysis, 55.1% were female. The mean age was 55.9 ± 20.4 years old. POSSUM revealed a moderated index score in 61.7% of the patients, mean score of 12.85 points ± 5.61. 89.1% of patients had no neoplastic diagnosis associated. Overall morbidity and mortality rate was 14.2% and 7.1%. P-POSSUM could predict more precisely mortality (p < 0.00).

CONCLUSIONS: The POSSUM score is likely to overestimate the risk of morbidity and mortality in patients with high/moderate risk, while the P-POSSUM score seems to be a more accurate predictor of mortality risk. Further studies are needed to confirm our results.

PMID:35042495 | DOI:10.1186/s12893-021-01455-1

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Nevin Manimala Statistics

Effects of swab pool size and transport medium on the detection and isolation of avian influenza viruses in ostriches

BMC Vet Res. 2022 Jan 18;18(1):48. doi: 10.1186/s12917-022-03150-6.

ABSTRACT

BACKGROUND: Rigorous testing is a prerequisite to prove freedom of notifiable influenza A virus infections in commercially farmed ostriches, as is the isolation and identification of circulating strains. Pooling 5 ostrich tracheal swabs in a 50 % v/v phosphate-buffered saline (PBS): glycerol transport medium (without antibiotics) is the current standard practice to increase reverse transcription real time PCR (RT-rtPCR) testing throughput and simultaneously reduce the test costs. In this study we investigated whether doubling ostrich tracheal swabs to 10 per pool would affect the sensitivity of detection of H5N8 high pathogenicity avian influenza virus (HPAIV) and H7N1 low pathogenicity avian influenza virus (LPAIV) by quantitative RT-rtPCR, and we also compared the effect of a protein-rich, brain heart infusion broth (BHI) virus transport media containing broad spectrum antimicrobials (VTM) on the efficacy of isolating the H5N8 and H7N1 viruses from ostrich tracheas, since the historical isolation success rate from these birds has been poor.

RESULTS: Increasing the ostrich swabs from 5 to 10 per pool in 3 mls of transport medium had no detrimental effect on the sensitivity of the RT-rtPCR assay in detecting H5N8 HPAIV or H7N1 LPAIV; and doubling of the swab pool size even seemed to improve the sensitivity of virus detection at levels that were statistically significant (p less than or equal to 0.05) in medium and low doses of spiked H5N8 HPAIV and at high levels of spiked H7N1 LPAIV. On virus isolation, more samples were positive when swabs were stored in a protein-rich viral transport medium supplemented with antimicrobials in PBS: glycerol (10/18 vs. 7/18 for H5N8 HPAI); although the differences were not statistically significant, overall higher virus titres were detected (106.7 – 103.0 vs. 106.6 – 103.1 EID50 for H5N8 HPAIV and 105.5 – 101.4 vs. 105.1 – 101.3 EID50 for H7N1 LPAIV); and fewer passages were required with less filtration for both H5N8 HPAI and H7N1 LPAI strains.

CONCLUSION: Ostrich tracheal swab pool size could be increased from 5 to 10 in 3mls of VTM with no loss in sensitivity of the RT-rtPCR assay in detecting HPAI or LPAI viruses, and HPAI virus could be isolated from a greater proportion of swabs stored in VTM compared to PBS: glycerol without antibiotics.

PMID:35042528 | DOI:10.1186/s12917-022-03150-6

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Examining COVID-19 vaccine uptake and attitudes among 2SLGBTQ+ youth experiencing homelessness

BMC Public Health. 2022 Jan 18;22(1):122. doi: 10.1186/s12889-022-12537-x.

ABSTRACT

OBJECTIVES: The COVID-19 pandemic has disproportionately impacted 2SLGBTQ+ youth experiencing homelessness. Little is known about vaccine attitudes and uptake among this population. To address this, the objectives of this study were to explore this group’s COVID-19 vaccine attitudes, and facilitators and barriers impacting vaccine uptake.

METHODS: 2SLGBTQ+ youth experiencing homelessness in the Greater Toronto Area were recruited to participate in online surveys assessing demographic characteristics, mental health, health service use, and COVID-19 vaccine attitudes. Descriptive statistics and statistical tests were used to analyze survey data to explore variables associated with vaccine confidence. Additionally, a select group of youth and frontline workers from youth serving organizations were invited to participate in online one-on-one interviews. An iterative thematic content approach was used to analyze interview data. Quantitative and qualitative data were merged for interpretation by use of a convergent parallel analytical design.

RESULTS: Ninety-two youth completed surveys and 32 youth and 15 key informants participated in one-on-one interviews. Quantitative and qualitative data showed that the majority of 2SLGBTQ+ youth experiencing homelessness were confident in the COVID-19 vaccine; however, numerous youth were non-vaccine confident due to mistrust in the healthcare system, lack of targeted vaccine-related public health information, concerns about safety and side effects, and accessibility issues. Solutions to increase vaccine confidence were provided, including fostering trust, targeted public health messaging, and addressing accessibility needs.

CONCLUSION: Our study highlights the need for the vaccine strategy and rollouts to prioritize 2SLGBTQ+ youth experiencing homelessness and to address the pervasive health disparities that have been exacerbated by the pandemic.

PMID:35042491 | DOI:10.1186/s12889-022-12537-x