Tag: statistics

Prim Health Care Res Dev. 2024 Nov 28;25:e64. doi: 10.1017/S1463423624000574.

ABSTRACT

BACKGROUND AND OBJECTIVE: Early and collaborative interventions are desirable to prevent long-term sick leave and promote sustainable return-to-work (RTW). The aim of this study was to evaluate if the use of the Capacity Note – a brief intervention promoting early and structured communication between general practitioners (GPs), patients, and employers – had an impact on length of sick leave in patients with common mental disorders (CMDs) in primary healthcare.

METHOD: In a pragmatic trial, GPs at eight primary healthcare centres were randomized to provide the intervention or control and recruited eligible patients: employed women and men, 18-64 years, who visited a GP due to CMD and became or were (<4 months) full- or part-time sick-listed. Patients in the intervention group (n=28) used the Capacity Note in addition to usual care. Patients in the control group (n=28) received usual care. Outcomes of interest were time until full RTW, sick leave status at end of follow-up (17 months), number of sick leave episodes during follow-up, and number of sick leave days at 6, 12, and 17 months of follow-up.

RESULTS: The proportion of patients with full RTW at the end of follow-up was 79.2% in the intervention group and 84.6% in the control group. Time until full RTW was 102 and 90 days (median) in intervention and control group, respectively. We found no statistically significant differences between the groups for any of the outcomes.

DISCUSSION: Despite efforts to increase the number of participants, the study ended up with a small sample. This prohibited us from drawing any final conclusions about the effect of the intervention. Obstacles to recruitment of patients and use of the intervention are discussed.

PMID:39606847 | DOI:10.1017/S1463423624000574

J Med Microbiol. 2024 Nov;73(11). doi: 10.1099/jmm.0.001935.

ABSTRACT

Introduction. Cytomegalovirus (CMV) is a widely disseminated betaherpesvirus that typically induces latant infections. In immunocompromised populations, especially transplant and HIV-infected patients, CMV infection increases in-hospital mortality.Gap statement. Although machine learning models have been widely used in clinical diagnosis and prognosis prediction, reports on machine learning model predictions for the in-hospital mortality of HIV/AIDS patients with CMV infection have not been reported.Aim. Analyze the general gemographic and clinical characteristics of HIV/AIDS patients with CMV infection and identify the factors affecting the prognosis of this population, which will help to reduce their in-hospital mortality.Methods. Hospitalized HIV/AIDS patients with CMV infection were recruited from the Fourth People’s Hospital of Nanning, Guangxi, from 2012 to 2019. After dividing them into survival and death groups based on their in-hospital survival status, their general and clinical profiles were described. Following 1 : 3 propensity score matching to equalize baseline characteristics, three machine-learning models (Random Forest, Support Vector Machine and eXtreme Gradient Boosting) were deployed to forecast factors influencing prognosis. The SHapley Additive exPlanations tool explained the models.Results. A total of 1102 HIV/AIDS patients with CMV infection were analysed. There was no statistical difference in the general condition of the study subjects (P＞0.05). Prevalent complications/coinfections included pneumonia (63.6%), tuberculosis (47.2%) and oral fungal infections (44.6%). There were significant differences between the groups in pneumonia, cryptococcosis and hypoproteinaemia (P<0.05). The differences in laboratory indicators between patients were also statistically significant (P<0.05). The three machine learning models demonstrated good performance, identifying primary predictors of mortality. Pneumonia, urea, indirect bilirubin and platelet distribution width exhibited positive associations with death, with higher levels correlating with an increased mortality risk. Conversely, CD4 T-cell count, CD8 T-cell count and platelet displayed negative correlations with mortality.Conclusions. HIV/AIDS patients with CMV infection exhibit distinctive clinical features impacting survival outcomes. Machine learning models accurately identify key influencing factors and predict mortality risk in this population, which appears to be essential to reducing in-hospital mortality.

PMID:39606806 | DOI:10.1099/jmm.0.001935

Front Hum Neurosci. 2024 Nov 13;18:1497034. doi: 10.3389/fnhum.2024.1497034. eCollection 2024.

ABSTRACT

In hyperscanning studies, participants perform a joint task while their brain activation is simultaneously recorded. Evidence of inter-brain coupling is examined, in these studies, as a predictor of behavioral change. While the field of hyperscanning has made significant strides in unraveling the associations between inter-brain coupling and changes in social interactions, drawing causal conclusions between brain and behavior remains challenging. This difficulty arises from factors like the inherently different timescales of behavioral responses and measured cerebral activity, as well as the predominant focus of existing methods on associations rather than causality. Specifically, a question remains as to whether inter-brain coupling between specific brain regions leads to changes in behavioral synchrony, or vice-versa. We propose two novel approaches to addressing this question. The first method involves using dyadic neurofeedback, wherein instances of inter-brain coupling are directly reinforced. Such a system could examine if continuous changes of inter-brain coupling are the result of deliberate mutual attempts to synchronize. The second method employs statistical approaches, including Granger causality and Structural Equation Modeling (SEM). Granger causality assesses the predictive influence of one time series on another, enabling the identification of directional neural interactions that drive behavior. SEM allows for detailed modeling of both direct and indirect effects of inter-brain coupling on behavior. We provide an example of data analysis with the SEM approach, discuss the advantages and limitations of each approach and posit that applying these approaches could provide significant insights into how inter-brain coupling supports crucial processes that occur in social interactions.

PMID:39606786 | PMC:PMC11599244 | DOI:10.3389/fnhum.2024.1497034

Toxicol Rep. 2024 Nov 4;13:101799. doi: 10.1016/j.toxrep.2024.101799. eCollection 2024 Dec.

ABSTRACT

BACKGROUND: Oral isotretinoin is a powerful medication commonly used for treating severe Acne valgaris, particularly in cases that are resistant to conventional therapies like topical treatments and antibiotics. It is a retinoid derived from vitamin A, known for its ability to significantly reduce sebum production, prevent clogged pores, and decrease inflammation.

OBJECTIVE: This study investigates the changes in liver function tests and lipid profiles before and after the use of oral isotretinoin among Acne Vulgaris clients.

METHOD: A quantitative retrospective study was conducted using electronic medical records from 50 Acne Vulgaris patients aged 13-40 years who received oral isotretinoin at Ibri Polyclinic between 2012 and 2022. The obtained data were analyzed using SPSS version 20.

RESULTS: The analysis revealed significant changes in liver function tests, with elevated levels of total bilirubin and ALT post-treatment. Lipid profiles also showed marked alterations, including increased cholesterol, LDL, HDL, and triglyceride levels.

CONCLUSION: The findings highlight the substantial impact of isotretinoin on liver function and lipid metabolism in Acne Vulgaris patients. Further research is needed to explore the mechanisms behind isotretinoin-induced hepatotoxicity and dyslipidemia, potentially guiding future interventions.

PMID:39606776 | PMC:PMC11600753 | DOI:10.1016/j.toxrep.2024.101799

J Saudi Heart Assoc. 2024 Nov 15;36(4):316-334. doi: 10.37616/2212-5043.1399. eCollection 2024.

ABSTRACT

OBJECTIVES: Mitral valve surgery is the reference treatment for severe symptomatic mitral regurgitation (MR). Percutaneous mitral valve interventions, such as the MitraClip procedure, offer an alternative, particularly for high-risk patients. The aim of this systematic review and meta-analysis was to analyze the safety and effectiveness of transcatheter mitral valve repair (TMVR) compared to surgical mitral valve repair or replacement (SMVR) in elderly patients with mitral regurgitation.

METHODS: We searched PubMed, Scopus, Ovid, EBSCO, and ProQuest through July 2024. Eligible studies were randomized controlled trials and observational comparative studies of TMVR versus SMVR for patients with MR, reporting outcomes such as all-cause mortality, MR recurrence, stroke, myocardial infarction, and length of stay (LOS). Statistical analyses were performed using RevMan.

RESULTS: Our search identified 3166 records, with 2756 screened and 21 studies included after review. The studies, comprising 20 retrospective cohorts and 1 randomized controlled trial with 20,900 patients, compared TMVR to SMVR. TMVR patients were significantly older than SMVR patients (MD 3.44 years; P < 0.00001). Mortality rates were similar at 30 days (relative risk (RR) 1.08; P = 0.79) and one year (RR 1.27; P = 0.18), but SMVR showed lower mortality at three years (RR 1.82; P = 0.006). SMVR also significantly reduced MR ≥ 3+ recurrence at 30 days (RR 6.95; P < 0.00001), one year (RR 3.31; P = 0.0001), and three years (RR 4.37; P < 0.00001). TMVR was associated with higher myocardial infarction rates (RR 1.58; P = 0.02) but reduced LOS (MD -4.88 days; P < 0.00001). Sensitivity analysis showed consistent results for recurrence of MR ≥ 3+ and variable outcomes for other metrics. Evidence of publication bias was noted for mortality at 30 days and LOS.

CONCLUSION: While TMVR with the MitraClip offers shorter hospital stays and is less invasive, SMVR provides better long-term survival and lower MR recurrence rates, emphasizing the need for a tailored approach based on patient risk profiles.

PMID:39606773 | PMC:PMC11590862 | DOI:10.37616/2212-5043.1399

Rev Bras Med Trab. 2024 Nov 14;22(3):e20231180. doi: 10.47626/1679-4435-2023-1180. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: The military police officer is exposed to several risk factors that could lead to physical and psychiatric disorders. However, there is a paucity of scientific literature on the health of special operations police officers.

OBJECTIVES: To identify the main causes and associated factors of forensic medical examinations among members of a Battalion of Special Police Operations.

METHODS: This cross-sectional study analyzed data from 210 forensic medical examinations performed between January 2019 and June 2021. The dependent variable was the reason for the appointment, and the independent variables were gender, age, military rank, and length of career. Bivariate analyses were performed using the chi-squared test or Fisher’s exact test.

RESULTS: Most police officers were men (98.1%), military (41.8%), with a mean age of 36.6 years and a mean length of service of 12.9 years. The most common reason for an examination was to obtain a physical fitness report (44.3%), followed by routine examination of healthy police officers (17.6%) and trauma (14.3%). There were no statistically significant associations between the independent variables and trauma appointments. However, there was a statistical association between appointments for physical fitness reports and being under 35 years of age.

CONCLUSIONS: Most common reasons for forensic medical examinations were physical fitness reports, routine examinations, and trauma. Examinations for physical fitness reports were statistically associated with younger age.

PMID:39606772 | PMC:PMC11595399 | DOI:10.47626/1679-4435-2023-1180

Rev Bras Med Trab. 2024 Nov 14;22(3):e20231131. doi: 10.47626/1679-4435-2023-1131. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: The demands and conditions of work can lead to development of a range of health conditions, including repetitive stress injuries and work-related musculoskeletal disorders.

OBJECTIVES: To assess the prevalence of musculoskeletal symptoms and the working conditions of primary school teachers working for the public municipal education system in Cuiabá, Mato Grosso, Brazil.

METHODS: A cross-sectional study was conducted with teachers working for the public municipal education system in the capital of Mato Grosso state. The sample comprised 326 teachers. Data were collected using the Vocal Production Condition – Teacher instrument and the Nordic Musculoskeletal Questionnaire.

RESULTS: The mean age of the sample was 43.01 years and teachers were predominantly female (87.12%), were married or in a stable relationship (62.70%), had postgraduate qualifications (73.93%), worked at one school only (58.95%), and stated that the pace of their working routine was sometimes stressful (59.01%), that they always took work home with them (57.45%), and that there was sometimes stress at work (54.92%), and reported presence of musculoskeletal symptoms during the last 12 months (76.74%).

CONCLUSIONS: The highest prevalence rates of musculoskeletal symptoms were observed among married women, those with postgraduate qualifications, those who worked at one school only, and those who had a stressful working routine. It was therefore concluded that mapping working conditions could provide a foundation for reducing the occurrence of musculoskeletal symptoms and improving the health of this population.

PMID:39606762 | PMC:PMC11595378 | DOI:10.47626/1679-4435-2023-1131

Rev Bras Med Trab. 2024 Nov 14;22(3):e20231215. doi: 10.47626/1679-4435-2023-1215. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: More than 500,000 work accidents were registered each year in Brazil from 2016 to 2018, representing more than BRL 300 million in expenditures.

OBJECTIVES: To analyze the prevalence of work accidents in Brazil between 2016 and 2020 according to geographic region, age group, and sex and analyze the prevalence according to the cause and economic activity type.

METHODS: Descriptive, cross-sectional study based on data from the Social Security Statistics Yearbook.

RESULTS: The work accident rate between 2016 and 2019 was lower than in previous years. The Southern and Southeastern regions had the highest prevalence of work accidents (11.7/1,000 workers and 9.10/1,000 workers, respectively), while the Northeastern region had the lowest rate (6.22/1,000 workers). There was a greater reduction in work accidents among men than women. The most prevalent types of work accidents involved injuries, poisoning, and other external causes, in addition to diseases of the musculoskeletal system and connective tissue.

CONCLUSIONS: Record keeping about work accidents must be improved, given that informal workers are not considered in social security data. More accurate data can also help increase prevention efforts, and can lead to more effective occupational health and safety policies to further reduce the work accident rate.

PMID:39606761 | PMC:PMC11595383 | DOI:10.47626/1679-4435-2023-1215

Rev Bras Med Trab. 2024 Nov 14;22(3):e20241227. doi: 10.47626/1679-4435-2024-1227. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: Healthcare workers in both the public and private systems were on the front line of the fight against the COVID-19 pandemic. As a consequence, they faced uncertainty, heavy demand, excessive working hours, and the fear of contracting the virus.

OBJECTIVES: To investigate the occurrence of psychological distress among public and private healthcare workers at the start of the COVID-19 pandemic.

METHODS: An observational, quantitative study was conducted from April to June of 2020, enrolling workers who had cared for suspected and confirmed cases of covid-19 in Brazil. Psychological distress was assessed using the Self-Reporting Questionnaire-20. Associations between the outcome and independent variables were analyzed using the chi-square test.

RESULTS: Majorities of the 400 healthcare workers studied were nursing professionals (69.8%), worked in the Southeast region of Brazil (69.5%), were affiliated to a public healthcare institution (71.8%), and had a mean working week of 45.81 hours. The rate of psychological distress in the sample was 56.8%. There was no statistically significant association between the outcome and the type of organization (public/private). There were associations between psychological distress and professional category and between psychological distress and prior comorbidities.

CONCLUSIONS: There was evidence of impact on mental wellbeing irrespective of care level or setting. Psychological distress was one of the greatest challenges faced by the healthcare workers during the pandemic, irrespective of the type of institution, and was a phenomenon of relevance to occupational health in general during the pandemic.

PMID:39606756 | PMC:PMC11595382 | DOI:10.47626/1679-4435-2024-1227

Rev Bras Med Trab. 2024 Nov 14;22(3):e20241175. doi: 10.47626/1679-4435-2024-1175. eCollection 2024 Jul-Sep.

ABSTRACT

INTRODUCTION: Burnout syndrome is a condition resulting from chronic exposure to interpersonal stressors in the workplace. Faculty in the health field are particularly susceptible to burnout syndrome due to frequent emotional stress.

OBJECTIVES: To identify an association between the dimensions of burnout syndrome and the coping strategies these faculty have adopted.

METHODS: An observational, analytical and cross-sectional study was conducted in 2021 with 164 faculty from a public university. The Maslach Burnout Inventory and the Brief-Coping Orientation to Problems Experienced were used. The analysis included descriptive statistics and Spearman correlation, using SPSS 16.0.

RESULTS: Emotional exhaustion was high for 54.88% of the sample. Depersonalization scored high for 97.57% of the participants, whereas personal accomplishment was high for 100%. These results are no indication of burnout syndrome, which requires high scores for emotional exhaustion and depersonalization and low scores for personal accomplishment. Active coping, planning, and positive reframing were the most used strategies, which are aimed at solving problems and are considered protective against this condition. Denial, behavioral disengagement, and substance use, which are focused on avoidance and emotion, with potentially negative effects, were the least used. The correlations between the dimensions of burnout syndrome and the coping factors were weak or very weak.

CONCLUSIONS: Although burnout syndrome was not identified, the sample was at a high risk of becoming ill due to emotional exhaustion. The correlations between the dimensions of burnout syndrome and the coping factors were weak.

PMID:39606754 | PMC:PMC11595380 | DOI:10.47626/1679-4435-2024-1175