Tag: statistics

BMC Nurs. 2024 Feb 24;23(1):139. doi: 10.1186/s12912-024-01816-0.

ABSTRACT

AIM: This study aimed to assess inclusive leadership and presenteeism among clinical nurses and to examine the moderating effect of perceived organizational support on presenteeism related to the inclusive leadership among nurses.

BACKGROUND: Nurses’ presenteeism has become common. In hospitals, inclusive leadership is an acknowledged leadership style that has a positive influence on nurses. However, little emphasis has been paid to research on their relationships and moderating effect.

METHODS: A cross-sectional study was undertaken to assess 2222 nurses using a general information questionnaire, Stanford Presenteeism Scale (SPS-6), Perceived Organisational Support Scale, and Inclusive Leadership Scale. Study variables were analyzed using descriptive statistics, correlation, and structural equation modelling (SEM).

RESULTS: Presenteeism was relatively severe among clinical nurses. There were correlations between inclusive leadership, perceived organizational support and presenteeism. Perceived organizational support moderated the relationship between inclusive leadership and presenteeism.

DISCUSSION AND CONCLUSION: Nursing managers should actively adopt an inclusive leadership style and improve nurses’ sense of perceived organizational support to improve clinical nurses’ presenteeism behaviors.

IMPLICATIONS FOR NURSING POLICY AND PRACTICE: Healthcare organizations and nursing managers should pay attention to the psychological needs of their nurses, provide complete understanding and support, encourage staff to actively participate in their work and contribute new ideas and opinions, reduce the incidence of presenteeism, and improve nurses’ sense of well-being at work.

PMID:38402383 | DOI:10.1186/s12912-024-01816-0

Respir Res. 2024 Feb 24;25(1):99. doi: 10.1186/s12931-024-02701-9.

ABSTRACT

BACKGROUND: Intra-breath oscillometry has been proposed as a sensitive means of detecting airway obstruction in young children. We aimed to assess the impact of early life wheezing and lower respiratory tract illness on lung function, using both standard and intra-breath oscillometry in 3 year old children.

METHODS: History of doctor-diagnosed asthma, wheezing, bronchiolitis and bronchitis and hospitalisation for respiratory problems were assessed by questionnaires in 384 population-based children. Association of respiratory history with standard and intra-breath oscillometry parameters, including resistance at 7 Hz (R₇), frequency-dependence of resistance (R_{7 – 19}), reactance at 7 Hz (X₇), area of the reactance curve (AX), end-inspiratory and end-expiratory R (R_eI, R_eE) and X (X_eI, X_eE), and volume-dependence of resistance (ΔR = R_eE-R_eI) was estimated by linear regression adjusted on confounders.

RESULTS: Among the 320 children who accepted the oscillometry test, 281 (88%) performed 3 technically acceptable and reproducible standard oscillometry measurements and 251 children also performed one intra-breath oscillometry measurement. Asthma was associated with higher R_eI, R_eE, ΔR and R₇ and wheezing was associated with higher ΔR. Bronchiolitis was associated with higher R₇ and AX and lower X_eI and bronchitis with higher R_eI. No statistically significant association was observed for hospitalisation.

CONCLUSIONS: Our findings confirm the good success rate of oscillometry in 3-year-old children and indicate an association between a history of early-life wheezing and lower respiratory tract illness and lower lung function as assessed by both standard and intra-breath oscillometry. Our study supports the relevance of using intra-breath oscillometry parameters as sensitive outcome measures in preschool children in epidemiological cohorts.

PMID:38402379 | DOI:10.1186/s12931-024-02701-9

Eur Child Adolesc Psychiatry. 2024 Feb 25. doi: 10.1007/s00787-024-02392-z. Online ahead of print.

ABSTRACT

Symptomatic effects of mental disorders in parents could bias their reporting on their child’s mental health. This study aimed to investigate the measurement invariance of the French version of the parental Strengths and Difficulties Questionnaire (SDQ) across parental mental health in a sample (N = 20,765) of parents of children aged 3 to 17 years in France. Confirmatory factor analysis (CFA) and Exploratory Structural Equation Modelling (ESEM) were used to evaluate the fit of three known alternative SDQ factor structures (five, three, or second-order factor structures). Invariance was tested across parental mental health (present anxiety and depressive symptoms, psychiatric history) and across socio-demographic characteristics (child’s age, child’s gender, parent’s gender, parent’s educational level). CFA models showed a poor fit, while all ESEM models achieved acceptable or good fit, with the five-factor model presenting the best fit. Invariance was observed for all characteristics tested, indicating that the SDQ can be used to study the links between parental mental health and their child’s mental health without bias. However, ESEM showed that the hyperactivity/inattention and conduct problems dimensions were not well differentiated in the French version of the SDQ.

PMID:38402376 | DOI:10.1007/s00787-024-02392-z

Eat Weight Disord. 2024 Feb 24;29(1):16. doi: 10.1007/s40519-024-01642-y.

ABSTRACT

BACKGROUND: The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used questionnaire to measure three transdiagnostic features of eating behavior: cognitive restraint, uncontrolled eating, and emotional eating.

OBJECTIVE: This research aims to investigate the psychometric properties of the Italian version of the TFEQ-R-18 in three large community samples.

METHOD: Cross-sectional research designs were employed. In Study 1 (N = 537), an exploratory graph analysis (EGA) was used to examine item clustering within the TFEQ-R-18. In Study 2 (N = 645), a confirmatory factor analysis (CFA) was conducted to test its structural validity. In Study 3 (N = 346), a MANOVA was employed assessing mean differences across eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder).

RESULTS: In Study 1, the EGA accurately identified the three original dimensions of the TFEQ-R-18. Study 2 showed that the Italian TFEQ-R-18 has good fit indexes (CFI = 0.989, RMSEA = 0.064; 90% CI [0.058, 0.070], SRMR = 0.062), and possesses robust psychometric properties. Study 3 reveals distinct, statistically significant differences among eating disorders.

CONCLUSION: The TFEQ-R-18 proves to be a concise and precise tool for measuring transdiagnostic eating behaviors. Its applicability in the Italian context, supported by robust psychometric properties, suggests its utility for both research and clinical purposes. The findings affirm its potential to inform interventions aimed at enhancing psychological health.

LEVEL OF EVIDENCE: Level V, descriptive study.

PMID:38402372 | DOI:10.1007/s40519-024-01642-y

Sci Rep. 2024 Feb 24;14(1):4516. doi: 10.1038/s41598-024-55110-9.

ABSTRACT

While novel oral anticoagulants are increasingly used to reduce risk of stroke in patients with atrial fibrillation, vitamin K antagonists such as warfarin continue to be used extensively for stroke prevention across the world. While effective in reducing the risk of strokes, the complex pharmacodynamics of warfarin make it difficult to use clinically, with many patients experiencing under- and/or over- anticoagulation. In this study we employed a novel implementation of deep reinforcement learning to provide clinical decision support to optimize time in therapeutic International Normalized Ratio (INR) range. We used a novel semi-Markov decision process formulation of the Batch-Constrained deep Q-learning algorithm to develop a reinforcement learning model to dynamically recommend optimal warfarin dosing to achieve INR of 2.0-3.0 for patients with atrial fibrillation. The model was developed using data from 22,502 patients in the warfarin treated groups of the pivotal randomized clinical trials of edoxaban (ENGAGE AF-TIMI 48), apixaban (ARISTOTLE) and rivaroxaban (ROCKET AF). The model was externally validated on data from 5730 warfarin-treated patients in a fourth trial of dabigatran (RE-LY) using multilevel regression models to estimate the relationship between center-level algorithm consistent dosing, time in therapeutic INR range (TTR), and a composite clinical outcome of stroke, systemic embolism or major hemorrhage. External validation showed a positive association between center-level algorithm-consistent dosing and TTR (R² = 0.56). Each 10% increase in algorithm-consistent dosing at the center level independently predicted a 6.78% improvement in TTR (95% CI 6.29, 7.28; p < 0.001) and a 11% decrease in the composite clinical outcome (HR 0.89; 95% CI 0.81, 1.00; p = 0.015). These results were comparable to those of a rules-based clinical algorithm used for benchmarking, for which each 10% increase in algorithm-consistent dosing independently predicted a 6.10% increase in TTR (95% CI 5.67, 6.54, p < 0.001) and a 10% decrease in the composite outcome (HR 0.90; 95% CI 0.83, 0.98, p = 0.018). Our findings suggest that a deep reinforcement learning algorithm can optimize time in therapeutic range for patients taking warfarin. A digital clinical decision support system to promote algorithm-consistent warfarin dosing could optimize time in therapeutic range and improve clinical outcomes in atrial fibrillation globally.

PMID:38402362 | DOI:10.1038/s41598-024-55110-9

J Perinatol. 2024 Feb 24. doi: 10.1038/s41372-024-01912-8. Online ahead of print.

NO ABSTRACT

PMID:38402349 | DOI:10.1038/s41372-024-01912-8

Sci Rep. 2024 Feb 24;14(1):4532. doi: 10.1038/s41598-024-54843-x.

ABSTRACT

In this study, the efficacy of sublingual squalene in decreasing the mortality rate among patients with COVID-19 was investigated. Squalene was extracted from pumpkin seed oil with a novel method. Then, the microemulsion form of squalene was prepared for sublingual usage. In the clinical study, among 850 admitted patients, 602 eligible COVID-19 patients were divided in two groups of control (N = 301) and cases (N = 301) between Nov 2021 and Jan 2022. Groups were statistically the same in terms of age, sex, BMI, lymphocyte count on 1^st admission day, hypertension, chronic kidney disease, chronic respiratory disease, immunosuppressive disease, and required standard treatments. The treatment group received five drops of sublingual squalene every 4 h for 5 days plus standard treatment, while the control group received only standard treatment. Patients were followed up for 30 days after discharge from the hospital. The sublingual form of squalene in the microemulsion form was associated with a significant decrease in the mortality rate (p < 0.001), in which 285 (94.7%) cases were alive after one month while 245 (81.4%) controls were alive after 1 month of discharge from the hospital. In addition, squalene appears to be effective in preventing re-hospitalization due to COVID-19 (p < 0.001), with 141 of controls (46.8%) versus 58 cases (19.3%). This study suggests sublingual squalene in the microemulsion as an effective drug for reducing mortality and re-hospitalization rates in COVID-19 patients.Trial Registration Number: IRCT20200927048848N3.

PMID:38402329 | DOI:10.1038/s41598-024-54843-x

Surg Today. 2024 Feb 24. doi: 10.1007/s00595-024-02814-0. Online ahead of print.

ABSTRACT

PURPOSES: The present study evaluated the impact of clinical guidelines for gastric cancer surgery on surgeons’ choice of procedure in real-world practice. We focused on the 2014 guideline revision recommending laparoscopic surgery and the evidence concerning splenectomy for prophylactic lymphadenectomy reported in 2015 using the National Clinical Database, which is the most comprehensive database in Japan.

METHODS: We investigated the monthly percentages of laparoscopic distal gastrectomies performed for stage I gastric cancer (LDG%) and splenectomies performed during total gastrectomy for advanced cancer (TGS%) between 2014 and 2017. We evaluated the descriptive statistics of the time-series changes in the LDG%, TGS%, and annual trends of outcomes.

RESULTS: In total, 124,787 patients were enrolled. The mean LDG% and TGS% were 69.8% and 9.2%, respectively. The LDG% and TGS% were 66.4% and 16.7%, respectively, in January 2014 and 73.1% and 5.9%, respectively, in December 2017. LDG% consistently increased, and TGS% showed a consistent downward trend throughout the observation period. There was no significant change in this trend after the publication of the guideline recommendations or clinical trial results.

CONCLUSION: No significant changes in surgical procedures were observed after publication of the guidelines or results of clinical trials.

PMID:38402328 | DOI:10.1007/s00595-024-02814-0

Sci Rep. 2024 Feb 24;14(1):4528. doi: 10.1038/s41598-024-55153-y.

ABSTRACT

The orthogonal frequency division multiplexing (OFDM) system applies coherent demodulation to achieve high spectral efficiency at a bandwidth cost by the pilot tones. Considering the statistical property of the down-link channels to the users, it can be found that there is an opportunity to reduce the pilot number in the conventional designs while maintaining the same signal demodulation performances. The design philosophy involves utilizing the difference of the channel coherent bandwidths (CCBs) by allocating data to appropriate positions upon the fact that different CCBs can tolerate different minimized pilot spacing. The proposed design allows each user’s equipment’s data not to exceed its CCB with the sparser pilots. The theoretical analysis is carried out based on the concept of channel frequency response using linear interpolation with channel estimation employing the least squares (LS) method. The gain of the proposed method is demonstrated in terms of the ergodic capacities and confirmed by the simulations.

PMID:38402301 | DOI:10.1038/s41598-024-55153-y

Sci Rep. 2024 Feb 24;14(1):4562. doi: 10.1038/s41598-024-53968-3.

ABSTRACT

During intensive care unit admission, relatives of critically ill patients can experience emotional distress. The authors hypothesized that families of patients who are diagnosed with intensive care unit (ICU) delirium experience more profound depression and anxiety disorders related to stress than do families of patients without delirium. We performed a prospective observational single-center study including families of adult patients (age above 18 years) hospitalized in a 17-bed ICU of a university hospital for at least 48 h who completed research questionnaires at day 2 after admission and day 30 after initial evaluation using dedicated questionnaires (HADS, CECS, IES, PTSD-C). A total of 98 family members of patients hospitalized in the ICU were included in the final analysis (50 family members whose relatives were CAM-ICU positive (DEL+), and 48 family members of patients without delirium (DEL-)). No statistically significant differences in demographics and psychosocial data were found between the groups. In the follow-up 30 days after the first conversation with a family member, the mean PTSD score for the relatives of patients with delirium was 11.02 (Me = 13.0; SD = 5.74), and the mean score for nondelirious patients’ family members was 6.42 (Me = 5.5; SD = 5.50; p < 0.001). A statistically significant increase in IES scores for family members of patients with delirium was observed for total PTSD (p = 0.001), IES-intrusion (p < 0.001), and IES-hyperarousal (p = 0.002). The prevalence of anxiety symptoms, depression, and posttraumatic stress disorder (PTSD) was higher in families of patients diagnosed with ICU delirium within 48 h of admission to the ICU. No factors increasing the depth of these disorders in family members of patients with ICU delirium were identified. Taking appropriate actions and thus providing families with appropriate support will contribute to the understanding of unfavorable emotional states, including anxiety, stress, depression, anger, agitation, or avoidance.

PMID:38402273 | DOI:10.1038/s41598-024-53968-3