Tag: statistics

Rev Med Inst Mex Seguro Soc. 2023 Sep 18;61(Suppl 2):S246-S253.

ABSTRACT

BACKGROUND: Nutrition in the Intensive Care Unit (ICU) is a cornerstone; however, energy requirements are a controversial issue that has not yet been resolved. Calorimetry is the gold standard for calculating energy expenditure, but it is expensive and not available in all ICU areas. Formulas have been developed to calculate basal energy expenditure (BAE) and make the process easier.

OBJECTIVE: To validate the predictive formulas of BAE compared to that obtained with ventilatory indirect calorimetry (IC) within the nutritional assessment in ICU patients.

MATERIAL AND METHODS: Analytical cross-sectional retrolective study. We performed BAE measurement on patients in the ICU of a third level hospital with ventilatory indirect calorimetry and compared the results obtained with those of the Harris Benedict, Muffin-St. Jeor, Institute of Medicine, and Faisy equations.

RESULTS: A total of 49 patients were included; a moderate correlation with statistical significance was found between the BAE measurements obtained by indirect calorimetry, with those obtained by four predictive equations that were studied. The Faisy equation obtained the strongest correction with r = 0.461 (p = 0.001).

CONCLUSION: The correlation between the BAE obtained by predictive equations and by IC goes from mild to moderate, due to the heterogeneity of critical patients and their changing nature throughout their disease.

PMID:38016112

Vopr Kurortol Fizioter Lech Fiz Kult. 2023;100(5):14-20. doi: 10.17116/kurort202310005114.

ABSTRACT

The problem of comprehensive physical therapy in polymorbidity (PM) identifies among the most urgent difficulties of modern rehabilitation medicine. It is known that PM are more common than it is generally accepted, and their impact on the endpoints of rehabilitative treatment is more significant. Yet, many problems of PM have not been investigated and properly solved.

OBJECTIVE: To evaluate the efficacy of comprehensive physical therapy (CPT) in PM in the age aspect on the basis of correlation analysis and ANOVA indicators (OR, RR, Q, x², r²), as well as evidence-based medicine (EBM), in particular randomized comparative study (RCS).

MATERIAL AND METHODS: A number of patients with PM equal 554 underwent CPT, of which 204 (36.8%) were male and 350 (63.2%) female. The identified age cohorts were following: the 1st group – 188 (33.9%) patients aged from 45 to 59; the 2nd group – 366 (66.1%) patients aged from 60 to 74. The ratio of middle-aged and elderly patients was 1.9:1.

RESULTS: The efficacy of CPT in patients with PM was judged, first of all, by documentary (medical histories and medical records of patients) and mathematical data (OR, RR, Q, x², r²). The evidence level of CPT effect was determined on the basis of the analysis of the particular method’s study results.

CONCLUSION: The incidence of positive CPT result in middle-aged patients was higher than in elderly. The positive strong statistical correlation between comprehensive physical therapy and the endpoint in most classes of diseases of patients with PM. The comparative assessment of CPT efficacy based on the EBM principles revealed the advantages of their use for elderly patients relative to middle-aged group.

PMID:38016052 | DOI:10.17116/kurort202310005114

Trans R Soc Trop Med Hyg. 2023 Nov 28:trad083. doi: 10.1093/trstmh/trad083. Online ahead of print.

ABSTRACT

BACKGROUND: Nigeria instituted the National Health Insurance Scheme (NHIS) for universal health coverage. This study compared the NHIS and out-of-pocket (OOP) antibiotic prescribing with the World Health Organization (WHO) optimal values.

METHODS: A total of 2190 prescription forms from the NHIS and OOP were included in this study conducted at Obafemi Awolowo University Teaching Hospitals Complex, Nigeria from January 2021 to December 2022 and analysed using WHO drug prescribing guidelines.

RESULTS: The average number of drugs per encounter was higher in the NHIS prescribing (χ2=58.956, p=0.00) than in OOP prescribing. The percentage of encounters with an antibiotic prescribed is higher in NHIS prescribing (χ2=46.034, p=0.000) than in OOP prescribing. The percentage of parenteral antibiotic prescribing is higher in OOP prescribing (χ2=25.413, p=0.000) than in NHIS prescribing. The percentage of antibiotic prescribed from the National Essential Medicine List is higher in NHIS prescribing (χ2=8.227, p=0.000) as well as the antibiotics prescribed from the Access category of the WHO Access, Watch and Reserve (AWaRe) Classification of antibiotics (χ2=23.946, p=0.000) when compared with OOP prescribing.

CONCLUSIONS: Prescribing indicators show better performances with NHIS antibiotic prescribing and are closer to the WHO-recommended optimal values than in OPP prescribing. Hence NHIS prescribing can be an easy target for hospital antibiotic stewardship intervention for optimal antibiotic prescribing.

PMID:38016023 | DOI:10.1093/trstmh/trad083

Cornea. 2023 Nov 28. doi: 10.1097/ICO.0000000000003438. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to report a case series of central toxic keratopathy (CTK) after collagen cross-linking (CXL) in keratoconus.

METHODS: This is a retrospective case series between January 2020 and September 2021. In this period, CXL was performed for progressive keratoconus in 964 eyes. CXL was performed using the epithelium-off accelerated protocol in all patients with a riboflavin soak time of 20 minutes and a UVA light exposure of 9 mW for 10 minutes using the Avedro KXL (Glaukos Inc, Aliso Viejo, CA) cross-linking system.

RESULTS: Twelve of 964 eyes (1.2%) developed CTK within 1 week of CXL. All patients presented with well-circumscribed, central disciform haze that was broader in the anterior stroma and narrower in the posterior stroma. We noted initial flattening in keratometry up to 3 months post-CXL in these patients, which gradually steepened over 12 months, but did not reach preoperative levels. We also noted exuberant flattening in pachymetry in the first 3 months, which improved over 12 months. There was a statistically significant decrease in pachymetry in patients who developed CTK at 3 and 12 months postoperatively when compared to patients who underwent CXL but did not develop CTK.

CONCLUSIONS: Several reports of CTK postrefractive surgery have been described previously. However, the association of CXL in the development of CTK has not been described previously. Here, we elucidated the clinical features of CTK after CXL and how it differs from corneal scarring or haze that occurs post-CXL.

PMID:38016022 | DOI:10.1097/ICO.0000000000003438

PLoS One. 2023 Nov 28;18(11):e0294947. doi: 10.1371/journal.pone.0294947. eCollection 2023.

ABSTRACT

This article is based on the statistical yearbook data of 30 provinces, municipalities and autonomous regions in China (excluding Hong Kong, Macao, Taiwan, and Tibet Autonomous Region) from 2000 to 2017, a total of 18 years of statistical yearbook data was used to conduct in-depth research on the reduction of CO2 emissions from the development of new energy in the region. First, it is proposed that the regional new energy development has a significant negative effect on CO2 emissions. Meanwhile, this impact has a significant time lag effect, and the development of new energy cannot be quickly and effectively applied in the short term to replace traditional fossil energy in the dynamic model. Therefore, there is a significant positive impact in the short term, but the significant negative effect of new energy development on CO2 emission can be shown in the long run. Secondly, the new energy development has a significant non-linear impact on CO2 emissions, showing an inverted U-shaped relationship, which confirms the existence of the Environmental Kuznets Curve (EKC) of CO2 emissions based on new energy development. Finally, in order to alleviate the continuous impact of national economic development on CO2 emissions, the DID model is used to prove that the level of technological innovation has a significant moderating effect on the CO2 emission reduction effect of new energy development, which confirms theoretically the importance of technological innovation in accelerating new energy substitution and improving energy efficiency.

PMID:38016002 | DOI:10.1371/journal.pone.0294947

PLoS One. 2023 Nov 28;18(11):e0294844. doi: 10.1371/journal.pone.0294844. eCollection 2023.

ABSTRACT

OBJECTIVES: To describe inpatient and outpatient cardiac rehabilitation (CR) utilization patterns over time and by subgroups among patients admitted for acute heart failure (AHF) in Japan.

BACKGROUND: Cardiac rehabilitation (CR) is a crucial secondary prevention strategy for patients with heart failure. While the number of older patients with AHF continues to rise, trends in inpatient and outpatient CR participation following AHF in Japan have not been described to date.

METHODS: We conducted a retrospective cohort study of adult patients hospitalized for AHF in Japan between April 2008 and December 2020. Using data from the Medical Data Vision database, we measured trends in inpatient and outpatient CR participation following AHF. Descriptive analyses and summary statistics for AHF patients by CR participation status were reported.

RESULTS: The analytic cohort included 88,052 patients. Among these patients, 37,810 (42.9%) participated in inpatient and/or outpatient CR. Of those, 36,431 (96.4%) participated in inpatient CR only and 1,277 (3.4%) participated in both inpatient and outpatient CR. Rates of inpatient CR rose more than 6-fold over the study period, from 9% in 2009 to 55% in 2020, whereas rates of outpatient CR were consistently low.

CONCLUSIONS: The rate of inpatient CR participation among AHF patients in Japan rose dramatically over a 12-year period, whereas outpatient CR following AHF was vastly underutilized. Further study is needed to assess the clinical effectiveness of inpatient CR and to create infrastructure and incentives to support and encourage outpatient CR.

PMID:38015991 | DOI:10.1371/journal.pone.0294844

PLoS One. 2023 Nov 28;18(11):e0294575. doi: 10.1371/journal.pone.0294575. eCollection 2023.

ABSTRACT

Inclusive citizen science, an emerging field, has seen extensive research. Prior studies primarily concentrated on creating theoretical models and practical strategies for diversifying citizen science (CS) projects. These studies relied on ethical frameworks or post-project empirical observations. Few examined active participants’ socio-demographic and behavioral data. Notably, none, to our knowledge, explored prospective citizen scientists’ traits as intrinsic factors to enhance diversity and engagement in CS. This paper presents a new inclusive CS engagement model based on quantitative analysis of surveys administered to 540 participants of the dedicated free informal education MOOC (Massive Open Online Course) ‘Your Right to Privacy Online’ from eight countries in the EU funded project, CSI-COP (Citizen Scientists Investigating Cookies and App GDPR compliance). The surveys were filled out just after completing the training stage and before joining the project as active CSs. Out of the 540 participants who completed the surveys analyzed in this study, only 170 (32%) individuals actively participated as CSs in the project. Therefore, the study attempted to understand what characterizes these participants compared to those who decided to refrain from joining the project after the training stage. The study employed descriptive analysis and advanced statistical tests to explore the correlations among different research variables. The findings revealed several important relationships and predictors for becoming a citizen scientist based on the surveys analysis, such as age, gender, culture, education, Internet accessibility and apps usage, as well as the satisfaction with the MOOC, the mode of training and initial intentions for becoming a CS. These findings lead to the development of the empirical model for inclusive engagement in CS and enhance the understanding of the internal factors that influence individuals’ intention and actual participation as CSs. The devised model offers valuable insights and key implications for future CS initiatives. It emphasizes the necessity of targeted recruitment strategies, focusing on underrepresented groups and overcoming accessibility barriers. Positive learning experiences, especially through MOOCs, are crucial; enhancing training programs and making educational materials accessible and culturally diverse can boost participant motivation. Acknowledging varying technological proficiency and providing necessary resources enhances active engagement. Addressing the intention-engagement gap is vital; understanding underlying factors and creating supportive environments can transform intentions into active involvement. Embracing cultural diversity through language-specific strategies ensures an inclusive environment for effective contributions.

PMID:38015965 | DOI:10.1371/journal.pone.0294575

PLoS One. 2023 Nov 28;18(11):e0292832. doi: 10.1371/journal.pone.0292832. eCollection 2023.

ABSTRACT

This study aims to review the long-term subjective and objective efficacy of mandibular advancement devices (MAD) in the treatment of adult obstructive sleep apnea (OSA). Electronic databases such as PubMed, Embase, and Cochrane Library were searched. Randomized controlled trials (RCTs) and non-randomized self-controlled trials with a treatment duration of at least 1 year with MAD were included. The quality assessment and data extraction of the included studies were conducted in the meta-analysis. A total of 22 studies were included in this study, of which 20 (546 patients) were included in the meta-analysis. All the studies had some shortcomings, such as small sample sizes, unbalanced sex, and high dropout rates. The results suggested that long-term treatment of MAD can significantly reduce the Epworth sleepiness scale (ESS) by -3.99 (95%CI -5.93 to -2.04, p<0.0001, I2 = 84%), and the apnea-hypopnea index (AHI) -16.77 (95%CI -20.80 to -12.74) events/h (p<0.00001, I2 = 97%). The efficacy remained statistically different in the severity (AHI<30 or >30 events/h) and treatment duration (duration <5y or >5y) subgroups. Long-term use of MAD could also significantly decrease blood pressure and improve the score of functional outcomes of sleep questionnaire (FOSQ). Moderate evidence suggested that the subjective and objective effect of MAD on adult OSA has long-term stability. Limited evidence suggests long-term use of MAD might improve comorbidities and healthcare. In clinical practice, regular follow-up is recommended.

PMID:38015938 | DOI:10.1371/journal.pone.0292832

Cornea. 2023 Nov 22. doi: 10.1097/ICO.0000000000003430. Online ahead of print.

ABSTRACT

PURPOSE: Schirmer test results are widely used for ocular surface disease assessment, but Schirmer strips are not standardized. We compare the characteristics and tear volume with millimeter moisture migration in different brands of Schirmer strips and introduce methods for volume-based, brand-independent calibration.

METHODS: Physical parameters of Haag-Streit, EagleVision, TearFlo, Contacare, and MIPL/A6 Schirmer strip brands were compared. Schirmer strip millimeter moisture migration distances were assessed 5 minutes after application of incremental microliter volumes of human tears. Linear regression analysis of data points from each Schirmer strip brand was performed, and the root-mean-square deviation of data points to the best-fit linear regression was calculated. Calibration correction was performed by converting migration distance to the corresponding tear volume. A reference table and calibration method formulas were created.

RESULTS: Schirmer strips differed in design, shape, and manufacturing precision. Strip width, weight, and length were different between the 5 brands (P < 0.05). A wide range of Schirmer strip moisture migration values for identical tear volumes was observed among brands. Statistical measurement resulted in a root-mean-square deviation of 2.9 mm for all data points from all brands. Millimeter to volume and weight to volume-based calibration correction methods resulted in a 2.2- and 3.1-fold measurement error reduction, respectively.

CONCLUSIONS: Our findings highlight the lack of standardization among different brands of Schirmer strips, raising concerns about potential sources of unintentional measurement errors. We propose volume-based Schirmer strip calibration methods and conversion of millimeter to microliter results to achieve brand-independent results and improve Schirmer test accuracy.

PMID:38015937 | DOI:10.1097/ICO.0000000000003430

JMIR Cancer. 2023 Nov 28;9:e48040. doi: 10.2196/48040.

ABSTRACT

BACKGROUND: Mobile health technologies, underpinned by scientific evidence and ethical standards, exhibit considerable promise and potential in actively engaging consumers and patients while also assisting health care providers in delivering cancer prevention and care services. The WASABY mobile app was conceived as an innovative, evidence-based mobile health tool aimed at disseminating age-appropriate messages from the European Code Against Cancer (ECAC) to adolescents across Europe.

OBJECTIVE: This study aims to assess the outcomes of the design, development, and promotion of the WASABY app through a 3-pronged evaluation framework that encompasses data on social media promotion, app store traffic, and user engagement.

METHODS: The WASABY app’s content, cocreated with cancer-focused civil society organizations across 6 European countries, drew upon scientific evidence from the ECAC. The app’s 10 modules were designed using the health belief model and a gamification conceptual framework characterized by spaced repetition learning techniques, refined through 2 rounds of testing. To evaluate the effectiveness of the app, we conducted a retrospective cohort study using the WASABY app’s user database registered from February 4 to June 30, 2021, using a 3-pronged assessment framework: social media promotion, app store traffic, and user engagement. Descriptive statistics and association analyses explored the relationship between sociodemographic variables and user performance analytics.

RESULTS: After extensive promotion on various social media platforms and subsequent traffic to the Apple App and Google Play stores, a sample of 748 users aged between 14 and 19 years was included in the study cohort. The selected sample exhibited a mean age of 16.08 (SD 1.28) years and was characterized by a predominant representation of female users (499/748, 66.7%). Most app users identified themselves as nonsmokers (689/748, 92.1%), reported either no or infrequent alcohol consumption (432/748, 57.8% and 250/748, 33.4%, respectively), and indicated being physically active for 1 to 5 hours per week (505/748, 67.5%). In aggregate, the app’s content garnered substantial interest, as evidenced by 40.8% (305/748) of users visiting each of the 10 individual modules. Notably, sex and smoking habits emerged as predictors of app completion rates; specifically, male and smoking users demonstrated a decreased likelihood of successfully completing the app’s content (odds ratio 0.878, 95% CI 0.809-0.954 and odds ratio 0.835, 95% CI 0.735-0.949, respectively).

CONCLUSIONS: The development and promotion of the WASABY app presents a valuable case study, illustrating the effective dissemination of evidence-based recommendations on cancer prevention within the ECAC through an innovative mobile app aimed at European adolescents. The data derived from this study provide insightful findings for the implementation of Europe’s Beating Cancer Plan, particularly the creation of the EU Mobile App for Cancer Prevention.

PMID:38015612 | DOI:10.2196/48040