Tag: statistics

Clin Child Fam Psychol Rev. 2023 Jul 5. doi: 10.1007/s10567-023-00442-7. Online ahead of print.

ABSTRACT

Study of individual treatment mechanisms in youth interventions facilitates evidence-based development, selection and implementation of treatment components that are most effective for each individual child. This position paper aims to bring together two important topics from the area of youth intervention research: mediators of treatment outcomes and single-case experimental design methodology. We start by outlining the benefits of studying within-person mechanisms and propose how statistical mediation analysis and single-case methods can be integrated to enable this type of research. Further, we review existing methodology for the study of individual youth treatment mechanisms and provide recommendations for the clinical practice research.

PMID:37405674 | DOI:10.1007/s10567-023-00442-7

Clin Implant Dent Relat Res. 2023 Jul 5. doi: 10.1111/cid.13244. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the influence of the characteristics of bone defects caused by peri-implantitis on the clinical resolution and radiographic bone gain following reconstructive surgery.

METHODS: This is a secondary analysis of a randomized clinical trial. Periapical x-rays of bone defects, caused by peri-implantitis exhibiting intrabony component, were analyzed at baseline and 12-month follow-up after reconstructive surgery. Therapy consisted of anti-infective therapy along with a mixture of allografts with or without a collagen barrier membrane. The association of defect configuration, defect angle (DA), defect width (DW), and baseline marginal bone level (MBL) with clinical resolution (based on a prior defined composite criteria) and radiographic bone gain was correlated by means of generalized estimating equations.

RESULTS: Overall, 33 patients with a total of 48 implants exhibiting peri-implantitis were included. None of the evaluated variables yielded statistical significance with disease resolution. Defect configuration demonstrated statistical significance when compared to class 1B and 3B, favoring radiographic bone gain for the former (p = 0.005). DW and MBL did not demonstrate statistical significance with radiographic bone gain. On the contrary, DA exhibited strong statistical significance with bone gain (p < 0.001) in the simple and multiple logistic regression analyses. Mean DA reported in this study was 40°, and this resulted in 1.85 mm radiographic bone gain. To achieve ≥1 mm of bone gain, DA must be <57°, while to attain ≥2 mm of bone gain, DA must be <30°.

CONCLUSION: Baseline DA of peri-implantitis intrabony components predicts radiographic bone gain in reconstructive therapy (NCT05282667-this clinical trial was not registered prior to participant recruitment and randomization).

PMID:37405662 | DOI:10.1111/cid.13244

Dermatol Ther (Heidelb). 2023 Jul 5. doi: 10.1007/s13555-023-00970-8. Online ahead of print.

ABSTRACT

INTRODUCTION: Pulsed dye laser (PDL) is currently considered to be the first-line treatment for port-wine stains (PWSs) on the extremities despite its less than satisfactory therapeutic efficacy. Hemoporfin-mediated photodynamic therapy (HMME-PDT) is a vascular-targeted therapy that has rarely been used to treat PWSs on the extremities. Here, we evaluate the clinical efficacy and safety of HMME-PDT for the treatment of PWSs on the extremities.

METHODS: Clinical data and dermoscopic images of PWSs on the extremities were obtained from 65 patients who underwent HMME-PDT between February 2019 and December 2022. The clinical efficacy of HMME-PDT was analyzed by comparing the pre- and post-treatment images. The safety of HMME-PDT was evaluated through observation during the treatment period and post-treatment follow-up.

RESULTS: The efficacy rate of a single HMME-PDT session was 63.0% and that of two and three to six sessions was 86.7% and 91.3%, respectively. A positive correlation was found between therapeutic efficacy and the number of HMME-PDT sessions. The therapeutic efficacy of HMME-PDT was better on the proximal extremities than on other parts of the extremities (P = 0.038), and the efficacy of treating PWSs in each site was relatively improved with an increase of treatment time. The clinical efficacy of HMME-PDT differed across four PWS vascular patterns identified by dermoscopy (P = 0.019). However, there was no statistical difference in the therapeutic efficacy based on age, sex, type of PWS, and treatment history (P > 0.05), which may be partly attributed to the relatively small sample size or poor cooperation of infant patients. No obvious adverse reactions were observed during the follow-up period.

CONCLUSIONS: HMME-PDT is a very safe and effective treatment for PWSs on the extremities. Multiple HMME-PDT treatments, lesions located in proximal limbs, and PWSs with type I and IV vascular patterns under dermoscopy were associated with higher efficacy of HMME-PDT. Dermoscopy may help predict the clinical efficacy of HMME-PDT.

TRIAL REGISTRATION NO: 2020KJT085.

PMID:37405633 | DOI:10.1007/s13555-023-00970-8

Eur Geriatr Med. 2023 Jul 5. doi: 10.1007/s41999-023-00825-7. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate to what extent the standardized concept of need-based care on Behavioural and Psychological Symptoms of Dementia (BPSD), and formal caregiver distress, is superior when compared to spending more time or standard care with residents with BPSD.

METHODS: A longitudinal cluster randomized controlled study in 23 nursing homes in Belgium with 3 parallel groups was set up. A total of 481 residents with dementia participated. Formal caregivers in the need-based care group treated residents who displayed agitated or aggressive behaviour with a non-pharmacological intervention, tailored to unmet needs, twice a week with re-evaluation every 8 weeks. In the time group, formal caregivers spent ‘extra time’. In the standard care group, it was ‘care as usual’. Outcomes were measured at four different time points with the Doloplus-2 (to assess pain behaviour), Cohen-Mansfield Agitation Inventory (CMAI) for agitation, the Neuropsychiatric Inventory (NPI-NH) for BPSD and formal caregivers’ distress.

RESULTS: Need-based interventions had a significant effect on residents’ levels of pain behaviour. In the need-based care group, scores on overall BPSD (agitation and aggression, depression, euphoria, irritability, sleep and night-time behaviour) improved significantly from baseline when compared to other timepoints. No significant different interactions over time were found between all three groups for categorized versions of NPI scores (ever versus never).

CONCLUSION: Need-based care reduced the level of BPSD in residents with dementia as well as formal caregivers’ distress. The study supports the importance of tailored non-pharmacological interventions in the residential care for people with dementia.

TRIAL REGISTRY: Trial registration number B300201942084 (18/11/2019).

PMID:37405630 | DOI:10.1007/s41999-023-00825-7

Environ Sci Pollut Res Int. 2023 Jul 5. doi: 10.1007/s11356-023-28353-8. Online ahead of print.

ABSTRACT

The study focuses on an Italian composting plant and aims to investigate the impact of the presence of plastic impurities in the collected biowaste on the environmental and economic performance of the plant. The study is divided into two main steps: firstly, a material flow analysis was conducted to quantify the number of impurities (e.g., conventional plastics and compostable plastics) before and after the composting process. Secondly, a life cycle assessment (LCA) and a complementary life cycle costing (LCC) of the composting process were conducted. The results of the material flow analysis confirmed the initial assumption that conventional plastic remains almost constant before and after the composting treatment, while compostable plastic almost disappears. As far as the life cycle analyses are concerned, the most environmentally damaging phases of the process were the shredding and mixing phases, while the operating costs (OPEX) contributed the most to the total annual costs of the company. Finally, a further scenario analysis was performed, assuming that the plastic contaminants in the treated biowaste consisted exclusively of compostable plastics. The comparison with this ideal scenario can support decision-makers to understand the potential improvements achievable by addressing the presence of plastic impurities in the biowaste. The results show that the treatment of plastic impurities causes relevant environmental and economic impacts, being responsible for 46% of the total waste to treat at the end of the process, almost 7% of the total annual costs covered by the plant owners, and about 30% of all negative externalities.

PMID:37405605 | DOI:10.1007/s11356-023-28353-8

Anat Histol Embryol. 2023 Jul 5. doi: 10.1111/ahe.12947. Online ahead of print.

ABSTRACT

Fossa masseterica, to which the musculus masseter is attached, is the pit on the lateral surface of the ramus mandibulae. Processus coronoideus is a protrusion on the upper part of fossa masseterica. Carnivores have a more developed fossa masseterica and a wider processus coronoideus than other species, due to their well-developed jaw muscles. However, there is limited information about the differences of these two structures among carnivorous species. In this study, it was investigated whether fossa masseterica and processus coronoideus differ in shape in domestic cats and domestic dogs. For this purpose, 22 dogs and 20 cats were examined by 3D geometric morphometry. Eighty-one landmarks were used on the fossa masseterica and processus coronoideus. The difference in centroid sizes and shape for cats and dogs was statistically significant (p < 0.0001). PC1 explained 26.47% of the total variance. It was seen that cats and dogs were completely separated according to PC1 results. In cats with a high PC1 value, the processus coronoideus was narrower than in dogs. Also, feline processus coronoideus was more curved than domestic canine processus coronoideus. In addition, the caudal inclination of processus coronoideus was deeper in dogs than in cats. Dogs had a negative PC1 value except for one sample (German Shepherd). The sample with the lowest PC1 value was the French Bulldog (female, 7 years, and 13 kg). Discriminant analysis results showed that the domestic cats and domestic dogs used in the study were completely separated from each other, and this difference was statistically significant. The results of this study showed that dogs with stronger jaw muscles had a deeper fossa masseterica and a wider processus coronoideus than cats.

PMID:37403741 | DOI:10.1111/ahe.12947

Cancer Med. 2023 Jul 5. doi: 10.1002/cam4.6234. Online ahead of print.

ABSTRACT

BACKGROUND: Melanoma frequently harbors BRAF, NRAS, or KIT mutations which influence both tumor development and treatment strategies. For example, it is still controversial whether adjuvant anti-PD-1 monotherapy or BRAF/MEK inhibitors may better improve the survival for resected BRAF-mutant melanoma. Furthermore, outcomes for melanoma with NRAS and KIT mutation receiving adjuvant immunotherapy remain unclear.

METHODS: One hundred seventy-four stage III melanoma patients who underwent radical surgery in Fudan University Shanghai Cancer Center (FUSCC) during January 2017 to December 2021 were included in this real-world study. Patients were followed up until death or May 30th, 2022. Pearson’s chi-squared test or Fisher’s exact test was performed for univariable analysis of the different category groups. Log-rank analysis was used to identify the prognostic factors for disease-free survival (DFS).

RESULTS: There were 41 (23.6%) patients with BRAF mutation, 31 (17.8%) with NRAS mutation, 17 (9.8%) with KIT mutation, and 85 (48.9%) wild-type patients without either genomic alteration of those three genes. Most ( n = 118, 67.8%) of them were acral melanoma, while 45 (25.9%) were cutaneous subtype, and 11 were (6.3%) primary unknown. Among them, 115 (66.1%) patients received pembrolizumab or toripalimab monotherapy as adjuvant therapy; 22 (12.6%) patients received high-dose interferon (IFN), and 37 (21.3%) patients were just for observation. There was no statistical difference in clinicopathologic factors between anti-PD-1 group and IFN/OBS group. Of all the enrolled patients, anti-PD-1 group had a better DFS than IFN/OBS group ( p = 0.039). In anti-PD-1 group, patients with BRAF or NRAS mutations had poorer DFS than wild-type group. No survival difference was found among patients harboring different gene mutations in IFN/OBS group. In wild-type patients, anti-PD-1 group had a better DFS than IFN/OBS group ( p = 0.003), while no survival benefits were found for patients with BRAF, NRAS, or KIT mutations.

CONCLUSION: Although anti-PD-1 adjuvant therapy provides a better DFS in the general population and in wild-type patients, patients with BRAF, KIT or, especially, NRAS mutation may not benefit further from immunotherapy than conventional IFN treatment or observation.

PMID:37403699 | DOI:10.1002/cam4.6234

Eur J Heart Fail. 2023 Jul 5. doi: 10.1002/ejhf.2970. Online ahead of print.

ABSTRACT

AIMS: Multivariable prediction models can be used to estimate risk of incident heart failure (HF) in the general population. A systematic review and meta-analysis was performed to determine the performance of models.

METHODS AND RESULTS: From inception to 3rd November 2022 MEDLINE and EMBASE databases were searched for studies of multivariable models derived, validated and/or augmented for HF prediction in community-based cohorts. Discrimination measures for models with cstatistic data from ≥3 cohorts were pooled by Bayesian meta-analysis, with Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation heterogeneity assessed through a 95% prediction interval (PI). Risk of bias was assessed using PROBAST. We included 36 studies with 59 prediction models. In meta-analysis, the Atherosclerosis Risk in Communities (ARIC) Risk Score (summary c-statistic 0.802, 95% CI 0.707-0.883), graph-based attention model (GRAM; 0.791, 95% CI 0.677-0.885), Pooled Cohort equations to Prevent Heart Failure (PCP-HF) white men model (0.820, 95% CI 0.792-0.843), PCP-HF white women model (0.852, 95% CI 0.804-0.895), and REverse Time AttentIoN Model (RETAIN; 0.839, 95% CI 0.748-0.916) had a statistically significant 95% PI and excellent discrimination performance. The ARIC Risk Score and PCP-HF models had significant summary discrimination among cohorts with a uniform prediction window. 77% of model results were at high risk of bias, certainty of evidence was low, and no model had a clinical impact study.

CONCLUSIONS: Prediction models for estimating risk of incident HF in the community demonstrate excellent discrimination performance. Their usefulness remains uncertain due to high risk of bias, low certainty of evidence, and absence of clinical effectiveness research. This article is protected by copyright. All rights reserved.

PMID:37403669 | DOI:10.1002/ejhf.2970

Curationis. 2023 Jun 29;46(1):e1-e8. doi: 10.4102/curationis.v46i1.2350.

ABSTRACT

BACKGROUND: Acute psychiatric units are found to be stressful working environments because of the nature of illness patients present with.

OBJECTIVES: This study aimed to determine self-reported incidents of physical and verbal violence towards nurses working in acute psychiatric units in Western Cape, South Africa.

METHOD: A questionnaire was used to collect data. Chi-square test was performed to determine association between gender, category and experience of violence. Mann-Whitney U test was carried out to determine associations between years of employment and the likelihood of experiencing physical violence and verbal abuse.

RESULTS: Overall physical violence 35 (34.3%) and verbal abuse 83 (83%) incidents. Most female respondents reported both physical violence (74.2%, n = 26) and verbal abuse (72.2%, n = 60), with (56.2%, n = 18) professional nurses reporting physical violence. Years of employment was statistically significantly associated with the likelihood of nurses experiencing physical violence (p = 0.007).

CONCLUSION: Most respondents (74.2%, n = 26) were females and they mostly experienced physical violence and verbal abuse while 28.2% (n = 29) were males. Years of service were associated with the likelihood of experiencing physical violence.Contribution: The knowledge gained will add on existing knowledge about the challenge of violence experienced by nurses in the workplace and might have an influence on policymakers.

PMID:37403668 | DOI:10.4102/curationis.v46i1.2350

Curationis. 2023 Jun 23;46(1):e1-e6. doi: 10.4102/curationis.v46i1.2364.

ABSTRACT

BACKGROUND: The attribute of empathy leads to more desired patient outcomes. A patient who experiences empathy from student nurses will feel important and cared for. It is vital to know how student nurses perceive themselves in terms of empathy in caring. Thus, self-reflection is a requirement on the part of student nurses in a caring relationship.

OBJECTIVES: This study aimed to determine student nurses’ self-perceptions of empathy in caring and compare the third- and fourth-year student nurses’ self-perceptions of empathy in caring.

METHOD: A quantitative, descriptive and comparative approach was employed in the study. The population was undergraduate student nurses in their third- and fourth-year level of study (n = 77), while 56 respondents participated in the study. Ethical approval was obtained prior to commencing with the study. Data were collected by way of the Consultation and Relational Empathy measure questionnaire that consisted of 10 items responded to by using the 5-point Likert scale. Data were analysed by means of descriptive statistics, inferential statistics and t-tests.

RESULTS: All the student nurses perceived themselves to have empathy in caring. There was no significant difference in perceptions of empathy in caring by the nurses in their third- and fourth-year level of study.

CONCLUSION: The results of the study provide insights for nursing education and training to shape and mould the empathy perceived by the student nurses. Future research could focus on the patients’ perspective coupled with the student nurses’ perspective to prevent bias.Contribution: This paper contributes by adding self perceptions of empathy by student nurses to support best practice in nursing.

PMID:37403667 | DOI:10.4102/curationis.v46i1.2364