Tag: statistics

Age Ageing. 2023 Mar 1;52(3):afad022. doi: 10.1093/ageing/afad022.

ABSTRACT

BACKGROUND: Some hospital admissions of nursing home residents (NHRs) might be attributed to inadequate interprofessional collaboration. To improve general practitioner-nurse collaboration in nursing homes (NHs), we developed an intervention package (interprof ACT) in a previous study.

OBJECTIVE: To assess the impact of interprof ACT on the proportion of hospitalisation and other clinical parameters within 12 months from randomisation among NHRs.

METHODS: Multicentre, cluster randomised controlled trial in 34 German NHs. NHRs of the control group received usual care, whereas NHRs in the intervention group received interprof ACT. Eligible NHs had at least 40 long-term care residents. NHs were randomised 1:1 pairwise. Blinded assessors collected primary outcome data.

RESULTS: Seventeen NHs (320 NHRs) were assigned to interprof ACT and 17 NHs (323 NHRs) to usual care. In the intervention group, 136 (42.5%) NHRs were hospitalised at least once within 12 months from randomisation and 151 (46.7%) in the control group (odds ratio (OR): 0.82, 95% confidence interval (CI): [0.55; 1.22], P = 0.33). No differences were found for the average number of hospitalisations: 0.8 hospitalisations per NHR (rate ratio (RR) 0.90, 95% CI: [0.66, 1.25], P = 0.54). Average length of stay was 5.7 days for NHRs in the intervention group and 6.5 days in the control group (RR: 0.70, 95% CI: [0.45, 1.11], P = 0.13). Falls were the most common adverse event, but none was related to the study intervention.

CONCLUSIONS: The implementation of interprof ACT did not show a statistically significant and clinically relevant effect on hospital admission of NHRs.

PMID:36934341 | DOI:10.1093/ageing/afad022

Nicotine Tob Res. 2023 Mar 19:ntad043. doi: 10.1093/ntr/ntad043. Online ahead of print.

ABSTRACT

INTRODUCTION: Loss aversion is a bias in decision-making wherein potential losses have a greater influence on choices than equivalent gains. Such a bias may protect individuals from harm. Consistent with this idea, lower loss aversion has been measured in individuals who endorse current cigarette smoking as well as other substance use compared to controls matched on important sociodemographic variables (age, gender, educational attainment). The goal of the present study was to systematically replicate and extend this association between loss aversion and smoking status by comparing those meeting criteria for current-, former-, and never-smoking status.

METHODS: 984 individuals (N=984) that endorsed current cigarette-smoking (past 30-day use; n=361), former-smoking (no past 30-day use, >100 cigarettes lifetime; n=317), and never-smoking (No past 30-day use, <100 cigarettes lifetime; n=306) were recruited using standard crowdsourcing methods and completed measures of loss aversion (50-50 gambles) and delay discounting (monetary choice questionnaire), an important decision-making bias with an established relationship to cigarette smoking status.

RESULTS: Lower loss aversion was observed in those endorsing current smoking compared to former-smoking [t(952)=-9.57, Bonferroni corrected p<.0001], and never-smoking [t(952)=-3.99, Bonferroni corrected p=.0002]. Loss aversion was also greater in former- compared to the never-smoking [t(952)=-5.26, Bonferroni corrected p<.0001]. This pattern did not change when accounting for delay discounting and sociodemographics. Delay discounting results replicated prior findings.

CONCLUSIONS: The results support loss aversion as a decision-making bias related to risk for cigarette smoking and other substance use. Further research is needed to understand the causal contributions of loss aversion and delay discounting and their potential intersections.

SIGNIFICANCE: Low loss aversion is a risk factor for cigarette smoking. This study reports higher loss aversion among individuals that endorsed never-smoking and former-smoking status in comparison to those endorsing current cigarette smoking. Loss aversion may influence or be influenced by a change in smoking status.

PMID:36934337 | DOI:10.1093/ntr/ntad043

Arch Orthop Trauma Surg. 2023 Mar 19. doi: 10.1007/s00402-023-04833-x. Online ahead of print.

ABSTRACT

PURPOSE: In the case of stemmed implants for lower limb joint arthroplasty procedures, implant stability and survivorship generally rely on the strength of fixation in the medullary canal regardless of whether the procedure is primary or revision surgery. This study aimed to investigate the relationship between the proximal (Dorr classification) and distal (Citak classification) femoral canal geometry classification systems.

METHODS: A total of 200 patients who received standing long leg radiographs (hip to ankle) at our institution were identified using our institutional electronic radiology database. Patients were recruited into 4 groups. There were 100 male and 100 female patients with each of those being split into 50 right-sided and 50 left-sided long-leg standing anteroposterior (AP) radiographs. Two independent, blinded observers reviewed each radiograph on two separate occasions, with a minimum of a one-week interval between sittings to review each respective radiograph.

RESULTS: No statistically significant correlation was found between demographic data and clinical measurements. A statistically significant correlation was found between the patient’s age and BMI results and Citak and Dorr measurements. There was excellent inter-observer and intra-observer agreement for the Citak and Dorr Classifications. The mean Cronbach’s α coefficient was 0.96 (range 0.93-0.98) for the Citak Classification and 0.95 (range 0.83-0.97) for the Dorr Classification. There was also an excellent intra-observer agreement with 95% average pairwise per cent agreement for the Citak Classification and 95% average pairwise per cent agreement for the Dorr classification. A statistically significant positive correlation was found between Dorr Calcar Isthmus and Citak Ratio (p < 0.05).

CONCLUSION: In this study, the Dorr and Citak classifications are put into relation to each other for the first time. The morphology of the femur was investigated in its entirety and it was shown that there was a positive correlation between the anatomical shape of the proximal and distal medullary canals.

PMID:36934328 | DOI:10.1007/s00402-023-04833-x

Iran J Immunol. 2023 Mar 14;20(1):114-128. doi: 10.22034/iji.2023.92527.2158.

ABSTRACT

Background: An issue that hinders researchers’ access to Natural Killer (NK) cells is their low proportion in peripheral blood leukocytes. This issue is currently addressed by methods involving a series of differentiation and expansions that are time-consuming and expensive. Objective: We have investigated whether the used leukocyte reduction filters, a by-product in the blood transfusion practice that currently is considered waste, can be utilized as a source of the NK cells. Methods: Following the blood donation of 46 donors based on the Iranian Blood Transfusion Organization’s protocols, a sample of peripheral blood of each donor and the leukocyte reduction filter used in their donation procedure have been obtained. The entrapped cells were flushed back from the leukocyte reduction filters. Both groups of samples were analyzed using an automatic hematological analyzer. NK cell isolation was done by the MACS negative selection method. The samples have been comparatively analyzed utilizing flow cytometry data of NK cells’ subpopulation compositions, viability, degranulation patterns, and cytotoxic capacity against the K562 cell line. Results: Every major leukocyte population was abundant in the samples extracted from the used leukocyte reduction filters. The NK cells extracted from leukocyte reduction filters did not show any statistically meaningful differences (P<0.5) from peripheral blood samples in terms of subpopulation composition, viability, degranulation potency, and cytotoxic capacity. Conclusion: Used leukocyte reduction filters can be considered an economic, easy to obtain, and robust source of abundant research-grade NK cells.

PMID:36934322 | DOI:10.22034/iji.2023.92527.2158

Iran J Immunol. 2023 Mar 14;20(1):104-113. doi: 10.22034/iji.2023.96695.2453.

ABSTRACT

Background: Abnormal humoral and cellular immune responses have been reported in immune-mediated polyneuropathies. CD137, as a costimulatory molecule and a TNF receptor superfamily member, has been demonstrated to have a key role in the pathogenesis of many autoimmune as well as inflammatory disorders. Objective: To evaluate the transcripts levels of CD137, its ligand (CD137L), and the serum levels of soluble CD137 (sCD137) in patients with immune-mediated polyneuropathy. Methods: A total of 45 patients and 46 sex and age-matched healthy individuals were enrolled in the study. CD137 and CD137L transcript levels were assessed by the Real-Time PCR, and the serum level of sCD137 was measured using the ELISA technique. The Bayesian regression model was used for statistical analysis at the 0.05 significance level in R 4.1.0 statistical environment. Results: Transcript levels of the CD137 and CD137L were higher in polyneuropathy patients in comparison with the healthy subjects (P=0.006 for both). Conversely, the mean level of sCD137 was significantly lower in the sera of patients compared to the controls (P<0.001). Conclusion: Our findings point to the possible role of CD137 and CD137L in immune-mediated polyneuropathy pathogenesis. More investigations are required to clarify the exact contributions of the mentioned molecules to the pathogenesis of immune-mediated polyneuropathies.

PMID:36934321 | DOI:10.22034/iji.2023.96695.2453

Int Forum Allergy Rhinol. 2023 Mar 19. doi: 10.1002/alr.23158. Online ahead of print.

ABSTRACT

BACKGROUND: Olfactory dysfunction has been reported to be involved in Parkinson’s disease (PD) pathogenesis. However, gustatory dysfunction in PD has not been evaluated as in-depth as olfactory dysfunction. We reviewed the previously published studies regarding gustatory function in PD patients and suggested the possibility that gustatory dysfunction may also be associated with PD.

METHODS: MEDLINE, Cochrane Library, Embase, and PubMed databases were searched for studies evaluating gustatory function in PD patients. We used the standardized mean difference and a 95% confidence interval (CI) as the effect analysis index regarding the taste strip test. The relative risk and 95% CI were used as the effect analysis index for the questionnaires and propylthiouracil (PTU)/phenylthiocarbamide (PTC) perception test. Statistical heterogeneity was assessed using forest plots, Cochran’s Q, and the I² statistic; heterogeneity was considered high when I² was over 75%. Publication bias was assessed by funnel plots and the Egger bias test.

RESULTS: We identified 19 articles that reported the results of gustatory function tests in PD patients and healthy controls. Most of these studies used various gustatory tests, including taste strips, questionnaires, taste solutions, PTU/PTC perception tests, and electrogustometry, and reported significantly lower gustatory function in PD patients than in the controls. However, several articles reported contradictory results.

CONCLUSIONS: Based on these studies, gustatory dysfunction is closely related to PD. However, the number of studies and enrolled subjects was small, and a unified gustatory function test was lacking. Therefore, further studies with larger populations and normalized gustatory function tests are needed. This article is protected by copyright. All rights reserved.

PMID:36934313 | DOI:10.1002/alr.23158

Schizophr Bull. 2023 Mar 19:sbad017. doi: 10.1093/schbul/sbad017. Online ahead of print.

ABSTRACT

BACKGROUND AND HYPOTHESIS: Children exposed to socioenvironmental adversities (eg, urbanicity, pollution, neighborhood deprivation, crime, and family disadvantage) are more likely to subsequently develop subclinical psychotic experiences during adolescence (eg, hearing voices, paranoia). However, the pathways through which this occurs have not been previously investigated. We hypothesized that cognitive ability and inflammation would partly explain this association.

STUDY DESIGN: Data were utilized from the Environmental-Risk Longitudinal Twin Study, a cohort of 2232 children born in 1994-1995 in England and Wales and followed to age 18. Socioenvironmental adversities were measured from birth to age 10 and classified into physical risk (defined by high urbanicity and air pollution) and socioeconomic risk (defined by high neighborhood deprivation, neighborhood disorder, and family disadvantage). Cognitive abilities (overall, crystallized, fluid, and working memory) were assessed at age 12; and inflammatory markers (C-reactive protein, interleukin-6, soluble urokinase plasminogen activator receptor) were measured at age 18 from blood samples. Participants were interviewed at age 18 regarding psychotic experiences.

STUDY RESULTS: Higher physical risk and socioeconomic risk were associated with increased odds of psychotic experiences in adolescence. The largest mediation pathways were from socioeconomic risk via overall cognitive ability and crystallized ability, which accounted for ~11% and ~19% of the association with psychotic experiences, respectively. No statistically significant pathways were found via inflammatory markers in exploratory (partially cross-sectional) analyses.

CONCLUSIONS: Cognitive ability, especially crystallized ability, may partly explain the association between childhood socioenvironmental adversity and adolescent psychotic experiences. Interventions to support cognitive development among children living in disadvantaged settings could buffer them against developing subclinical psychotic phenomena.

PMID:36934309 | DOI:10.1093/schbul/sbad017

Alzheimers Dement. 2023 Mar 18. doi: 10.1002/alz.13008. Online ahead of print.

ABSTRACT

Alzheimer’s disease (AD) is a debilitating neurodegenerative disorder, characterized by memory deficit and dementia. AD is considered a multifactorial disorder where multiple processes like amyloid-beta and tau accumulation, axonal degeneration, synaptic plasticity, and autophagic processes plays an important role. In this study, the spatial proteomic differences in the neonatal 5xFAD brain tissue were investigated using MALDI-MSI coupled to LC-MS/MS, and the statistically significantly altered proteins were associated with AD. Thirty-five differentially expressed proteins (DEPs) between the brain tissues of neonatal 5xFAD and their littermate mice were detected via MALDI-MSI technique. Among the 35 proteins identified, 26 of them were directly associated with AD. Our results indicated a remarkable resemblance in the protein expression profiles of neonatal 5xFAD brain when compared to AD patient specimens or AD mouse models. These findings showed that the molecular alterations in the AD brain existed even at birth and that some proteins are neurodegenerative presages in neonatal AD brain. HIGHLIGHTS: Spatial proteomic alterations in the 5xFAD mouse brain compared to the littermate. 26 out of 35 differentially expressed proteins associated with Alzheimer’s disease (AD). Molecular alterations and neurodegenerative presages in neonatal AD brain. Alterations in the synaptic function an early and common neurobiological thread.

PMID:36934297 | DOI:10.1002/alz.13008

Antimicrob Resist Infect Control. 2023 Mar 19;12(1):19. doi: 10.1186/s13756-023-01228-w.

ABSTRACT

OBJECTIVES: This study aimed to identify barriers to the proper use of antibiotics by healthcare professionals and to help the hospital Antimicrobial Stewardship develop suitable actions for the staff.

METHODS: In a Belgian teaching hospital, a survey was conducted among physicians, pharmacists, and nurses involved in antibiotherapy. Questions from the 2019 European Center for Disease Prevention and Control (ECDC) survey were analyzed based on components of the COM-B model (capabilities, opportunities, and motivations). First, collected data were reviewed with the Ethnos software to analyze the different COM-B model components. For statistical analyses, responses were grouped into three clear-cut answers in a Fisher’s exact test.

RESULTS: Overall, 400 staff members were included. We found that our professions, combined, have a good perception of antibiotic resistance (97.8%). For capabilities, however, only 77.2% state that they have sufficient knowledge, with 91.3%, 71.5%, and 63.0% for physicians, nurses, and pharmacists, respectively. For opportunities (access to resources, information, and training), it is observed that 72.2% report having easy access to the guidelines they need to manage infections. In comparison, for 64.2% of the respondents, this information changed their opinion on the useless or inappropriate prescription, administration, and delivery of antibiotics. For 55.0%, this information has enabled them to change their practices. Finally, for motivations, 92.8% of respondents state that they know about the link between their practices and the emergence and spread of antibiotic resistance. However, only 65.0% of participants say they have a role in managing antibiotic resistance. We found that 5 out of 8 questions are significantly dependent on the profession: 2 inquiries related to capability, 1 to opportunity, and 2 to motivation.

CONCLUSION: We found that responses to the ECDC questionnaire are related to the profession. While some topics are universal/cross-functional, others must be explicitly tailored to each professional category. Information is useless if not accessible. Communication and provision of documents are thus paramount.

PMID:36934291 | DOI:10.1186/s13756-023-01228-w

BMC Health Serv Res. 2023 Mar 18;23(1):270. doi: 10.1186/s12913-023-09205-0.

ABSTRACT

BACKGROUND: Sentinel events (SEs) can result in severe and unwanted outcomes. To minimize the fear of sentinel events reporting and the occurrence of sentinel events, patient safety culture improvements within healthcare organizations is needed. To our knowledge, limited studies explored the relationships between patient safety culture and sentinel events on a local level and no research has been conducted at the national level in Saudi Arabia.

OBJECTIVES: This study aimed to explore the relationships between the patient safety culture and the reported-SEs on a national level during the year 2020 in Saudi hospitals.

METHODS: This was a descriptive study. We utilized two data sources (the reported-SEs and the patient safety culture survey) that were linked using hospitals information. To explore the relationships between patient safety culture and reported-SEs rates, we performed descriptive statistics, a test of independence, post-hoc analysis, correlation analysis, and multivariate regression and stepwise analyses.

RESULTS: The highest positive domain scores in patient safety culture domains in the Saudi hospitals (n = 366) were “Teamwork Within Units” (80.65%) and “Organizational learning-continuous improvement” (80.33%), and the lowest were “Staffing” (32.10%) and “Nonpunitive Response to Error” (26.19%). The highest numbers of reported-SEs in 103 hospitals were related to the contributory factors of “Communication and Information” (63.20%) and “Staff Competency and Performance” (61.04%). The correlation analysis performed on 89 Saudi hospitals showed that higher positive patient safety culture scores were significantly associated with lower rates of reported-SEs in 3 out of the 12 domains, which are “Teamwork Within Units”, “Communication Openness”, and “Handoffs and Transitions”. Multivariate analyses showed that “Handoffs and Transitions”, “Nonpunitive Response to Error”, and “Teamwork Within Units” domains were significant predictors of the number of SEs. The “Staff Competency and Performance” and “Environmental Factors” were the most contributory factors of SEs in the number of significant correlations with the patient safety culture domains.

CONCLUSION: This study identified patient safety culture areas of improvement where hospitals in Saudi Arabia need actions. Our study confirms that a more positive patient safety culture is associated with lower occurrence of sentinel events. To minimize the fear of sentinel events reporting and to improve overall patient safety a culture change is needed by promoting a blame-free culture and improving teamwork, handoffs, and communication openness.

PMID:36934282 | DOI:10.1186/s12913-023-09205-0