Tag: statistics

PM R. 2023 May 4. doi: 10.1002/pmrj.12990. Online ahead of print.

ABSTRACT

INTRODUCTION: Children with infantile hemiplegia with low or very low bimanual functional performance have great impediments to spontaneously use their affected upper limb, which affects their performance of day-to-day activities and their quality of life.

OBJECTIVE: The main objective of our study was to determine whether the order of application and the dose of modified Constraint Induced Movement Therapy within a combined (hybrid) protocol influences the results of bimanual functional performance of the affected upper limb and the quality of life of children with congenital hemiplegia (5-8 years old) with very low/low bimanual functional performance.

DESIGN: single-blinded randomized controlled trial.

PARTICIPANTS: Twenty-one children with congenital hemiplegia (5-8 years old) were recruited from two public hospitals and an infantile hemiplegia association in Spain.

INTERVENTIONS: The experimental group (n = 11) received 100 hours of intensive therapies for affected upper limb: 80 hours of modified Constraint Induced Movement Therapy and 20 hours of bimanual intensive therapy. The control group (n = 10) received the same dose with 80 hours of bimanual intensive therapy and 20 hours of modified Constraint Induced Movement Therapy. The protocol was provided 2 hours per day, 5 days per week, for 10 weeks.

OUTCOME MEASURES: The primary outcome was bimanual functional performance, measured with the Assisting Hand Assessment, and the second outcome was quality of life, measured with the Pediatric Quality of Life Inventory Cerebral-Palsy module (PedsQL™ v. 3.0, CP module). Four assessments were performed: Week 0-4-8-10.

RESULTS: The experimental group obtained an increase of 22 AHA units at week 8 with the application of modified Constraint Induced Movement, in contrast with the control group, who obtained an increase of 3.7 AHA units after Bimanual Intensive Therapy. At week 10, the control group showed its greatest increase in bimanual functional performance, with 10.6 AHA units after modified Constraint Induced Movement Therapy. Regarding quality of life, the greatest improvement occurred after modified Constraint Induced Movement, with 13.1 points in the experimental group (80 hours), and 6.3 points in the control group (20 hours). The protocol interaction was statistically significant for bimanual functional performance (p = 0.018) and quality of life (p = 0.09).

CONCLUSIONS: modified Constraint Induced Movement Therapy is more beneficial than Bimanual Intensive Therapy to improve upper limb functioning and quality of life in children with congenital hemiplegia showing very low/low bimanual performance. This article is protected by copyright. All rights reserved.

PMID:37139775 | DOI:10.1002/pmrj.12990

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2023 Apr 25;40(2):373-377. doi: 10.7507/1001-5515.202208060.

ABSTRACT

Heart failure is a disease that seriously threatens human health and has become a global public health problem. Diagnostic and prognostic analysis of heart failure based on medical imaging and clinical data can reveal the progression of heart failure and reduce the risk of death of patients, which has important research value. The traditional analysis methods based on statistics and machine learning have some problems, such as insufficient model capability, poor accuracy due to prior dependence, and poor model adaptability. In recent years, with the development of artificial intelligence technology, deep learning has been gradually applied to clinical data analysis in the field of heart failure, showing a new perspective. This paper reviews the main progress, application methods and major achievements of deep learning in heart failure diagnosis, heart failure mortality and heart failure readmission, summarizes the existing problems and presents the prospects of related research to promote the clinical application of deep learning in heart failure clinical research.

PMID:37139771 | DOI:10.7507/1001-5515.202208060

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2023 Apr 25;40(2):343-349. doi: 10.7507/1001-5515.202201051.

ABSTRACT

Without artificial airway though oral, nasal or airway incision, the bi-level positive airway pressure (Bi-PAP) has been widely employed for respiratory patients. In an effort to investigate the therapeutic effects and measures for the respiratory patients under the noninvasive Bi-PAP ventilation, a therapy system model was designed for virtual ventilation experiments. In this system model, it includes a sub-model of noninvasive Bi-PAP respirator, a sub-model of respiratory patient, and a sub-model of the breath circuit and mask. And based on the Matlab Simulink, a simulation platform for the noninvasive Bi-PAP therapy system was developed to conduct the virtual experiments in simulated respiratory patient with no spontaneous breathing (NSB), chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ARDS). The simulated outputs such as the respiratory flows, pressures, volumes, etc, were collected and compared to the outputs which were obtained in the physical experiments with the active servo lung. By statistically analyzed with SPSS, the results demonstrated that there was no significant difference ( P > 0.1) and was in high similarity ( R > 0.7) between the data collected in simulations and physical experiments. The therapy system model of noninvasive Bi-PAP is probably applied for simulating the practical clinical experiment, and maybe conveniently applied to study the technology of noninvasive Bi-PAP for clinicians.

PMID:37139767 | DOI:10.7507/1001-5515.202201051

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2023 Apr 25;40(2):295-302. doi: 10.7507/1001-5515.202210016.

ABSTRACT

In the orthodontics process, intervention and sliding of an orthodontic bracket during the orthodontic process can arise large response of the labio-cheek soft tissue. Soft tissue damage and ulcers frequently happen at the early stage of orthodontic treatment. In the field of orthodontic medicine, qualitative analysis is always carried out through statistics of clinical cases, while quantitative explanation of bio-mechanical mechanism is lacking. For this purpose, finite element analysis of a three-dimensional labio-cheek-bracket-tooth model is conducted to quantify the bracket-induced mechanical response of the labio-cheek soft tissue, which involves complex coupling of contact nonlinearity, material nonlinearity and geometric nonlinearity. Firstly, based on the biological composition characteristics of labio-cheek, a second-order Ogden model is optimally selected to describe the adipose-like material of the labio-cheek soft tissue. Secondly, according to the characteristics of oral activity, a two-stage simulation model of bracket intervention and orthogonal sliding is established, and the key contact parameters are optimally set. Finally, the two-level analysis method of overall model and submodel is used to achieve efficient solution of high-precision strains in submodels based on the displacement boundary obtained from the overall model calculation. Calculation results with four typical tooth morphologies during orthodontic treatment show that: ① the maximum strain of soft tissue is distributed along the sharp edges of the bracket, consistent with the clinically observed profile of soft tissue deformation; ② the maximum strain of soft tissue is reduced as the teeth align, consistent with the clinical manifestation of common damage and ulcers at the beginning of orthodontic treatment and reduced patient discomfort at the end of treatment. The method in this paper can provide reference for relevant quantitative analysis studies in the field of orthodontic medical treatment at home and abroad, and further benefit to the product development analysis of new orthodontic devices.

PMID:37139761 | DOI:10.7507/1001-5515.202210016

Prehosp Disaster Med. 2023 May 4:1-7. doi: 10.1017/S1049023X2300047X. Online ahead of print.

ABSTRACT

BACKGROUND: Incorporating emerging knowledge into Emergency Medical Service (EMS) competency assessments is critical to reflect current evidence-based out-of-hospital care. However, a standardized approach is needed to incorporate new evidence into EMS competency assessments because of the rapid pace of knowledge generation.

OBJECTIVE: The objective was to develop a framework to evaluate and integrate new source material into EMS competency assessments.

METHODS: The National Registry of Emergency Medical Technicians (National Registry) and the Prehospital Guidelines Consortium (PGC) convened a panel of experts. A Delphi method, consisting of virtual meetings and electronic surveys, was used to develop a Table of Evidence matrix that defines sources of EMS evidence. In Round One, participants listed all potential sources of evidence available to inform EMS education. In Round Two, participants categorized these sources into: (a) levels of evidence quality; and (b) type of source material. In Round Three, the panel revised a proposed Table of Evidence. Finally, in Round Four, participants provided recommendations on how each source should be incorporated into competency assessments depending on type and quality. Descriptive statistics were calculated with qualitative analyses conducted by two independent reviewers and a third arbitrator.

RESULTS: In Round One, 24 sources of evidence were identified. In Round Two, these were classified into high- (n = 4), medium- (n = 15), and low-quality (n = 5) of evidence, followed by categorization by purpose into providing recommendations (n = 10), primary research (n = 7), and educational content (n = 7). In Round Three, the Table of Evidence was revised based on participant feedback. In Round Four, the panel developed a tiered system of evidence integration from immediate incorporation of high-quality sources to more stringent requirements for lower-quality sources.

CONCLUSION: The Table of Evidence provides a framework for the rapid and standardized incorporation of new source material into EMS competency assessments. Future goals are to evaluate the application of the Table of Evidence framework in initial and continued competency assessments.

PMID:37139715 | DOI:10.1017/S1049023X2300047X

Chempluschem. 2023 May 4:e202300111. doi: 10.1002/cplu.202300111. Online ahead of print.

ABSTRACT

Metal dispersion is a key concept in the heterogeneous catalysis. The conventional approach for its estimation strongly relies on chemisorption with different probe molecules. Albeit it can generally provide an ‘averaged’ value in a cost-effective manner, the inhomogeneity of the metal species and the complicated metal-support interactions pose formidable challenges for the accurate determination. Full metal species quantification (FMSQ) is introduced as an advanced method to depict the whole distribution of the metal species, ranging from single atoms to clusters and nanoparticles, in a practical solid catalyst. In this approach, automated analysis of massive high-angle annular dark field scanning transmission electron microscopic images is realized through algorithms specialized in combining the electron microscopy-based atom recognition statistics and deep learning-driven nanoparticle segmentation. FMSQ can circumvent the drawbacks of chemisorption, allowing more reliable structure-performance relationships beyond the metal size.

PMID:37139714 | DOI:10.1002/cplu.202300111

Analyst. 2023 May 4. doi: 10.1039/d3an00511a. Online ahead of print.

ABSTRACT

A facile and high-resolution enhancement of latent fingerprints (LFPs) has been developed by using a wet nitrocellulose (NC) membrane as a matrix under natural light. A clear fingerprint pattern was presented on the membrane after a fingertip touch owing to the difference in light transmittance between the ridge residues and the wet-NC-membrane background. Compared with conventional methods, this protocol can provide a higher resolution fingerprint image to extract level 3 details accurately. It is also compatible with commonly used fingerprint visualization techniques (magnetic ferric oxide powder and AgNO₃. The modified membrane could be more general to realize the high-resolution visualization of LFP transferred from various substrates, even independent of light projection. Due to the excellent feasibility and reproducibility of level 3 details extracted by the wet NC membrane, the frequency distribution of the distance between adjacent sweat pores (FDDasp) could be used to effectively distinguish the fragmentary fingerprints. Finally, the level 3 features of LFPs from females and males were conveniently extracted by the wet-NC-membrane method for gender identification. The statistical results indicated that females had a higher average sweat pore density (115/9 mm²) than males (84/9 mm²). Taken together, this approach provided a high-resolution, reproducible, and accurate imaging of LFPs, which shows great promise for forensic information analysis.

PMID:37139711 | DOI:10.1039/d3an00511a

Musculoskeletal Care. 2023 May 4. doi: 10.1002/msc.1770. Online ahead of print.

ABSTRACT

BACKGROUND: Musculoskeletal shoulder pain is a common problem and its symptoms often become persistent. The experience of pain is multidimensional, and therefore, a range of patient characteristics may influence treatment response. An altered sensory processing has been associated with persistent musculoskeletal pain states and may contribute to outcomes in patients with musculoskeletal shoulder pain. The presence and potential impact of altered sensory processing in this patient cohort is not currently known. The aim of this prospective longitudinal cohort study is to investigate if baseline sensory characteristics are associated with clinical outcomes in patients presenting to a tertiary hospital with persistent musculoskeletal shoulder pain. If found, a relationship between sensory characteristics and outcome may lead to the creation of more effective treatment strategies and improvements in risk adjustment and prognosis.

METHODS: This is a single-centre prospective cohort study with 6-, 12- and 24-month follow-up. A total of 120 participants aged ≥18 years with persistent musculoskeletal shoulder pain (≥3 months) will be recruited from an Australian public tertiary hospital orthopaedic department. Baseline assessments, including quantitative sensory tests and a standardised physical examination, will be performed. In addition, information will be obtained from patient interviews, self-report questionnaires and medical records. Follow-up outcome measures will comprise information from the Shoulder Pain and Disability Index and a six-point Global Rating of Change scale.

ANALYSIS: Descriptive statistics will be used to report baseline characteristics and outcome measures over time. Change in outcome measures at the primary endpoint of six months from baseline will be calculated using paired t-tests. Associations between baseline characteristics and outcomes at a 6-month follow-up will be reported using multivariable linear and logistic regression models.

DISCUSSION: Understanding the relationship between sensory profile and the variable response to treatment in people with persistent musculoskeletal shoulder pain may enhance our understanding of the mechanisms contributing to the presentation. In addition, through better understanding of the contributing factors, the results of this study may contribute to the development of an individualised, patient-centred approach to treatment for people with this highly prevalent and debilitating condition.

PMID:37139704 | DOI:10.1002/msc.1770

Glob Health Action. 2023 Dec 31;16(1):2203544. doi: 10.1080/16549716.2023.2203544.

ABSTRACT

BACKGROUND: In India, caesarean delivery (CD) accounts for 17% of the births, of which 41% occur in private facilities. However, areas to CD in rural areas are limited, particularly for the poor populations. Little information is available on state-wise district-level CD rates by geography and the population wealth quintiles, especially in Madhya Pradesh (MP), the fifth most populous and third poorest state.

OBJECTIVE: Investigate geographic and socioeconomic inequities of CD across the 51 districts in MP and compare the contribution of public and private healthcare facilities to the overall state CD rate.

METHODS: This cross-sectional study utilised the summary fact sheets of the National Family Health Survey (NFHS)-5 performed from January 2019 to April 2021. Women aged 15 to 49 years, with live births two years preceding the survey were included. District-level CD rates in MP were used to determine the inequalities in accessing CD in the poorer and poorest wealth quintiles. CD rates were stratified as <10%, 10-20% and >20% to measure equity of access. A linear regression model was used to examine the correlation between the fractions of the population in the two bottom wealth quintiles and CD rates.

RESULTS: Eighteen districts had a CD rate below 10%, 32 districts were within the 10%-20% threshold and four had a rate of 20% or higher. Districts with a higher proportion of poorer population and were at a distance from the capital city Bhopal were associated with lower CD rates. However, this decline was steeper for private healthcare facilities (R2 = 0.382) revealing a possible dependency of the poor populations on public healthcare facilities (R2 = 0.009) for accessing CD.

CONCLUSION: Although CD rates have increased across MP, inequities within districts and wealth quintiles exist, warranting closer attention to the outreach of government policies and the need to incentivise CDs where underuse is significant.

PMID:37139686 | DOI:10.1080/16549716.2023.2203544

AIDS. 2023 Jun 1;37(7):1165-1166. doi: 10.1097/QAD.0000000000003550.

NO ABSTRACT

PMID:37139652 | DOI:10.1097/QAD.0000000000003550