Tag: statistics

Cardiovasc Toxicol. 2022 Aug 5. doi: 10.1007/s12012-022-09764-4. Online ahead of print.

ABSTRACT

Many drugs carry some risk of QT interval prolongation, which can lead to life-threatening dysrhythmias including Torsades de Pointes (TdP). CredibleMeds.org identifies medications categorized as “Known Risk of TdP” but does not stratify risk in acute supratherapeutic ingestions. We sought to determine the proportion of cases exhibiting QTc prolongation and life-threatening dysrhythmias including ventricular tachycardia (VT)/ventricular fibrillation (VF), TdP, and asystole in patients exposed to these substances. Retrospective chart review of cases reported to our Regional Poison Center from 2014 to 2019 of exposures to one or more of the “Known Risk” substances was performed. Demographics, therapies, clinical effects, and medical outcome for each case were analyzed. There were 1125 exposures, of which 760 had a documented QTc interval. QTc ≥ 500 ms was reported in 138 (18.2%) of the 760 cases. The most common “Known Risk” substances were citalopram, escitalopram and cocaine. Although not in the “Known Risk” category, mirtazapine, amitriptyline, diphenhydramine, and trazodone had a statistically significant association with QTc > 500 ms. Life-threatening dysrhythmias occurred in 13 cases, with VT/VF in 6 of the 760 (0.8%) cases, and one case of TdP. Flecainide (OR 11.1, 95% CI 2.2-55.8) and methadone (OR 7.1, 95% CI 2.1-23.4) were associated with increased risk of all life-threatening dysrhythmias. Exposures to medications on the Credible Meds list of “Known Risk of TdP” QTc prolongation is common, but life-threatening dysrhythmias are rare. Mirtazapine, amitriptyline, diphenhydramine, and trazodone were associated with prolonged QTc. Flecainide and methadone had the highest associated risk of life-threatening dysrhythmias.

PMID:35930218 | DOI:10.1007/s12012-022-09764-4

AIDS Behav. 2022 Aug 5. doi: 10.1007/s10461-022-03782-7. Online ahead of print.

ABSTRACT

Although HIV pre-exposure prophylaxis (PrEP) is free in Thailand, many transgender women discontinue taking it after initiation. We determined the loss to follow-up (LTFU) rate of transgender women who initiated PrEP at the Mplus Foundation, Chiang Mai, Thailand, and identified associated risk factors using Cox proportional hazard models. Of 235 participants who initiated PrEP, 59 (55%) out of 108 remaining participants had reactive syphilis. The LTFU rate at 6 months was 38% (95% confidence interval [CI]: 29-48%). Multivariable analysis indicates that LTFU is independently associated with age ≥ 26 years old (adjusted hazard ratio [aHR] = 2.09; 95% CI: 1.06-4.14) and reactive syphilis (aHR = 1.98; 95% CI:1.01-3.88). Delayed appointment scheduling by the PrEP providers and the syphilis clinic was associated with transgender women having reactive syphilis, and the lockdown policy during the COVID-19 pandemic might have influenced them to discontinue PrEP and their subsequent LTFU.

PMID:35930202 | DOI:10.1007/s10461-022-03782-7

Environ Monit Assess. 2022 Aug 5;194(9):646. doi: 10.1007/s10661-022-10299-y.

ABSTRACT

Digital Shoreline Analysis System (DSAS) is the most frequently used coastal engineering system for shoreline change quantification. Factors like human and system errors, wrong perception of the shoreline changes, and non-exact data sources may cause errors in the measured data. Detection and modification of such data can increase the accuracy of results. At present, the DSAS tool lacks this capability, so this research aimed to present a new module for DSAS to detect uncertain data in shoreline change rate measurements. The module’s basis for detecting uncertain data is to use statistical methods: adjusted boxplot, Grubbs’ test, standard deviation tests, median test, modified Z-score test, and voting method. The module’s performance was evaluated based on a data set obtained through Qeshm Island shoreline change quantification in Iran. The details of these methods, the prepared module, the case study, and the shoreline change measurement statistical methods were discussed in this study. The results showed the acceptable output of this module in detecting uncertain data.

PMID:35930198 | DOI:10.1007/s10661-022-10299-y

Sleep Breath. 2022 Aug 5. doi: 10.1007/s11325-022-02687-y. Online ahead of print.

ABSTRACT

PURPOSE: Obstructive sleep apnea (OSA) can impair cognition. Continuous positive airway pressure (CPAP) is a recommended treatment for OSA but its effectiveness on cognitive improvement is uncertain, a finding which may be biased by various durations and adherence to treatment with CPAP. In a meta-analysis assessing high-quality randomized controlled trials (RCTs), we estimated whether or not CPAP benefits cognition in patients with OSA.

METHODS: PRISMA criteria were followed in the performance of this meta-analysis. The weighted mean difference (WMD) and 95% confidence interval (CI) of six neuropsychological scores covering eight cognitive domains were used to evaluate the benefit between CPAP and non-CPAP interventions. Subgroups of different therapeutic durations and adherence, which were divided into short-term (< 8 weeks) and long-term (≥ 12 weeks) durations, and poor (nighttime < 4 h/night) and good (nighttime ≥ 4 h/night) adherence were also analyzed.

RESULTS: Among 16 RCTs, 1529 participants with OSA were included. Comparing the CPAP group and the control group for all treatment durations and adherence, a mild improvement for digit span forward which reflected short-term memory was observed (WMD[95%CI] = 0.67[0.03,1.31], p = 0.04). Trail making test-part B, which reflected executive function was improved for participants with OSA who had good adherence to CPAP (WMD[95%CI] = – 6.24[- 12.60,0.12], p = 0.05). Patients with OSA who received short-term CPAP treatment (WMD[95%CI] = – 7.20[- 12.57, – 1.82], p = 0.009) had a significant improvement in executive function when compared with controls. There was no statistical difference for all scales between long-term (≥ 12 weeks) CPAP treatment group and control group.

CONCLUSION: The effectiveness of CPAP on cognitive improvement in patients with OSA is limited, although good adherence to CPAP can mildly benefit executive function with short-term effectiveness.

PMID:35930191 | DOI:10.1007/s11325-022-02687-y

J Med Ultrason (2001). 2022 Aug 5. doi: 10.1007/s10396-022-01244-0. Online ahead of print.

ABSTRACT

PURPOSE: Using simple experimental models for lung ultrasound, we evaluated the relationship of the attenuation inside the sources of vertical artifacts to the echo intensity and attenuation of artifacts.

METHODS: As sources of artifacts, we made 10 different hemispherical gel objects with two different mediums (pure agar or agar containing graphite with an attenuation coefficient of 0.5 dB/cm · MHz) and five different diameters (3.6, 5.6, 7.5, 9.5, or 11.4 mm). Ten of each hemispherical gel object were prepared for the statistical analyses. Each object was placed onto a chest wall phantom as the plane of the hemisphere was placed in an upward position. The echo intensity and attenuation of the artifact generated from each object was measured and compared.

RESULTS: For all sizes, the intensity and attenuation of the artifacts in the objects made of agar containing graphite were significantly lower and larger, respectively, than those in the objects made of pure agar. In the objects containing graphite, the intensity decreased when the frequency was changed from 5 to 9 MHz.

CONCLUSION: Based on this experiment, assessing the intensity and attenuation of vertical artifacts may help estimate the physical composition of sources of vertical artifacts in lung ultrasound.

PMID:35930175 | DOI:10.1007/s10396-022-01244-0

Environ Sci Pollut Res Int. 2022 Aug 5. doi: 10.1007/s11356-022-22267-7. Online ahead of print.

ABSTRACT

The present study aims to understand the spatio-temporal dynamics in habitat ecology and fish assemblage and determine the relationship of habitat transition and fish distribution in a large riverine-reservoir cascade system (Sardar Sarovar Reservoir part in Madhya Pradesh). This study was carried out along a 125-km riverine-reservoir interface (RRI) during 2018-2020. The study showed presence of a total of 110 fish species (104 spp. in upstream main Narmada River stretch excluding reservoirs, 56 in RRI, and 39 in Sardar Sarovar reservoir). We recorded 50 species common in upstream riverine stretch of Narmada and the RRI while RRI uniquely harbored 3 native species (Chitala chitala, Labeo boga, Salmostoma phulo) not previously reported from Narmada River stretch upstream. The similarity percentage (SIMPER) analysis showed presence of S. phulo causing 27.91%, Schistura dayi (3.71%), and Rita pavimentata (3.41%) of dissimilarity among Maheshwar (S1), Rajghat (S2), Koteshwar (S3) non-confluence zone, and Kakrana (S4)-confluence zone. The analysis of data indicated disappearance of some species like deccan peninsular carp Labeo fimbriatus, Mahseer Tor khudree which was earlier reported but was absent in recent years. The statistical correlation of environmental variables with observed abundances of fish feeding guilds showed significant positive correlation with specific conductivity and total dissolved solid content of the water. The canonical correspondence analysis (CCA) indicated association among omnivorous fishes of the reservoir with water temperature; total dissolved solids; specific conductivity; total alkalinity; chlorophyll; and NO₃-N. The herbivore fishes were found to be more associated with magnesium, dissolved oxygen, and phosphorus content of the water while insectivorous fishes were more associated with the silicate and transparency of the water. The abundance of omnivores species indicated dominance of generalist fish species rather than specialists in the interface region of reservoir showing conservation and ecological importance of the ecosystem. The baseline information generated on fish assemblage and ecological perspectives of the river reservoir interface and science-based management recommendations formulated in the study are critical for sustaining fish diversity, promoting fisheries enhancement, and management planning of tropical large reservoirs.

PMID:35930149 | DOI:10.1007/s11356-022-22267-7

Environ Sci Pollut Res Int. 2022 Aug 5. doi: 10.1007/s11356-022-22235-1. Online ahead of print.

ABSTRACT

In the era of global urbanization, the cities across the world are experiencing significant change in the climate pattern. However, analysing the trend and pattern of rainfall over the urban areas has a number of challenges such as availability of long-term data as well as the uneven distribution of rain-gauge stations. In this research, the rainfall regionalization approach has been applied along with the advanced statistical techniques for analysing the trend and pattern of rainfall in the Delhi metropolitan city. Fuzzy C-means and K-means clustering techniques have been applied for the identification of homogeneous rainfall regions while innovative trend analysis (ITA) along with the family of Mann-Kendall (MK) tests has been applied for the trend analysis of rainfall. The result shows that in all rain-gauge stations of Delhi, an increasing trend in rainfall has been recorded during 1991-2018. But the rate of increase was low as the trend slope of ITA and Sen’s slope in MK tests are low, which varies between 0.03 and 0.05 and 0.01 and 0.16, respectively. Furthermore, none of the rain-gauge stations have experienced a monotonic trend in rainfall as the null hypothesis has not been rejected (p value > 0.05) for any stations. Furthermore, the study shows that ITA has a better performance than the family of MK tests. The findings of this study may be utilized for the urban flood mitigation and solving other issues related to water resources in Delhi and other cities.

PMID:35930147 | DOI:10.1007/s11356-022-22235-1

Clin Oral Investig. 2022 Aug 5. doi: 10.1007/s00784-022-04644-1. Online ahead of print.

ABSTRACT

AIM: This study aimed to identify medications taken by patients before dental appointments and to simulate and characterize their interactions with medications often prescribed by dental surgeons.

MATERIALS AND METHODS: A retrospective cross-sectional study evaluated 320 medical records, 118 from the Emergency Service (ES) archives, and 202 from elective appointments at the Dental Clinic (DC) of a university in southern Brazil. Drug interactions were identified and classified according to severity using the Medscape® application into four grades: (1) Minor, (2) Monitor closely, (3) Serious, or (4) Contraindicated. Descriptive and inferential statistical analyses were carried out (α = 5%).

RESULTS: Preexisting systemic conditions were noted in 55.9% of the medical records from the ES and 64.35% from the DC. In the ES records, 47.45% contained information on continuous use medication for treatment of systemic conditions and 59.40% of DC records contained such information. A total of 359 potential interactions were found. Drug interactions with analgesics were most frequent, accounting for 50.41% of the sample.

CONCLUSIONS: The most prevalent drug interaction severity was grade 2: monitor or use with caution. Many patients take medications to treat systemic conditions and seek dental care, generating a significant possible source of drug interactions.

CLINICAL RELEVANCE: Prescribers must carefully analyze the patients’ medical histories and obtain accurate data regarding their use of medications to be able to assess the risk-benefit relationships of possible combinations.

PMID:35930141 | DOI:10.1007/s00784-022-04644-1

Pharmacoeconomics. 2022 Aug 5. doi: 10.1007/s40273-022-01172-4. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to compare the responsiveness of EQ-5D-3L (3L) with EQ-5D-5L (5L) descriptive systems and value sets in two independent samples (rehabilitation and stroke patients).

METHODS: Descriptive system results were compared cross-sectionally, and descriptive responsiveness was tested by calculating changed level responses (‘moves’) from baseline to follow-up, proportion of improved patients, Paretian Classification of Health Change (PCHC), and probability of superiority (PS). Responsiveness of values based on nine country-specific value sets was assessed by standardized response mean (SRM) and standardized effect size (SES). Relative efficiency of 5L over 3L was assessed by calculating ratios of the SRM and SES statistics.

RESULTS: Descriptive comparisons confirmed earlier evidence and showed a consistent overestimation of health problems in 3L. Descriptive responsiveness improved with 5L in terms of moves per respondent, proportions of improved patients and PS, whereas PCHC showed mixed results. Better value responsiveness statistics were observed for 5L in rehabilitation patients for all value sets. In stroke patients, 3L showed better responsiveness statistics compared with 5L. Relative efficiency results were moderately to strongly better with 5L for rehabilitation, and slightly to moderately better with 3L for stroke.

CONCLUSIONS: Descriptive results were the main driver of 3L-5L responsiveness differences. Responsiveness of 3L was influenced by the ‘confined to bed’ label and the overestimation bias of 3L, which affected all responsiveness results. This may impact quality-adjusted life-year (QALY) estimations, leading to over- or underestimations of QALYs gained, depending on the condition and condition severity. QALY calculations based on 5L data will result in more accurate estimates.

PMID:35930137 | DOI:10.1007/s40273-022-01172-4

Ann Palliat Med. 2022 Jul;11(7):2478-2491. doi: 10.21037/apm-22-656.

ABSTRACT

BACKGROUND: The efficacy and safety between connective tissue graft (CTG) and acellular dermal matrix (ADM) remain inconsistent. Meta-analysis is a valuable approach to resolve inconsistencies across studies and provide a high level of evidence to comprehensively evaluate the effect and safety of ADM versus CTG for root coverage of Miller’s Class I and II gingival recession. Our study was conducted to comprehensively analyze the efficacy and safety of ADM versus CTG for root coverage in patients with gingival recession.

METHODS: Articles on randomized controlled trials (RCTs) that compared the ADM with CTG for adult patients with the gingival recession in terms of percent root coverage (PRC), clinical attachment level (CAL), keratinized tissue (KT), probing depth (PD), recession width (RW), and recession depth (RD) were identified in PubMed, Embase, Cochrane Library, and Web of Science databases until 15 May 2020. Weighted mean difference (WMD) was used as the statistic for measurement data and the effect sizes were expressed as 95% confidence intervals (CIs).

RESULTS: A total of 24 RCTs were eligible for the final analysis. A total of 587 patients with 1,315 gingival recession sites were involved in the study. There were 724 loci in the ADM group and 591 loci in the CTG group. The patients who underwent ADM had a higher gain in CAL (WMD: 0.25, 95% CI: 0.03 to 0.47, P=0.026) but a smaller gain in KT width (WMD: -0.44, 95% CI: -0.63 to -0.25, P<0.001) than those who underwent CTG. No significant differences were found between the patients who underwent ADM and those who received CTG in PRC (WMD: -1.61, 95% CI: -3.49 to 0.28, P=0.094), PD (WMD: 0.07, 95% CI: -0.01 to 0.14, P=0.067), RW (WMD: 0.07, 95% CI: -0.10 to 0.23, P=0.437), and RD (WMD: 0.11, 95% CI: -0.10 to 0.31, P=0.294).

DISCUSSION: The ADM treatment for patients with gingival recession may be superior to CTG in gaining CAL, but CTG has a significant advantage over ADM for gaining KT width. ADM can be considered in the future as a treatment for root coverage in patients with gingival recession.

PMID:35927781 | DOI:10.21037/apm-22-656