Tag: statistics

J Nurs Manag. 2022 Jun 10. doi: 10.1111/jonm.13708. Online ahead of print.

ABSTRACT

AIMS: To explore the prevalence and potential facilitators and inhibitors of compassion fatigue and compassion satisfaction among Chinese palliative care nurses.

BACKGROUND: Nurses with compassion fatigue may suffer from health-related problems, causing decreased work efficiency and quality of care. Palliative care nurses are especially at risk of compassion fatigue due to close contact with terminal patients.

METHODS: A province-wide cross-sectional survey using convenience sampling was conducted among 318 palliative care nurses at 25 hospitals and healthcare institutions in Sichuan Province, China. Data were collected using demographic questionnaire and five scales: Professional Quality of Life Scale, General Self-Efficacy Scale, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and Connor-Davison Resilience Scale. Data analyses including descriptive statistics, t-test, one-way ANOVA, simple linear regression, and multiple linear regression.

RESULTS: Mean scores (SD) for burnout, secondary traumatic stress, and compassion satisfaction were 25.42 (4.75), 26.08 (5.72), and 35.67 (5.77), respectively. Related factors predicted 40.30%, 27.10%, and 35.4% of the variance in the model of burnout, secondary traumatic stress, and compassion satisfaction, respectively (all P<0.001).

CONCLUSIONS: The levels of burnout and secondary traumatic stress among Chinese palliative care nurses were higher than those among other types of nurses. Social support, resilience, positive coping, family recognition of work, and income satisfaction are inhibitors of compassion fatigue among palliative care nurses. Implications for Nursing Management Nursing administrators and educators should consider providing effective and targeted strategies (e.g. ongoing training and psychological interventions) to decrease compassion fatigue among palliative care nurses based on the cultural and ethical settings.

PMID:35689416 | DOI:10.1111/jonm.13708

J Dent Res. 2022 Jun 10:220345221100234. doi: 10.1177/00220345221100234. Online ahead of print.

ABSTRACT

The periodontal ligament (PDL) provides support, proprioception, nutrition, and protection within the tooth-PDL-bone complex (TPBC). While understanding the mechanical behavior of the PDL is critical, current research has inferred PDL mechanics from finite element models, from experimental measures on complete TPBCs, or through direct measurement of isolated PDL sections. Here, transducers are used in an attempt to quantify ex vivo PDL strain. In-fiber Bragg grating (FBG) sensors are small flexible sensors that can be placed within an intact TPBC and yield repeatable strain measurements from within the PDL space. The objective of this study was to determine: 1) if the FBG strain measured from the PDL space of intact swine premolars ex vivo was equivalent to physical PDL strains estimated through finite element analysis and 2) if a change in FBG strain could be linearly related to a change in finite element strain under variable tooth displacement, applied to an intact swine TPBC. Experimentally, individual TPBCs were subjected to 2 displacements (n = 14). The location of the FBG was determined from representative micro-computed tomography images. From a linear elastic finite element model of a TPBC, the strain magnitudes at the sensor locations were recorded. An experimental ratio (i.e., FBG strain at the first displacement divided by the FBG strain at the second displacement) and a finite element ratio (i.e., finite element strain at the first displacement divided by the finite element strain at the second displacement) were calculated. A linear regression model indicated a statistically significant relationship between the experimental and finite element ratio (P = 0.017) with a correlation coefficient (R²) of 0.448. It was concluded that the FBG sensor could be used as a measure for a change in strain and thus could be implemented in applications where the mechanical properties of an intact PDL are monitored over time.

PMID:35689395 | DOI:10.1177/00220345221100234

Neuropathol Appl Neurobiol. 2022 Jun 10:e12828. doi: 10.1111/nan.12828. Online ahead of print.

ABSTRACT

OBJECTIVES: Acute Nipah (NiV) encephalitis is characterised by a dual pathogenetic mechanism of neuroglial infection and ischaemia-microinfarction associated with vasculitis induced thrombotic occlusion. We investigated the contributions of these two mechanisms in fatal cases.

MATERIALS AND METHODS: We analysed brain tissues (cerebrum, brainstem and cerebellum) from 15 autopsies using light microscopy, immunohistochemistry (IHC), in situ hybridization and quantitative methods RESULTS: Three types of discrete plaque-like parenchymal lesions were identified: Type 1 with neuroglial IHC positivity for viral antigens, and minimal or no necrosis; Type 2 with neuroglial immunopositivity and necrosis; and Type 3 with necrosis but no viral antigens. Most viral antigen/RNA-positive cells were neurons. Cerebral glial immunopositivity was rare suggesting that microinfarction played a more important role in white matter injury. Type 1 lesions were also detected in the brainstem and cerebellum, but the differences between cerebral cortex and these 2 regions were not statistically significant. In the cerebral cortex, Type 1 lesions overwhelmingly predominated, and only 14% Type 1 versus 69% Type 2 lesions were associated with thrombosis. This suggests that neuronal infection as a mechanism of pathogenesis was more important than microinfarction, both in general and in Type 1 lesions in particular. Between the “early” group (<8 days fever) and the “late” group (≥ 8 days fever), there was a decrease of Type 1 and Type 2 lesions with a concomitant increase of Type 3 lesions, suggesting the latter possibly represented late-stage microinfarction and/or neuronal infection.

CONCLUSION: Neuronal infection appears to play a more important role than vasculopathy-induced microinfarction in acute NiV encephalitis.

PMID:35689364 | DOI:10.1111/nan.12828

Med Sci Monit. 2022 Jun 11;28:e936614. doi: 10.12659/MSM.936614.

ABSTRACT

BACKGROUND Extracorporeal shock wave therapy (ESWT) is a modern physiotherapeutic method that is useful for treating musculoskeletal conditions. There are still limited data from well-designed studies evaluating the clinical efficiency of ESWT in low back pain (LBP). Therefore, this study aimed to assess the effectiveness of the focused ESWT (fESWT) in reducing pain and improving the functional status of patients with chronic LBP. MATERIAL AND METHODS The study involved 40 patients with L5-S1 discopathy with chronic LBP pain who were randomized into 2 groups: group A (n=20, mean age of 42.3±13.1 years) and group B (n=20, mean age of 45.4±14 years). Group A was an experimental group treated with an fESWT at the lumbar and sacral spine (0.15 mJ/mm², 1000 pulses, 4 Hz). Group B was a control group, treated with a sham fESWT. The treatment protocol in both groups included identical stabilization training (45 minutes, once a day, 5 days a week). Study outcomes included subjective pain with a visual analog scale (VAS) and Laitinen Pain Scale (LPS), and functional status using the Oswestry Disability Index (ODI). Measurements were made before and after treatments, as well as follow-up observations at 1 and 3 months following ESWT. The study was prospectively registered at the ISRCTN registry platform (no. ISRCTN13785224). RESULTS There was a significant analgesic effect (VAS and LPS) in both groups; however, it was significantly greater in the experimental group compared to the sham group (P<0.05). A more significant decrease in the perceived pain (VAS and LPS) was observed immediately after the active fESWT therapy. In follow-up observations (after 1 and 3 months), there were no significant between-group differences (P>0.05). Also, there was a significant effect in terms of functional state (ODI) for both groups (P<0.05); however, between-group comparisons revealed no statistically significant differences (P>0.05). CONCLUSIONS Focused ESWT with an exercise program can be effective in patients with chronic LBP. ESWT allows reducing pain, although it does not seem to significantly improve a patient’s functional state.

PMID:35689370 | DOI:10.12659/MSM.936614

Ann Neurol. 2022 Jun 10. doi: 10.1002/ana.26431. Online ahead of print.

ABSTRACT

OBJECTIVE: Cerebral venous thrombosis caused by vaccine-induced immune thrombotic thrombocytopenia (VITT-CVT) is a rare adverse effect of adenovirus-based SARS-CoV-2 vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality.

METHODS: We used data from an international prospective registry of patients with CVT after adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable or definite VITT-CVT cases included until 18 January 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis.

RESULTS: 99 VITT-CVT patients from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11/24 (46%), and 28/37 (76%) of patients diagnosed in March, April, and from May onwards, respectively, were treated in-line with VITT recommendations (p<0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 (32%) vs 29/55 (52%), adjusted OR 0.43 (95%CI 0.16-1.19)). However, patients who received immunomodulation had lower mortality (19/65 (29%) vs 24/34 (70%), adjusted OR 0.19 (95%CI 0.06-0.58)). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 (33%) vs 13/35 (37%), adjusted OR 0.70 (95%CI 0.24-2.04)). Mortality was also not significantly influenced by platelet transfusion (17/27 (63%) vs 26/72 (36%), adjusted OR 2.19 (95%CI 0.74-6.54)).

CONCLUSIONS: In VITT-CVT patients, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT. This article is protected by copyright. All rights reserved.

PMID:35689346 | DOI:10.1002/ana.26431

Aliment Pharmacol Ther. 2022 Jul;56(1):186-187. doi: 10.1111/apt.16982.

NO ABSTRACT

PMID:35689317 | DOI:10.1111/apt.16982

Pharmacoepidemiol Drug Saf. 2022 Jun 10. doi: 10.1002/pds.5493. Online ahead of print.

ABSTRACT

OBJECTIVE: Immune checkpoint inhibitors (ICIs) have been widely used in cancer treatment; however, some case reports suggested that ICIs treatment might result in ileus. This study aims to comprehensively reveal the relationship between ileus and ICIs treatment in real-world cases from Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS).

METHODS: Reports from January 1, 2011 to December 31, 2020 were extracted from the FAERS. ICIs-related adverse events in patients were defined as related to use of anti-programmed cell death protein 1 antibodies (PD-1, nivolumab and pembrolizumab), anti-programmed cell death-ligand 1 inhibitors (PD-L1, atezolizumab, durvalumab, avelumab, and cemiplimab), and anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA-4, ipilimumab and tremelimumab). ICIs-related ileus cases were identified to characterize their clinical features. Reporting odds ratios (ROR) and information component (IC) were used to assess the relationship between ICIs and ileus.

RESULTS: Among the 105001 cases related to ICIs, 245 were reported with ICI-related ileus. The affected patients were mainly elderly (median age, 64.5 years) and male (58%, n=143). The median onset for all cases was 36 (range 0-880) days, and no statistical difference was observed between monotherapy and combination therapy (PD-1 or PD-L1 plus CTLA-4) (p = 0.21). Most patients required drug withdrawal treatment (n=113, 74%) and can achieve a recovered-resolved state (n=72, 46%). All ICIs were significantly associated with ileus (ROR=4.27, 95%Cl: 3.75-4.85; IC=2.04, 95%Cl: 1.79-2.31). Ileus events were most commonly reported in PD-1 treatment (n=164, ROR=3.83, 95%Cl: 3.28-4.48; IC=1.90, 95%Cl: 1.62-2.21).

CONCLUSION: This pharmacovigilance database analysis suggested that ICIs are related to ileus. However, combination therapy may not speed up the onset of ileus. This article is protected by copyright. All rights reserved.

PMID:35689298 | DOI:10.1002/pds.5493

Reprod Health. 2022 Jun 10;19(1):136. doi: 10.1186/s12978-022-01444-4.

ABSTRACT

BACKGROUND: Cervical cancer is currently the second-leading cause of cancer death among women in Ethiopia. Vaccination against the human papillomavirus (HPV) is an effective primary prevention strategy for HPV-related illnesses. The knowledge and willingness of parents toward the HPV vaccine are crucial to increasing the uptake of the vaccine. The vaccine’s acceptance by children and young adolescents is dependent on parental consent. Therefore, this study aimed to assess knowledge, willingness, and associated factors of the human papillomavirus vaccine among parents of girls aged 9-14 years at Debre Tabor Town.

METHOD: A community-based cross-sectional study was conducted among participants from December 10, 2020, to January 15, 2021. A simple random sample technique was used to include 638 participants. A structured face-to-face interviewer-administered questionnaire was used to collect data. The data were entered and analyzed using Epi-Data and SPSS software, respectively. Bivariate and multivariable analyses were used to examine the association. The Odds Ratio (OR), 95% CI, and p-values less than 0.05 were used to determine the statistical association.

RESULTS: Thirty-five percent (35.4%, 95% CI = 31.4%, 38.8%) and 44.8% (95% CI = 40.40%, 48.67%) of participants were knowledgeable about HPV vaccination and willing to get it, respectively. Being government employees (AOR = 5.46, 95% CI = 2.42, 9.34), and having a family history of sexually transmitted diseases (STD) (AOR = 1.76, 95% CI = 1.14, 2.72) were significantly associated with knowledge of the human papilloma virus (HPV) vaccine. Participants’ age (AOR = 1.43, 95% CI = 1.16, 2.87), secondary education and above (AOR = 1.70, 95% CI = 1.05, 2.74), fear of HPV infection (AOR = 2.29, 95% CI = 1.21, 4.32), and having good knowledge of the HPV vaccine (AOR = 3.30, 95% CI = 2.21, 4.93) were significantly associated with willingness to receive the HPV vaccine.

CONCLUSION AND RECOMMENDATION: The knowledge and willingness of parents toward the HPV vaccine were low. Then, health officials should boost HPV vaccination promotion through public media. In schools, churches, mosques, and health facilities, health extension workers and health professionals provide information about the HPV vaccine for the parents. Mixed quantitative and qualitative studies are preferable for future research to address “why” issues.

PMID:35689288 | DOI:10.1186/s12978-022-01444-4

Arthritis Res Ther. 2022 Jun 10;24(1):137. doi: 10.1186/s13075-022-02828-4.

ABSTRACT

BACKGROUND: Post-traumatic osteoarthritis (PTOA) does not currently have clinical prognostic biomarkers or disease-modifying drugs, though promising candidates such as dexamethasone (Dex) exist. Many challenges in studying and treating this disease stem from tissue interactions that complicate understanding of drug effects. We present an ex vivo human osteochondral model of PTOA to investigate disease effects on cartilage and bone homeostasis and discover biomarkers for disease progression and drug efficacy.

METHODS: Human osteochondral explants were harvested from normal (Collins grade 0-1) ankle talocrural joints of human donors (2 female, 5 male, ages 23-70). After pre-equilibration, osteochondral explants were treated with a single-impact mechanical injury and TNF-α, IL-6, and sIL-6R ± 100 nM Dex for 21 days and media collected every 2-3 days. Chondrocyte viability, tissue DNA content, and glycosaminoglycan (sGAG) percent loss to the media were assayed and compared to untreated controls using a linear mixed effects model. Mass spectrometry analysis was performed for both cartilage tissue and pooled culture medium, and the statistical significance of protein abundance changes was determined with the R package limma and empirical Bayes statistics. Partial least squares regression analyses of sGAG loss and Dex attenuation of sGAG loss against proteomic data were performed.

RESULTS: Injury and cytokine treatment caused an increase in the release of matrix components, proteases, pro-inflammatory factors, and intracellular proteins, while tissue lost intracellular metabolic proteins, which was mitigated with the addition of Dex. Dex maintained chondrocyte viability and reduced sGAG loss caused by injury and cytokine treatment by 2/3 overall, with donor-specific differences in the sGAG attenuation effect. Biomarkers of bone metabolism had mixed effects, and collagen II synthesis was suppressed with both disease and Dex treatment by 2- to 5-fold. Semitryptic peptides associated with increased sGAG loss were identified. Pro-inflammatory humoral proteins and apolipoproteins were associated with lower Dex responses.

CONCLUSIONS: Catabolic effects on cartilage tissue caused by injury and cytokine treatment were reduced with the addition of Dex in this osteochondral PTOA model. This study presents potential peptide biomarkers of early PTOA progression and Dex efficacy that can help identify and treat patients at risk of PTOA.

PMID:35689293 | DOI:10.1186/s13075-022-02828-4

BMC Musculoskelet Disord. 2022 Jun 10;23(1):560. doi: 10.1186/s12891-022-05488-2.

ABSTRACT

BACKGROUND: Elastic knee sleeves are often worn following anterior cruciate ligament reconstruction (ACLR) but their effects on movement patterns are unclear.

AIM: To determine the immediate and six-week effects of wearing a knee sleeve on biomechanics of the knee during a step-down hop task.

METHODS: Using a cross-over design, we estimated sagittal plane knee kinematics and kinetics and stance duration during a step-down hop for 31 participants (age 26.0 [SD 6.6] years, 15 women) after ACLR (median 16 months post-surgery) with and without wearing a knee sleeve. In a subsequent randomised clinical trial, participants in the ‘Sleeve Group’ (n = 9) then wore the sleeve for 6 weeks at least 1 h daily, while a ‘Control Group’ (n = 9) did not wear the sleeve. We used statistical parametric mapping to compare (1) knee flexion/extension angle and external flexion/extension moment trajectories between three conditions at baseline (uninjured side, unsleeved injured side and sleeved injured side); (2) within-participant changes for knee flexion angles and external flexion/extension moment trajectories from baseline to follow-up between groups. We compared discrete flexion angles and moments, and stance duration between conditions and between groups.

RESULTS: Without sleeves, knee flexion was lower for the injured than the uninjured sides during mid-stance phase. When wearing the sleeve on the injured side, knee flexion increased during the loading phase of the stance phase. Discrete initial and peak knee flexion angles increased by (mean difference, 95% CIs) 2.7° (1.3, 4.1) and 3.0° (1.2, 4.9), respectively, when wearing the knee sleeve. Knee external flexion moments for the unsleeved injured sides were lower than the uninjured sides for 80% of stance phase, with no change when sleeved. The groups differenced for within-group changes in knee flexion trajectories at follow-up. Knee flexion angles increased for the Control group only. Stance duration decreased by 22% for the Sleeve group from baseline to follow-up (-89 ms; -153, -24) but not for the Controls.

CONCLUSIONS: Application of knee sleeves following ACLR is associated with improved knee flexion angles during hop landing training. Longer term (daily) knee sleeve application may help improve hop stance duration, potentially indicating improved hop performance.

TRIAL REGISTRATION: The trial was prospectively registered with the Australia New Zealand Clinical Trials Registry No: ACTRN12618001083280, 28/06/2018. ANZCTR.

PMID:35689284 | DOI:10.1186/s12891-022-05488-2