Tag: statistics

Medicine (Baltimore). 2022 Jun 10;101(23):e29149. doi: 10.1097/MD.0000000000029149.

ABSTRACT

BACKGROUND: Sacubitril-valsartan has been shown to have superior effects over angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in patients with heart failure (HF). However, the effects of sacubitril-valsartan have never been systematically evaluated. Therefore, we performed a protocol for systematic review and meta-analysis to evaluate the efficacy and safety of sacubitril-valsartan in patients with HF.

METHODS: We selected 8 databases, including PubMed, the Web of Science, Embase, Cochrane Library, the Chinese National Knowledge Infrastructure, the Chinese Science Journal Database, Wanfang Data, and the Chinese Biomedical Literature Database. The search time was from database establishment to March 2022. Two reviewers will screen the records and include quality studies according to inclusion criteria independently. Two reviewers will assess the risk of bias of the included studies by the “Risk of Bias Assessment Tool” of the Cochrane Handbook for randomized controlled trials. Statistical analysis will be performed with Review Manager software 5.3.

RESULTS: A synthesis of current evidence of sacubitril-valsartan for treating HF will be provided in this protocol.

CONCLUSION: The results of this study will provide a theoretical basis for the clinical use of sacubitril-valsartan to treat HF.

PMID:35687770 | DOI:10.1097/MD.0000000000029149

J Neurosci Nurs. 2022 Jun 6. doi: 10.1097/JNN.0000000000000658. Online ahead of print.

ABSTRACT

BACKGROUND: In the last few decades, the revised diagnostic criteria for multiple sclerosis (MS) and the development of numerous new MS therapies have created the possibility of early diagnosis and opportune MS management. However, these changes, and the mounting emphasis on patient choice and shared decision making, have not been accompanied by improvements in information provided to patients with MS (PwMS). Information provision for PwMS increases disease-related knowledge that may assist them in decision making and quality of life. The purpose of this study was to validate the Multiple Sclerosis and Magnetic Resonance Imaging Knowledge Questionnaire (MSMRIKQ) to improve patients’ shared decision-making capabilities. METHODS: In this methodological study, the instrument development process was completed in 4 stages using principles of measurement theory: (1) establishing a pool of items after patient and clinician panels’ review, (2) evaluating the validity of the scale-both face and content validity, (3) pilot testing the scale, and (4) post-pilot testing statistical analysis of items and scale reliability and validity. RESULTS: The 20-item instrument was finalized based on a panel of MS experts’ and patients’ comments. The final version of the MSMRIKQ was pilot tested with a sample of 46 PwMS. Face validity was established on all MSMRIKQ items. Individual item-level and scale-level content validity indices for universal agreement estimates were acceptable at item-level content validity index = 1 and scale-level content validity index = 1 for the 20 items. The Kuder-Richardson 20 reliability estimate for the entire scale was 0.58; the Kuder-Richardson 20 estimates for the subscales of MS and magnetic resonance imaging knowledge were 0.35 and 0.51, respectively. The split-half reliability with Spearman-Brown correction for the total scale was 0.60. The Poisson regression model was significant for predicting MS knowledge within this population. CONCLUSION: The MSMRIKQ is a basic knowledge instrument for clinical and research use.

PMID:35687725 | DOI:10.1097/JNN.0000000000000658

Am J Phys Med Rehabil. 2022 Jun 8. doi: 10.1097/PHM.0000000000002055. Online ahead of print.

ABSTRACT

The objective of this retrospective, observational study was to quantitatively study the impact of the early COVID-19 pandemic on the inpatient clinical experience of Physical Medicine and Rehabilitation (PM&R) resident physicians in an inpatient rehabilitation facility (IRF) setting. Inpatient clinical experience as evidenced by admissions, rehabilitation diagnosis, medical emergencies, acute care transfers, and resident work hours from January to June 2019 (pre-pandemic) were compared January to June 2020 (immediately before and during pandemic). There was a statistically significant decrease in the mean daily admissions in April 2020 and a significant increase in medically complex admissions in June 2020, reflective of medical patterns due to the pandemic. There was a decrease in mean work hours during the pandemic, but no statistically significant difference in admission rate of other rehabilitation diagnoses, medical emergencies or transfers to acute care. This study demonstrates no substantial pandemic related impact on inpatient clinical experience for PM&R residents in the studied program.

PMID:35687755 | DOI:10.1097/PHM.0000000000002055

Pacing Clin Electrophysiol. 2022 Jun 10. doi: 10.1111/pace.14549. Online ahead of print.

ABSTRACT

BACKGROUND: For cardiac resynchronization therapy (CRT), image-guided approaches targeting left ventricular (LV) lead placement at the site of latest mechanical activation had inconsistent outcomes. We examined evidence for improved CRT outcomes when LV lead placement concordant with latest mechanical activation occurred.

METHODS: A review of EMBASE and PubMed was performed for randomized controlled trials or prospective observational studies from October 2008 through October 2020 comparing outcomes with concordant versus discordant LV lead placement. Meta-analyses were performed to assess the association between concordance and death, death or heart (HF) hospitalization, ≥ 15% reduction in LV end systolic volume (LVESV), and changes in LVESV or ejection fraction (LVEF).

RESULTS: From 5,897 citations, 9 publications (8 studies) with 1355 patients were selected; 975 with a concordant LV lead and 380 with a discordant lead. Mean age was 66 to 68, 82% were male, and 64% had ischemic cardiomyopathy. Meta-analyses demonstrated a statistically significant reduction in death/HF hospitalization at 2 years (OR 0.38; 95% CI 0.16, 0.92) and LVESV at 6 months (mean difference [MD] -13.4%; 95% CI -6.7%, -20.0%), and an increase in LVEF (MD 4.03; 95% CI 0.77, 7.30) with the concordant LV lead. There were trends towards decreased death at 2 years (OR 0.49; 95% CI 0.19, 1.23) and ≥ 15% reduction in LVESV at 6 months (OR 3.81; 95% CI 0.24, 61.24) with concordant LV lead placement.

CONCLUSIONS: A concordant LV lead was associated with better CRT outcomes. Further study of feasible methods to achieve LV lead concordance is needed. This article is protected by copyright. All rights reserved.

PMID:35687711 | DOI:10.1111/pace.14549

Altern Ther Health Med. 2022 Jun 10:AT7430. Online ahead of print.

ABSTRACT

CONTEXT: Correct and effective handovers of patients’ information during shift changes can ensure patients’ safety and can help an incoming shift of nurses to continuously monitor patients’ psychological problems and avoid unnecessary physical restraints. Development of a standard procedure for handover of patients who have been physically restrained has important clinical significance related to the smooth continuation of nursing work and assurance of the quality of care.

OBJECTIVE: The study intended to investigate the clinical effects of the situation-background-assessment-recommendation (SBAR) communication mode on the quality of the information passed during shift changes about patients in intensive care units (ICUs) who had been physically restrained and to compare it to the clinical effects obtained using traditional methods of communication.

DESIGN: The study was a retrospective analysis of the process used by nurses who were passing patient’s information during shift changes when caring for patients who had been physically restrained.

SETTING: The study took place in an ICU at the Second Hospital of Hebei Medical University in Shijiazhuang, Hebei, China.

PARTICIPANTS: Participants were 21 nurses caring for 239 ICU patients under physical restraint at the Second Hospital.

INTERVENTION: Of the 239 patients, 118 had been hospitalized between March 1 and March 15, 2018 and were assigned to the control group, and 121 had been hospitalized between June 1 and June 15, 2018 and were assigned to the intervention group. An ICU Physical Restraint Handover Order was established according to the SBAR communication mode. The intervention group used the SBAR communication mode and the control group used the hospital’s routine communication mode for the physical restraint of a patient during a nursing shift.

OUTCOME MEASURES: The study measured the differences between the groups in the nurses’ passing rates based on standards for the use of physical restraints, the quality of handover of information during shift changes about patients under physical restraint, the quality of the documentation written by nurses about the physical restraint, and the nurses’ satisfaction with the handover of information during a shift change.

RESULTS: Among the patient, 112 in the intervention group (92.56%) and 92 in the control group (77.97%) were qualified for physical restraint. A statistically significant difference existed between the two groups in the passing rate for the use of physical restraints (P = .001). The quality score for the handovers during shift changes of patients under physical restraint in the intervention group was 95.46 ± 2.50 and for the control group was 91.08 ± 3.57, with the difference being statistically significant (P = .030). The quality score for the nursing documentation for the intervention group, at 97.21 ± 1.49, was higher than that of the control group, at 90.78 ± 3.42, and the difference was statistically significant (P < .001). The nurses’ satisfaction score for the intervention group, at 98.14 ± 1.01 was higher than that of the control group, at 92.57 ± 1.86, and the difference was statistically significant (P = .006).

CONCLUSIONS: The use of the SBAR communication mode to improve the information passed to nurses about patients under physical restraint during a shift change can improve the quality of the physical restraint and nurses’ satisfaction and has a better clinical-application effect than the traditional methods used during shift changes.

PMID:35687709

Altern Ther Health Med. 2022 Jun 10:AT7423. Online ahead of print.

ABSTRACT

OBJECTIVES: Our study aimed to investigate the clinical features, management, and maternal-infant prognosis in patients with complete uterine rupture in the second and third trimester of pregnancy.

METHODS: A total of 15 patients with complete uterine rupture in their second and third trimester of pregnancy who were admitted to our hospital between January 2012 and December 2020 were included in our study. The patients enrolled were divided into the scar group (11 patients) and the non-scar group (4 patients) according to the existence or absence of a uterine scar. The general data, clinical characteristics and follow-up results in the 2 groups were compared.

RESULTS: There was no significant difference in age, pregnancy duration or delivery cycle between the 2 groups (P > .05). The incidence of original scar rupture in the scar group was significantly higher than in the non-scar group (P > .05). No significant difference was found in clinical characteristics between the scar and the non-scar groups (P > .05). The most common clinical features included abdominal pain, inability to lie flat, hemorrhagic shock, prenatal vaginal bleeding and uterine rupture, mostly occurring in the lower segments of the uterus and cervix. A total of 3 patients were misdiagnosed as having surgical disease. After completing relevant examinations, the uterine rupture was repaired surgically; the patients were discharged after blood transfusion, and their condition resolved. In all, 3 patients in the non-scar group and 1 patient in the scar group were transferred to the intensive care unit (ICU). All 15 patients were discharged after treatment. Follow-up was completed by all patients for 12 to 36 months, with an average follow-up time of 23.09 ± 2.19 months. Of the 15 patients, 2 underwent induced abortion after 24 months due to unplanned pregnancy. A 5-minute Apgar score of ≤7 in the scar group was higher than that in the non-scar group, but the difference was not statistically significant (P > .05). Perinatal mortality in the 15 patients was 40.00% (6/15).

CONCLUSION: The most common clinical features in patients with complete uterine rupture in the second and third trimester of pregnancy included abdominal pain, inability to lie flat, hemorrhagic shock, prenatal vaginal bleeding and uterine rupture, mostly occurring in the lower segments of the uterus and cervix. In addition, a remarkably worse maternal-infant prognosis was seen in patients with complete uterine rupture in the second and third trimester of scarless pregnancy compared with patients with complete uterine rupture in the second and third trimester of scarred pregnancy.

PMID:35687703

J Proteome Res. 2022 Jun 10. doi: 10.1021/acs.jproteome.2c00161. Online ahead of print.

ABSTRACT

In their recent review ( J. Proteome Res. 2022, 21 (4), 849-864), Crook et al. diligently discuss the basics (and less basics) of Bayesian modeling, survey its various applications to proteomics, and highlight its potential for the improvement of computational proteomic tools. Despite its interest and comprehensiveness on these aspects, the pitfalls and risks of Bayesian approaches are hardly introduced to proteomic investigators. Among them, one is sufficiently important to be brought to attention: namely, the possibility that priors introduced at an early stage of the computational investigations detrimentally influence the final statistical significance.

PMID:35687673 | DOI:10.1021/acs.jproteome.2c00161

Expert Rev Gastroenterol Hepatol. 2022 Jun 10. doi: 10.1080/17474124.2022.2088508. Online ahead of print.

ABSTRACT

BACKGROUND: Endoscopic mucosal resection of duodenal polyps (EMR) is a challenging intervention. The aim of this study was to review the patient characteristics, techniques, procedure outcomes, adverse events, and recurrence of duodenal polyps.

RESEARCH DESIGN AND METHODS: Patients were included if they had pathologically confirmed non-ampullary duodenal polyps that were either sporadic or familial adenomatous polyposis syndrome-related and had received EMR with at least one follow-up EGD for surveillance. Descriptive statistics were employed to report findings.

RESULTS: A total of 65 patients underwent a total of 90 EMRs for duodenal polyps. The mean age was 65.4 years and 29 of the patients were female. Complete resection of the visible mass was achieved in 96.9% of cases. Endoscopic hemostasis was required in 18.5% of patients. Delayed bleeding occurred in 9%, and delayed perforations requiring surgical intervention in 2.2% of patients with no mortality. Surgery after EMR was needed in 12.7% of cases. Eleven (16.9%) patients had recurrent duodenal adenoma on follow-up EGD.

CONCLUSION: Duodenal polyps can be safely resected and have a notable recurrence rate. This is particularly true for adenomas, warranting post-resection endoscopic surveillance. The appropriate interval for post-resection surveillance for duodenal adenomas should be a focus of future study.

PMID:35687675 | DOI:10.1080/17474124.2022.2088508

IEEE Trans Cybern. 2022 Jun 10;PP. doi: 10.1109/TCYB.2022.3165879. Online ahead of print.

ABSTRACT

Fuzzy membership is an effective approach used in twin support vector machines (SVMs) to reduce the effect of noise and outliers in classification problems. Fuzzy twin SVMs (TWSVMs) assign membership weights to reduce the effect of outliers, however, it ignores the positioning of the input data samples and hence fails to distinguish between support vectors and noise. To overcome this issue, intuitionistic fuzzy TWSVM combined the concept of intuitionistic fuzzy number with TWSVMs to reduce the effect of outliers and distinguish support vectors from noise. Despite these benefits, TWSVMs and intuitionistic fuzzy TWSVMs still suffer from some drawbacks as: 1) the local neighborhood information is ignored among the data points and 2) they solve quadratic programming problems (QPPs), which is computationally inefficient. To overcome these issues, we propose a novel intuitionistic fuzzy weighted least squares TWSVMs for classification problems. The proposed approach uses local neighborhood information among the data points and also uses both membership and nonmembership weights to reduce the effect of noise and outliers. The proposed approach solves a system of linear equations instead of solving the QPPs which makes the model more efficient. We evaluated the proposed intuitionistic fuzzy weighted least squares TWSVMs on several benchmark datasets to show the efficiency of the proposed model. Statistical analysis is done to quantify the results statistically. As an application, we used the proposed model for the diagnosis of Schizophrenia disease.

PMID:35687632 | DOI:10.1109/TCYB.2022.3165879

PLoS One. 2022 Jun 10;17(6):e0269727. doi: 10.1371/journal.pone.0269727. eCollection 2022.

ABSTRACT

As a member state of the European Union, where vaccines against COVID-19 are available and affordable, Bulgaria reports the lowest immunization coverage and the most pronounced vaccine distrust. The present study aimed to assess the self-reported adverse reactions following COVID-19 vaccination as a possible tool to increase the trust in vaccines. A cross-sectional survey-based study, covering 761 vaccinated respondents, was conducted in Plovdiv (469 with an mRNA vaccine and 292 with an adenoviral vector vaccine). Descriptive statistics parametric and non-parametric methods were applied. Statistical significance was set at p<0.05. The median age of the respondents was 42 years, females (72.5%). At least one adverse reaction was reported in 89.9% of those immunized with mRNA vaccine and 93.8% in the adenoviral vector vaccine group (p>0.05). They were mild to moderate and resolved within several days. The levels of local reactions were comparable: 91.7% in those who received mRNA and 89.7% in those who received an adenoviral vector vaccine (p = 0.366). The most common types of systemic reactions were fatigue, headache, and muscle pains. An association was found between the systemic reactions and the type of vaccine administered: 59.7% in mRNA recipients and 89.4% in adenoviral vector vaccinees (p<0.001). None of the registered systemic reactions required medical attention. There were 3 reports of generalized urticaria after an mRNA and 2 after an adenoviral vector vaccine. The reported reactions are relatively high but expected and no adverse events have been reported that are not listed in the official Summary of Product Characteristics.

PMID:35687609 | DOI:10.1371/journal.pone.0269727