Tag: statistics

Acta Biomed. 2022 Oct 26;93(5):e2022313. doi: 10.23750/abm.v93i5.13402.

ABSTRACT

BACKGROUND AND AIM: The pandemic caused by SARS-COV-2 has increased Semi-Intensive Care Unit (SICU) admission, causing an increase in healthcare-associated infection (HAI). Mostly HAI reveals the same risk factors, but fewer studies have analyzed the possibility of multiple coinfections in these patients. The study aimed was to identify patterns of co-presence of different species describing at the same time the association between such patterns and patient demographics and, finally, comparing the patterns between the two cohorts of COVID-19 patients admitted at Policlinico during the first wave and the second one).

METHODS: All the patients admitted to SICUs during two COVID-19 waves, from March to June 2020 months and from October to December 2020, were screened following the local infection control surveillance program; whoever manifested fever has undergone on microbiological culture to detect bacterial species. Statistical analysis was performed to observe the existence of microbiological patterns through DBSCAN method.

RESULTS: 246 patients were investigated and 83 patients were considered in our study because they presented infection symptoms with a mean age of 67 years and 33.7% of female patients. During the first and second waves were found respectively 10 and 8 bacterial clusters with no difference regarding the most frequent species.

CONCLUSIONS: The results show the importance of an analysis which considers the risk factors for the possibility of co- and superinfection (such as age and gender) to structure a good prognostic tool to predict which patients will encounter severe coinfections during hospitalization.

PMID:36300221 | DOI:10.23750/abm.v93i5.13402

Acta Biomed. 2022 Oct 26;93(5):e2022309. doi: 10.23750/abm.v93i5.13803.

ABSTRACT

BACKGROUND AND AIM: Medication administration errors represent a topic of great scientific interest. Medication administration is considered by nursing students a complex process during which it is easy to make mistakes; therefore, institutional measures have been adopted in order to reduce medication errors. However, it remains a critical issue in nursing practice for which several causes have been identified, including environmental factors and individual knowledge. Mistakes can be made by nurses and especially by students who must cope with additional causal factors including anxiety management. The aim was to investigate state anxiety levels among nursing students when it comes to medication administration.

RESEARCH DESIGN AND METHODS: An observational study involving a convenience sample of 150 nursing students from a Northern Italy University has been conducted; they were asked to complete a questionnaire to measure the levels of state anxiety in relation to medication administration. Results. There were no particularly high levels of state anxiety among students associated with medication administration; however, state anxiety levels were slightly higher in third-year students than in second-year students, and this is most likely due to the growing complexity of the medication administration process compared to the lack of experience. Conclusions. Although the results don’t show statistically significant data, the effectiveness of nursing education plays a crucial role in reducing medication errors, which is why it is essential to provide suitable tools for the professionals of the future and invest in clinical simulations.

PMID:36300204 | DOI:10.23750/abm.v93i5.13803

Policy Polit Nurs Pract. 2022 Oct 26:15271544221130052. doi: 10.1177/15271544221130052. Online ahead of print.

ABSTRACT

Systemic and structural racism in nursing have profound impacts on Black People, Indigenous Peoples, and People of Color. They contributed to underrepresentation in faculty, senior nurse executives, and presidents’ positions in academic and healthcare organizations, physical and mental health issues in racialized groups. This quality improvement study described ways in which the Black Nurses Task Force of the Registered Nurses Association of Ontario can build solidarity with nursing and government organizations to dismantle systemic and structural racism in nursing. This study used a structured online survey, comprised of quantitative and qualitative questions. The qualitative data were analyzed using interpretative thematic analysis and the quantitative data were analyzed with descriptive statistics. Findings showed that 88% of participants experienced racism and 63% said racism affected their mental health. Three themes emerged from the qualitative data: Social support for Black nurses, accountability of leaders and solidarity with Black nurses. These findings demonstrated the urgent need to dismantle systemic and structural racism in nursing.

PMID:36300199 | DOI:10.1177/15271544221130052

Public Health Pract (Oxf). 2022 Oct 17;4:100330. doi: 10.1016/j.puhip.2022.100330. eCollection 2022 Dec.

ABSTRACT

OBJECTIVES: On June 26, 2015, the Supreme Court legalized same-sex marriages in the United States. This change has had some positive implications for the health of Lesbian, gay, bisexual, and transgender (LGBT) individuals and public health in general. Sexually transmitted infections (STIs) are common among LGBT individuals and legalization of same sex marriage effected the rate of emergency department (ED) visits for STIs. We examined the effect of same-sex marriage legalization on emergency department visits related to STIs among LGBT individuals.

STUDY DESIGN: Quasi-experimental difference-in-difference negative binomial design is used with state and time fixed-effects. We used data for 16 states from State Emergency Department Database and State Inpatient Database from January 2007-December 2015. People over 18 years of age visited the ED for STIs were included.

RESULTS: At 5% significance level, number of STIs cases decreased by 6.1% (95% CI, 0.906-0.973; P = 0.001) after same-sex marriage legalization. When adjusting for sex, these cases decreased by 7.6% (95% CI, 0.885-0.966; P < 0.001) for females, and 4.7% (95% CI, 0.914-0.995; P = 0.027) for males. By age cohorts, 18-24 aged had 8.5% (95% CI, 0.875-0.957; P < 0.001) decrease, while older age cohorts was statistically insignificant.

CONCLUSIONS: Our results show that there is an association between legalization and decreased STIs cases in ED visits. Policy makers need to focus on encouraging a positive attitude towards LGBT community, as it leads to better quality of health for sexual minority groups and leads to positive externalities for general community.

PMID:36300196 | PMC:PMC9589203 | DOI:10.1016/j.puhip.2022.100330

Front Neurosci. 2022 Oct 10;16:975189. doi: 10.3389/fnins.2022.975189. eCollection 2022.

ABSTRACT

BACKGROUND: Apathy is among the most prevalent and incapacitating non-motor symptoms of Parkinson’s disease (PD). PD patients with apathy (PD-A) have been reported to have abnormal spontaneous brain activity mainly in 0.01-0.08 Hz. However, the frequency-dependence of brain activity in PD-A remains unclear. Therefore, this study aimed to examine whether abnormalities in PD-A are associated with specific frequency bands.

MATERIALS AND METHODS: Overall, 28 patients with PD-A, 19 PD patients without apathy (PD-NA), and 32 gender-, age-matched healthy controls (HCs) were enrolled. We collected resting-state functional magnetic resonance imaging (rs-fMRI) data, demographic information, and neuropsychological assessments, including apathy, depression, anxiety and cognitive function for every participant. The amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuation (fALFF), percent amplitude of fluctuation (PerAF), regional homogeneity (ReHo), and degree centrality (DC) were calculated in the conventional (0.01-0.08 Hz), slow-4 (0.027-0.073 Hz), and slow-5 (0.01-0.027 Hz) frequency bands based on statistical parametric mapping (SPM12) and RESTplus V1.25. Two-sample t-tests were performed to compare the differences among the three groups.

RESULTS: PD-A reduced ALFF in the right anterior cingulate gyri in the slow-5 band and decreased fALFF in the right middle frontal gyrus in the conventional band, compared to patients with PD-NA. However, PerAF, ReHo, and DC could not distinguish PD-A from PD-NA in the three bands. PD-A had higher ALFF and fALFF in the left middle occipital gyrus and lower fALFF in the bilateral insula in the slow-5 band compared to the HCs. Furthermore, abnormal DC value in hippocampus and parahippocampus was observed separately in the conventional band and in the slow-4 band between PD-A and HCs. Moreover, PD-A and PD-NA showed lower ReHo in cerebellum in the three bands compared to the HCs.

CONCLUSION: Our study revealed that PD-A and PD-NA might have different neurophysiological mechanisms. Concurrently, the ALFF in the slow-5 band and fALFF in the conventional band were sensitive in differentiating PD-A from PD-NA. The influence of apathy on the disease can be considered in the future research on PD, with the effects of frequency band taken into account when analyzing spontaneous brain activities in PD-A.

PMID:36300172 | PMC:PMC9589053 | DOI:10.3389/fnins.2022.975189

Transl Gastroenterol Hepatol. 2022 Oct 25;7:39. doi: 10.21037/tgh-20-280. eCollection 2022.

ABSTRACT

BACKGROUND: Gastrointestinal procedures generally require pre-procedural fasting to optimize sedation safety. While the American Society of Anesthesiologists (ASA) recommends no intake of clear liquids and solid food 2-4 and 6-8 hours respectively prior to endoscopic procedures, the actual nil per os (NPO) duration for these procedures in practice is unknown. Our objective was to analyze NPO duration for patients undergoing these procedures and to determine its association with clinical and administrative variables.

METHODS: Inpatient data from 2016-2018 for the three procedures was extracted from electronic medical records and administrative data at a single-center tertiary academic medical center. Various statistical tests (Kruskal-Wallis, Wilcoxon, Pearson) were employed depending on the outcome type and data distribution.

RESULTS: One thousand three hundred and twenty-five esophagogastroduodenoscopies (EGDs), 753 colonoscopies, and 550 endoscopic retrograde cholangiopancreatographies (ERCPs) were included. The median NPO time for all procedures was 12.6 hours (IQR, 9.6-16.1 hours). The median NPO times were 12.6, 11.9, and 13.1 hours for EGD, colonoscopy, and ERCP respectively. NPO duration was greater for Hispanic than non-Hispanic patients (median 13.9 vs. 12.4, P=0.018). NPO duration was also associated with increased age (r=0.041, P=0.027) and inversely related to hospital occupancy (r=-0.08, P<0.0001). There were no statistically significant associations with provider type, hospital location or service, length of stay, and total number of comorbidities.

CONCLUSIONS: NPO times for common inpatient gastroenterology (GI) procedures generally exceeded 12 hours, suggesting there is an opportunity to adopt changes to decrease NPO duration for low-risk patients while maintaining adherence to guidelines and best practice.

PMID:36300152 | PMC:PMC9469011 | DOI:10.21037/tgh-20-280

Transl Gastroenterol Hepatol. 2022 Oct 25;7:38. doi: 10.21037/tgh-20-318. eCollection 2022.

ABSTRACT

BACKGROUND: Recently, increasing literature has been reported on optimal therapies in patients with advanced hepatocellular carcinoma (HCC) and many therapeutic modalities have been proposed to improve the survival rate. However, the results are not consistent due to different research protocols, small sample sizes and different study endpoints and there is no standard treatment protocol has been defined. Therefore, it is very important to explore the optimal bonding mode and to evaluate the efficacy and safety of the optimal sequential therapy for those patients.

METHODS: We searched available databases through January 2020 for relevant studies. The main outcome measure was 1-year overall survival (OS) and overall response rate (ORR); the secondary outcome measure was a composite of toxic effects retrieved grade 3 or 4 adverse events (AEs) from all included studies. Statistical analyses were conducted using STATA version 15 and GeMTC package in the R statistical software.

RESULTS: After a detailed review, 8 randomized controlled trials (RCTs) and 20 retrospective studies involving 3,675 advanced HCC patients were included for network meta-analysis. Indirect comparisons showed that hepatic arterial infusion chemotherapy (HAIC) plus radiofrequency ablation (RFA) was highest probability of obtaining the best OS rate of 1 year [surface under the cumulative ranking (SUCRA), 0.95] and ORR (SUCRA, 0.86) when compared with other potential optimal therapies and which had ranked the first in all treatment regimens, followed by HAIC (SUCRA, 0.75). Direct and indirect comparison of 1-year OS and ORR with all treatment regimens each other showed that for all treatment regimens, patients showed significant clinical benefit when compared with transcatheter arterial chemoembolization (TACE) or sorafenib alone. However, the incidence of treatment-related AEs of grade 3 or 4 occurred in patients who have received targeted drug sorafenib therapy (SUCRA, 0.51) compared with other interesting regimens.

CONCLUSIONS: HAIC may be a valuable therapeutic strategy for advanced HCC patients to prevent recurrence and metastasis after RFA, as well as in improving patient prognosis and quality of life. Meanwhile, HAIC combined with RFA is a safe and effective treatment in patients with advanced HCC, and this combination therapy can significantly prolong 1-year survival rate when compared with other optimal sequential therapies.

TRIAL REGISTRATION: This study is registered with PROSPERO, number CRD42020176149.

PMID:36300147 | PMC:PMC9468989 | DOI:10.21037/tgh-20-318

Transl Gastroenterol Hepatol. 2022 Oct 25;7:41. doi: 10.21037/tgh-20-242. eCollection 2022.

ABSTRACT

Hepatocellular carcinoma (HCC) is a significant cause of morbidity and mortality worldwide. Despite significant advancements in detection and treatment of HCC, its management remains a challenge. Artificial intelligence (AI) has played a role in medicine for several decades, however, clinically applicable AI-driven solutions have only started to emerge, due to gradual improvement in sensitivity and specificity of AI, and implementation of convoluted neural networks. A review of the existing literature has been conducted to determine the role of AI in HCC, and three main domains were identified in the search: detection, characterisation and prediction. Implementation of AI models into detection of HCC has immense potential, as AI excels at analysis and integration of large datasets. The use of biomarkers, with the rise of ‘-omics’, can revolutionise the detection of HCC. Tumour characterisation (differentiation between benign masses, HCC, and other malignant tumours, as well as staging and grading) using AI was shown to be superior to classical statistical methods, based on radiological and pathological images. Finally, AI solutions for predicting treatment outcomes and survival emerged in recent years with the potential to shape future HCC guidelines. These AI algorithms based on a combination of clinical data and imaging-extracted features can also support clinical decision making, especially treatment choice. However, AI research on HCC has several limitations, hindering its clinical adoption; small sample size, single-centre data collection, lack of collaboration and transparency, lack of external validation, and model overfitting all results in low generalisability of the results that currently exist. AI has potential to revolutionise detection, characterisation and prediction of HCC, however, for AI solutions to reach widespread clinical adoption, interdisciplinary collaboration is needed, to foster an environment in which AI solutions can be further improved, validated and included in treatment algorithms. In conclusion, AI has a multifaceted role in HCC across all aspects of the disease and its importance can increase in the near future, as more sophisticated technologies emerge.

PMID:36300146 | PMC:PMC9468986 | DOI:10.21037/tgh-20-242

R Soc Open Sci. 2022 Oct 19;9(10):220021. doi: 10.1098/rsos.220021. eCollection 2022 Oct.

ABSTRACT

Coronavirus disease 2019 (COVID-19) forecasts from over 100 models are readily available. However, little published information exists regarding the performance of their uncertainty estimates (i.e. probabilistic performance). To evaluate their probabilistic performance, we employ the classical model (CM), an established method typically used to validate expert opinion. In this analysis, we assess both the predictive and probabilistic performance of COVID-19 forecasting models during 2021. We also compare the performance of aggregated forecasts (i.e. ensembles) based on equal and CM performance-based weights to an established ensemble from the Centers for Disease Control and Prevention (CDC). Our analysis of forecasts of COVID-19 mortality from 22 individual models and three ensembles across 49 states indicates that-(i) good predictive performance does not imply good probabilistic performance, and vice versa; (ii) models often provide tight but inaccurate uncertainty estimates; (iii) most models perform worse than a naive baseline model; (iv) both the CDC and CM performance-weighted ensembles perform well; but (v) while the CDC ensemble was more informative, the CM ensemble was more statistically accurate across states. This study presents a worthwhile method for appropriately assessing the performance of probabilistic forecasts and can potentially improve both public health decision-making and COVID-19 modelling.

PMID:36300136 | PMC:PMC9579776 | DOI:10.1098/rsos.220021

Occup Ther Int. 2022 Oct 10;2022:8366857. doi: 10.1155/2022/8366857. eCollection 2022.

ABSTRACT

OBJECTIVE: In recent years, people’s living standards have been greatly improved, but at the same time, it also brings many health problems, among which mental health problems and sleep problems of college students are important problems. The aim of the study is to explore the effect of physical activity intervention on college students’ mental health and provide a new way of thinking for colleges and universities to carry out mental health interventions.

METHODS: This paper focuses on the physical health problems of college students and explores the relationship between aerobic exercise, emotion, and sleep quality among college students. The SPSS statistical method was used to analyze the differences in aerobic exercise, emotion, and sleep quality among college students in terms of demographic variables; to explore the relationship between aerobic exercise, emotion, and sleep quality; and to construct a structural equation model using the relationship between them. Results/Discussion. This study explores the relationship between aerobic exercise and sleep quality and psychological health of college students, further analyzes the path model of the role of aerobic exercise and psychological health on sleep quality of college students, and verifies it through experiments, which proves to help universities and relevant departments understand the current situation of exercise and sleep quality of college students and provide timely and effective design of mandatory aerobic exercise courses for college students who lack exercise and have sleep problems. At the same time, it helps college students to understand their sleep situation and adjust their aerobic exercise courses according to their sleep status.

PMID:36300132 | PMC:PMC9576443 | DOI:10.1155/2022/8366857