Tag: statistics

Nurse Educ Today. 2021 Dec 24;109:105260. doi: 10.1016/j.nedt.2021.105260. Online ahead of print.

ABSTRACT

BACKGROUND: Prebriefing is the first phase of simulation; however, the literature does not adequately identify prebriefing standards and implementation strategies, providing little direction for simulation facilitators to conduct prebriefing in a manner that promotes student self-efficacy and clinical competency.

OBJECTIVES: The aim of this study was to examine the effects of the Self-Efficacy Prebriefing Model (SEPM) on nursing student self-efficacy and clinical competency.

DESIGN: An experimental design with group randomization was used to compare self-efficacy and clinical competency in nursing students who received prebriefing per the SEPM compared to a control group.

SETTING: The study was conducted in one public Midwestern university in the United States.

PARTICIPANTS: 66 senior Bachelor of Science in Nursing students enrolled in a clinical course completed the study.

METHODS: Clinical competency and self-efficacy were examined between an experimental group that received prebriefing per the SEPM and a control group that received standard prebriefing. The relationship between self-efficacy and clinical competency was examined. Clinical competency and self-efficacy were evaluated using the Creighton Competency Evaluation Instrument and Revised Clinical and Simulation General Self-Efficacy Scale.

RESULTS: The experimental group had statistically significantly higher self-efficacy (p = .001) and clinical competency (p < .001) as compared to the control group. There was no significant relationship noted between self-efficacy and clinical competency (p = .207).

CONCLUSION: The SEPM promoted nursing student self-efficacy and clinical competency in simulation. Prebriefing has an essential role in the simulation process and in promoting student outcomes.

PMID:34973554 | DOI:10.1016/j.nedt.2021.105260

Clin Biomech (Bristol, Avon). 2021 Dec 29;92:105553. doi: 10.1016/j.clinbiomech.2021.105553. Online ahead of print.

ABSTRACT

BACKGROUND: The 3D printing technology allows to produce custom shapes and add functionalities to foot orthoses which offers better options for the treatment of flatfeet. This study aimed to assess the effect of 3D printed foot orthoses stiffness and/or a newly design posting on muscle activity, plantar pressures, and center of pressure displacement in individuals with flatfeet.

METHODS: Nineteen individuals with flatfeet took part in this study. Two pairs of foot orthoses with different stiffness were designed for each participant and 3D printed. In addition, the flexible foot orthoses could feature an innovative rearfoot posting. Muscle activity, plantar pressures, and center of pressure displacement were recorded during walking.

FINDINGS: Walking with foot orthoses did not alter muscle activity time histories. Regarding plantar pressures, the most notable changes were observed in the midfoot area, where peak pressures, mean pressures and contact area increased significantly during walking with foot orthoses. The latter was reinforced by increasing the stiffness. Concerning the center of pressure displacement, foot orthoses shifted the center of pressure forward and medially at early stance. At the end of the stance phase, a transition of the center of pressure in posterior direction was observed during the posting condition. No effect of stiffness was observed on center of pressure displacement.

INTERPRETATION: The foot orthoses stiffness and the addition of posting influenced plantar pressures during walking. The foot orthoses stiffness mainly altered the plantar pressures under the midfoot area. However, posting mainly acted on peak and mean pressures under the rearfoot area.

PMID:34973589 | DOI:10.1016/j.clinbiomech.2021.105553

Int J Food Microbiol. 2021 Dec 22;363:109505. doi: 10.1016/j.ijfoodmicro.2021.109505. Online ahead of print.

ABSTRACT

Bacillus cereus, a foodborne pathogen, is capable of forming spores and biofilms as methods to withstand environmental stresses. These bacterial structures are an issue for food safety as they aid the bacteria survive heat sterilisation processes of foods and food contact surfaces. This study was conducted to investigate the role of the biofilm structure in providing an extra layer of protection to spores against heat treatments. For this, heat resistance of B. cereus spores in intact biofilms was compared to that of planktonic spores in vitro and in a Cheonggukjang jjigae food model. Using methods developed in this study to measure the wet and dry heat resistance of spores in intact biofilms, it was found that B. cereus spores have significantly higher heat resistances when present in biofilms rather than as planktonic spores, and that dry heat is less effective than wet heat at killing spores in biofilms. In further detail, for wet heat treatments, spores in biofilms of the strain isolated from Cheonggukjang (Korean fermented whole soybean), B. cereus CH3, had generally higher wet heat resistances than the reference strain, B. cereus ATCC 10987, both in vitro and in the Cheonggukjang jjigae food model. However, the spores in biofilms of the two strains showed similar heat resistance to dry heat, with some exceptions, when biofilms were formed in vitro or in Cheonggukjang jjigae broth. Meanwhile, B. cereus ATCC 10987 spores in biofilms had higher or similar wet heat resistances in vitro compared to in Cheonggukjang jjigae broth. Wet heat resistances of B. cereus CH3 spores in biofilms were all statistically similar regardless of biofilm formation media (brain heart infusion and Cheonggukjang jjigae broths). For dry heat, spores in biofilms of both B. cereus strains were more heat resistant when biofilms were formed in the Cheonggukjang jjigae food model rather than in vitro. Altogether, heat resistances of spores in biofilms formed in vitro and in the food environment were found to be different depending on the tested B. cereus strain, but higher than planktonic spores in any case. This is the first study examining the heat resistance of B. cereus spores in intact biofilms matrices attached to the surface, both in vitro and in a food model. Therefore, this research is valuable to understand the protective effects of biofilms formed in food environments and to reduce the food safety risks associated with B. cereus.

PMID:34973549 | DOI:10.1016/j.ijfoodmicro.2021.109505

Travel Med Infect Dis. 2021 Dec 29:102251. doi: 10.1016/j.tmaid.2021.102251. Online ahead of print.

ABSTRACT

BACKGROUND: Malaria is a life-threatening, mosquito-borne parasitic disease, caused by Plasmodium spp. It is a major public health issue. Malaria in Switzerland is primarily “imported” by infected international travellers, migrants, and asylum-seekers.

METHOD: We investigated the epidemiology and characteristics of imported malaria in Switzerland in the period between 1990 and 2019 using data from the Swiss Federal Office of Public Health (BAG). We also obtained traveller statistics from the World Tourism Organization (UNWTO).

RESULTS: During the last thirty years a total of 8’439 malaria cases and 52 deaths were reported in Switzerland. The main origin of infection was West Africa, followed by Central Africa and East Africa. The profile of malaria in migrants in Switzerland has changed, reflecting variation in migrant flows. The estimated risk of malaria in travellers sank significantly over the time frame of the study (p < 0.001, 95% CI -0.076 to -0.043).

CONCLUSIONS: Travel medicine should focus on West Africa, the main source of malaria in Switzerland. Despite most cases and all but one death being caused by Plasmodium falciparum, Plasmodium vivax remains a threat for travellers and is associated with complex prevention and therapy regimens. Public health authorities need to pre-empt the need for malaria screening, prevention and treatment based on the profile of migrant waves from malaria endemic areas including Eritrea and Afghanistan arriving in Europe.

PMID:34973453 | DOI:10.1016/j.tmaid.2021.102251

Int J Pediatr Otorhinolaryngol. 2021 Nov 24;153:110990. doi: 10.1016/j.ijporl.2021.110990. Online ahead of print.

ABSTRACT

OBJECTIVES: Until today, there is no consensus about the ideal age for a myringoplasty in children. In this retrospective study, we study our own series to characterize different prognostic factors to answer questions/dilemmas such as when to carry out surgery in a child with an ear drum perforation, when to postpone surgery or when to use a different technique to improve the outcome after tympanoplasty.

METHODS: We performed a retrospective study on charts of 97 children who underwent a myringoplasty. The same surgeon (IF) treated all included children and with the same classical surgical technique: retro-auricular approach and microscopic underlay placement of fascia of the musculus temporalis. Children with associated disease (cholesteatoma, revision surgery and ossicular chain defects) were excluded. All children had a minimum follow up of 12 months. A successful procedure was defined as a closed eardrum after 12 months and an air bone gap <20 dB. Prognostic factors were inventoried and studied.

RESULTS: Success rate after myringoplasty is 80.2% in this pediatric case series. Age was not a statistical significant prognostic factor. Only the history of an adenoidectomy had a positive effect on tympanic closure (p = 0.047). A negative prognostic factor was the size of the perforation: large perforations showed only 42.9% eardrum closure (p = 0.040). There was a complication rate of 28.9%, in which formation of granulation tissue and ear discharge were most common but easily treated.

CONCLUSION: Tympanoplasty type 1 with musculus temporalis fascia in underlay is a safe and successful technique in children of all ages with eardrum perforations. Our data suggests using a different technique (cartilage tympanoplasty) in cases with large perforation. Postponing surgery is not advocated, unless perhaps in children with poor Eustachian function or adenoidhyperplasia.

PMID:34973522 | DOI:10.1016/j.ijporl.2021.110990

J Shoulder Elbow Surg. 2021 Dec 29:S1058-2746(21)00865-X. doi: 10.1016/j.jse.2021.11.017. Online ahead of print.

ABSTRACT

BACKGROUND: Lateral Epicondylitis is common in workers who perform repetitive movements of the entire upper limb. Approximately 85% to 90% respond satisfactorily to conservative treatment, but in resistant patients, surgical treatment is considered. Classic open surgery is successful between 70% and 97%, similar to more modern techniques such as arthroscopy. We tried to demonstrate the superiority of the Wolf technique in clinical results. The goals of this study were to compare the functional and pain outcomes of arthroscopic surgery with open surgery using fasciotomy as the wolf technique in the treatment of lateral epicondylitis.

METHODS: This was a retrospective study of 47 working-age patients with resistant lateral epicondylitis: 27 underwent surgery arthroscopically, and 20 underwent open surgery. Pre- and postsurgical VAS and function were assessed using DASH, MEPS and BMRS scales, as well as the return to their previous work and the surgical time.

RESULTS: The reduction in VAS showed no statistically significant differences between the groups (5.26 in arthroscopy versus 5.75 in fasciotomy, p = 0.5), QuickDash (19 versus 19.4 with p = 0.9), MEPS (82 versus 81.5 with p = 0.8) or BMRS (81.9 versus 82.6 with p = 0.9). The differences in terms of time off were also not statistically significant. The days of work leave in the arthroscopy group corresponded on average 83.78 days, and in the Wolff group, it corresponded to 89.95 days. The mean surgical time in the arthroscopic intervention group was 44.2 minutes and in the fasciotomy group was 27.5 minutes, showing statistically significant results (p <0.001).

CONCLUSIONS: Arthroscopic surgery and open surgery in lateral epicondylitis techniques provide similar functional results and pain reduction.

LEVEL OF EVIDENCE: Level III; Retrospective Cohort Comparison; Treatment Study.

PMID:34973424 | DOI:10.1016/j.jse.2021.11.017

World Neurosurg. 2021 Dec 29:S1878-8750(21)01936-7. doi: 10.1016/j.wneu.2021.12.091. Online ahead of print.

ABSTRACT

BACKGROUND: Despite the fact that bevacizumab (Bev) has been approved to treat recurrent GBM, GBM patients failed to demonstrate a significant overall survival (OS) advantage. In recent years, the advent of more bevacizumab (Bev) combination regimens seems to bring new hope for patients, nevertheless, there is still a lack of intuitive comparison among these therapies.

OBJECTIVE: To explore the efficacy and safety of various bevacizumab (Bev) combination regimens in patients with recurrent glioblastoma and to further explore the differences in the efficacy of each treatment in randomized controlled trials (RCTs) and nonrandomized controlled trials (non-RCTs).

METHODS: We comprehensively searched the PubMed, Cochrane Library, and OVID databases for relevant RCTs and non-RCTs of Bev in combined regimens for recurrent glioblastoma. The Cochrane quality assessment method was used to assess the quality of RCTs, and the Newcastle-Ottawa scale was used to assess the quality of non-RCTs. Excel software was used to extract data from the literature, and a network meta-analysis was performed using RevMan 5.3 and Stata 16 statistical software.

RESULTS: In patients with recurrent glioblastoma, the 6-month overall survival of patients receiving bevacizumab combination therapy was ranked from high to low as follows: Bev + rindopepimut, Bev + lomustine (CCNU), CCNU, Tumor Treating Fields (TTFields) + Bev, Bev, Bev + irinotecan (Iri), Bev + temozolomide (TMZ), Bev + vorinostat, Bev + onartuzumab, Bev + dasatinib, Bev + carboplatin, Bev + trebananib, Bev + VB-111, TMZ, PCV, VB-111, and carboplatin. The 6-month progression-free survival from high to low was ranked as follows: Bev + CCNU, Bev + rindopepimut, Bev + dasatinib, Bev + vorinostat, Bev, Bev + Iri, Bev + TMZ, CCNU, Bev + carboplatin, TMZ, Bev + VB-111, PCV, Bev + trebananib, carboplatin, and VB-111. We compared the total incidence of serious adverse events (≥ 3) and found that Bev + vorinostat and Bev + trebananib were safer than Bev, while other regimens were not as safe as Bev. A descriptive analysis showed that Bev + rindopepimut also appeared to be safer than Bev. Subgroup analysis: Among RCTs, Bev + CCNU therapy had the highest 6-month overall survival and 6-month progression-free survival. Among non-RCTs, Bev + Iri therapy showed the highest 6-month overall survival and good 6-month progression-free survival.

CONCLUSION: Both Bev + CCNU and Bev + rindopepimut could be considered as effective therapies for treating the recurrent glioblastoma according to the network meta-analysis results. Among them, Bev + rindopepimut therapy seems to be safer and more effective. Moreover, we found that Bev + Iri also appeared to be an effective therapy in a retrospective study.

PMID:34973444 | DOI:10.1016/j.wneu.2021.12.091

J Vasc Surg. 2021 Dec 29:S0741-5214(21)02735-X. doi: 10.1016/j.jvs.2021.12.055. Online ahead of print.

ABSTRACT

OBJECTIVES: To provide the midterm results of endovascular repair for acute zone 0 intramural hematoma patients with the most proximal tear or ulcer-like projection in the descending aorta.

METHODS: Information about acute zone 0 intramural hematoma patients with the most proximal tear or ulcer-like projection in the descending aorta from January 1, 2010, to December 31, 2019, were retrospectively reviewed. We performed Kaplan-Meier curves to calculate the intervention-free survival and survival after endovascular or open repair. We used propensity score matching to compare the outcomes of endovascular with surgical repair.

RESULTS: This study included 99 patients, 34 of them initially underwent medical treatment; the 0.5, 1, 3 years intervention-free survival rates were 23.5%, 17.6%, and 14.7%, respectively. 51 patients underwent endovascular therapy; most of them had a maximal diameter of ascending aorta＜50mm and maximal diameter of intramural hematoma in ascending aorta＜10mm, the 1, 3, 5 years survival rate were all 98.0%. 42 patients underwent open surgery, and the 1, 3, 5 years survival rates were all 92.9%. After propensity score matching, there was no statistical difference in 30 days and follow-up mortality, while the endovascular repair was associated with shorter operation time (69 vs. 314 minutes, p＜.001), shorter length of ICU stay (24 vs. 70 hours, p=.001), and shorter length of hospital stay (7 vs. 12 days, p=.011).

CONCLUSION: In acute zone 0 intramural hematoma patients with the most proximal tear or ulcer-like projection in the descending aorta, besides open surgery, endovascular repair is optional on the premise of the maximal diameter of ascending aorta＜50mm and maximal diameter of intramural hematoma in ascending aorta＜10mm.

PMID:34973400 | DOI:10.1016/j.jvs.2021.12.055

Asian Nurs Res (Korean Soc Nurs Sci). 2021 Dec 29:S1976-1317(21)00093-1. doi: 10.1016/j.anr.2021.12.004. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to develop website-based learning contents to activate voluntary monitoring and reporting of adverse drug reactions (ADRs) for clinical nurses and to verify their effectiveness.

METHOD: Using a quasi-experimental control group pretest-posttest design with random allocation, a total of 60 nurses with more than 1 year of clinical experience were recruited from a university hospital in Seoul, Korea. A website was developed that provides learning contents including real cases and the latest drug-related knowledge, as well as video lectures. Knowledge on ADRs monitoring, self-efficacy, ADRs practice behavior, and medication performance ability were measured at 2 weeks after intervention. A small notebook for monitoring ADRs of nurses was given to the control group. Data were analyzed using descriptive statistics, the ^χ2test, and the independent t-test using SPSS Statistics Software Version 21.0.

RESULTS: The scores of ADRs monitoring knowledge, self-efficacy, and ADRs monitoring practice in the experimental group significantly increased after the intervention compared with the control group (p<.05). However, there was no significant difference between the two groups in medication performance ability related to ADRs monitoring.

CONCLUSION: In order to spread a safety culture in which voluntary ADRs monitoring and reporting is activated, it is necessary for clinical nurses to share and communicate ADRs-related information and real cases through an open website.

PMID:34973410 | DOI:10.1016/j.anr.2021.12.004

Environ Pollut. 2021 Dec 29:118769. doi: 10.1016/j.envpol.2021.118769. Online ahead of print.

ABSTRACT

Urban rivers play a vital role in global methane (CH₄) emissions. Previous studies have mainly focused on CH₄ concentrations in urban rivers with a large amount of organic sediment. However, to date, the CH₄ concentration in gravel-bed urban rivers with very little organic sediment has not been well documented. Here, we collected water samples from an oxic urban river (Xin’an River, China; annual mean dissolved oxygen concentration was 9.91 ± 1.99 mg L^-1) with a stony riverbed containing very little organic sediment. Dissolved CH₄ concentrations were measured using a membrane inlet mass spectrometer to investigate whether such rivers potentially act as an important source of atmospheric CH₄ and the corresponding potential drivers. The results showed that CH₄ was supersaturated at all sampling sites in the five sampling months. The mean CH₄ saturation ratio (ratio of river dissolved CH₄ concentration to the corresponding CH₄ concentration that is in equilibrium with the atmosphere) across all sampling sites in the five sampling months was 204 ± 257, suggesting that the Xin’an River had a large CH₄ emission potential. The CH₄ concentration was significantly higher in the downstream river than in the upstream river (p < 0.05), which suggested that human activities along the river greatly impacted the CH₄ level. Statistical analyses and incubation experiments indicated that algae can produce CH₄ under oxic conditions, which may contribute to the significantly higher CH₄ concentration in August 2020 (p < 0.001) when a severe algal bloom occurred. Furthermore, other factors, such as heavy rainfall events, dissolved organic carbon concentration, and water temperature, may also be vital factors affecting CH₄ concentration. Our study enhances the understanding of dissolved CH₄ dynamics in oxic urban rivers with very little organic sediment and further proposes feasible measures to control the CH₄ concentration in urban rivers.

PMID:34973384 | DOI:10.1016/j.envpol.2021.118769