Tag: statistics

BMC Cancer. 2022 Aug 22;22(1):910. doi: 10.1186/s12885-022-09990-7.

ABSTRACT

BACKGROUND: Controversy exists regarding the relationship of the outcome of patients with colorectal cancer (CRC) with the time from symptom onset to diagnosis. The aim of this study is to investigate this association, with the assumption that this relationship was nonlinear and with adjustment for multiple confounders, such as tumor grade, symptoms, or admission to an emergency department.

METHODS: This multicenter study with prospective follow-up was performed in five regions of Spain from 2010 to 2012. Symptomatic cases of incident CRC from a previous study were examined. At the time of diagnosis, each patient was interviewed, and the associated hospital and clinical records were reviewed. During follow-up, the clinical records were reviewed again to assess survival. Cox survival analysis with a restricted cubic spline was used to model overall and CRC-specific survival, with adjustment for variables related to the patient, health service, and tumor.

RESULTS: A total of 795 patients had symptomatic CRC and 769 of them had complete data on diagnostic delay and survival. Univariate analysis indicated a lower HR for death in patients who had diagnostic intervals less than 4.2 months. However, after adjustment for variables related to the patient, tumor, and utilized health service, there was no relationship of the diagnostic delay with survival of patients with colon and rectal cancer, colon cancer alone, or rectal cancer alone. Cubic spline analysis indicated an inverse association of the diagnostic delay with 5-year survival. However, this association was not statistically significant.

CONCLUSIONS: Our results indicated that the duration of diagnostic delay had no significant effect on the outcome of patients with CRC. We suggest that the most important determinant of the duration of diagnostic delay is the biological profile of the tumor. However, it remains the responsibility of community health centers and authorities to minimize diagnostic delays in patients with CRC and to implement initiatives that improve early diagnosis and provide better outcomes.

PMID:35996104 | DOI:10.1186/s12885-022-09990-7

BMC Musculoskelet Disord. 2022 Aug 22;23(1):803. doi: 10.1186/s12891-022-05758-z.

ABSTRACT

BACKGROUND: Lateral epicondylitis is one of the most common upper extremity problems presented to orthopedic surgeons. Despite a rapid and accurate arrival at a diagnosis by clinical examination, there exists no consensus classification for this condition, which hampers clinical approaches for treatment of the disease based on its severity. Thus, the aim of this study was to propose and valiadate a new magnetic resonance imaging (MRI) classification of lateral epicondylitis, staging by tendinosis, the degree of thickness tears of the common extensor tendon (CET) and bone bruise lesion.

METHOD: MRI assessment of the elbow of 75 patients (57 women and 18 men; mean age:51.4 years (range,34-73) from Jan 2014 to Jan 2021 who were diagnosed with lateral epicondylitis were included in the study. MR images were reviewed retrospectively by two independent upper extremities orthopedists and one musculoskeletal radiologist. Inter- and intra-observer reliabilities for the classification were calculated using kappa statistics for the analysis of interrater agreement. Correlation between the stage of the disease and the duration of symptom before MRI was calculated using Kruskal-wallis test.

RESULTS: Various degrees of CET lesions were demonstrated in this population (Stage I-17, IIA-7, IIB-22 and III-29). Intra-observer agreements of MRI staging were substantial to satisfactory. Inter-observer agreements were moderate to substantial. There was no significant correlation between the disease stage and the patient age or the duration of symptom before MRI.

CONCLUSION: Our MRI classification has emerged as one of the most reliable methods to define stages of chronic lateral epicondylitis. At the end, we have suggeted a clearer direction for understanding the disease pathology as well as an appropriate management protocol for each stage of the disease in line with the recent body of literature.

PMID:35996100 | DOI:10.1186/s12891-022-05758-z

BMC Public Health. 2022 Aug 22;22(1):1593. doi: 10.1186/s12889-022-13973-5.

ABSTRACT

BACKGROUND: Construction workers working in physically and mentally challenging environments experience high levels of occupational fatigue, which is the primary cause of industrial accidents and illnesses. Therefore, it is very important to measure fatigue in real time to manage the safety and health of construction workers. This study presents a novel approach for simultaneously measuring the subjective and objective fatigue of construction workers using ecological momentary assessment (EMA) and smartwatches. Due to the complexity and diversity of construction site environments, it is necessary to examine whether data collection using smartwatches is suitable in actual construction sites. This study aims to examine the feasibility of the integrated fatigue measurement method.

METHODS: This study comprised two phases: (1) development of an integrated fatigue measurement system for construction workers, and (2) a validation study to evaluate the method’s feasibility based on sensor data acquisition, EMA compliance, and feedback from construction workers in the field (N = 80). Three days of biometric data were collected through sensors embedded in the smartwatches for objective fatigue measurement, including heart rate, accelerometer, and gyroscope data. Two types of self-reported data regarding each worker’s fatigue were collected through a researcher-developed EMA application. The acceptability and usability of this system were examined based on the researchers’ observations and unstructured interviews.

RESULTS: Based on the standardized self-report questionnaire scores, participants were classified into high (n = 35, 43.75%) and low (n = 45, 56.25%) fatigue groups for comparison. The quantitative outcomes did not show a statistically significant difference between the two fatigue groups. Both groups experienced positive emotions and were able to recognize their health condition at the time of self-reporting, but stated that responding to this measurement system could be burdensome.

CONCLUSIONS: This feasibility study provides a unique understanding of the applications of EMA and smartwatches for safety management in the construction workforce. The developed measurement system shows potential for monitoring fatigue based on the real-time collection of relevant data. It is expected that by expanding this integrated system through further research and onsite application, the health and safety of construction workers can be improved.

PMID:35996096 | DOI:10.1186/s12889-022-13973-5

BMC Infect Dis. 2022 Aug 22;22(1):703. doi: 10.1186/s12879-022-07675-x.

ABSTRACT

BACKGROUND AND AIM: It seems that acceptance of COVID-19 vaccination is the most effective way to tackle the COVID-19 pandemic now. Health care workers (HCWs) are one of the most important groups who are at risk for COVID-19 infection. This study aimed to assess the COVID-19 vaccine acceptance among HCWs in Iran and its determinants.

METHODS: A cross-sectional survey was carried out among 3600 HCWs in Iran. Data were collected through a self-administered questionnaire by a trained team from February to March 2021. Multi-stage cluster sampling method was used for selecting respondents of the study. Multivariate logistic regression analysis was used to determine the key factors of COVID-19 vaccine acceptance among participants. P-value < 0.05 was considered statistically significant.

RESULTS: Out of the 3536 respondents, 2191 (62.1%) intended to uptake the COVID-19 vaccine. Only about 10 percent of respondents said they did not trust any vaccine (domestic or foreign). Willing to accept a COVID-19 vaccine was relatively high among males, doctors, and those who had a history of hospitalization due to COVID-19 infection. The multivariate regression analysis showed respondents who were 40-50 years (aOR: 1.56; 95% CI: 1.47-1.66), had a history of COVID-19 infection (aOR: 0.85; 95% CI: 0.83-0.88), and hospitalized due to COVID-19 infection (aOR: 2.18; 95% CI: 1.97-2.39), were significantly associated with vaccine acceptance (p < 0.05).

CONCLUSION: Our study showed moderate acceptance of COVID-19 vaccination in the HCWs in the Islamic Republic of Iran. The most important factor in the acceptance of the COVID-19 vaccine by the health staff is having a history of hospitalization. Further training and justification of health personnel is needed to increase the acceptance of COVID 19 vaccine.

PMID:35996088 | DOI:10.1186/s12879-022-07675-x

BMC Geriatr. 2022 Aug 22;22(1):691. doi: 10.1186/s12877-022-03389-6.

ABSTRACT

As the population ages, the number of people living with Alzheimer’s disease is expected to grow; consequently, nursing students are expected to care for more people with Alzheimer’s disease in their future careers. Exploring nursing students’ level of knowledge and attitudes is essential here to fill any knowledge gap and enhance attitudes. For this reason, the current study aimed to measure the knowledge of and attitudes toward people living with Alzheimer’s disease among undergraduate Jordanian nursing students. A descriptive cross-sectional design was utilized. Data were collected through an online questionnaire consisting of the Alzheimer’s Disease Knowledge Scale (ADKS) and Dementia Attitudes Scale (DAS). A third part contained questions about previous formal education about Alzheimer’s disease, reading Alzheimer’s research, and the need for formal education about Alzheimer’s disease. The study targeted all undergraduate Jordanian nursing students. A total of 275 students agreed to participate and completed the questionnaire. Jordanian nursing students had low knowledge regarding people living with Alzheimer’s disease, with a mean ADKS score of 18.3 out of 30; however, their attitudes were positive, with a mean DAS score of 91 out of 140. There was no statistical difference in attitude or knowledge between different academic levels. The majority of students (90.5%) expressed their desire to have a formal education regarding Alzheimer’s disease. Knowledge regarding people with Alzheimer’s disease could be improved through training and education. Positive attitudes reported by students could augment the learning process.

PMID:35996080 | DOI:10.1186/s12877-022-03389-6

BMC Anesthesiol. 2022 Aug 22;22(1):267. doi: 10.1186/s12871-022-01804-4.

ABSTRACT

BACKGROUND: Postoperative delirium (POD) is a critical complication in patients accepting colon carcinoma surgery. Neostigmine, as a cholinesterase inhibitor, can enhance the transmission of cholinergic transmitters in synaptic space, and play an important role in maintaining the normal level of cognition, attention and consciousness. The objective of this study was to investigate the effect of neostigmine on POD and clinical prognosis.

METHODS: A randomized, double-blind controlled trial was implemented in Qingdao Municipal Hospital Affiliated to Qingdao University. A total of 454 patients aged 40 to 90 years old accepted colon carcinoma surgery were enrolled between June 7, 2020, and June 7, 2021, with final follow-up on December 8, 2021. Patients were randomly assigned to two groups: the neostigmine group (group N) and the placebo group (group P), the patients in group N were injected with 0.04 mg/kg neostigmine and 0.02 mg/kg atropine intravenously. The primary endpoint was the incidence of POD, researchers evaluated the occurrence of POD by the Confusion Assessment Method (CAM) twice daily (at 10 a.m. and 2 p.m.) during the first 7 postoperative days, POD severity was assessed by the Memorial Delirium Assessment Scale (MDAS). The secondary endpoints were the extubating time, postanesthesia care unit (PACU) time, the incidence of various postoperative complications, length of hospital stays, and 6 months postoperative mortality.

RESULTS: The incidence of POD was 20.20% (81/401), including 19.39% (38/196) in group N and 20.98% (43/205) in group P. There was no significant statistical significance in the incidence of POD between group N and group P (P > 0.05); Compared to group P, the extubating time and PACU time in group N were significantly reduced (P < 0.001), the incidence of postoperative pulmonary complications (POPCs) decreased significantly in group N (P < 0.05), while no significant differences were observed in postoperative hospital stay and mortality in 6 months between the two groups (P > 0.05).

CONCLUSION: For patients accepted colon carcinoma surgery, neostigmine did not significantly reduce the incidence of POD, postoperative mortality and postoperative hospital stay, while it indeed reduced the extubating time, PACU time and the incidence of POPCs.

TRIAL REGISTRATION: The randomized, double-blind, controlled trial was registered retrospectively at www.chictr.org.cn on 07/06/2020 (ChiCTR2000033639).

PMID:35996073 | DOI:10.1186/s12871-022-01804-4

Ann Intern Med. 2022 Aug 23. doi: 10.7326/M22-0988. Online ahead of print.

ABSTRACT

BACKGROUND: The BNT162b2 (Pfizer-BioNTech) vaccine has been shown to be safe with regard to risk for severe cardiovascular events (such as myocardial infarction [MI], pulmonary embolism [PE], and stroke) in persons aged 75 years or older. Less is known about the safety of other COVID-19 vaccines or outcomes in younger populations.

OBJECTIVE: To assess short-term risk for severe cardiovascular events (excluding myocarditis and pericarditis) after COVID-19 vaccination in France’s 46.5 million adults younger than 75 years.

DESIGN: Self-controlled case series method adapted to event-dependent exposure and high event-related mortality.

SETTING: France, 27 December 2020 to 20 July 2021.

PATIENTS: All adults younger than 75 years hospitalized for PE, acute MI, hemorrhagic stroke, or ischemic stroke (n = 73 325 total events).

MEASUREMENTS: Linkage between the French National Health Data System and COVID-19 vaccine databases enabled identification of hospitalizations for cardiovascular events (MI, PE, or stroke) and receipt of a first or second dose of the Pfizer-BioNTech, mRNA-1273 (Moderna), Ad26.COV2.S (Janssen), or ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccine. The relative incidence (RI) of each cardiovascular event was estimated in the 3 weeks after vaccination compared with other periods, with adjustment for temporality (7-day periods).

RESULTS: No association was found between the Pfizer-BioNTech or Moderna vaccine and severe cardiovascular events. The first dose of the Oxford-AstraZeneca vaccine was associated with acute MI and PE in the second week after vaccination (RI, 1.29 [95% CI, 1.11 to 1.51] and 1.41 [CI, 1.13 to 1.75], respectively). An association with MI in the second week after a single dose of the Janssen vaccine could not be ruled out (RI, 1.75 [CI, 1.16 to 2.62]).

LIMITATIONS: It was not possible to ascertain the relative timing of injection and cardiovascular events on the day of vaccination. Outpatient deaths related to cardiovascular events were not included.

CONCLUSION: In persons aged 18 to 74 years, adenoviral-based vaccines may be associated with increased incidence of MI and PE. No association between mRNA-based vaccines and the cardiovascular events studied was observed.

PRIMARY FUNDING SOURCE: None.

PMID:35994748 | DOI:10.7326/M22-0988

J Trop Pediatr. 2022 Aug 4;68(5):fmac072. doi: 10.1093/tropej/fmac072.

ABSTRACT

AIM: In this study, we aimed to evaluate serum vitamin D and zinc levels in children diagnosed with coronavirus disease 2019 (COVID-19).

MATERIALS AND METHODS: In this study, 88 children with COVID-19 disease and 88 healthy children aged 1-18 years were enrolled between 01 July 2021 and 30 October 2021 in the Pediatrics Clinic of Tekirdağ Çorlu State Hospital. Serum vitamin D and zinc levels have been measured and NCSS (Number Cruncher Statistical System) program has been utilized for statistical analysis.

RESULTS: We included 88 COVID-19 positive pediatric patients [50% (n = 44) female] and 88 healthy children [48.86% (n = 43) female] in this study. The mean serum vitamin D levels of COVID-19 positive patients were statistically significantly lower than the control group (p = 0.0001). The zinc mean values of the study group were found to be statistically significantly lower than the control group (p = 0.0001). There was a statistically significant correlation between serum vitamin D and zinc values in all patient groups (r = 0.245, p = 0.001).

CONCLUSION: As a result, zinc and vitamin D levels were observed lower in COVID-19 patients than in healthy individuals. Since there is no defined treatment protocol for COVID-19 infection on children yet, zinc and vitamin D supplementation can be used as a supportive treatment in COVID-19 infection.

PMID:35994727 | DOI:10.1093/tropej/fmac072

J Phys Chem A. 2022 Aug 22. doi: 10.1021/acs.jpca.2c04265. Online ahead of print.

ABSTRACT

We have recorded the resonance-enhanced multiphoton ionization spectrum for NO (A) products from photodissociation of the N₂-NO complex. We made measurements at excitation energies ranging from 28 to 758 cm^-1 above the threshold to produce NO (A) + N₂ (X) products, and the resulting spectra reveal the NO (A) rotational states formed during dissociation, allowing us to determine the rotational state distribution. At the lowest available energies, 28 and 50 cm^-1 above threshold, we observed contributions from NO (A) rotational states that exceed the available energy and must originate from excitation due to hotbands of the complex. At all higher energies, we did not observe any energetically disallowed NO (A) rotational states, and for all available energies above 259 cm^-1 the observed rotational transitions do not extend to the maximum allowed by energy conservation. Furthermore, the observed distributions were typically biased toward low rotational states, in contrast with expectations from vibrational predissociation. From the rotational state distributions, we determined the average fraction of energy partitioned into NO (A) rotation, f_{NO rot, ave}, to be 0.088 at the highest available energy, and this fraction increased as the available energy decreased. By combining the average NO (A) rotational energy along with the average center-of-mass translational energy from our previous work, we determined the average rotational energy for the undetected N₂ (X) photoproduct. The results showed that the N₂ fragment has a higher average rotational energy relative to the NO fragment. Finally, we found that the NO (A) rotational state distribution was colder than expected for a statistical dissociation.

PMID:35994689 | DOI:10.1021/acs.jpca.2c04265

Proc Natl Acad Sci U S A. 2022 Aug 30;119(35):e2119513119. doi: 10.1073/pnas.2119513119. Epub 2022 Aug 22.

ABSTRACT

In a striking result, Louca and Pennell [S. Louca, M. W. Pennell, Nature 580, 502-505 (2020)] recently proved that a large class of phylogenetic birth-death models is statistically unidentifiable from lineage-through-time (LTT) data: Any pair of sufficiently smooth birth and death rate functions is “congruent” to an infinite collection of other rate functions, all of which have the same likelihood for any LTT vector of any dimension. As Louca and Pennell argue, this fact has distressing implications for the thousands of studies that have utilized birth-death models to study evolution. In this paper, we qualify their finding by proving that an alternative and widely used class of birth-death models is indeed identifiable. Specifically, we show that piecewise constant birth-death models can, in principle, be consistently estimated and distinguished from one another, given a sufficiently large extant timetree and some knowledge of the present-day population. Subject to mild regularity conditions, we further show that any unidentifiable birth-death model class can be arbitrarily closely approximated by a class of identifiable models. The sampling requirements needed for our results to hold are explicit and are expected to be satisfied in many contexts such as the phylodynamic analysis of a global pandemic.

PMID:35994663 | DOI:10.1073/pnas.2119513119