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Nevin Manimala Statistics

An in Depth Look Into Intracranial Abscesses and Empyemas: a Ten-year Experience in a Single Institute

Med Arch. 2022 Jun;76(3):183-189. doi: 10.5455/medarh.2022.76.183-189.

ABSTRACT

BACKGROUND: As the incidence of intracranial infections increase due to diagnostic procedures improvement, more real-life data is needed to reach a more solid informed management approach.

OBJECTIVE: This study aims to describe and analyse clinical features of intracranial abscesses patients treated at a tertiary hospital in North Jordan during a 10-year period.

METHODS: We retrospectively identified 37 patients treated at King Abdullah University Hospital (KAUH) from 2011 to 2020 in Irbid, North Jordan. Treatment consisted of either aspiration, open craniotomy excision (OCE) or conservative therapy. Extracted variables included demographic data such (age, gender), clinical presentation, lab findings, radiological findings as well as management plan. Retrieved data was compared between the patients who underwent a single operation and those who underwent reoperation after the initial procedure.

RESULTS: Thirty-seven patients with 55 intracerebral abscesses were identified, 29 of whom had intraparenchymal brain abscesses, 4 patients had epidural empyema, and 4 had subdural empyema. The mean age was 28.8 (± 20.7) years, with a male predominance (78.4%). Sixteen patients underwent open craniotomy excision (OCE), 14 patients were treated by aspiration and 7 patients were treated conservatively. When comparing the single operation and the reoperation groups, there was no statistically significant difference across variables.

CONCLUSION: Our study presents valuable insight from a tertiary hospital in north Jordan on intracranial abscesses and empyemas. Our findings confirm that good recovery can be established after aspiration or OCE in the majority of patients. Similar results were obtained when comparing the SOP and the ROP groups.

PMID:36200111 | PMC:PMC9478810 | DOI:10.5455/medarh.2022.76.183-189

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Nevin Manimala Statistics

Mapping of space-time patterns of infectious disease using spatial statistical models: a case study of COVID-19 in India

Infect Dis (Lond). 2022 Oct 5:1-17. doi: 10.1080/23744235.2022.2129778. Online ahead of print.

ABSTRACT

INTRODUCTION: Mapping of infectious diseases like COVID-19 is the foremost importance for diseases control and prevention. This study attempts to identify the spatio-temporal pattern and evolution trend of COVID-19 at the district level in India using spatial statistical models.

MATERIALS AND METHODS: Active cases of eleven time-stamps (30 March-2 December, 2020) with an approximately 20-day interval are considered. The study reveals applications of spatial statistical tools, i.e. optimised hotspot and outlier analysis (which follow Gi* and Moran I statistics) and emerging hotspot with the base of space time cube, are effective for the spatio-temporal evolution of disease clusters.

RESULTS: The result shows the overall increasing trend of COVID-19 infection with a Mann-Kendall trend score of 2.95 (p = 0.0031). The spatial clusters of high infection (hotspots) and low infection (coldspots) change their location over time but are limited to the districts of the south-western states (Kerala, Karnataka, Andhra Pradesh, Maharashtra, Gujarat) and the north-eastern states (West Bengal, Jharkhand, Assam, Tripura, Manipur, etc.) respectively.

CONCLUSIONS: A total of eight types of patterns are identified, but the most concerning types are consecutive (7.24% of districts), intensifying (15.13% districts) and persistent (24.34% of districts) which will help health policy makers and the government to prioritize-based resource allocation and control measures.

PMID:36199164 | DOI:10.1080/23744235.2022.2129778

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Use of antimicrobials licensed for systemic administration in UK equine practice

Equine Vet J. 2022 Oct 5. doi: 10.1111/evj.13878. Online ahead of print.

ABSTRACT

BACKGROUND: Judicious antimicrobial use (AMU) is important for preserving therapeutic effectiveness. Large-scale studies of antimicrobial prescribing can provide clinical benchmarks and help identify opportunities for improved stewardship.

OBJECTIVES: To describe systemic AMU in UK equine practice and identify factors associated with systemic and Category B (third and fourth generation cephalosporins, quinolones and polymixins) AMU.

STUDY DESIGN: Retrospective cohort.

METHODS: Anonymised electronic patient records (EPRs) for all equids attended by 39 UK veterinary practices between 1 January and 31 December 2018 were collected via the VetCompass™ programme. Systemic antimicrobial prescriptions were identified using electronic keyword searches. Indications for AMU were determined through manual review of a randomly selected subset of EPRs. The types and frequency of systemic antimicrobials prescribed and indications were summarised using descriptive statistics. Mixed-effects logistic regression was used to evaluate practice- and horse-related risk factors.

RESULTS: Systemic antimicrobials were prescribed to 12,538 (19.5%, 95% CI 19.2-19.8%) of 64,322 equids attended in 2018. Category B antimicrobials were prescribed to 1.9% (95% CI 1.8-2.0%) of attended equids and in 8.9% (95% CI 8.5-9.4%) of antimicrobial courses. Bacteriological culture was performed in 19.1% (95% CI 17.1-21.3%) of Category B antimicrobial courses. The most commonly prescribed antimicrobial classes were potentiated sulphonamides (50.2% of equids receiving antimicrobials) and tetracyclines (33.5% of equids receiving antimicrobials). Integumentary disorders were the most common reason for systemic AMU (40.5% of courses). Urogenital disorders were the most common reason for Category B AMU (31.1% of courses). Increased odds of systemic and Category B AMU were observed in equids <1 year compared to those aged 5-14 years. Breed was associated with AMU, with odds of systemic and Category B AMU highest in Thoroughbreds and Thoroughbred crosses.

MAIN LIMITATIONS: Convenience sample of practices may limit generalisability.

CONCLUSIONS: Empirical use of Category B antimicrobials remains commonplace.

PMID:36199158 | DOI:10.1111/evj.13878

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Genetic association of ANGPT2 with primary open-angle glaucoma

Eye Vis (Lond). 2022 Oct 6;9(1):37. doi: 10.1186/s40662-022-00309-y.

ABSTRACT

BACKGROUND: To determine the association of the ANGPT2 gene with primary open-angle glaucoma (POAG) in Chinese.

METHODS: Six single-nucleotide polymorphisms (SNPs) in ANGPT2 (rs2515487, rs2922869, rs13255574, rs4455855, rs13269021, and rs11775442) were genotyped in a total of 2601 study subjects from two cohorts. One is a Hong Kong Chinese cohort of 484 high tension glaucoma (HTG) and 537 normal tension glaucoma (NTG) patients, and 496 non-glaucoma control subjects. Another cohort is a Shantou Chinese cohort of 403 HTG and 135 NTG patients, and 543 non-glaucoma control subjects. Subgroup analysis by sex was conducted. Outcomes from different cohorts were combined for meta-analysis.

RESULTS: The association of SNP rs11775442 with NTG in the Hong Kong cohort [P = 0.0498, OR = 1.24, 95% confidence interval (CI) 1.00-1.55] after adjusting for age and sex did not reach statistical significance after Bonferroni correction. Other SNPs were not significantly associated with NTG, HTG and POAG in individual cohort or in the combined analyses (P > 0.05). In the subgroup analysis by sex, SNP rs13269021 in the Shantou cohort, but not in the Hong Kong cohort, was significantly associated with NTG in males (P = 0.0081, OR = 1.67, 95% CI: 1.14-2.43) but not in females (P = 0.874). In the combined analyses by sex, no SNPs were significantly associated with NTG, HTG and POAG.

CONCLUSIONS: In the subgroup analysis by sex, a significant association was shown in SNP rs13269021 with NTG in Shantou males, but not in Hong Kong males. Further studies are needed to verify the association between ANGPT2 locus (rs13269021) and NTG in Chinese males.

PMID:36199153 | DOI:10.1186/s40662-022-00309-y

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Nevin Manimala Statistics

Farm management practices, biosecurity and influenza a virus detection in swine farms: a comprehensive study in colombia

Porcine Health Manag. 2022 Oct 5;8(1):42. doi: 10.1186/s40813-022-00287-6.

ABSTRACT

Biosecurity protocols (BP) and good management practices are key to reduce the risk of introduction and transmission of infectious diseases into the pig farms. In this observational cross-sectional study, survey data were collected from 176 pig farms with inventories over 100 sows in Colombia. We analyzed a complex survey dataset to explore the structure and identify clustering patterns using Multiple Correspondence Analysis (MCA) of swine farms in Colombia, and estimated its association with Influenza A virus detection. Two principal dimensions contributed to 27.6% of the dataset variation. Farms with highest contribution to dimension 1 were larger farrow-to-finish farms, using self-replacement of gilts and implementing most of the measures evaluated. In contrast, farms with highest contribution to dimension 2 were medium to large farrow-to-finish farms, but implemented biosecurity in a lower degree. Additionally, two farm clusters were identified by Hierarchical Cluster Analysis (HCA), and the odds of influenza A virus detection was statistically different between clusters (OR 7.29, CI: 1.7,66, p = < 0.01). Moreover, after logistic regression analysis, three important variables were associated with higher odds of influenza detection: (1) “location in an area with a high density of pigs”, (2) “farm size”, and (3) “after cleaning and disinfecting, the facilities are allowed to dry before use”. Our results revealed two clustering patterns of swine farms. This systematic analysis of complex survey data identified relationships between biosecurity, husbandry practices and influenza status. This approach helped to identify gaps on biosecurity and key elements for designing successful strategies to prevent and control swine respiratory diseases in the swine industry.

PMID:36199147 | DOI:10.1186/s40813-022-00287-6

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The relationship between aggressive behaviors of preschool children and the violence against Iranian women in the COVID-19 pandemic

BMC Womens Health. 2022 Oct 5;22(1):406. doi: 10.1186/s12905-022-01954-0.

ABSTRACT

BACKGROUND: During epidemics, supports are limited and individual and collective vulnerabilities as well as domestic violence are increased. Therefore, various groups in society, especially children and their mothers, are extremely vulnerable. This study aimed to assess the relationship between aggressive behaviors of preschool children and the violence against Iranian women during the COVID-19 pandemic.

METHODS: This descriptive-correlational study was conducted in October-November 2020. Stratified random sampling was performed among preschool children in Kerman. Data were collected using the Violence toward Women Inventory and the Aggression scale for preschoolers Scale. Data were analyzed using SPSS25, ANOVA, independent t-test, and Pearson correlation test.

RESULTS: The results showed that the total mean scores of violence against women and preschoolers’ aggression were 54.43 ± 10.6 and 88.44 ± 6.5, respectively. The results showed a statistically significant difference in aggressive behaviors of preschool children, mother’s job, number of children, mother’s education, income, and age. A positive and significant relationship was also found between the subscales of violence against women and aggression in preschool children.

CONCLUSIONS: The results showed a positive and significant relationship between violence against women and aggression of preschool children. Therefore, it is recommended that parents identify and eliminate the risk factors for domestic violence during the COVID-19 in order to protect their children. Parents also must learn coping strategies for stress and resilience in the epidemic crises.

PMID:36199132 | DOI:10.1186/s12905-022-01954-0

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Nevin Manimala Statistics

Midwives’ knowledge and practice of Respectful Maternity Care: a survey from Iran

BMC Pregnancy Childbirth. 2022 Oct 5;22(1):752. doi: 10.1186/s12884-022-05065-4.

ABSTRACT

BACKGROUND: In the past decade, countries worldwide aimed to evaluate the quality of childbirth care and reduce the high rates of disrespect and abuse during childbirth. Few studies have attempted to identify providers’ characteristics associated with respectful maternity care quantitatively. This study aims to evaluate midwives’ knowledge and practice of respectful maternity care (RMC).

METHODS: A cross-sectional study was carried out in 15 teaching and non-teaching hospitals in Tehran, Iran. The hospitals were selected by using a cluster sampling design. Midwives’ Knowledge and Practice of Respectful Maternity Care scale (MKP-RMC) was administered to 250 midwives working in maternity units at study hospitals. The data were analysed by statistics package for social science (SPSS, version 21.0, Chicago, IL).

RESULTS: Findings demonstrated that the mean score for knowledge and practice of midwives were 20.96 ± 3.54 and 101.64 ± 11.49, respectively. Also, in both knowledge and practice scales, midwives had the highest score in “providing safe care’ domain and the lowest score in “preventing mistreatment” domain.

CONCLUSION: Our findings showed that for Iranian midwives, providing care to preserve mothers’ and their babies’ wellbeing is more critical than preventing maternal mistreatment, resulting from the importance of the care provision in the Iranian healthcare system. Promoting midwives’ knowledge and practice through developing a tailored educational program to prevent mistreatment and providing emotional support alongside physical care is recommended.

PMID:36199103 | DOI:10.1186/s12884-022-05065-4

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Africa-wide meta-analysis on the prevalence and distribution of human cystic echinococcosis and canine Echinococcus granulosus infections

Parasit Vectors. 2022 Oct 5;15(1):357. doi: 10.1186/s13071-022-05474-6.

ABSTRACT

BACKGROUND: Echinococcosis is a neglected zoonosis of increasing public health concern worldwide. According to the World Health Organization, 19,300 lives and 871,000 disability-adjusted life-years are lost globally each year because of cystic echinococcosis. Annual costs associated with cystic echinococcosis were estimated at US$ 3 billion because of treatment of cases and losses in the livestock industry.

METHODS: We performed the random-effects model of meta-analysis using 51-year (1970-2021) data available from AJOL, Google Scholar, PubMed, Science Direct, Scopus and Web of Science. We also applied the Joanna Briggs Institute critical appraisal instrument for studies reporting prevalence data, the Cochran’s Q-test, Egger’s regression test and the single study deletion technique to respectively examine within-study bias, heterogeneity, across-study bias and sensitivity.

RESULTS: Thirty-nine eligible studies on human cystic echinococcosis (HCE) from 13 countries across the five African sub-regions showed an overall prevalence of 1.7% (95% CI 1.1, 2.6) with a statistically significant (P < 0.001) sub-group range of 0.0% (95% CI 0.0, 14.1) to 11.0% (95% CI 7.6, 15.7). Highest prevalences were observed in Eastern Africa (2.7%; 95% CI 1.4, 5.4) by sub-region and Sudan (49.6%; 95% 41.2, 58.1) by country. Another set of 42 studies on Echinococcus granulosus infections (EGI) in dogs from 14 countries across the five African sub-regions revealed an overall prevalence of 16.9% (95% CI 12.7, 22.3) with a significant (P < 0.001) variation of 0.4 (95% CI 0.0, 5.9) to 35.8% (95% CI 25.4, 47.8) across sub-groups. Highest prevalences of E. granulosus were observed in North Africa (25.6%; 95% CI 20.4, 31.6) by sub-region and Libya (9.2%; 95% CI 5.7, 13.9) by country.

CONCLUSION: Human cystic echinococcosis and EGI are respectively prevalent among Africans and African dogs. We recommend a holistic control approach that targets humans, livestock, dogs and the environment, which all play roles in disease transmission. This approach should involve strategic use of anthelminthics in animals, standardized veterinary meat inspection in abattoirs, control of stray dogs to reduce environmental contamination and proper environmental sanitation. Mass screening of humans in hyper-endemic regions will also encourage early detection and treatment.

PMID:36199100 | DOI:10.1186/s13071-022-05474-6

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Nevin Manimala Statistics

Need for numbers: assessing cancer survivors’ needs for personalized and generic statistical information

BMC Med Inform Decis Mak. 2022 Oct 5;22(1):260. doi: 10.1186/s12911-022-02005-2.

ABSTRACT

BACKGROUND: Statistical information (e.g., on long-term survival or side effects) may be valuable for healthcare providers to share with their patients to facilitate shared decision making on treatment options. In this pre-registered study, we assessed cancer survivors’ need for generic (population-based) versus personalized (tailored towards patient/tumor characteristics) statistical information after their diagnosis. We examined how information coping style, subjective numeracy, and anxiety levels of survivors relate to these needs and identified statistical need profiles. Additionally, we qualitatively explored survivors’ considerations for (not) wanting statistical information.

METHODS: Cancer survivors’ need for statistics regarding incidence, survival, recurrence, side effects and quality of life were assessed with an online questionnaire. For each of these topics, survivors were asked to think back to their first cancer diagnosis and to indicate their need for generic and personalized statistics on a 4-point scale (‘not at all’- ‘very much’). Associations between information coping style, subjective numeracy, and anxiety with need for generic and personalized statistics were examined with Pearson’s correlations. Statistical need profiles were identified using latent class analysis. Considerations for (not) wanting statistics were analyzed qualitatively.

RESULTS: Overall, cancer survivors (n = 174) had a higher need for personalized than for generic statistics (p < .001, d = 0.74). Need for personalized statistics was associated with higher subjective numeracy (r = .29) and an information-seeking coping style (r = .41). Three statistical need profiles were identified (1) a strong need for both generic and personalized statistics (34%), (2) a stronger need for personalized than for generic statistics (55%), and (3) a little need for both generic and personalized statistics (11%). Considerations for wanting personalized cancer statistics ranged from feelings of being in control to making better informed decisions about treatment. Considerations for not wanting statistics related to negative experience with statistics and to the unpredictability of future events for individual patients.

CONCLUSIONS: In light of the increased possibilities for using personalized statistics in clinical practice and decision aids, it appears that most cancer survivors want personalized statistical information during treatment decision-making. Subjective numeracy and information coping style seem important factors influencing this need. We encourage further development and implementation of data-driven personalized decision support technologies in oncological care to support patients in treatment decision making.

PMID:36199092 | DOI:10.1186/s12911-022-02005-2

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Nevin Manimala Statistics

Is the assumption of equal distances between global assessment categories used in borderline regression valid?

BMC Med Educ. 2022 Oct 5;22(1):708. doi: 10.1186/s12909-022-03753-5.

ABSTRACT

BACKGROUND: Standard setting for clinical examinations typically uses the borderline regression method to set the pass mark. An assumption made in using this method is that there are equal intervals between global ratings (GR) (e.g. Fail, Borderline Pass, Clear Pass, Good and Excellent). However, this assumption has never been tested in the medical literature to the best of our knowledge. We examine if the assumption of equal intervals between GR is met, and the potential implications for student outcomes.

METHODS: Clinical finals examiners were recruited across two institutions to place the typical ‘Borderline Pass’, ‘Clear Pass’ and ‘Good’ candidate on a continuous slider scale between a typical ‘Fail’ candidate at point 0 and a typical ‘Excellent’ candidate at point 1. Results were analysed using one-sample t-testing of each interval to an equal interval size of 0.25. Secondary data analysis was performed on summative assessment scores for 94 clinical stations and 1191 medical student examination outcomes in the final 2 years of study at a single centre.

RESULTS: On a scale from 0.00 (Fail) to 1.00 (Excellent), mean examiner GRs for ‘Borderline Pass’, ‘Clear Pass’ and ‘Good’ were 0.33, 0.55 and 0.77 respectively. All of the four intervals between GRs (Fail-Borderline Pass, Borderline Pass-Clear Pass, Clear Pass-Good, Good-Excellent) were statistically significantly different to the expected value of 0.25 (all p-values < 0.0125). An ordinal linear regression using mean examiner GRs was performed for each of the 94 stations, to determine pass marks out of 24. This increased pass marks for all 94 stations compared with the original GR locations (mean increase 0.21), and caused one additional fail by overall exam pass mark (out of 1191 students) and 92 additional station fails (out of 11,346 stations).

CONCLUSIONS: Although the current assumption of equal intervals between GRs across the performance spectrum is not met, and an adjusted regression equation causes an increase in station pass marks, the effect on overall exam pass/fail outcomes is modest.

PMID:36199083 | DOI:10.1186/s12909-022-03753-5