Tag: statistics

Clin Endocrinol (Oxf). 2022 Feb 2. doi: 10.1111/cen.14682. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate non-urological patients with multiple comorbidities for factors contributing towards differences in testosterone concentration in multi-ethnic Malaysian men.

METHODS: Sexually active men ≥40 years with no known urological problems were recruited at the phlebotomy clinic at our center. A brief history along with latest fasting lipid profile and plasma glucose levels were obtained. An Aging Male Symptoms (AMS) questionnaire was administered; waist circumference (WC) and serum testosterone concentration were measured. Analysis of testosterone concentration between Malay, Indian and Chinese men was performed. Statistical tests such as ANOVA, Chi square test, univariate and multivariable regression were performed. Any P<0.05 denoted as statistically significant.

RESULTS: Among the 604 participants analyzed, mean testosterone concentration was significantly lower in Malays (15.1±5.9 nmol/L) compared to the Chinese (17.0±5.9 nmol/L) and Indian (16.1±6.5 nmol/L) participants. The mean WC was also found to be higher among the Malays (96.1±10.9 cm) compared to Chinese (92.6±9.6 cm) and Indians (95.6±9.9 cm). Testosterone concentration tended to be lower with higher age, but this was not statistically significant (P>0.05). In the multivariable analysis only Malay ethnicity, WC ≥ 90 cm and low HDL were associated with lower testosterone concentration.

CONCLUSION: In this study, Malaysian men of Malay origin had lower testosterone concentration compared with Indian and Chinese men. WC and low HDL were also associated with lower testosterone concentrations. This article is protected by copyright. All rights reserved.

PMID:35107834 | DOI:10.1111/cen.14682

Int Nurs Rev. 2022 Feb 2. doi: 10.1111/inr.12746. Online ahead of print.

ABSTRACT

AIM: To compare the occurrence and the reasons for unfinished care among coronavirus disease (COVID-19) and non-COVID-19 patients as perceived by nurses.

BACKGROUND: The recent pandemic has imposed tremendous changes in hospitals in all countries.

INTRODUCTION: Investigating the occurrence of and the reasons for unfinished care as perceived by nurses working in COVID-19 and non-COVID-19 units might help to gain insights and to address future pandemics.

METHODS: A comparative cross-sectional study based on the STROBE guideline has been conducted during November 2020-January 2021. The Unfinished Nursing Care Survey, comprising part A (elements) and part B (reasons), was administered online to all 479 nurses working in medical and surgical units converted progressively into COVID-19 and non-COVID-19 units. A total of 90 and 200 nurses participated, respectively.

RESULTS: No differences in the unfinished care occurrence have emerged at the overall level between nurses caring for COVID (2.10 out of 5; 95% confidence interval [CI], 1.94-2.27) and non-COVID-19 patients (2.16; 95% CI, 2.06-2.26). Reasons for unfinished care reported significant higher averages among nurses caring for COVID (2.21; 95% CI, 2.10-2.31) as compared with those caring for non-COVID-19 patients (2.07; 95% CI, 2.01-2.14; p = 0.030).

DISCUSSION: The overall occurrence of unfinished care was slightly higher compared with pre-pandemic data in all patients.

CONCLUSIONS: Reasons triggering unfinished care were slightly different and were due to priority setting and human resources issues, which were perceived at higher significance among nurses working in COVID-19 compared with non-COVID-19 units.

IMPLICATION FOR NURSING AND HEALTH POLICIES: A clear map of action has emerged that might be valid in the post-COVID-19 era as well as in the case of future pandemics.

PMID:35107837 | DOI:10.1111/inr.12746

Acad Psychiatry. 2022 Feb 2. doi: 10.1007/s40596-022-01585-5. Online ahead of print.

ABSTRACT

OBJECTIVE: Podcasts have recently been introduced into psychiatry education, despite limited evidence evaluating podcasting in medical education. PsychEd is an educational, publicly available podcast targeting junior learners in psychiatry. This study characterized PsychEd’s listeners and the podcast’s role in their education.

METHODS: The study involved a mixed-methods survey, followed by semi-structured phone interviews with respondents. There were 97 survey responders in total, of whom 9 participated in a telephone interview. Survey responses were coded as interval data and analyzed descriptively using statistical software. Interviews were transcribed and coded for emergent themes using a grounded theory model.

RESULTS: PsychEd listeners represented an interprofessional audience, with 46 respondents (48%) being physicians or physicians in training, and 34 (35%) being allied mental health professionals. All respondents (100%) rated the podcast as “helpful” or “very helpful” for general knowledge. Listeners were attracted to PsychEd for the auditory learning format, the opportunity to review existing knowledge, the focus on core topics, the Canadian expertise, and the presentation of “clinical pearls.” Respondents highlighted valuable qualities of a psychiatry podcast: conversational, case-based, narrative approach, longer episodes (i.e., 30-60 minutes) as compared to other medical specialties, and a clinical focus. Furthermore, they identified podcasts as an opportunity for shared interprofessional curricula.

CONCLUSION: This study is the first to examine the motivations and experiences of listeners of a psychiatry educational podcast. The findings support existing literature on the benefits of podcasts in medical education. Future studies should explore the impact of podcasts on learning and behaviors.

PMID:35107818 | DOI:10.1007/s40596-022-01585-5

J Cancer Surviv. 2022 Feb 2. doi: 10.1007/s11764-021-01146-z. Online ahead of print.

ABSTRACT

PURPOSE: This article examines the extent to which employees worked from home because of the pandemic, focusing on differentials between people with and without disabilities with implications for cancer survivors.

METHODS: We use data on COVID-19 from the Current Population Survey over the May 2020 to June 2021 period. We present descriptive statistics and the results from regression and decomposition analysis.

RESULTS: While workers with disabilities were more likely than those without disabilities to be teleworking before the pandemic, they were less likely to be teleworking as a result of the pandemic. Differences in the occupational distribution account for most of this difference. People with disabilities experienced relatively more pandemic-related hardships as well, compared to people without disabilities, including a greater chance of not being able to work due to their employer losing business and more difficulty in accessing medical care.

CONCLUSIONS: Many people with disabilities benefit from working from home, and the pandemic has increased employer acceptance of these arrangements, but the potential is limited by the current occupational distribution.

IMPLICATIONS FOR CANCER SURVIVORS: While the CPS dataset does not have information on cancer survivorship, we use other data to impute that the average likelihood of cancer survivorship is 12.6% among people with disabilities, more than double the 6.1% rate among those without a disability. Hence cancer survivorship is partly picked up by the CPS questions on disability, and our results have implications for cancer survivors, especially because increased opportunities for telework have the potential to help cancer survivors maintain economic stability and avoid financial hardship.

PMID:35107797 | DOI:10.1007/s11764-021-01146-z

Environ Sci Pollut Res Int. 2022 Feb 2. doi: 10.1007/s11356-022-18838-3. Online ahead of print.

ABSTRACT

Urbanization leads to changes in landscape configuration and land use/land cover (LULC) patterns, and these changes are important factors affecting the surface urban heat island (SUHI) effect. However, from the perspective of spatiotemporal changes, quantitative analytical results regarding the impacts of the LULC composition, configuration, and pattern in inland plateau lakeside cities on the SUHI effect, and the responsive relationships among these factors remain unclear. By combining satellite remote sensing data with analytical methods, such as urban-rural gradients, spatial statistics, and landscape pattern indices, the impacts of LULC changes on the SUHI effect in Kunming, China, are revealed. The results show the following. (1) The explosive growth in impervious surfaces (ISs) caused by urbanization, leading to changes in the LULC composition, configuration and pattern, is the main reason for the deterioration of the SUHI effect. Over the past 30 years, Kunming’s ISs have increased by 304.58 km², SUHI has expanded by 764.26 km², and the regional average land surface temperature (LST) has increased by 1 °C. (2) This study also found that a large area of bare ground is another important reason for the sharp rise in LST, explaining why bare land (BL) has the highest average LST (28.72 °C). (3) The pattern of LULC can well explain the spatial distribution characteristics of SUHIs. The normalized difference built-up index (NDBI), normalized difference bareness index (NDBaI), and LST have the same change curve along the urban-rural gradient, while the normalized difference vegetation index (NDVI), modified normalized difference water index (MNDWI), and LST have opposite trends. (4) ISs and water body (WB) are the main types of warming and cooling, respectively, but the warming effect of ISs is greater than the cooling effect of WB. From the average value of the correlation coefficient with LST, NDBI (0.84) > MNDWI (-0.63). (5) Kunming’s remote sensing index values do not have simple linear relationships with the LST. NDBaI, NDBI, and LST show significant exponential relationships, and NDVI, MNDWI, and LST show significant quadratic polynomial relationships. (6) The dominant landscape type determines the correlation between the landscape shape index (LSI) and the LST of green spaces (GSs). (7) Adopting a simple and regular landscape layout can effectively reduce the SUHI effect. These research results could provide a scientific decision-making basis for the spatial urban planning and ecological construction of Kunming and could have practical significance for guiding the green, healthy, and sustainable development of the city.

PMID:35107726 | DOI:10.1007/s11356-022-18838-3

Breast Cancer Res Treat. 2022 Feb 2. doi: 10.1007/s10549-022-06515-5. Online ahead of print.

ABSTRACT

PURPOSE: Heart disease is a significant concern among breast cancer survivors, in part due to cardiotoxic treatments including chemotherapy and radiotherapy. Long-term trends in heart disease mortality have not been well characterized. We examined heart disease mortality trends among US breast cancer survivors by treatment type.

METHODS: We included first primary invasive breast cancer survivors diagnosed between 1975 and 2016 (aged 18-84; survived 12 + months; received initial chemotherapy, radiotherapy, or surgery) in the SEER-9 Database. Standardized mortality ratios (SMRs) and 10-year cumulative heart disease mortality estimates accounting for competing events were calculated by calendar year of diagnosis and initial treatment regimen. P_trends were assessed using Poisson regression. All statistical tests were 2-sided.

RESULTS: Of 516,916 breast cancer survivors, 40,812 died of heart disease through 2017. Heart disease SMRs declined overall from 1975-1979 to 2010-2016 (SMR 1.01 [95%CI: 0.98, 1.03] to 0.74 [0.69, 0.79], p_trend < 0.001). This decline was also observed for survivors treated with radiotherapy alone and chemotherapy plus radiotherapy. A sharper decline in heart disease SMRs was observed from 1975 to 1989 for left-sided radiotherapy, compared to right-sided. In contrast, there was a non-significant increasing trend in SMRs for chemotherapy alone, and significant by regional stage (p_trend = 0.036). Largest declines in 10-year cumulative mortality were observed from 1975-1984 to 2005-2016 among surgery only: 7.02% (95%CI: 6.80%, 7.23%) to 4.68% (95%CI: 4.39%, 4.99%) and radiotherapy alone: 6.35% (95%CI: 5.95%, 6.77%) to 2.94% (95%CI: 2.73%, 3.16%).

CONCLUSIONS: We observed declining heart disease mortality trends by most treatment types yet increasing for regional stage patients treated with chemotherapy alone, highlighting a need for additional studies with detailed treatment data and cardiovascular management throughout cancer survivorship.

PMID:35107712 | DOI:10.1007/s10549-022-06515-5

Adv Tech Stand Neurosurg. 2022;44:277-296. doi: 10.1007/978-3-030-87649-4_16.

ABSTRACT

Over the past 25 years the endovascular treatment of cerebral aneurysms has gained preference in some countries over the traditional surgical procedures. The review part of the article clearly demonstrates that the clinical results of both modalities are similar and the difference is seen only in technical effectivity. Surgical techniques fail far less frequently than the endovascular ones. Incompletely occluded or growing aneurysms after the endovascular approach expose the patient to the risk of rebleeding with all possible consequences. Markedly repeated procedures are much more common for endovascularly treated aneurysms, again with all the risks.In the authors institution over the past 20 years, a total of 2032 aneurysms were treated. In 1263 endovascularly managed aneurysms the regrowth or inclomplete initial occlusion necessitated 159 repeated propcedures (12.6%). In surgical group the total of 27 aneurysms needed retreatment (3.5%). The difference is statistically significant. In nine patients in endovascular group the rebleeding was the reason for repeated procedures. No rebleeding was seen in the surgical group.This fact, also shown in the review part of the article, is important in patients counseling. Given the similar clinical results of both modalities the patient should be advised on the necessity of repeated follow-ups and of possible technical failure and eventual repeated procedure which is more likely if endovascular procedure is chosen.

PMID:35107686 | DOI:10.1007/978-3-030-87649-4_16

J Robot Surg. 2022 Feb 2. doi: 10.1007/s11701-021-01364-8. Online ahead of print.

ABSTRACT

Fundoplication is often added to the crural repair for long-term relief of reflux in patients undergoing hiatal hernia repair. Fundoplication can be achieved surgically or with endoscopic means such as trans-oral incisionless fundoplication (TIF). Patients with hiatal hernias larger than 2 cm may undergo surgical hiatal hernia repair with concomitant TIF (hybrid repair). Our study aims to analyze the resources utilized for hybrid repair and compare it with hiatal hernia repair with surgical fundoplication (conventional repair). We conducted a retrospective review of 112 consecutive patients who underwent robotic-assisted hiatal hernia repair. Patients who underwent some form of fundoplication were selected and then divided into two groups-surgical fundoplication (conventional approach) or hybrid approach. This is a pool of patients operated by a single surgeon at a community hospital. Multiple variables were analyzed. The mean operative time was 39 min less; also the mean length of stay was 10 h less in hybrid approach group as compared to conventional repair group. Although statistically significant, there was no meaningful clinical significance to these findings. Cost analysis was performed for direct costs as well as indirect costs. Neither the 30-day outcomes nor the cost-effectiveness for hybrid repair was superior to those of conventional repair. Therefore, in our experience at the community-level hospital, we conclude that hiatal hernia repair with surgical fundoplication is more cost-effective than surgical repair of hiatal hernia with TIF.

PMID:35107709 | DOI:10.1007/s11701-021-01364-8

Adv Tech Stand Neurosurg. 2022;44:121-132. doi: 10.1007/978-3-030-87649-4_6.

ABSTRACT

Long-term functional outcomes of microsurgical resection for cavernous malformations of the brainstem (CMB) have been largely unknown. Favorable outcomes after CMB surgery might be related to the achievement of complete resection and mRS at 1 month after the surgery. Preoperative sensory, cerebellar, trigeminal nerve, and lower cranial nerve symptoms tended to improve after surgery.We evaluated 25 consecutive patients with CMB surgically treated at our center between 2006 and 2021. The subjects included 11 men and 14 women, with ages ranging from 13 to 61 years (mean ± SD = 37 ± 12 years). Modified Rankin Scale (mRS) scores and neurological symptoms of the patients were evaluated before surgery, 1 month after surgery, and at the final follow-up at the outpatient clinic. The mean number of previous hemorrhages was 7 ± 1.0 and the mean lesion size was 21 ± 8 mm. The mRS scores on admission and at the final follow-up were 2.9 points and 1.7 points, respectively. The mRS scores at the final follow-up were significantly improved compared to those on admission. There was no statistical difference between the preoperative mRS and mRS at 1 month after the operation. Multivariable analysis indicated that mRS scores at 1 month after surgery were the most significant predictive factors for favorable outcomes. Complete resection was achieved in 24 of 33 operations. Incomplete resection was significantly related to the frequency of subsequent recurrent hemorrhage and high mRS scores at the final follow-up. Preoperative sensory, cerebellar, trigeminal nerve, and lower cranial nerve symptoms improved significantly after surgery.

PMID:35107676 | DOI:10.1007/978-3-030-87649-4_6

J Patient Rep Outcomes. 2022 Feb 2;6(1):12. doi: 10.1186/s41687-022-00415-4.

ABSTRACT

PURPOSE: The purposes of this investigation were to (1) identify the domains of health-related quality of life most impacted in people with RRMS, (2) compare the health-related QOL in people with RRMS to general population norms, and (3) to describe subgroups within the RRMS population that have similar health and wellness needs.

METHODS: This was a cross-sectional QOL investigation of adults with RRMS. The SF-36v2 survey and demographic information were collected electronically via Qualtrics. Participants (n = 120) were recruited through social media and the National Multiple Sclerosis Society of the United States. One-sample Z-tests were completed for all subscales, and component mean scores to determine if a difference between the sample and population norms existed.

RESULTS: All values of z were statistically significant, p < .01, for all subscale and composite scores. Social function, physical function, and the mental health component scores had the lowest subscale means. A first stage depression screen revealed that 49% of the surveyed population were at risk for depression, compared to 18% in the general population. Further dividing the sample into years since MS diagnosis, the recently diagnosed group had 61% at risk for depression.

CONCLUSIONS: Challenges related to the mental health of individuals with RRMS are influencing overall health-related QOL. Early on in the disease course (0-3 years), mental health affected QOL more than physical health. More attention must be given to the nonphysical domains of health to advance the QOL for people with RRMS.

PMID:35107657 | DOI:10.1186/s41687-022-00415-4