Tag: statistics

J Diabetes Investig. 2022 Sep 16. doi: 10.1111/jdi.13899. Online ahead of print.

ABSTRACT

AIMS/INTRODUCTION: Clinical evidence is lacking about the influence of sodium-glucose cotransporter 2 inhibitors on white blood cell (WBC) counts, a commonly used and widely available marker of inflammation. The aim of the present analysis was to assess the effect of canagliflozin relative to glimepiride on WBC counts.

MATERIALS AND METHODS: This was a post-hoc subanalysis of the CANDLE trial (Effects of Canagliflozin in Patients with Type 2 Diabetes and Chronic Heart Failure: A Randomized Trial; UMIN000017669), an investigator-initiated, multicenter, open-label, randomized, controlled trial. A total of 233 patients with type 2 diabetes and concomitant heart failure were randomly assigned to either canagliflozin (n = 113) or glimepiride (n = 120) treatment for 24 weeks. Overall, patient baseline characteristics were as follows: mean ± standard deviation age, 68.6 ± 10.1 years; hemoglobin A1c, 7.0 ± 0.9%; left ventricular ejection fraction, 56.7 ± 14.4%; and median N-terminal pro-brain natriuretic peptide, 252 pg/mL (interquartile range 96-563 pg/mL). The mean baseline WBC counts were 6704 cells/μL (95% confidence interval 6,362-7,047) in the canagliflozin group and 6322 cells/μL (95% confidence interval 5,991-6,654) in the glimepiride group. There were no significant differences between treatment groups in terms of changes in WBC counts from baseline to weeks 4 and 12. In contrast, a group difference (canagliflozin minus glimepiride) from baseline to week 24 was significant (mean difference – 456 cells/μL [95% confidence interval -774 to -139, P = 0.005]).

CONCLUSIONS: Our findings suggest that 24 weeks of treatment with canagliflozin, relative to glimepiride, reduced WBC counts in patients with type 2 diabetes and heart failure.

PMID:36114704 | DOI:10.1111/jdi.13899

Nurs Open. 2022 Sep 16. doi: 10.1002/nop2.1363. Online ahead of print.

ABSTRACT

AIMS: To determine the effect of design thinking approach in interprofessional education programme of human sexuality course.

DESIGN: A pre-test and post-test of single-group quasi-experimental study.

METHODS: The 35 nursing students and seven psychology students in their third year were selected by the computer randomly sampling through the lottery method. The course proceeded between September 2019 and January 2020. The participants had received an 8-week, 16-hr design thinking approach in interprofessional education programme of human sexuality course (one section per week, 2 hr per section). We used the nursing attitude toward sexual healthcare scale, nursing intervention toward sexual healthcare scale to assess students’ attitude and behaviour intention toward sexual health care and competence of interprofessional education scale to assess students’ competence of cooperation before and after the teaching programme. Data analysis used descriptive statistics and t-tests. A qualitative reflection log was also provided and analysed for themes. The SQUIRE-EDU checklist was followed.

RESULTS: The students’ attitude and behavioural intention dimension score in the post-test is higher than those in the pre-test and reach statistically significant differences both in total and subscale. Interprofessional core competence score of Observation Experience, Reflective Feedback, Interprofessional Cooperation, Innovative Design, and Applied Technology score in the post-test is higher than those in the pre-test and reach statistically significant differences both in total and subscale. Design thinking in interprofessional education programme of human sexuality course could significantly improve both nursing and psychology students’ attitude, behaviour intention of providing sexual health care and competence of interprofessional cooperation.

PMID:36114695 | DOI:10.1002/nop2.1363

J Diabetes. 2022 Sep 16. doi: 10.1111/1753-0407.13315. Online ahead of print.

ABSTRACT

BACKGROUND: In the euthyroid state, the risk of developing diabetes according to changes in thyroid-stimulating hormone (TSH) levels remains controversial. Additionally, the correlation of various body indices affecting blood glucose levels according to changes in TSH levels over a certain period is not well known.

METHODS: Patients who underwent health check-ups twice at a 2 year interval at a tertiary university hospital between 2009 and 2018 were included. By dividing baseline TSH levels into quartiles (TSH_Q1, Q2, Q3, and Q4), various variables were compared, and their changes after 2 years (∆TSH_Q1, Q2, Q3, and Q4) were confirmed.

RESULTS: Among 15 557 patients, the incidence of diabetes mellitus after 2 years was 2.4% (377/15 557 patients). There was no statistically significant difference in the incidence of diabetes according to TSH_Q (p = 0.243) or ∆TSH_Q (p = 0.131). However, as TSH levels increased, skeletal muscle mass decreased (p < 0.001), and body fat mass and percent body fat significantly increased (p < 0.001). As ∆TSH increased, ∆fasting blood glucose and ∆body mass index also significantly increased (all p < 0.001). The incidence of diabetes decreased significantly as skeletal muscle mass increased (odds ratio 0.734, p < 0.001).

CONCLUSIONS: Owing to the short study period, it was not possible to prove a statistical relationship between the incidence of diabetes mellitus and TSH levels in the euthyroid state. Significant decreases in skeletal muscle mass and increases in body mass index and body fat mass according to baseline TSH levels were demonstrated. Therefore, a focus on improving physical functions, such as increasing muscle mass and decreasing fat, is required in this case.

PMID:36114679 | DOI:10.1111/1753-0407.13315

Mol Plant. 2022 Sep 16:S1674-2052(22)00301-X. doi: 10.1016/j.molp.2022.09.007. Online ahead of print.

ABSTRACT

Plants are natural experts in organic synthesis being able to generate large numbers of specific metabolites with widely varying structures in order to adapt to variable survival challenges. Metabolomics is a research discipline that integrates the capabilities of several types of research including analytical chemistry, statistics and biochemical expertise. Its ongoing development provides solutions for the systematic understanding of quantitative changes in the levels of these metabolites and is usually performed by targeting either a specific cell, a specific tissue, or the entire organism. Considerable advances in science and technology over the last three decades have propelled us into the era of multi-omics with metabolomics, although at an earlier developmental stage than genomics, transcriptomics and proteomics, offering the distinct advantage of studying the cellular entities which have the greatest influence on end-phenotype. Here we summarize the state-of-the-art of metabolite detection and identification, also illustrating this with case study applications including (i) comparing metabolite composition within and between species, (ii) assessing spatio-temporal changes in metabolism during plant development, (iii) mining characteristic metabolites in different ecological environments and upon exposure to various stresses, and (iv) the performance of metabolomics on panels of natural genetic variance as a means of functional gene identification, metabolic pathway elucidation and metabolomics-assisted breeding. We additionally highlight the prominent contributions of joint analysis of metabolomics with other-omics including genomics, transcriptomics, proteomics, epigenomics, phenomics, microbiomes and ion-omics. Finally, we provide an outlook for further directions and challenges of metabolomics in enhancing our understanding of plant metabolic diversity.

PMID:36114669 | DOI:10.1016/j.molp.2022.09.007

Eur J Heart Fail. 2022 Sep 16. doi: 10.1002/ejhf.2695. Online ahead of print.

ABSTRACT

BACKGROUND: Recent data suggest that guideline directed medical treatment of patients with heart failure with reduced ejection fraction (HFrEF) might improve clinical outcomes in patients with heart failure (HF) up to a left ventricular ejection fraction (LVEF) of 55-65%, whereas patients with higher LVEF do not seem to benefit. Recent data have shown that LVEF may have a U-shaped relation with outcome, with poorer outcome also in patients with supranormal values. This suggests that patients with supranormal LVEF may be a distinctive group of patients METHODS AND RESULTS: RELAX AHF-2 was a multicenter, placebo-controlled trial on the effects of serelaxin on 180-day cardiovascular (CV) mortality and worsening HF at day 5 in patients with acute HF. Echocardiograms were performed at hospital admission in 6128 patients. 155 (2.5%) patients were classified as HFsnEF (LVEF>65%), 1440 (23.5%) as HFpEF (LVEF 50-65%), 1353 (22.1%) as HFmrEF (LVEF 41-49%) and 3180 (51.9%) as HFrEF (LVEF<40%). Patients with HFsnEF compared to HFpEF were more often women, had higher prevalence of non-ischemic HF, had lower levels of natriuretic peptides, were less likely to be treated with beta-blockers and had higher blood urea nitrogen plasma levels. All-cause mortality was not statistically different between groups, although patients with HFsnEF had the highest numerical rate. A declining trend was seen in the proportion of 180-day deaths due to CV causes from HFrEF (290/359, 80.8%) to HFsnEF (14/24, 58.0%). The reverse was observed with death from non-cardiovascular causes. No treatment effect of serelaxin was observed in any of the subgroups.

CONCLUSIONS: In this study, only 2.5% of patients were classified as HFsnEF. HFsnEF was primarily characterized by female sex, lower natriuretic peptides and a higher risk of non-CV death. This article is protected by copyright. All rights reserved.

PMID:36114655 | DOI:10.1002/ejhf.2695

Comput Inform Nurs. 2022 Sep 16. doi: 10.1097/CIN.0000000000000972. Online ahead of print.

ABSTRACT

The application of data science resources can enhance our ability to reduce health disparities affecting communities across the country. In this paper, we use the Preferred Reporting Items for Structured Review and Meta-Analyses methodology to conduct a thematic analysis of selected studies and identify micro and macro themes within the literature. The authors of this analysis reviewed articles that included data science software applications and their role in focusing efforts to address health disparities affecting the health of citizens in specific communities across the country. Abstracts were reviewed for research relevance after duplicates were removed, and documents were eliminated from consideration during the screening based on the exclusion criteria. At the conclusion of the structured literature review, the results emphasized the strong utility of geographically directed assessment. This highlights the need for the integration of geo- and statistical methodologies in the use of data science software for healthcare applications, which can be a useful means to identify locations where health disparities are present and can focus efforts to resolve these health disparities. Nurses, physicians, and health educators can be dispatched to the geographical areas where health disparities are most prevalent.

PMID:36114637 | DOI:10.1097/CIN.0000000000000972

Psychogeriatrics. 2022 Sep 16. doi: 10.1111/psyg.12892. Online ahead of print.

ABSTRACT

AIM: Pain is prevalent in geriatric patients and is not only a signal of physical diseases but also a symptom of mental health problems. This study aimed to explore the relationship between pain and depression in geriatric patients scheduled for orthopaedic surgery.

METHODS: The study used a correlational and cross-sectional design. The study sample consisted of geriatric patients (n = 200) scheduled for orthopaedic surgery in a research and training hospital in northern Turkey. Data were collected by the researchers using the Geriatric Pain Measure and Geriatric Depression Scale. In the data analysis, descriptive statistics, Pearson’s correlation, and hierarchical regression analysis were used.

RESULTS: The patients’ mean age was 73.16 ± 8.27 years. It was found that 5.5% (n = 11) of the participants had mild pain, 45.5% (n = 91) had moderate pain, and 49% (n = 98) had severe pain. There was a positive and moderate significant relationship between the mean Geriatric Pain Measure and Geriatric Depression Scale scores (r = 0.479, P < 0.01). Age (β = 0.133; P < 0.05) and education (β = 2.484; P < 0.05) were statistically significantly associated with depression. There was a significant and positive relationship between depression and being dependent in activities of daily living (β = 5.098; P < 0.05).

CONCLUSION: This study demonstrated that geriatric patients who were older, illiterate, dependent in activities of daily living, and with higher levels of pain had higher depression. A multidisciplinary team approach including nurses should be utilised in pain management and it should not be ignored that severe pain may be associated with depression in geriatric patients.

PMID:36114633 | DOI:10.1111/psyg.12892

Vet Q. 2022 Sep 16:1-12. doi: 10.1080/01652176.2022.2126537. Online ahead of print.

ABSTRACT

Equine atypical myopathy (AM also referred to as multiple acyl-CoA dehydrogenases deficiency [MADD]) is thought to be caused by toxins metabolized from hypoglycin A (HGA) and méthylènecyclopropylglycine (MCPrG). HGA is contained in the seeds and seedlings of the sycamore tree (Acer pseudoplatanus); MCPrG has so far only been confirmed in seeds. Among other things, these substances can disrupt the fatty acids β-oxidation pathway with the subsequent accumulation of certain acylcarnitines. The tentative diagnosis is based on anamnesis and clinical signs and can be verified by the detection of elevated creatine kinase activity, specific profile of acylcarnitines and the presence of HGA, MCPrG conjugates and/or their metabolites in peripheral blood and/or urine. Dry blood spots were collected for 15 days from a 3.5-year-old stallion which had been affected by AM and, as a control group, from twelve healthy horses. Two mass spectrometry methods were used for the analysis of 31 acylcarnitines, carnitine, HGA, MCPrG and their metabolites. HGA and six increased acylcarnitines were detected in the patient’s blood throughout the monitoring period. Nine acylcarnitines were strongly correlated with HGA. Multivariate statistical analysis showed a clear separation of samples from the AM horse, where the metabolic profile tended to normalization in the later days after intoxication. Due to the longer persistence in the blood, the detection of HGA and elevated acylcarnitines profile appear to be an appropriate tool to confirm the diagnosis of AM, compared to metabolic products of HGA and MCPrG even in advanced cases.

PMID:36114619 | DOI:10.1080/01652176.2022.2126537

Mil Med Res. 2022 Sep 16;9(1):50. doi: 10.1186/s40779-022-00413-z.

ABSTRACT

BACKGROUND: Posttraumatic stress disorder (PTSD) has been associated with volumetric and white matter microstructural changes among general and veteran populations. However, regions implicated have greatly varied and often conflict between studies, potentially due to confounding comorbidities within samples. This study compared grey matter volume and white matter microstructure among Australian combat veterans with and without a lifetime diagnosis of PTSD, in a homogenous sample assessed for known confounding comorbidities.

METHODS: Sixty-eight male trauma-exposed veterans (16 PTSD-diagnosed; mean age 69 years) completed a battery of psychometric assessments and underwent magnetic resonance and diffusion tensor imaging. Analyses included tract-based spatial statistics, voxel-wise analyses, diffusion connectome-based group-wise analysis, and volumetric analysis.

RESULTS: Significantly smaller grey matter volumes were observed in the left prefrontal cortex (P = 0.026), bilateral middle frontal gyrus (P = 0.021), and left anterior insula (P = 0.048) in the PTSD group compared to controls. Significant negative correlations were found between PTSD symptom severity and fractional anisotropy values in the left corticospinal tract (R² = 0.34, P = 0.024) and left inferior cerebellar peduncle (R² = 0.62, P = 0.016). No connectome-based differences in white matter properties were observed.

CONCLUSIONS: Findings from this study reinforce reports of white matter alterations, as indicated by reduced fractional anisotropy values, in relation to PTSD symptom severity, as well as patterns of reduced volume in the prefrontal cortex. These results contribute to the developing profile of neuroanatomical differences uniquely attributable to veterans who suffer from chronic PTSD.

PMID:36114591 | DOI:10.1186/s40779-022-00413-z

Trop Med Health. 2022 Sep 16;50(1):67. doi: 10.1186/s41182-022-00462-z.

ABSTRACT

BACKGROUND: Neisseria meningitidis causes severe life-threatening meningococcal disease with a case fatality rate of 10-15% even with proper treatment. In Ethiopia, particularly in our study area, inadequate information is found on meningococcal disease. So, this study aimed to assess N. meningitidis carriage rate, antibiotic susceptibility profile, and associated factors among prisoners in Jimma Town, Southwestern Ethiopia.

METHODS: A cross-sectional study was conducted in Jimma town, Southwest Ethiopia, from May to October 2019. A stratified sampling technique was used and proportional allocation was done. A total of 550 oropharyngeal swabs were collected, processed, isolated, and identified N. meningitidis using standard microbiological techniques. Antibiotics susceptibility test was done for isolates using the disk diffusion method. Data on demographic and associated factors for carriage were collected using a structured questionnaire. Data were summarized using frequency, percentage, graph, and table. A logistic regression model was used to see the association between the dependent and independent variables. Variables with a p-value < 0.25 during bivariate analysis were included in multivariate analysis to identify factors significantly associated with the meningococcal carriage and, a p-value < 0.05 was considered statistically significant.

RESULT: Out of the 550 study participants, 76(13.8%) with (CI: 7.20-18.20) were found carriers of N meningitidis. The predominant isolates were non-serogroupable 26(34.2%) and serogroup W/Y 22(28.9%), respectively. N. meningitidis isolates showed highest sensitivity to chloramphenicol 74(97.4%). Meningococcal carriage rate was significantly associated with being age group of 16-20 years; having respiratory symptoms within 3 months and active cigarette smoking within 3 months.

CONCLUSIONS: The majority of participants harbor most of the serogroups responsible for invasive cases of meningococcal disease. Respiratory symptoms, active cigarette smoking, and age group of 16-20 years increased the risk of N. meningitidis pharyngeal carriage rate. This study suggests providing better health education to control respiratory symptoms, smoking, and providing antibiotic prophylaxis for prisoners.

PMID:36114580 | DOI:10.1186/s41182-022-00462-z