Tag: statistics

Psychiatriki. 2021 Mar 26. doi: 10.22365/jpsych.2021.013. Online ahead of print.

ABSTRACT

Atrial fibrillation (AF) is a common sustained cardiac arrhythmia, which is expected to expand enormously due to population ageing. The aim of the present study was to explore the significance of AF patients’ needs and the associated factors as well as the impact of anxiety and depression on these needs. The sample of the study included 215 AF hospitalized patients. Data were collected by the completion of a questionnaire which, in addition to patients’ characteristics, it also included the Hospital Anxiety and Depression Scale (HADS) and the questionnaire “Needs of hospitalized patients with coronary artery disease”, that is evaluating the significance of the following 6 categories of needs: a) for support and guidance, b) for information from medical and nursing staff, c) for communication with other patients and family, d) for individualization of care and participation, e) to trust the medical and nursing staff and f) to meet emotional and physical needs. The statistical significance level was p< 0.05. Of the 215 participants, 68.4% were men and 67.5% were > 60 years old. Moreover, 47.5% of the participants experienced anxiety and 29.5% depression. The need for support, to be informed and to trust the medical and nursing staff considered to be of high significance by the patients (median 29,20 and 6, respectively). Anxiety and depression were significantly associated with all patients’ needs (p<0.05) apart from the need to meet the emotional and physical needs and the need to trust the medical and nursing staff, which were not associated with anxiety levels. In terms of patients’ needs, those who reported to be little or not at all informed about their disease considered of a higher significance the need for support and guidance (p=0.030), the need to be informed and to trus the medical and nursing staff (p=0.001 and p=0.012, respectively) and the need for communication with other patients and family (p=0.007). The need for individualization of care and participation in it, was considered more significant by patients aged >70 years and those having no children (p=0.039 and p=0.029, respectively) while the need for communication with other patients and family was considered more significant by women (p=0.028). The present findings emphasize the importance of providing care tailored to meet the needs of AF patients who experience anxiety and depression.

PMID:33770750 | DOI:10.22365/jpsych.2021.013

J Electrocardiol. 2021 Mar 16;66:48. doi: 10.1016/j.jelectrocard.2021.03.002. Online ahead of print.

NO ABSTRACT

PMID:33770647 | DOI:10.1016/j.jelectrocard.2021.03.002

J Environ Radioact. 2021 Mar 23;233:106571. doi: 10.1016/j.jenvrad.2021.106571. Online ahead of print.

ABSTRACT

The geographic variation of terrestrial radiation can be exploited in epidemiological studies of the health effects of protracted low-dose exposure. Various methods have been applied to derive maps of this variation. We aimed to construct a map of terrestrial radiation for Switzerland. We used airborne γ-spectrometry measurements to model the ambient dose rates from terrestrial radiation through a Bayesian mixed-effects model and conducted inference using Integrated Nested Laplace Approximation (INLA). We predicted higher levels of ambient dose rates in the alpine regions and Ticino compared with the western and northern parts of Switzerland. We provide a map that can be used for exposure assessment in epidemiological studies and as a baseline map for assessing potential contamination.

PMID:33770702 | DOI:10.1016/j.jenvrad.2021.106571

J Neurol Sci. 2021 Mar 20;424:117410. doi: 10.1016/j.jns.2021.117410. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the prevalence and factors associated with oral anticoagulant undertreatment of atrial fibrillation (AF) among a cohort of rural patients with stroke outcomes and examine how undertreatment may influence a patient’s one-year survival after stroke.

METHODS: This retrospective cohort study examined ischemic stroke patients with pre-stroke AF diagnosis from September 2003 to May 2019 and divided them into proper treatment and undertreatment group. Analysis included chi-square test, variance analysis, Kruskal-Wallis test, logistic regression, Kaplan-Meier estimator, and Cox proportional-hazards model.

RESULTS: Out of 1062 ischemic stroke patients with a pre-stroke AF diagnosis, 1015 patients had a CHA₂DS₂-VASc score ≥2, and 532 (52.4%) of those were undertreated. Median time from AF diagnosis to index stroke was significantly lower among undertreated patients (1.9 years vs. 3.6 years, p < 0.001). Other thromboembolism, excluding stroke, TIA, and myocardial infarction (OR 0.41, p < 0.001), the number of encounters per year (OR 0.90, p < 0.001), and the median time between AF diagnosis and stroke event (OR 0.86, p < 0.001) were negatively associated with undertreatment. Kaplan-Meier estimator showed no statistical difference in the one-year survival probability between groups (log-rank test, p = 0.29), while the Cox-Hazard model showed that age (HR 1.05, p < 0.001) and history of congestive heart failure (HR 1.88, p < 0.001) increased the risk of mortality.

CONCLUSIONS: More than half of our rural stroke patients with a pre-index AF diagnosis were not on guideline-recommended treatment. The study highlights a large care gap and an opportunity to improve AF management.

PMID:33770707 | DOI:10.1016/j.jns.2021.117410

J Electrocardiol. 2021 Feb 25;66:38-42. doi: 10.1016/j.jelectrocard.2021.02.009. Online ahead of print.

ABSTRACT

AIMS: Right Bundle Branch Block (RBBB) has been reported in 5-11% of the acute myocardial infarctions (AMI), and it could be the only electrocardiographic abnormality in this group of patients. We investigated the mortality in patients with AMI and the presence of RBBB.

MATERIALS AND METHODS: A retrospective cohort study was conducted between January 2011 to December 2017 at a university hospital in Bogotá, Colombia. Records were obtained from all patients who presented at the emergency department with AMI; patients with early transfer and incomplete follow-up were excluded.

RESULTS: 1015 patients were included, the mean age was 66 years, 67% of the patients were men, and 38% had STEMI. RBBB was documented in 8% of patients and LBBB in 4% of patients. In-hospital mortality was higher in the group of patients with RBBB vs. patients without RBBB (8.64% vs. 3.74%, p = 0.034). The percentage of patients with Killip ≥II classification was higher in patients with new RBBB vs. patients with old or unknown duration RBBB (23% vs. 13%, p = 0.216).

CONCLUSIONS: In patients with AMI, the presence of RBBB was associated with a statistically significant increase of in-hospital mortality.

PMID:33770645 | DOI:10.1016/j.jelectrocard.2021.02.009

Waste Manag. 2021 Mar 23;126:191-200. doi: 10.1016/j.wasman.2021.03.009. Online ahead of print.

ABSTRACT

Countries’ growth along with the need to protect the environment has made waste management a major global concern. In this study, a detailed analysis is carried out of the current situation in 41 countries belonging to the OECD and/or the European Union, in order to identify the most sustainable practices that could be successfully implemented in other nations with similar characteristics. Cluster analysis is used to detect homogeneous groups, shedding light on the possible connection between environmental policies and waste treatment. Contingency tables are employed to determine the relationship between the effectiveness of the policies adopted and two indicators of sustainable practices: material recycling and waste generation. The study is conducted using statistical information from the Sustainable Governance Indicators project and the OECD, with data referring to 2018. Five internally homogeneous groups of countries have been identified, where Israel, Turkey and USA have the lowest participation and compliance in environmental policies. Also, the results show that countries with a high degree of participation in environmental treaties (Croatia, Denmark, Finland, France, Germany, Japan, Luxembourg, the Netherlands, Norway, Spain, Sweden, Switzerland) are making great progress, reducing the use of landfills in favour of other, more environmentally friendly options. Moreover, the contingency tables confirm that the effectiveness of policies translates into a clear trend towards recycling and, to some extent, reduces waste generation.

PMID:33770617 | DOI:10.1016/j.wasman.2021.03.009

Cytokine. 2021 Mar 23;142:155487. doi: 10.1016/j.cyto.2021.155487. Online ahead of print.

ABSTRACT

Advanced breast cancer frequently metastasizes to the skeleton causing major mobility issues and hazards to quality of life. To manage osteolytic bone metastasis, bone-modifying agents and chemotherapy are recommended as the standard of care. Here, we investigated serologic biomarkers that might be associated with prognosis in breast cancer patients treated with zoledronic acid (ZA) and taxane-based chemotherapy. We collected serum samples from breast cancer patients with bone metastasis who received taxane plus ZA as palliative treatment. Fourteen biomarkers of angiogenesis, immunogenicity, and apoptosis were assessed, and the correlation between serum cytokine levels and patient’s prognosis was statistically analyzed. Sixty-six patients were enrolled, and samples from 40 patients were analyzed after laboratory quality control. Patients with low baseline PDGF-AA, high IFN-γ, low MCP-2, low TGF-β1, and low TNF-α were significantly associated with longer progression-free survival (PFS). Decreasing VEGF and TNF-α and increasing FGF-2 and PDGF-AA in the early treatment phase indicated longer PFS. In univariate and multivariate analyses, low TGF-β1 and TNF-α and high IFN-γ at baseline were associated with a significantly low hazard ratio for disease progression. Further, we designed a risk score with TGF-β1, TNF-α, and IFN-γ levels, which could prognosticate patients for PFS. In conclusion, serum cytokine level, such as TGF-β1, TNF-α, and IFN-γ, could be a potential prognostic biomarker for breast cancer patients with bone metastasis treated with ZA and taxane-based chemotherapy.

PMID:33770643 | DOI:10.1016/j.cyto.2021.155487

J Psychosom Res. 2021 Mar 16;144:110420. doi: 10.1016/j.jpsychores.2021.110420. Online ahead of print.

ABSTRACT

OBJECTIVE: Wuhan, the epicentre of the coronavirus diseases (COVID-19) outbreak, has been locked down on January 23, 2020. We conducted a study among the lay public in Wuhan to access their support, understanding of, compliance with, and the psychological impacts of the quarantine.

METHODS: We conducted a cross-sectional, online-based survey study between January 28, 2020, and February 2, 2020 among the adult lay public in Wuhan to access their support, understanding of, compliance with, and the psychological impacts of the quarantine. Multivariable logistic analysis was used to identify factors associated with psychological impacts.

RESULTS: Among the 4100 participants investigated, a total of 15.9% were compliant with all the five household prevention measures, whereas 74.4% were compliant with all the three community prevention measures investigated. By demographics, participants of younger age, higher income, residing in an urban area, knowing neighbors infected with COVID-19 reported significantly higher psychological impact score. Participants with a lower level of support for quarantine were more likely to have a higher psychological impact score (OR = 1.45, 95% CI 1.07-1.96). Participants with a lower level of compliance with preventive measures (score of 0-19) reported higher psychological impact (OR = 1.40, 95% CI 1.22-1.60 vs. score 20-24). Participants who had been out of house socializing and attended public events expressed higher psychological impact.

CONCLUSIONS: Support, understanding of the rationale for quarantine are essential in ensuring appropriate psychological well-being during the quarantine. Improvements in compliance with preventive measures are highly warranted and may bring about a reduction in psychological distress.

PMID:33770568 | DOI:10.1016/j.jpsychores.2021.110420

J Mech Behav Biomed Mater. 2021 Mar 20;118:104478. doi: 10.1016/j.jmbbm.2021.104478. Online ahead of print.

ABSTRACT

Ag-doped Cr/DLC coatings were deposited on medical grade 316 LVM stainless steel using DC magnetron sputtering. Morphological study of the coating indicated the formation of island of Ag clusters owing to the inability of Ag to form carbides, which is also corroborated from the XRD analysis. The composite coating showcased elastic nature suggestive from the p-h curve obtained from the nanoindentation test. However, the coating possesses 33% ductility, which is an important virtue for stress relieving attributed to Ag in the carbon matrix. The coating registered improved adhesion due to Cr₃C₂ carbide formation in the interlayer. The composite coating was subjected to lubricated sliding in physiological fluid against carbon fiber reinforced PEEK (CFRPEEK) friction pair to realize a closer scenario to hip implant articulation. A lubricious film of Ag with scattered particles of PEEK was formed in the sliding interface resulting in a long run-in process during sliding. The composite coating suffered mild wear on the Ag-doped DLC top layer with few gullies of wear scar deep into the interlayer due to graphitization of carbon in the film. A statistically significant difference was observed in the hardness, H³/E², elastic work, and plastic work; however, there was no statistically significant difference in H/E attribute between the unworn and worn surface. What is more, Raman spectra of the worn (I_D/I_G = 1.9 ± 0.2) and unworn surface (I_D/I_G = 2.1 ± 0.1) were indicative of no significant loss in the structural integrity of the composite coating.

PMID:33770586 | DOI:10.1016/j.jmbbm.2021.104478

Epilepsy Behav. 2021 Mar 23;118:107919. doi: 10.1016/j.yebeh.2021.107919. Online ahead of print.

ABSTRACT

Insular epilepsy is increasingly recognized in epilepsy surgery centers. Recent studies suggest that resection of an epileptogenic zone that involves the insula as a treatment for drug-resistant seizures is associated with good outcomes in terms of seizure control. However, despite the existing evidence of a role of the insula in emotions and affective information processing, the long-term psychological outcome of patients undergoing these surgeries remain poorly documented. A group of 27 adults (18 women) who underwent an insulo-opercular resection (in combination with a part of the temporal lobe in 10, and of the frontal lobe in 5) as part of epilepsy surgery at our center between 2004 and 2019 completed psychometric questionnaires to assess depression (Beck Depression Inventory – 2nd edition; BDI-II), anxiety (State-Trait Anxiety Inventory, Trait Version; STAI-T), and quality of life (Patient Weighted Quality of Life In Epilepsy; QOLIE-10-P). Scores were compared to those of patients who had standard temporal lobe epilepsy (TLE) surgery with similar socio-demographic and disease characteristics. Seizure control after insular epilepsy surgery was comparable to that observed after TLE surgery, with a majority of patients reporting being seizure free (insular: 63.0%; temporal: 63.2%) or having rare disabling seizures (insular: 7.4%; temporal: 18.4%) at the time of questionnaire completion. Statistical comparisons revealed no significant group difference on scores of depression, anxiety, or quality of life. Hemisphere or extent of insular resection had no significant effect on the studied variables. In the total sample, employment status and seizure control, but not location of surgery, significantly predicted quality of life. Self-reported long-term psychological status after insulo-opercular resection as part of epilepsy surgery thus appears to be similar to that observed after TLE surgery, which is commonly performed in epilepsy surgery centers.

PMID:33770610 | DOI:10.1016/j.yebeh.2021.107919