Tag: statistics

Am J Emerg Med. 2021 Nov 17;51:384-387. doi: 10.1016/j.ajem.2021.11.023. Online ahead of print.

ABSTRACT

BACKGROUND: Emergency physicians (EP) are frequently interrupted to screen electrocardiograms (ECG) from Emergency Department (ED) patients undergoing triage. Our objective was to identify discrepancies between the computer ECG interpretation and the cardiologist ECG interpretation and if any patients with normal ECGs underwent emergent cardiac intervention. We hypothesized that computer-interpreted normal ECGs do not require immediate review by an EP.

METHODS: This was a retrospective study of adult (≥ 18 years old) ED patients with computer-interpreted normal ECGs. Laboratory, diagnostic testing and clinical outcomes were abstracted following accepted methodologic guidelines. The primary outcome was emergent cardiac catheterization (within four hours of ED arrival). All ECGs underwent final cardiologist interpretation. When cardiology interpretation differed from the computer (discrepant ECG interpretation), the difference was classified as potentially clinically significant or not clinically significant. Data was described with simple descriptive statistics.

MAIN FINDINGS: 989 ECGs interpreted as normal by the computer were analyzed with a mean age of 50.4 ± 16.8 years (range 18-96 years) and 527 (53%) female. Discrepant ECG interpretations were identified in 184 cases including 124 (12.5%, 95% CI 10.4, 14.7%) not clinically significant and 60 (6.1%, 95% CI 4.6, 7.7%) potentially clinically significant. The 60 potentially clinically significant changes included: ST/T wave changes 45 (75%), T wave inversions 6 (10%), prolonged QT 3 (5%), and possible ischemia 10 (17%). Of these 60, 21 (35%) patients were admitted. Six patients had potassium levels >6.0 mEq/L, with one having a potentially clinically significant ECG change. No patient (0%, 95% CI 0, 0.3%) underwent immediate (within four hours) cardiac catherization whereas two underwent delayed cardiac interventions.

CONCLUSIONS: Cardiologists frequently disagree with a computer-interpreted normal ECG. Patients with computer-interpreted normal ECGs, however, rarely had significant ischemic events. A rare number of patients will have important cardiac outcomes regardless of the computer-generated normal ECG interpretation. Immediate EP review of the ECG, however, would not have changed these patients’ ED courses.

PMID:34823195 | DOI:10.1016/j.ajem.2021.11.023

Public Health. 2021 Nov 22;201:108-114. doi: 10.1016/j.puhe.2021.09.025. Online ahead of print.

ABSTRACT

OBJECTIVES: The prediction and early warning of infectious diseases is an important work in the field of public health. This study constructed the grey self-memory system model to predict the incidence trend of infectious diseases affected by many uncertain factors.

STUDY DESIGN: The design of this study is a combination of the prediction method and empirical analysis.

METHODS: By organically coupling the self-memory algorithm with the mean GM(1,1) model, the tuberculosis incidence statistics of China from 2004 to 2018 were selected for prediction analysis. Meanwhile, by comparing with the other traditional prediction methods, three representative accuracy check indexes (MSE, AME, MAPE) were conducting for error analysis.

RESULTS: Owing to the multiple time-points initial fields, which replace the single time-points, the limitation of the traditional grey prediction model, which is sensitive to the initial value, is overcome in the self-memory equation. Consequently, compared with the mean GM model and other statistical methods, the grey self-memory model shows significant forecasting advantages, and its single-step rolling prediction accuracy is superior to other prediction methods. Therefore, the incidence of tuberculosis in China in the next year can be predicted as 55.30 (unit: 1/10⁵).

CONCLUSIONS: The grey self-memory system model can closely capture the individual random fluctuation in the whole evolution trend of the uncertain system. It is appropriate for predicting the future incidence trend of infectious diseases and is worth popularizing to other similar public health prediction problems.

PMID:34823142 | DOI:10.1016/j.puhe.2021.09.025

Epilepsy Res. 2021 Nov 7;178:106809. doi: 10.1016/j.eplepsyres.2021.106809. Online ahead of print.

ABSTRACT

OBJECTIVE: Delta-gamma phase-amplitude coupling in EEG is useful for localizing epileptic sources and to evaluate severity in children with infantile spasms. We (1) develop an automated EEG preprocessing pipeline to clean data using artifact subspace reconstruction (ASR) and independent component (IC) analysis (ICA) and (2) evaluate delta-gamma modulation index (MI) as a method to distinguish children with epileptic spasms (cases) from normal controls during sleep and awake.

METHODS: Using 400 scalp EEG datasets (200 sleep, 200 awake) from 100 subjects, we calculated MI after applying high-pass and line-noise filters (Clean 0), and after ASR followed by either conservative (Clean 1) or stringent (Clean 2) artifactual IC rejection. Classification of cases and controls using MI was evaluated with Receiver Operating Characteristics (ROC) to obtain area under curve (AUC).

RESULTS: The artifact rejection algorithm reduced raw signal variance by 29-45% and 38-60% for Clean 1 and Clean 2, respectively. MI derived from sleep data, with or without preprocessing, robustly classified the groups (all AUC > 0.98). In contrast, group classification using MI derived from awake data was successful only after Clean 2 (AUC = 0.85).

CONCLUSIONS: We have developed an automated EEG preprocessing pipeline to perform artifact rejection and quantify delta-gamma modulation index.

PMID:34823159 | DOI:10.1016/j.eplepsyres.2021.106809

Geriatr Nurs. 2021 Nov 22;43:64-76. doi: 10.1016/j.gerinurse.2021.11.003. Online ahead of print.

ABSTRACT

Frail older adults are vulnerable to hospitalization and transitional care is needed to maintain care continuity; however, there exists no review regarding transitional care focusing on frailty. This study aimed to investigate transitional care for frail older adults and its effectiveness. Search terms were (P) frail older adults; (I) transitional care initiated before discharge; (C) usual care; (O) all health outcomes. Fourteen trials were identified. The most measured outcome was readmission (n = 13), followed by mortality (n = 9), function (n = 7), quality of life (n = 5), and self-rated health (n = 5). Statistical significance effects were reported in the followings: n = 6, readmission; n = 0, mortality; n = 3, function; n = 2, quality of life; and n = 4, self-rated health. The meta-analysis demonstrated that transitional care reduced readmission at six months but not other time points nor mortality or quality of life. The intervention effectiveness was inconclusive; therefore, an evidence-based yet novel approach is necessary to establish an adequate transitional care intervention for frail older adults.

PMID:34823079 | DOI:10.1016/j.gerinurse.2021.11.003

J Trace Elem Med Biol. 2021 Nov 18;69:126903. doi: 10.1016/j.jtemb.2021.126903. Online ahead of print.

ABSTRACT

BACKGROUND: Normal fetal growth is associated with maternal nutrition. Trace elements play important roles in fetus growth. This review aims to provide a summary of the literature evaluating the relation between selenium, zinc and copper levels during pregnancy with birth weight.

METHOD: A systematic literature search was conducted in Medline database (PubMed), Scopus, Web of science and Google scholar up to September 2020. Fifty observational studies were included in the final analyses. The desired pooled effect size was considered as standardized mean differences with 95 % CI or correlation. Cochran’s Q statistic was used to test the heterogeneity between the included studies (I²).

RESULT: A significant differences were found between pooled standardized mean differences (SMD) of umbilical cord blood copper levels in small-for-gestational age birth weight (SGA) and appropriate-for-gestational age birth weight (AGA) (SMD: 0.34 μg/L, 95 % CI: 0.13 to 0.56). There was a significant pooled correlation between umbilical cord blood selenium concentrations and birth weight (r: 0.08, 95 % CI: 0.01 to 0.16). A significant pooled correlation was found between umbilical cord blood zinc concentrations and birth weight (r: 0.09, 95 % CI: 0.04 to 0.15), with significant heterogeneity (I² % = 0.63). There was significant positive association between maternal blood zinc concentrations and birth weight.

CONCLUSION: Findings showed the association of trace elements including selenium, zinc and copper during pregnancy with birth weight. There was significant correlation between umbilical cord and maternal blood selenium and zinc levels with birth weight. The umbilical cord blood copper levels in SGA birth weight was higher than copper levels in AGA birth weight.

PMID:34823102 | DOI:10.1016/j.jtemb.2021.126903

Ann Diagn Pathol. 2021 Nov 17;56:151860. doi: 10.1016/j.anndiagpath.2021.151860. Online ahead of print.

ABSTRACT

BACKGROUND: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative option for patients with myelofibrosis (MF). Bone marrow (BM) morphologic evaluation of myelofibrosis following allo-HSCT is known to be challenging in this context because resolution of morphologic changes is a gradual process.

PATIENTS AND METHODS: We compared BM samples of patients with myelofibrosis who underwent first allo-HSCT and achieved molecular remission by day 100 with BM samples of patients who continued to have persistent molecular evidence of disease following allo-HSCT.

RESULTS: The study group included 29 patients: 17 primary MF, 7 post-polycythemia vera (PV) MF, and 5 post-essential thrombocythemia (ET) MF. In this cohort there were 18 JAK2 p.V617F, 8 CALR; 1 MPL, and 2 patients had concurrent JAK2 p.V617F and MPL mutations. The control group included 5 patients with primary MF, one with post-PV MF, one with post-ET MF (5 JAK2 p.V617F; 2 CALR). Following allo-HSCT, both groups showed reduction in BM cellularity and number of megakaryocytes. The study cohort also less commonly had dense megakaryocyte clusters and endosteal located megakaryocytes and showed less fibrosis. There was no statistical difference in BM cellularity, presence of erythroid islands, degree of osteosclerosis, or megakaryocyte number, size, nuclear lobation, presence of clusters or intrasinusoidal location.

CONCLUSIONS: Following allo-HSCT at 100 days, morphologic evaluation of BM in patients with MF cannot reliably predict persistence versus clearance of molecular evidence of MF. Disappearance of BM MF, dense megakaryocyte clusters, and endosteal localization of megakaryocytes are suggestive of disease response.

PMID:34823075 | DOI:10.1016/j.anndiagpath.2021.151860

Top Companion Anim Med. 2021 Nov 22:100615. doi: 10.1016/j.tcam.2021.100615. Online ahead of print.

ABSTRACT

Tear production is an important factor in maintaining proper function of the cornea and conjunctiva. The purpose of this study was to determine the effects of bolus followed by infusion of fentanyl, lidocaine and ketamine on tear production as measured by the Schirmer I Tear Test (STT-I) in dogs. A prospective, randomized, “double-blind” study was performed. A total of 55 healthy conscious client-owned dogs were included in the study. Dogs were randomly allocated to one of four groups and given intravenous fentanyl 0.005 mg kg^-1 followed by 0.005 mg kg^-1 hour^-1 (FEN-group), ketamine 0.6 mg kg^-1 followed by 0.6 mg kg^-1 hour^-1 (KET-group), lidocaine 1 mg kg^-1 followed by 1 mg kg^-1 hour^-1 (LID-group), or saline 0.3 mL kg^-1 followed by 2 mL kg^-1 hour^-1 (SAL-group). The STT-I was performed prior to (baseline) and again 30 minutes (T30) after initiation of drug administration. Data were expressed as the median (minimum – maximum) and analyzed by Wilcoxon and Steel-Dwass tests (p < 0.05). The STT-I values increased little but were statistically significant in the KET-group from 18 (14-23) to 19 (14-25) (P = 0.039) and in the LID-group from 21 (14-25) to 20 (17-29) (P = 0.027). At 30 minutes, STT-I values were significantly higher in LID-group 20 (17-29) than in FEN-group 18 (12-22) (P = 0.006). Fentanyl, ketamine and lidocaine administered at the studied doses as a bolus and then followed by an infusion within 30 minutes in healthy conscious dogs demonstrated a clinically insignificant effect on tear production as measured by STT-I.

PMID:34823068 | DOI:10.1016/j.tcam.2021.100615

Clin Psychol Psychother. 2021 Nov 25. doi: 10.1002/cpp.2697. Online ahead of print.

ABSTRACT

Pathological grief has received increasing attention in recent years, as about 10% of the bereaved suffer from one kind of it. Pathological grief in the form of Prolonged grief disorder (PGD) is a relatively new diagnostic category which will be included into the up-coming ICD-11. To date, various risk and protective factors, as well as treatment options for pathological grief, have been proposed. Nevertheless, empirical evidence in that area is still scarce. Our aim was to identify the association of interpersonal closeness with the deceased and bereavement outcome. Interpersonal closeness with the deceased in 54 participants (27 patients suffering from PGD and 27 bereaved healthy controls) was assessed as the overlap of pictured identities via the Inclusion of the Other in the Self Scale (IOS-scale). In addition to that, data on PGD symptomatology, general mental distress, and depression were collected. Patients suffering from PGD reported higher inclusion of the deceased in the self. By contrast, they reported feeling less close towards another living close person. Results of the IOS-scale were associated with PGD-severity, general mental distress, and depression. Inclusion of the deceased in the self is a significant statistical predictor for PGD-caseness.

PMID:34822735 | DOI:10.1002/cpp.2697

Nurs Open. 2021 Nov 25. doi: 10.1002/nop2.1132. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to evaluate the construct validity and internal consistency of the revised Mental Health Literacy Scale (MHLS) in South Africa (SA) and Zambia.

DESIGN: This cross-sectional study was conducted between October 2018 and December 2019.

METHODS: The study population comprised PHC workers (n = 454) in five districts in SA and Zambia. Principal component analysis (PCA) was used to explore the construct validity, and Cronbach’s alpha was applied to measure the internal consistency of the MHLS.

RESULTS: Cronbach’s alpha values for three attributes were below the appropriate level, but the value was strong (0.804) for the whole scale. The study found nine components explaining ~59% of the total variance of variables. All MHLS items loaded to main attributes based on the theory of MHL. The results stated that the revised version of the MHLS is a construct valid instrument with strong internal consistency.

PMID:34822738 | DOI:10.1002/nop2.1132

Toxics. 2021 Nov 6;9(11):297. doi: 10.3390/toxics9110297.

ABSTRACT

Water quality is continuously affected by anthropogenic and environmental conditions. A significant issue of the Indian rivers is the massive water pollution, leading to the spreading of different diseases due to its daily use. Therefore, this study investigates three aspects. The first one is testing the hypothesis of the existence of a monotonic trend of the series of eight water parameters of the Brahmaputra River recorded for 17 years at ten hydrological stations. When this hypothesis was rejected, a loess trend was fitted. The second aspect is to assess the water quality using three indicators (WQI)-CCME WQI, British Colombia, and a weighted index. The third aspect is to group the years and the stations in clusters used to determine the regional (spatial) and temporal trend of the WQI series, utilizing a new algorithm. A statistical analysis does not reject the hypothesis of a monotonic trend presence for the spatially distributed data but not for the temporal ones. Hierarchical clustering based on the computed WQIs detected two clusters for the spatially distributed data and two for the temporal-distributed data. The procedure proposed for determining the WQI temporal and regional evolution provided good results in terms of mean absolute error, root mean squared error (RMSE), and mean absolute percentage error (MAPE).

PMID:34822688 | DOI:10.3390/toxics9110297