Tag: statistics

J Radiol Prot. 2022 Feb 3. doi: 10.1088/1361-6498/ac5187. Online ahead of print.

ABSTRACT

INTRODUCTION AND OBJECTIVES: It is relevant to estimate the uncertainties in the estimation of eye lens doses from a personal dosimeter over the protective apron without using additional dosimetry near the eyes. Additional dosimetry for interventionists represents a difficulty for routine clinical practice. This study analyses the estimated eye doses from dosimeter values taken at chest level over the apron and their uncertainties.

METHODS: Measurements of Hp(0.07) using OSL dosimeters located on the chest over the apron and on the glasses (in the inner and outer part of the protection) were taken from 10 interventionalists in a university hospital, in the period 2018-2019 during standard clinical practice.

RESULTS: For a total sample of 133 interventional procedures included in our study, the ratio between the Hp(0.07) on the glasses (left-outer side) and on the chest over the apron had an average of 0.74, with quartiles of 0.47, 0.64, 0.88. Statistically significant differences were found among operators using the U-Mann-Whitney test. The average transmission factor for the glasses was 0.30, with quartiles of 0.21, 0.25, 0.32.

CONCLUSION: Different complexity in the procedures, in the quality of the scatter radiation and in the individual operational practices, involve a relevant dispersion in the results for lens dose estimations from the over apron dosimeter. Lens doses may be between a 64% and an 88% of the over apron dosimeter values (using median or 3rd quartile). The use of 88% may be a conservative approach.

PMID:35114656 | DOI:10.1088/1361-6498/ac5187

Respir Med. 2022 Jan 26;193:106745. doi: 10.1016/j.rmed.2022.106745. Online ahead of print.

ABSTRACT

The nature of the inflammatory and fibrotic processes found in patients with post-COVID-19 syndrome makes it possible to speculate that in such patients fractional exhaled nitric oxide (FeNO) may be a useful biomarker. Consequently, we set out to verify the consistency of this hypothesis. We consecutively enrolled 68 post-COVID patients after being hospitalized for persistent clinical manifestations within 2 months from disease onset and 29 healthy volunteers as control group. None of post-COVID patients had bronchial asthma or were being treated with a corticosteroid. Only 19 out of 68 post-COVID-19 patients reported a FeNO value > 25 ppb. The mean FeNO value in post-COVID-19 patients was 18.55 ppb (95% CI: 15.50 to 21.58), while in healthy subjects it was 17.46 ppb (95% CI: 15.75 to 19.17). The mean difference was not statistically significant (P = 0.053). However, the mean FeNO value of post-COVID-19 patients was higher in men than in women (20.97 ppb; 95% CI: 16.61 to 25.33 vs 14.36 ppb; 95% CI: 11.11 to 17.61) with a difference between the two sexes that was statistically significant (P = 0.016). Mean FeNO was 14.89 ppb (95% CI: 10.90 to 18.89) in patients who had been treated with systemic corticosteroids because of their COVID-19, and 20.80 ppb (95% CI: 16.56 to 25.04) in those who had not taken them, with a difference that was statistically significant (P = 0.043). The data generated in this study suggest that measurement of FeNO is not useful as a biomarker in post-COVID-19 patient. However, this hypothesis needs solid validation with additional specifically designed studies.

PMID:35114576 | DOI:10.1016/j.rmed.2022.106745

Atherosclerosis. 2022 Jan 22;344:13-19. doi: 10.1016/j.atherosclerosis.2022.01.016. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: The effect of MHT on cardiovascular disease (CVD) risk among women with prediabetes or type 2 diabetes (PreDM or T2DM) is unclear. We examined the association between ever or early use MHT and CVD risk in postmenopausal women with PreDM or T2DM, and the potential modifying effect of race.

METHODS: 2,917 postmenopausal women with PreDM or T2DM were pooled from 3 prospective CVD cohorts (the Atherosclerosis Risk in Communities, the Multi-Ethnic Study of Atherosclerosis, and the Jackson Heart Study). Ever (yes vs no) or early use of MHT (MHT initiated ≤5 vs > 5 years since menopause), and their associations with ischemic stroke, coronary heart disease (CHD), and atherosclerotic cardiovascular disease (ASCVD) were assessed using Cox proportional hazards models.

RESULTS: During a median follow-up of 15 years, 264 stroke, 484 CHD, and 659 ASCVD events were observed. In fully adjusted models, ever use of MHT was associated with reduced risk of stroke (hazard ratio 0.86, 95% CI 0.76-0.98), CHD (0.85, 0.74-0.98), and ASCVD (0.83, 0.73-0.95) in white women with PreDM or T2DM. Early use of MHT was associated with reduced risk of stroke (0.82, 0.72-0.95), CHD (0.85, 0.74-0.98), and ASCVD (0.82, 0.70-0.96) in the white group. No risk reduction with ever or early use of MHT was found for black women with PreDM or T2DM.

CONCLUSIONS: MHT is associated with statistically reduced CVD risk among white but not black women with PreDM or DM. Race is an effect modifier in the association between MHT use and CVD.

PMID:35114556 | DOI:10.1016/j.atherosclerosis.2022.01.016

J Environ Manage. 2022 Jan 31;308:114627. doi: 10.1016/j.jenvman.2022.114627. Online ahead of print.

ABSTRACT

Rapid urbanization has altered the structure and function of urban ecosystems with respect to the demand for planning ecological restoration to inhibit ecological degradation. However, there is still a challenge to quickly and effectively identify the restored priority areas to maximize ecological service (ES) supply and enhance human well-being. Taking the Shenzhen metropolitan region as a case study area, this study identified the restored priority sites based on the ES bundles evolution and urbanization effects. The ES bundles were identified by analyzing the spatial dynamics under the hybrid urban landscape, then the impact of urbanization on the ES bundles was explored using linear regression analysis characterized by different levels of urbanization in different stages. Furthermore, the spatial statistics were used to identify the priority sites. The results showed that 68.78% of the grids had changed their ES bundles in terms of their quantities, types, and sites in Shenzhen during 1978-2018. The urbanization driver spatially shifts from provision of service to regulation and cultural ecosystem services and significantly negatively influences the composition and structure of the ES bundles in different urbanization stages. 1196 of the 1 square kilometer grids, which accounted for 54.17%, were identified to prioritize for ecological restoration in Shenzhen. However, only 4.08% of them need to set as the key ecological restoration site. This study explored an effectively spatial way to implement ecological restoration planning in a rapidly urbanized area.

PMID:35114516 | DOI:10.1016/j.jenvman.2022.114627

J Mech Behav Biomed Mater. 2022 Jan 20;127:105090. doi: 10.1016/j.jmbbm.2022.105090. Online ahead of print.

ABSTRACT

Sorghum [Sorghum bicolor (L.) Moench] is a tropical grass that can be used as a bioenergy crop but commonly suffers from stem structural failure (lodging) when exposed to mechanical stimuli, such as rain and wind. Mechanical stimulation can trigger adaptive growth in plant stems (thigmomorphogenesis) by activating regulatory networks of hormones, proteins, transcription factors, and targeted genes, which ultimately alters their physiology, morphology, and biomechanical properties. The goals of this study are 1) to investigate differences in the morpho-anatomical-biomechanical properties of internodes from control and mechanically-stimulated plants and 2) to examine whether the changes also depend on the plant developmental stages at the time of stimulation. The sweet sorghum cultivar Della was grown in a greenhouse under two growth conditions: with and without mechanical stimulation. The mechanical stimulation involved periodic bending of the stems in one direction during a seven-week growth period. At maturity, the anatomical traits of the stimulated and non-stimulated stems were characterized, including internode lengths and diameters, and biomechanical properties, including elastic (instantaneous) modulus, flexural stiffness, strength, and time-dependent compliance under bending. The morpho-anatomical and biomechanical characteristics of two internodes of the stems that were at different stages of development at the time of mechanical stimulation were examined. Younger internodes were more responsive and experienced more pronounced changes in length due to the stimulation when compared to the older internodes. Statistical analyses showed differences between the stimulated and non-stimulated stems in terms of both their anatomical and biomechanical properties. Mechanical stimulation produced shorter internodes with slightly larger diameters, as well as softer (more compliant) and stronger stems.

PMID:35114492 | DOI:10.1016/j.jmbbm.2022.105090

Cancer Treat Res Commun. 2022 Jan 29;31:100526. doi: 10.1016/j.ctarc.2022.100526. Online ahead of print.

ABSTRACT

Introduction of EGFR-TKI has changed the treatment paradigm for NSCLC patient with activating mutations of EGFR exons 18-21, replacing chemotherapy as standard first line treatment. Given the delays in molecular study results we sometimes face the need to start treatment in very symptomatic patients with high tumor burden. The reason for this retrospective study is to analyze the survival impact of performing an induction cytotoxic therapy until obtaining the molecular profile (EGFR mutation), followed by targeted therapy. This is a retrospective analysis of 31 patients who did upfront chemotherapy (ChT) before switching to EGFR TKI upon the molecular profile result. The calculated survival endpoints were progression-free survival (PFS), duration of TKI response and overall survival (OS). All patients were treated with upfront chemotherapy with a median of one cycle (range 1-3) followed by a first generation EGFR-TKI. Median PFS was 13 months (95% CI, 6.6-19.4) and median OS 33 months (95% CI, 11.9-54.0). After first line progression 14 patients were treated with Osimertinib. In this subgroup median OS was 52 months (95% CI, 34.0-69.9). In the multivariable Cox model, only body mass index retained independent prognostic significance for progression-free survival (p = 0.045). Survival outcomes in this cohort are in line with published data regarding first generation EGFR-TKI, both in terms of PFS and OS. Despite the limitations of this study, starting with upfront chemotherapy doesn’t seem detrimental in terms of survival outcomes, with the potential advantage of symptomatic control. To our knowledge, this is the first study to address this strategy, which requires further confirmation.

PMID:35114501 | DOI:10.1016/j.ctarc.2022.100526

Res Vet Sci. 2022 Jan 24;144:108-114. doi: 10.1016/j.rvsc.2022.01.017. Online ahead of print.

ABSTRACT

Horses preparation for competition may cause psychological and physical stress. Physical vascular therapy BEMER® is reported to increase vasomotion and microcirculation, supporting body healing. This study aimed at assessing whether BEMER® physical vascular therapy in horses influences recovery rate of hematological and biochemical blood parameters within 1 h after moderate exercise and reduces stress measured by physiological and behavioral indicators. This prospective, randomized, double blinded, placebo-controlled crossover study included twelve warmblood horses (3 mares, 8 geldings, 1 stallion). Additionally to their daily work, horses were subjected to 15 min of exercise on a longe. Horses were randomly divided in two groups: A (n = 6), B (n = 6). Group A underwent first to BEMER® blanket for two weeks, then to Placebo blanket for two weeks. Group B did the opposite. Blood samples, thermographic infrared images, Heart Rate Variability and behavior were analyzed. ANOVA was used to investigate any treatment effect. After two weeks of treatment, although not statistically significant, hematocrit (%) measured immediately post exercise was lower in horses undergoing BEMER® treatment (48.30% ± 3.21) than both No blanket (51.15% ± 3.57) and Placebo blanket (49.58% ± 5.77). While wearing BEMER® blanket and after treatment, horses had a lower LF/HF ratio compared to other groups, although this difference was not statistically significant. These results possibly suggest an effect of BEMER® therapy on vagal activity and relaxation. Substantial progress in recovery after exercise was not confirmed, leading to the need for further investigation on the overall effect of BEMER® therapy.

PMID:35114491 | DOI:10.1016/j.rvsc.2022.01.017

J Surg Res. 2022 Jan 31;274:9-15. doi: 10.1016/j.jss.2021.12.025. Online ahead of print.

ABSTRACT

INTRODUCTION: Currently, standard practice is to use the continuous suturing technique on the bronchial anastomosis during lung transplantation. This study used a large cohort to investigate and contrast continuous and interrupted suturing techniques, comparing survival outcomes and occurrence of postoperative bronchial complications to examine if utilization of interrupted suturing has merit.

METHODS: Survival outcomes of 740 single-center lung transplant recipients over 8 y (February 2012-March 2020) were compared by suturing techniques: either continuous or interrupted at the bronchial anastomosis. Clinical parameters and demographics were compared between two suturing groups, with P values < 0.05 considered significant. The groups were compared for postoperative morbidity, including need for bronchial interventions. Survival was compared using Kaplan-Meier curves and log-rank tests. Cox regression analysis was run with statistically significant variables to study association with survival.

RESULTS: Of the 740 patients, 462 received the continuous suturing technique and 278 received the interrupted suturing technique. Most demographic and clinical data were not statistically significant between the two groups, and those that were significant were not associated with worse survival outcomes, with the exception of the variable diagnosis. Bronchial complications were comparable between the continuous and interrupted groups (12.6% versus 10.4%, P = 0.382). Extracorporeal membrane oxygenation (ECMO) use did not differ significantly between the two groups (P = 0.12). The Kaplan-Meier curve showed comparable survival between groups (P = 0.98), and Cox regression analysis showed that only diagnosis, bronchial complications, and ECMO utilization were associated with different survival outcomes. Chronic obstructive pulmonary disorder was shown to be associated with more favorable survival outcomes as opposed to idiopathic pulmonary fibrosis and the category “other”. The need for ECMO and the occurrence of a bronchial complication were also associated with worse survival outcomes.

CONCLUSIONS: Both techniques showed reasonable post-transplant outcomes, as our study demonstrated similar survival outcomes and bronchial complication rates.

PMID:35114484 | DOI:10.1016/j.jss.2021.12.025

Nurse Educ Today. 2022 Jan 14;110:105263. doi: 10.1016/j.nedt.2021.105263. Online ahead of print.

ABSTRACT

BACKGROUND: Incivility within nursing is professionally unacceptable. Little research exists regarding student nurses’ experiences with incivility from healthcare professionals and others within the clinical environment and particularly within a Canadian context.

AIM: To describe the incidence and perceptions of incivility experienced by undergraduate nursing students from healthcare professionals and others within clinical practice.

METHOD: This descriptive study used an electronic survey and was conducted at an eastern Canadian university. Descriptive statistics were applied.

RESULTS: Of 650 nursing students invited to participate in the study, 260 surveys were fully completed. Of these, 70% of respondents indicated experiencing incivility, mostly in acute care settings. Registered nurses and licensed practical nurses were the major offenders. Discourteous gestures and condescending remarks were the most frequently experienced uncivil acts, resulting in feelings of high anxiety and inadequacy. Participants coped by avoiding communication with the perpetrator. Incivility was rarely reported because of a belief it would be fruitless to do so, lack of awareness of policies and fear of retaliation.

CONCLUSIONS: Nursing students experience incivility frequently in clinical practice with serious consequences. Recommendations arising from this study encourage educators and healthcare leaders to collaborate to review, implement and evaluate curricula, policies and processes to address incivility.

PMID:35114439 | DOI:10.1016/j.nedt.2021.105263

Nurse Educ Today. 2022 Jan 26;110:105278. doi: 10.1016/j.nedt.2022.105278. Online ahead of print.

ABSTRACT

BACKGROUND: Caring for patients with wounds requires diverse competences from nursing professionals. However, wound care education in undergraduate nursing education is often fragmented and lacks consistent learning goals and content.

OBJECTIVES: To create learning goals and content for wound care education in Bachelor’s level nursing education in Finland and to assess the consensus relating to these learning goals and content among wound care experts.

DESIGN: A consensus-building approach using the Delphi technique.

SETTINGS: A Delphi panel of wound care experts built on an online platform.

PARTICIPANTS: The participants of the Delphi panel were registered nurses, authorised wound care nurses, nurse educators and physicians.

METHODS: Learning goals and content for wound care education which had been formulated on the basis of previous focus-group interviews were presented to the Delphi panel. The data were collected in 2021 with two online Delphi rounds: 51 panellists participated in the first round and 36 in the second round. The data were analysed using statistical and qualitative analysis.

RESULTS: Learning goals and content were divided into four competence areas: 1) Anatomy and physiology, 2) Care of chronic and acute wounds, 3) Wound management and care of a patient with a wound, 4) Values and attitudes. These competence areas comprised 26 learning goals and 29 pieces of content. The consensus between the panellists was high, at >90% in all competence areas.

CONCLUSIONS: The basis of registered nurses’ wound care competence is built during their undergraduate nursing studies. The results of this study can be used to standardise wound care education by implementing consistent learning goals and content in Bachelor’s level nursing education.

PMID:35114440 | DOI:10.1016/j.nedt.2022.105278