Tag: statistics

J Hosp Infect. 2021 Mar 11:S0195-6701(21)00101-8. doi: 10.1016/j.jhin.2021.03.006. Online ahead of print.

NO ABSTRACT

PMID:33716087 | DOI:10.1016/j.jhin.2021.03.006

J Pain Symptom Manage. 2021 Mar 11:S0885-3924(21)00227-X. doi: 10.1016/j.jpainsymman.2021.03.002. Online ahead of print.

ABSTRACT

CONTEXT: Insomnia is a common problem affecting cancer survivors. While effective non-pharmacological treatments are available, it is unknown whether individual genetic characteristics influence treatment response.

OBJECTIVES: We conducted an exploratory analysis of genetic associations with insomnia treatment response in a randomized trial of cognitive behavioral therapy for insomnia (CBT-I) vs. acupuncture in heterogeneous group of cancer survivors.

METHODS: We successfully genotyped 136 participants for 11 genetic variants. Successful treatment response was defined as a reduction in Insomnia Severity Index score of at least eight points from baseline to week 8. We used Fisher exact tests to evaluate associations between genotype and treatment success for each treatment arm, for an alpha level of 0.05 with unadjusted and Holm-Bonferroni-adjusted p-values.

RESULTS: We found that more carriers of COMT rs4680-A alleles responded to acupuncture compared to the GG carriers (63.6% vs. 27.8%, p=0.013). More carriers of the NFKB2 rs1056890 CC genotype also responded to acupuncture compared to TT or CT carriers (72.2% vs. 38.9%, p=0.009). There were no significant differences found between any of the tested gene variants and CBT-I response. None of the results remained statistically significant after adjustment for multiple testing.

CONCLUSION: In cancer survivors, specific variants in the COMT and NFKB2 genes are potentially associated with response to acupuncture but not to CBT-I. Confirming these preliminary results will help inform precision insomnia management for cancer survivors.

PMID:33716034 | DOI:10.1016/j.jpainsymman.2021.03.002

Neuropsychologia. 2021 Mar 11:107826. doi: 10.1016/j.neuropsychologia.2021.107826. Online ahead of print.

ABSTRACT

Anticipation of upcoming events plays a crucial role in automatic behaviors. It is, however, still unclear whether the event-related brain potential (ERP) markers of anticipation could track the implicit acquisition of probabilistic regularities that can be considered as building blocks of automatic behaviors. Therefore, in a four-choice reaction time (RT) task performed by young adults (N = 36), the contingent negative variation (CNV) as an ERP marker of anticipation was measured from the onset of a cue stimulus until the presentation of a target stimulus. Due to the probability structure of the task, target stimuli were either predictable or unpredictable, but this was unknown to participants. The cue did not contain predictive information on the upcoming target. Results showed that the CNV amplitude during response preparation was larger before the unpredictable than before the predictable target stimuli. In addition, although RTs increased, the P3 amplitude decreased for the unpredictable as compared with the predictable target stimuli, possibly due to the stronger response preparation that preceded stimulus presentation. These results suggest that enhanced attentional resources are allocated to the implicit anticipation and processing of unpredictable events. This might originate from the formation of internal models on the probabilistic regularities of the stimulus stream, which primarily facilitates the processing of predictable events. Overall, we provide ERP evidence that supports the role of implicit anticipation and predictive processes in the acquisition of probabilistic regularities.

PMID:33716039 | DOI:10.1016/j.neuropsychologia.2021.107826

Food Chem Toxicol. 2021 Mar 11:112109. doi: 10.1016/j.fct.2021.112109. Online ahead of print.

ABSTRACT

In this work, a colorimetric sensor array has been designed for the identification and discrimination of thiometon (TM) and phosalone (PS) as organophosphate pesticides and prothioconazole (PC) as a triazole pesticide. For this purpose, two different plasmonic nanoparticles including unmodified gold nanoparticles (AuNPs) and unmodified silver nanoparticles (AgNPs) were used as sensing elements. The principle of the proposed strategy relied on the aggregation AuNPs and AgNPs through the cross-reactive interaction between the target pesticides and plasmonic nanoparticles. Therefore, these aggregation-induced UV-Vis spectra changes were utilized to discriminate the target pesticides with the help of linear discriminant analysis (LDA). Besides, we have employed the bar plots and the heat maps as visual non-statistical methods to differentiate the pesticides in a wide range of concentrations (i.e., 20 to 5000 ng mL^-1). Multivariate calibration plots from partial least squares (PLS)- regression indicated that the responses linearly depend on the pesticide concentrations in the range of 100-1000 ng mL^-1 with the limit of detections (LOD) of 66.8, 68.3, and 41.4 ng mL^-1, for TM, PS, and PC, respectively. Finally, the potential applicability of the proposed sensor array has been evaluated for the detection and identification of the pesticides in the mixtures, water samples, and cucumber fruit.

PMID:33716053 | DOI:10.1016/j.fct.2021.112109

J Cyst Fibros. 2021 Mar 11:S1569-1993(21)00046-1. doi: 10.1016/j.jcf.2021.02.011. Online ahead of print.

ABSTRACT

BACKGROUND: Mannitol is a mucoactive hyperosmotic agent used as add-on therapy in patients with cystic fibrosis (CF), administered twice-daily (BID) via a small, portable, breath-actuated dry-powder inhaler. This study was conducted to provide confirmatory evidence of mannitol’s efficacy and safety in adults.

METHODS: This multicenter, double-blind, randomized, parallel-group, controlled clinical trial recruited adults (aged ≥18 years) with CF, and forced expiratory volume in 1 second (FEV₁) 40-90% predicted. Subjects received either mannitol 400 mg or mannitol 50 mg (control), BID via dry-powder inhaler for 26 weeks. Primary endpoint: FEV₁ averaged over the 26-week treatment period.

RESULTS: Of 423 subjects randomized (209 or 214 receiving mannitol 400 mg BID or control, respectively), 373 (88.2%) completed the study, with a similar proportion completing in the two groups. For FEV₁ averaged over 26 weeks, mannitol 400 mg BID was statistically superior to control (adjusted mean difference 54 mL [95% CI 8, 100 mL]; p = 0.020). This was supported by sensitivity analyses of the primary endpoint, and by observed improvements in secondary pulmonary function endpoints (eg, absolute adjusted mean difference in percent predicted FEV₁ averaged over 26 weeks 1.21% [0.07%, 2.36%]; p = 0.037). Adverse events were mainly mild or moderate in severity, with treatment-related adverse events in 15.5 and 12.2% of subjects receiving mannitol 400 mg BID and control, respectively.

CONCLUSIONS: In adults with CF, mannitol 400 mg BID inhaled as a dry-powder statistically significantly improved lung function (FEV₁) compared with control, with this improvement supported by sensitivity analyses and secondary pulmonary function endpoints. Mannitol had a good overall safety and tolerability profile. ClinicalTrials.gov: NCT02134353.

PMID:33715994 | DOI:10.1016/j.jcf.2021.02.011

J Oral Maxillofac Surg. 2021 Feb 11:S0278-2391(21)00113-0. doi: 10.1016/j.joms.2021.02.006. Online ahead of print.

ABSTRACT

PURPOSE: We investigated the confidence levels of undergraduate dental students who used dental anesthesia simulators and patient reports of undergraduate dental students’ confidence levels in delivering anesthesia injections, in comparison with undergraduate dental students who did not use dental anesthesia simulators. We also investigated application success rates.

MATERIALS AND METHODS: The study was carried out in the dental anesthesia simulator laboratory and in the faculty clinics of the Faculty of Dentistry of Ankara University. One-hundred volunteer undergraduate dental students who had completed the third year of the 5-year undergraduate education program and who had not performed local anesthesia on a patient participated in the study. Seventy and 30 undergraduate dental students did and did not receive training on dental anesthesia simulators, respectively, before performing procedures on patients. Using a questionnaire, undergraduate dental students conducted a self-assessment of preparedness and confidence, educators assessed the application success rates, and patients evaluated the undergraduate dental students’ confidence levels.

RESULTS: Patients reported that the undergraduate dental students trained using the simulators were more confident. The self-reported confidence and success rates in providing anesthesia did not differ significantly as per the use of dental anesthesia simulators.

CONCLUSIONS: Although use of simulators did not enhance self-reported confidence, patients reported that undergraduate dental students who used the simulators were more confident and reassuring. Use of simulators did not increase the undergraduate dental students’ self-reported confidence or preparedness. However, we recommend using such simulators to overcome the ethical and moral issues associated with other teaching methods.

PMID:33716007 | DOI:10.1016/j.joms.2021.02.006

Environ Res. 2021 Mar 11:111014. doi: 10.1016/j.envres.2021.111014. Online ahead of print.

ABSTRACT

Congenital heart disease (CHD) is the most common congenital anomaly and one of the leading causes of newborn death. Few studies analyze multiple ambient air pollutants and different congenital heart disease subtypes at the same time. We conducted a meta-analysis to explore the association between gestational air pollution exposure and CHD subtype. We searched PubMed, Embase, Web of Science from inception till July 31, 2020. Newcastle Ottawa Scale (NOS) was used to evaluate the quality of the literature. Funnel plots and Egger’s regression were used to estimate publication bias. Heterogeneity was evaluated by the chi-square test and the coefficient of inconsistency I² in this study. Finally, we performed a subgroup analysis to find reasons for heterogeneity. In the preliminary analysis, the result shows that the association between air pollutants and congenital heart diseases was not statistically significant, except for CO and SO₂. There is a positive association between air pollutants and ventricular septal defect (VSD) in our subtype analysis, the OR (95%CI) for PM₁₀, PM_2.5, and O₃ was 1.057(1.005-1.109), 1.208(1.080-1.337), and 1.205(1.101-1.310), respectively. In addition, we also observed a negative association between SO₂ and atrial septal defect (ASD) (OR: 0.817, 95%CI: 0.743-0.890) in subgroup analysis. The source of heterogeneity in our study mainly included study area and exposure time. These findings have implications for researchers to further study the relationship between air pollution and congenital heart disease.

PMID:33716027 | DOI:10.1016/j.envres.2021.111014

Rev Esp Cir Ortop Traumatol. 2021 Mar 11:S1888-4415(21)00015-1. doi: 10.1016/j.recot.2020.10.010. Online ahead of print.

ABSTRACT

INTRODUCTION: Diaphyseal forearm fractures in skeletally immature patients are common injuries that account for 30% of upper extremity fractures in this age group. There are cases with unstable injuries or unacceptable reductions, in which surgical resolution by reduction and stabilisation with percutaneous elastic endomedullary nailing is indicated. One of the advantages of this system is that it avoids an approach to the fracture site, allowing closed reduction in the vast majority of fractures. However, it is not always possible to achieve an acceptable closed reduction and opening of the fracture site is necessary. The aim of this study was to determine whether there are preoperative factors to predict the difficulty of performing closed reduction in these patients.

METHODS: A retrospective study of skeletally immature patients with acute diaphyseal forearm fractures treated with elastic endomedullary nailing by the same paediatric surgeon was performed. The primary outcome variable was defined as the need for open reduction; considered as a direct surgical approach to the fracture site. Demographic characteristics of the included patients and radiographic characteristics of the fracture were analysed.

RESULTS: We found that the median percentage of preoperative radial shortening in the closed reduction and open reduction groups was 1 and 5%, respectively; resulting in a statistically significant difference (p = 0.04).

CONCLUSION: Radial shortening on preoperative radiographs predicts an increased risk of requiring an open reduction of the fracture (39% association); thus we understand that this variable should be considered by the general traumatologist as a prognostic factor in defining the referral of these patients.

PMID:33715982 | DOI:10.1016/j.recot.2020.10.010

Disabil Health J. 2021 Mar 5:101090. doi: 10.1016/j.dhjo.2021.101090. Online ahead of print.

ABSTRACT

BACKGROUND: People with disabilities and chronic health conditions rely on a range of services and supports to complete daily tasks, maintain health, and participate in the community. Preliminary research suggests the COVID-19 pandemic greatly disrupted these services and this population may be particularly susceptible to unemployment.

OBJECTIVE: Describe employment and service disruptions for individuals with disabilities and chronic health conditions during the onset of community-based spread of COVID-19 in the United States.

METHODS: Adults with disabilities and chronic health conditions completed online surveys to report employment and service changes via multiple choice and open-ended questions. Multiple choice questions were analyzed using descriptive statistics; open-ended responses were coded using content analysis.

RESULTS: Participants (n = 109): 79.8% female, 88.1% white, 77.121% completed a 4-year college degree or greater, 61.4% had annual income ≥$45,000. Only 14.9% of survey respondents reported disruptions in employment. On average, 54.0% of service changes were due to discontinuation, including loss of physical therapy, job coaching, community organizations, transportation, and peer supports. Other changes included a shift to virtual service delivery and family members taking the role of service providers.

CONCLUSIONS: Individuals with chronic health conditions and disabilities experienced service disruptions, even in a sample with considerably more economic, social, and educational privilege than the general population of people with chronic health conditions and disabilities in the United States.

PMID:33715986 | DOI:10.1016/j.dhjo.2021.101090

Surg Obes Relat Dis. 2021 Feb 6:S1550-7289(21)00081-2. doi: 10.1016/j.soard.2021.01.042. Online ahead of print.

ABSTRACT

BACKGROUND: Studies on early postoperative readmissions after bariatric surgery (BS) have examined readmissions as a single entity, regardless of urgency. Strategies to lower nonurgent readmissions would reduce unnecessary hospital utilization.

OBJECTIVES: To identify predictors of urgent readmissions (UR) versus nonurgent readmissions (NUR) at 30 days post-BS.

SETTING: Single academic institution.

METHODS: Patients undergoing primary BS over 2 years (n = 589) were retrospectively reviewed. Baseline demographic, medical, and hospitalization data were compared between readmitted patients, stratified by urgency, and nonreadmitted patients. Multivariate regression models of UR and NUR were created using variables with a P value ≤ .2 on univariate analyses. A P value ≤ .05 was considered statistically significant.

RESULTS: There were 39 documented instances of 30-day readmissions, of which 44% (n = 17) were NUR; NUR patients were more likely to be female (100% versus 78.2% male; P = .03) and trended toward being younger, experiencing ≥2 perioperative complications, and having a longer index hospital length of stay (LOS). Patients with URs had a higher baseline BMI (52.5 ± 11.4 kg/m² versus 48.7 ± 8.3 kg/m², respectively; P = .04), were more likely to have sleep apnea (77.3% versus 56.1%, respectively; P = .05), had a longer LOS (3 versus 2 d, respectively; P = .007), and were more likely to have ≥2 postoperative complications (46% versus 17.0%, respectively; P = .003) compared with those with an NUR. Independent predictors of NUR included public insurance (odds ratio [OR] = 3.7; 95% confidence interval [CI], 1.17-11.67; P = .03), younger age (OR = 1.05; 95% CI, 1-1.01; P = .04), and female sex, while URs were independently predicted by LOS (OR = 1.3; 95% CI, 1.04-1.5; P = .02).

CONCLUSIONS: Public insurance appears to be associated with NURs, while LOS predicts URs after BS. This suggests an important dichotomy within readmissions based on urgency, which has important implications for targeted quality initiatives.

PMID:33715991 | DOI:10.1016/j.soard.2021.01.042