Tag: statistics

J Diabetes Investig. 2022 Feb 3. doi: 10.1111/jdi.13764. Online ahead of print.

ABSTRACT

AIMS: To assess the impact of baseline characteristics on the efficacy and safety of oral semaglutide in Japanese patients with type 2 diabetes.

MATERIALS AND METHODS: In PIONEER 9 and 10, Japanese patients were randomized to once-daily oral semaglutide (3, 7, or 14 mg) or a comparator (placebo or once-daily subcutaneous liraglutide 0.9 mg in PIONEER 9; once-weekly subcutaneous dulaglutide 0.75 mg in PIONEER 10) for 52 weeks, with 5 weeks of follow up. An exploratory analysis grouped patients in each trial according to baseline glycated hemoglobin (HbA_1c ; ≤8.0, >8.0-≤9.0, or >9.0%), body mass index (<25, ≥25-<30, or ≥30 kg/m² ), and, for PIONEER 10 only, by background medication (sulfonylurea, glinide, thiazolidinedione, α-glucosidase inhibitor, sodium-glucose cotransporter-2 inhibitor). Efficacy (changes from baseline to week 26 in HbA_1c and body weight) and safety were assessed.

RESULTS: 701 patients were included (PIONEER 9: N = 243; PIONEER 10: N = 458). In both trials, HbA_1c reductions increased as baseline HbA_1c increased; there were no other apparent patterns between the variables investigated and HbA_1c or body weight changes. There was one statistically significant subgroup interaction between baseline HbA_1c and estimated treatment differences in body weight change for oral semaglutide 14 mg versus placebo in PIONEER 9 (P = 0.0286). Baseline HbA_1c , baseline body mass index and background medication did not appear to affect the proportions of patients reporting adverse events.

CONCLUSIONS: Oral semaglutide is effective across a range of baseline subgroups of Japanese patients with type 2 diabetes, with no unexpected safety findings.

PMID:35112504 | DOI:10.1111/jdi.13764

Diabetes Obes Metab. 2022 Feb 2. doi: 10.1111/dom.14656. Online ahead of print.

NO ABSTRACT

PMID:35112456 | DOI:10.1111/dom.14656

J Appl Clin Med Phys. 2022 Feb 2:e13541. doi: 10.1002/acm2.13541. Online ahead of print.

ABSTRACT

Despite breast cancer prevalence and widespread adoption of deep inspiration breath-hold (DIBH) radiation techniques, few data exist on the error risks related to using surface-guided (SG) DIBH during breast radiation therapy (RT). Due to the increasingly technical nature of these methods and being a paradigm shift from traditional breast setups/treatments, the associated risk for error is high. Failure modes and effects analysis (FMEA) has been used in identifying risky RT processes yet is time-consuming to perform. A subset of RT staff and a hospital patient-safety representative performed FMEA to study SG-DIBH RT processes. After this group (cohort 1) analyzed these processes, additional scoring data were acquired from RT staff uninvolved in the original FMEA (cohort 2). Cohort 2 received abbreviated FMEA training while using the same process maps that cohort 1 had created, which was done with the goal of validating our results and exploring the feasibility of expedited FMEA training and efficient implementation elsewhere. An extensive review of the SG-DIBH RT process revealed 57 failure modes in 16 distinct steps. Risks deemed to have the highest priority, large risk priority number (RPN), and severity were addressed with policy changes, checklists, and standardization; of these, most were linked with operator error via manual inputs and verification. Reproducibility results showed that 5% of the average RPN between cohorts 1 and 2 was statistically different. Unexpected associations were noted between RPN and RT staff role; 12% of the physicist and therapist average scores were statistically different. Different levels of FMEA training yielded similar scoring within one RT department, suggesting a time-savings can be achieved with abbreviated training. Scores between professions, however, yielded significant differences suggesting the importance of involving staff across disciplines.

PMID:35112445 | DOI:10.1002/acm2.13541

Angew Chem Int Ed Engl. 2022 Feb 2. doi: 10.1002/anie.202117596. Online ahead of print.

ABSTRACT

Quantitative measurements of sex difference in vesicle chemistry (i.e., chemical storage and release) at a single vesicle level are very essential to understand sex differences in cognitive behaviors; however, such measurements are very challenging to conventional analytical methods. By using single-vesicle electrochemistry, we find the duration of single exocytotic events of chromaffin cells prepared from male rats is statistically longer than that from female rats, leading to more neurotransmitter released in male group. Further analysis reveals that a higher percentage of vesicles in female group release part of neurotransmitter, i.e., partial release, during exocytosis than that in male group. This sex dimorphism in neurotransmitter release in exocytosis might relate to the sex difference in the expression of voltage-dependent calcium channels and membrane lipid composition. Our finding offers the first experimental evidence that sex dimorphism even exists in vesicle chemistry, providing a brand new viewpoint for understanding the sex dimorphism in cognitive behaviors.

PMID:35112448 | DOI:10.1002/anie.202117596

Appl Psychol Health Well Being. 2022 Feb 2. doi: 10.1111/aphw.12346. Online ahead of print.

ABSTRACT

Theory-based, user-informed interventions are needed to increase the low participation rates of population-based faecal occult blood test (FOBT) bowel cancer screening. This study investigated the theoretical fit of the health action process approach (HAPA) for home FOBT screening and measured screening invitees’ attitudes towards different intervention strategies. A cross-sectional sample (n = 377), aged 50-74 years, participated in this study. Two scales were created for this study. The process approach to mail-out screening (PAMS) scale measured HAPA constructs, and the user ratings of mail-out screening interventions (UR-MSI) scale measured attitudes towards different intervention strategies. Structural equation modelling was used to assess the fit of PAMS scale responses to the HAPA model, and descriptive statistics were calculated for UR-MSI responses. PAMS results showed acceptable model fit, CFI = .968, RMSEA = .050 and explained 49.9% of the variation in FOBT screening participation. Positive ratings of interventions ranged from 20.47%, an intervention prompting planning to complete the FOBT kit, to 72.25%, an intervention promoting the positive health outcome associated with FOBT screening. Intervention strategies should be combined such that they target all factors specified within the HAPA model. User-informed intervention design should be used to effectively facilitate FOBT uptake in the community.

PMID:35107867 | DOI:10.1111/aphw.12346

Brain Behav. 2022 Feb 2:e2504. doi: 10.1002/brb3.2504. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study was to analyze the glymphatic system function and its relationship with clinical characteristics, global diffusion tensor imaging (DTI) parameters, and global structural connectivity in treatment-naïve patients with newly diagnosed focal epilepsy.

METHODS: This retrospective single-center study investigated patients with focal epilepsy and healthy controls. All participants underwent routine brain magnetic resonance imaging and DTI. DTI analysis along the perivascular space (DTI-ALPS) was used to evaluate glymphatic system function. We also calculated the measures of global DTI parameters, including whole-brain fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), and performed a graph theoretical network analysis to measure global structural connectivity.

RESULTS: A total of 109 patients with focal epilepsy and 88 healthy controls were analyzed. There were no significant differences in the DTI-ALPS index (1.67 vs. 1.68, p = 0.861) between the groups. However, statistically significant associations were found between the DTI-ALPS index and age (r = -0.242, p = 0.01), FA (r = 0.257, p = 0.007), MD (r = -0.469, p < 0.001), AD (r = -0.303, p = 0.001), RD (r = -0.434, p < 0.001), and the assortative coefficient (r = 0.230, p = 0.016) in patients with focal epilepsy.

CONCLUSION: The main finding of this study is that DTI-ALPS index is significantly correlated with global DTI parameters and structural connectivity measures of the brain in patients with focal epilepsy. In addition, DTI-ALPS index decreases with age in these patients. We conclude that the DTI-ALPS index can be used to investigate glymphatic system function in patients with focal epilepsy.

PMID:35107879 | DOI:10.1002/brb3.2504

United European Gastroenterol J. 2022 Feb 2. doi: 10.1002/ueg2.12204. Online ahead of print.

ABSTRACT

BACKGROUND: There is continued uncertainty regarding the risks of hepato-pancreato-biliary cancers in patients with inflammatory bowel disease (IBD) with or without concomitant primary sclerosing cholangitis (PSC).

OBJECTIVE: To give updated estimates on risk of hepato-pancreato-biliary cancers in patients with IBD, including pancreatic cancer, hepatocellular carcinoma, gall bladder cancer, and intra – and extrahepatic cholangiocarcinoma.

METHODS: In a population-based cohort study, we included all patients diagnosed with IBD in Norway and Sweden from 1987 to 2016. The cohort comprised of 141,960 patients, identified through hospital databases and the National Patient Register. Participants were followed through linkage to national cancer, cause of death, and population registries. We calculated absolute risk and standardized incidence ratios (SIRs) of hepato-pancreato-biliary cancers by PSC and other clinical characteristics.

RESULTS: Of the 141,960 IBD patients, 3.2% were diagnosed with PSC. During a median follow-up of 10.0 years, we identified 443 biliary tract cancers (SIR 5.2, 95% confidence interval [CI] 4.8-5.7), 161 hepatocellular carcinomas (SIR 2.4, 95% CI 2.0-2.7) and 282 pancreatic cancers (SIR 1.3, 95% CI 1.2-1.5). The relative risks were considerably higher in PSC-IBD patients, with SIR of 140 (95% CI 123-159) for biliary tract, 38.6 (95% CI 29.2-50.0) for hepatocellular, and 9.0 (95% CI 6.3-12.6) for pancreatic cancer. The SIRs were still slightly increased in non-PSC-IBD patients, compared to the general population. For biliary tract cancer, the cumulative probability at 25 years was 15.6% in PSC-IBD patients, and 0.4% in non-PSC-IBD patients.

CONCLUSIONS: The dramatically increased risks of hepato-pancreato-biliary cancers in PSC-IBD patients support periodic surveillance for these malignancies. While much lower, the excess relative risks in non-PSC-IBD patients were not trivial compared to non-IBD related risk factors.

PMID:35107865 | DOI:10.1002/ueg2.12204

Clin Endocrinol (Oxf). 2022 Feb 2. doi: 10.1111/cen.14682. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate non-urological patients with multiple comorbidities for factors contributing towards differences in testosterone concentration in multi-ethnic Malaysian men.

METHODS: Sexually active men ≥40 years with no known urological problems were recruited at the phlebotomy clinic at our center. A brief history along with latest fasting lipid profile and plasma glucose levels were obtained. An Aging Male Symptoms (AMS) questionnaire was administered; waist circumference (WC) and serum testosterone concentration were measured. Analysis of testosterone concentration between Malay, Indian and Chinese men was performed. Statistical tests such as ANOVA, Chi square test, univariate and multivariable regression were performed. Any P<0.05 denoted as statistically significant.

RESULTS: Among the 604 participants analyzed, mean testosterone concentration was significantly lower in Malays (15.1±5.9 nmol/L) compared to the Chinese (17.0±5.9 nmol/L) and Indian (16.1±6.5 nmol/L) participants. The mean WC was also found to be higher among the Malays (96.1±10.9 cm) compared to Chinese (92.6±9.6 cm) and Indians (95.6±9.9 cm). Testosterone concentration tended to be lower with higher age, but this was not statistically significant (P>0.05). In the multivariable analysis only Malay ethnicity, WC ≥ 90 cm and low HDL were associated with lower testosterone concentration.

CONCLUSION: In this study, Malaysian men of Malay origin had lower testosterone concentration compared with Indian and Chinese men. WC and low HDL were also associated with lower testosterone concentrations. This article is protected by copyright. All rights reserved.

PMID:35107834 | DOI:10.1111/cen.14682

Int Nurs Rev. 2022 Feb 2. doi: 10.1111/inr.12746. Online ahead of print.

ABSTRACT

AIM: To compare the occurrence and the reasons for unfinished care among coronavirus disease (COVID-19) and non-COVID-19 patients as perceived by nurses.

BACKGROUND: The recent pandemic has imposed tremendous changes in hospitals in all countries.

INTRODUCTION: Investigating the occurrence of and the reasons for unfinished care as perceived by nurses working in COVID-19 and non-COVID-19 units might help to gain insights and to address future pandemics.

METHODS: A comparative cross-sectional study based on the STROBE guideline has been conducted during November 2020-January 2021. The Unfinished Nursing Care Survey, comprising part A (elements) and part B (reasons), was administered online to all 479 nurses working in medical and surgical units converted progressively into COVID-19 and non-COVID-19 units. A total of 90 and 200 nurses participated, respectively.

RESULTS: No differences in the unfinished care occurrence have emerged at the overall level between nurses caring for COVID (2.10 out of 5; 95% confidence interval [CI], 1.94-2.27) and non-COVID-19 patients (2.16; 95% CI, 2.06-2.26). Reasons for unfinished care reported significant higher averages among nurses caring for COVID (2.21; 95% CI, 2.10-2.31) as compared with those caring for non-COVID-19 patients (2.07; 95% CI, 2.01-2.14; p = 0.030).

DISCUSSION: The overall occurrence of unfinished care was slightly higher compared with pre-pandemic data in all patients.

CONCLUSIONS: Reasons triggering unfinished care were slightly different and were due to priority setting and human resources issues, which were perceived at higher significance among nurses working in COVID-19 compared with non-COVID-19 units.

IMPLICATION FOR NURSING AND HEALTH POLICIES: A clear map of action has emerged that might be valid in the post-COVID-19 era as well as in the case of future pandemics.

PMID:35107837 | DOI:10.1111/inr.12746

Acad Psychiatry. 2022 Feb 2. doi: 10.1007/s40596-022-01585-5. Online ahead of print.

ABSTRACT

OBJECTIVE: Podcasts have recently been introduced into psychiatry education, despite limited evidence evaluating podcasting in medical education. PsychEd is an educational, publicly available podcast targeting junior learners in psychiatry. This study characterized PsychEd’s listeners and the podcast’s role in their education.

METHODS: The study involved a mixed-methods survey, followed by semi-structured phone interviews with respondents. There were 97 survey responders in total, of whom 9 participated in a telephone interview. Survey responses were coded as interval data and analyzed descriptively using statistical software. Interviews were transcribed and coded for emergent themes using a grounded theory model.

RESULTS: PsychEd listeners represented an interprofessional audience, with 46 respondents (48%) being physicians or physicians in training, and 34 (35%) being allied mental health professionals. All respondents (100%) rated the podcast as “helpful” or “very helpful” for general knowledge. Listeners were attracted to PsychEd for the auditory learning format, the opportunity to review existing knowledge, the focus on core topics, the Canadian expertise, and the presentation of “clinical pearls.” Respondents highlighted valuable qualities of a psychiatry podcast: conversational, case-based, narrative approach, longer episodes (i.e., 30-60 minutes) as compared to other medical specialties, and a clinical focus. Furthermore, they identified podcasts as an opportunity for shared interprofessional curricula.

CONCLUSION: This study is the first to examine the motivations and experiences of listeners of a psychiatry educational podcast. The findings support existing literature on the benefits of podcasts in medical education. Future studies should explore the impact of podcasts on learning and behaviors.

PMID:35107818 | DOI:10.1007/s40596-022-01585-5