Tag: statistics

Int J Gynaecol Obstet. 2022 Jan 25. doi: 10.1002/ijgo.14113. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to determine the factors that affect the women’s willingness of childbearing age to detect/screen for cervical cancer.

METHODS: A cross-sectional study was carried out on sexually active women, aged 30-50 years residing in Banyumas and Gunung Kidul Districts, Indonesia. There were 600 respondents identified. This study focused on the impact of knowledge, access to health information, and the support of their husband to the willingness to perform early detection of cervical cancer.

RESULTS: This study revealed that there was a statistically significant difference (p-value 0.000) between the women who were willing and unwilling to do the screening in terms of higher knowledge (64.67% and 36.21%), obtained access to the information (80.43% and 54.74%), and also supported by their husband (63.59% and 29.31%). This study also discovered that the willingness to be screened was significantly affected by spouse support (OR 4.19, CI 95% 2.81-6.27). Other factors such as education level (OR 2.94, CI 95% 1.20-6.63), Knowledge (OR 2.29, CI 95% 1.52-3.44), and access to information (OR 2.08, CI 95% 1.34-3.24) were also important drivers.

CONCLUSION: To improve the coverage of cervical screening, several aspects could be treated, including education, knowledge, access to information, and husband support.

PMID:35075629 | DOI:10.1002/ijgo.14113

Urol J. 2022 Jan 25. doi: 10.22037/uj.v19i.6919. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to introduce an advanced surgical technique for laparoscopic radical cystectomy (LRC), evaluate the perioperative outcome and compare it to that of conventional LRC (CLRC).

MATERIALS AND METHODS: Between March 2018 and March 2020, sixty patients were divided into the “two-zone and three-segment” laparoscopic radical cystectomy (TTLRC) group or the CLRC group. Patient baseline characteristics, preoperative characteristics and postoperative complications were collected. Data were evaluated using Pearson’s chi square test, Fisher’s exact test, Student’s t-test and Mann-Whitney test. Two-sided p values of less than 0.05 were considered statistically significant.

RESULTS: The TTLRC technique was developed based on the pelvic anatomy of six formalin fixed male cadavers. None of the patient baseline characteristics, including ECOG-PS score, comorbidity, ASA score and Hb, were significantly different between the two groups (p>0.05). There were significant differences in the operating time and estimated blood loss (total time: 3±0.2 vs 3.8±0.4, p<0.001; time to cystectomy and lymph node dissection: 1.7±0.2 vs 2.2±0.3, p<0.001; estimated blood loss 182.1±18.8 vs 264.3±27.4, p<0.001). Although there were no differences in late complications, early complications were significantly different between the two groups (p = 0.033). No statistically significant differences were found between the two groups in other outcomes (p>0.05).

CONCLUSION: The TTLRC technique achieves a clearer surgical field, has a shorter operating time and produces less blood loss than CLRC. It is safe and feasible for urologists to perform this improved LRC procedure.

PMID:35075626 | DOI:10.22037/uj.v19i.6919

Daru. 2022 Jan 24. doi: 10.1007/s40199-021-00431-7. Online ahead of print.

ABSTRACT

PURPOSE: To examine the impact of the COVID-19 pandemic on calcineurin inhibitors and related prescriptions for community patients in England.

METHODS: Data from all primary-care patients who had calcineurin inhibitors prescriptions, dispensed in the community in England were included. Descriptive statistics and interrupted time series analysis over 27 months (15 months before and 12 months after 1^st lockdown) was evaluated.

RESULTS: Descriptive statistics show that mean values have declined since the pandemic’s onset. Over the 27 months: mean Tacrolimus 865,045 doses, standard deviation (SD) 76,147 doses, with 95% CI 834,923, 895,168, (min 567,508, max 1,010,900), ciclosporin 315,496 doses, SD 40,094, 95% CI 299,635, 331,356 (min 191,281, max 382,253) and sirolimus 21,384 doses, SD 2,610, 95% CI 20,352, 22,417 (min 13,022, max 26,156). Analysis of variance between the pre- and post- periods show significant variations in quantities of tacrolimus F 7.432, p = 0.012, ciclosporin F 33.147, p < 0.001 and sirolimus F 18.596, p < 0.001 (1df), mirrored in price analysis. The Interrupted Time Series (ARIMA Modelling) shows declining trends. After the pandemic’s onset, a statistically significant downward trend in quantity for tacrolimus p = 0.008 is observed, with an estimated monthly decline of 14,524 doses, ciclosporin p = 0.185, with an estimated decline of 2,161 doses and sirolimus p = 0.002 with an estimated decline of 485 doses, along with declining prices.

CONCLUSION: A decrease in prescription medicines use raises concerns for the care of (renal) transplant patients. Patients are encouraged to discuss their planned care with their doctor, secure supplies and remain adherent to their medication.

PMID:35075618 | DOI:10.1007/s40199-021-00431-7

Langenbecks Arch Surg. 2022 Jan 24. doi: 10.1007/s00423-022-02446-3. Online ahead of print.

ABSTRACT

INTRODUCTION: The spleen provides a unique immune function in its production of opsins directed against encapsulated bacteria. Splenectomy, therefore, increases the risk of infections in patients as well as post-operative complications. This study aims to assess the risk of post-operative complications within 5 years of splenectomy by indication for splenectomy: trauma, disease, or in association with a distal pancreatectomy for pancreatic disease. The relationship between vaccination and infectious outcomes was also investigated.

METHODS: This study is a review of splenectomy cases between June 2005 and June 2015 at a single institution. Infection, splenectomy indication, and vaccination history were identified from electronic medical records and lab test confirmations. Data was analyzed using Student’s t test for continuous variables, the Mann-Whitney U test for ordinal variables, and a Chi-square/Fisher exact test for categorical variables.

RESULTS: A total of 106 splenectomy patients were included: 35 traumatic (74% male) and 71 non-traumatic causes (42% male) with no significant difference in age. There were no statistical differences in complications during splenectomy and vaccination administration between the splenectomy indication groups: trauma, disease, and with distal pancreatectomy. There was a statistically significant higher infection rate within 5 years post-splenectomy in the non-traumatic vs traumatic group (42% vs 14.0%, p = 0.0040) with majority gastrointestinal (7/38) and respiratory (5/38) and surgical wound infections (3/38) observed in non-traumatic versus traumatic, respectively.

CONCLUSION: Results from data analysis show a statistically significant difference in rates of infection within 5 years post-operatively between traumatic versus non-traumatic indications for splenectomies, with the non-traumatic group experiencing a higher rate of infectious outcomes. The non-traumatic group included patients with disease and distal pancreatectomy indications. This suggests that patients who have non-traumatic causes may be at a higher risk of developing infections following splenectomy procedure. Additionally, vaccinations did not appear to have a protective effect.

PMID:35075620 | DOI:10.1007/s00423-022-02446-3

Clin Chem Lab Med. 2022 Jan 21. doi: 10.1515/cclm-2021-0899. Online ahead of print.

ABSTRACT

OBJECTIVES: The use of BD Vacutainer^® Barricor™ tubes (BAR) can reduce turnaround time (TAT) and improve separation of plasma from cellular components using a specific mechanical separator. Concentrations of amino acids (AAs) and cytokines, known to be labile during pre-analytical time delays, were compared in heparin (BAR, BD Heparin standard tube [PST]), EDTA and serum gel tubes (SER) to validate previously identified quality indicators (QIs) in BAR.

METHODS: Samples of healthy individuals (n=10) were collected in heparin, EDTA and SER tubes and exposed to varying pre- and post-centrifugation delays at room temperature (RT). Cytokines (interleukin [IL]-8, IL-16 and sCD40L) were analyzed by enzyme-linked immunosorbent assay (ELISA) and AAs were characterized by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS).

RESULTS: All QIs, AAs/AA ratio and cytokines increased during prolonged blood storage in heparin plasma (PST, BAR) and SER tubes. Comparison of 53 h/1 h pre-centrifugation delay resulted in an increase in taurine (Tau) and glutamic acid (Glu) concentrations by more than three times, soluble CD40L increased by 13.6, 9.2 and 4.3 fold in PST, BAR-CTRL and BAR-FAST, and IL-8 increased even more by 112.8 (PST), 266.1 (BAR-CTRL), 268.1 (BAR-FAST) and 70.0 (SER) fold, respectively. Overall, compared to prolonged blood storage, effects of post-centrifugation delays were less pronounced in all tested materials.

CONCLUSIONS: BAR tubes are compatible with the use of several established QIs and can therefore be used in clinical biobanking to reduce pre-analytical TAT without compromising QIs and thus pre-analytical sample quality analysis.

PMID:35073617 | DOI:10.1515/cclm-2021-0899

Gesundheitswesen. 2022 Jan 24. doi: 10.1055/a-1696-1616. Online ahead of print.

ABSTRACT

INTRODUCTION: Following upon our publication “Maturity Levels of Quality and Risk Management at the University Hospital Schleswig-Holstein” in 2018, we present the further development of the maturity model. Quality and risk management in hospitals is not only required by law but also plays a significant role in an optimized patient- and process-oriented health care.

METHODS: A questionnaire-based self-assessment was carried out by 46 clinical units of the UKSH (location Kiel and Lübeck) for the analysis of nine quality criteria overall. Four of these criteria (quality assurance (QS), critical incident reporting system (CIRS), complaint management (BM) and process management (PM)) were already analysed in 2016 and were extended to the five new aspects, namely audits and on-site inspections, responsibilities, morbidity and mortality conferences, hygiene training and surgical safety checklist. Every quality item was graded into four categories from “A” (fully implemented) to “D” (not implemented at all).

RESULTS: The comparison of the results for quality criteria QS, CIRS, BM, PM and the overall maturity level between 2016 and 2020 demonstrated statistically significant improvements in 2020 concerning the criteria QS (p=0.013), CIRS (p=0.026), PM (p=0.000) and the overall maturity levels (p=0.019). The criteria BM did not show any statistically significant improvement. The five newly added quality criteria demonstrated maturity levels “A” (fully implemented) and “B” (largely implemented) the following: audits and on-site inspections (100%), responsibilities (95.6%), morbidity and mortality conferences (65.2%), hygiene training (95.6%), and surgical safety checklist (100%).

CONCLUSION: An integrated quality and risk management has already been a firm element of UKSH for years. Nevertheless, review of effectiveness of the initiated targeted measures is still a challenge. This is the reason why it is necessary to develop effective and resource-saving approaches for the evaluation of measures and the identification of potential for improvement. The recognised potential for improvement should be risk-prioritized and completely exploited using sustainable measures. Following this principle, we designed a qualitative model of maturity levels for the evaluation of our quality and risk management system at the UKSH in 2016, whose further development we demonstrate here.

PMID:35073592 | DOI:10.1055/a-1696-1616

Pharmacology. 2022 Jan 24:1-11. doi: 10.1159/000521531. Online ahead of print.

ABSTRACT

INTRODUCTION: The interindividual variability of the antiplatelet effect of clopidogrel is determined by multiple clinical and genetic factors. A lot of genotype-oriented studies have concentrated on the impact of CYP2C19 gene polymorphisms on platelet aggregation in patients receiving clopidogrel. However, the influence of this polymorphism may be only 12-20%, so other genetic markers should also be investigated. The aim of this work was to study the impact of carriage of CES1, PON1, ABCG2, CYP4F2, CYP3A4, IGTB3, P2Y12, PEAR1, and B4GALT2 polymorphisms on antiplatelet effect of clopidogrel and clinical outcomes in patients with acute coronary syndrome (ACS) and atrial fibrillation (AF).

METHODS: 103 patients who underwent ACS with or without percutaneous coronary intervention and concomitant nonvalvular AF were included in an open multicenter prospective study to assess efficacy and safety of combined antithrombotic therapy. The study assessed the frequency of different primary clinical outcomes (incidence of major bleeding, hospital mortality, cardiovascular mortality, stroke and transient ischemic attacks (TIAs), renal mortality) and secondary outcomes (resistance to therapy – high residual platelet reactivity, excessive platelet suppression). Residual platelet reactivity was examined using the VerifyNow system (Accumetrics, Latham, NY, USA).

RESULTS: None of the studied genetic markers had no statistically significant effect on the antiaggregant response to clopidogrel in patients with ACS and AF. However, CYP4F2 C(Val433Met) T, PEAR1 rs41273215 C>T were statistically significantly associated with an increased frequency of bleeding on antithrombotic therapy. B4GALT2 rs1061781 was statistically significantly associated with increased frequency of strokes and TIA.

CONCLUSION: In our study, we determined that carriers of CYP4F2 gene polymorphisms C(Val433Met)T, PEAR1 rs41273215 C>T (CT+TT) were associated with lower safety of antithrombotic therapy in patients with ACS and AF. And, the B4GALT2 rs1061781 gene polymorphism was associated with a greater risk of insufficient efficacy of the therapy. The data obtained in our study may improve the understanding of the effect of less studied genetic markers on the efficacy and safety of antithrombotic therapy in patients with ACS and AF.

PMID:35073541 | DOI:10.1159/000521531

Diabetes. 2022 Jan 24:db210704. doi: 10.2337/db21-0704. Online ahead of print.

ABSTRACT

MiRNAs are small non-coding RNAs that may contribute to common diseases via epigenetic regulation of gene expression; little is known regarding their role in type 2 diabetes (T2D). We performed miRNA-sequencing and transcriptomic profiling of peripheral monocytes from the longitudinal Multi-Ethnic Study of Atherosclerosis (MESA; N=1,154). We examined associations between miRNAs and prevalent impaired fasting glucose and T2D and evaluated the T2D-associated miRNAs effect on incident T2D. Of 774 detected miRNAs, six (miR-22-3p, miR-33a-5p, miR-181c-5p, miR-92b-3p, miR-222-3p, and miR-944) were associated with prevalent T2D. For five of the six miRNAs (all but miR-222-3p) our findings suggested a doseresponse relationship with impaired fasting glucose and type 2 diabetes. Two of the six miRNAs were associated with incident T2D (miR-92b-3p: HR 1.64, p=1.30E-03; miR-222-3p: HR 1.97, p=9.10E-03 in the highest versus lowest tertile of expression). Most of the T2D associated miRNAs were also associated with HDL cholesterol concentrations. The genes targeted by these miRNAs belong to key nodes of a cholesterol metabolism transcriptomic network. Higher levels of miRNA expression expected to increase intracellular cholesterol accumulation in monocytes are linked to an increase in T2D risk.

PMID:35073575 | DOI:10.2337/db21-0704

Biomed Mater. 2022 Jan 24. doi: 10.1088/1748-605X/ac4e65. Online ahead of print.

ABSTRACT

Lithium disilicate (Li₂Si₂O₅) glass-ceramic is a commonly used dental ceramic material. In this study, Li₂Si₂O₅whiskers were prepared by the hydrothermal method, mixed with Li₂Si₂O₅glass powders, and Li₂Si₂O₅whisker-reinforced glass-ceramics were prepared by reaction sintering. The biosafety of the new Li₂Si₂O₅glass-ceramics were evaluated by in vitro cytotoxicity, hemolysis, oral mucosal irritation, acute systemic toxicity, and subacute systemic toxicity (oral route) tests according to ISO 7405/ISO 10993 standards. The cytotoxicity test results showed that the cell growth of the experimental group was good, and the cell number and morphology were not significantly different from those of the blank group (P > 0.05). The toxicity grading for both experimental and blank control groups were 0. The hemolysis rate of the material was 1.25%, which indicated that it did not cause hemolytic reaction. The material was non-irritating to the oral mucosa. In acute systemic toxicity test, animals in the experimental group showed increased body weight, moved freely, with no signs of poisoning. The food utilization rate and relative growth rate (change of the weight) of rats in the subacute systemic toxicity test were not statistically different from those of the control group (P > 0.05). Preliminary evaluation of the biosafety of the Li₂Si₂O₅whisker-reinforced glass-ceramics showed that it met the existing regulatory standards, and further biosafety experiments can be conducted, following which the material may be expected to be applied in clinical practice.

PMID:35073528 | DOI:10.1088/1748-605X/ac4e65

Clin Exp Optom. 2022 Jan 24:1-7. doi: 10.1080/08164622.2022.2029684. Online ahead of print.

ABSTRACT

CLINICAL RELEVANCE: Dual-focus soft contact lenses are effective in slowing myopia progression; however, their influence on near work-induced transient myopia (NITM) remains unknown. When performing a 5-min near task at 20 cm, we observed that dual-focus soft contact lens wear induced greater lags of accommodation and a lower initial NITM than single-vision soft contact lenses, which provides relevant information for better understanding the impact of using this optical design on the accommodative function.

BACKGROUND: NITM has been proposed as a myogenic factor, although it is a matter of debate by the scientific community. The main objective of this study was to assess the short-term effect of wearing dual-focus soft contact lenses for myopia control on the steady-state accommodative response and NITM.

METHODS: Twenty-four young myope adults wore, on two different days, dual-focus and single-vision soft contact lenses, while the accommodative response was dynamically measured with an open-field autorefractor during the execution of the NITM task. The shift and the time required to recover baseline levels in the refractive state after performing the 5-min near task (20 cm) were the main dependent variables.

RESULTS: We found a lower magnitude of accommodation during the execution of the near task with the dual-focus in comparison to the single-vision soft contact lenses (p < 0.001). There was a lower initial NITM with the dual-focus when compared to the single-vision lenses (corrected p-value = 0.003, Cohen’s d = 0.68), but no statistically significant differences were observed for decay duration (p = 0.984).

CONCLUSIONS: Dual-focus soft contact lens wear causes a reduced accommodative response during a near task, and an initial small myopic shift at distance after a 5-min period of near viewing. The current findings may help to understand the mechanisms involved in myopia control with this optical strategy.

PMID:35073496 | DOI:10.1080/08164622.2022.2029684