Tag: statistics

Health Promot Chronic Dis Prev Can. 2022 Jan;42(1):21-28. doi: 10.24095/hpcdp.42.1.04.

ABSTRACT

INTRODUCTION: We developed separate random forest algorithms to predict e-cigarette (vaping) ever use and daily use among Ontario youth, and subsequently examined predictor importance and statistical interaction.

METHODS: This cross-sectional study used a representative sample of Ontario elementary and high school students in 2019 (N = 6471). Vaping frequency over the last 12 months was used to define ever-vaping and daily vaping. We considered a large set of individual characteristics as potential correlates for ever-vaping (176 variables) and daily vaping (179 variables). Using cross-validation, we developed random forest algorithms and evaluated model performance based on the C-index, a measure to assess the discriminatory ability of a model, for both outcomes. Further, the top 10 correlates were identified by relative importance score calculation and their interaction with sociodemographic characteristics.

RESULTS: There were 2064 (31.9%) ever-vapers, and 490 (7.6%) of the respondents were daily users. The random forest algorithms for both outcomes achieved high performance, with C-index over 0.90. The top 10 correlates of daily vaping included use of caffeine, cannabis and tobacco, source and type of e-cigarette and absence in last 20 school days. Those of ever-vaping included school size, use of alcohol, cannabis and tobacco; 9 of the top 10 ever-vaping correlates demonstrated interactions with ethnicity.

CONCLUSION: Machine learning is a promising methodology for identifying the risks of ever-vaping and daily vaping. Furthermore, it enables the identification of important correlates and the assessment of complex intersections, which may inform future longitudinal studies to customize public health policies for targeted population subgroups.

PMID:35044141 | DOI:10.24095/hpcdp.42.1.04

Monaldi Arch Chest Dis. 2022 Jan 18. doi: 10.4081/monaldi.2022.2062. Online ahead of print.

ABSTRACT

The COVID-19 pandemic has led to mortality and morbidity since December 2019. Many possible treatment options have been advised till date. The role of ivermectin in the treatment of COVID-19 disease remains controversial. The aim of our study was to evaluate the effect of ivermectin in hospitalized patients with non-severe and severe COVID-19 disease. We conducted a retrospective cohort study that compared outcomes in 2 groups of COVID-19 patients hospitalized at the largest tertiary care center of Pakistan. The study group was given ivermectin along with standard treatment of covid-19 disease; the comparison group was not. Data on mortality, inflammatory markers such as C-reactive protein (CRP) and ferritin, length of hospital stay and baseline characteristics were collected from Aga Khan University’s database from October 2020 till February 2021. Statistical analysis was done to determine the effectiveness of ivermectin in non-severe and severe COVID-19. Comparison of effectiveness of Ivermectin in both the genders was also conducted. The cohort included 188 patients out of which 90 were treated with ivermectin. Mortality and length of hospitalization was not found to be significantly different in the study group compared with the control group (5.6% vs 5.1%; p=0.87 and 5 days vs 4 days; p=0.27). Analysis of secondary outcomes did not yield statistically significant results, apart from ferritin levels which were significantly less in patients treated with ivermectin (547.1 vs 756.7; p=0.03). The ferritin and CRP levels in affected males were higher than in females on admission and discharge. Our findings suggest ivermectin does not significantly affect all-cause mortality, length of hospitalization and CRP levels in hospitalized COVID-19 patients. Large scale randomized controlled trials (RCTs) are required to further evaluate the role of ivermectin in covid-19 disease.

PMID:35044137 | DOI:10.4081/monaldi.2022.2062

Monaldi Arch Chest Dis. 2022 Jan 19. doi: 10.4081/monaldi.2022.2142. Online ahead of print.

ABSTRACT

The correct type and time of follow-up for patients affected by COVID19 ARDS is still unclear. The aim of this study was to evaluate at the survivors to COVID19 ARDS requiring non-invasive respiratory support (NRS) admitted to a Respiratory Intensive care unit (RICU) from March 8th till May 31th 2020 looking at all sequelae via a comprehensive follow up. All patients underwent a multi-disciplinary instrumental and clinical assessment within three months form admission to evaluate all infection related sequelae. Thirty-eight patients were enrolled Lung-Ultrasound (LUS) showed an outstanding discrimination ability (ROC AUC: 0.95) and a substantial agreement rate (Cohen’s K: 0.74) compared to chest CT-scan detecting improvement of lung consolidations. Youden’s test showed a cut-off pressure of 11 cmH2O ExpiratoryPAP-Continuous-PAP-max (EPAP-CPAP) applied at the airways during hospitalization to be significantly correlated (p value: 0.026) to the increased pulmonary artery common trunk diameter. A total of 8/38 patients (21.8%), 2 of whom during follow-up, were diagnosed with Pulmonary Emboli (PE) and started anticoagulant treatment. Patients with PE had a statistically significant shorter length of time of hospitalization, time to negative swab, CPAP/NIV duration, P/F ratio and D-dimers at follow-up compared to non PE. A comprehensive approach to patients with ARDS COVID19 requiring NRS is necessary. This study highlighted cardiopulmonary impairment related to the ARDS and to the high-EPAP-CPAP-max greater than 11mmHg provided during admission, the usefulness of LUS in monitoring post-infection recovery and the correct identification and treatment of patients with PE during follow up.

PMID:35044135 | DOI:10.4081/monaldi.2022.2142

Monaldi Arch Chest Dis. 2022 Jan 18. doi: 10.4081/monaldi.2022.2026. Online ahead of print.

ABSTRACT

This study was planned to estimate the proportion of confirmed multi-drug resistance pulmonary tuberculosis (TB) cases out of the presumptive cases referred to DTC (District Tuberculosis Center) Jodhpur for diagnosis; to identify clinical and socio-demographic risk factors associated with the multidrug-resistant pulmonary TB and to assess the spatial distribution to find out clustering and pattern in the distribution of pulmonary TB with the help of Geographic Information System (GIS). In the Jodhpur district, 150 confirmed pulmonary multi-drug resistant tuberculosis (MDR-TB) cases, diagnosed by probe-based molecular drug susceptibility testing method and categorized as MDR in DTC’s register (District Tuberculosis Center), were taken. Simultaneously, 300 control of confirmed non-MDR or drug-sensitive pulmonary TB patients were taken. Statistical analysis was done with logistic regression. In addition, for spatial analysis, secondary data from 2013-17 was analyzed using Global Moran’s I and Getis and Ordi (Gi*) statistics. In 2012-18, a total of 12563 CBNAAT (Cartridge-based nucleic acid amplification test) were performed. 2898 (23%) showed M. TB positive but rifampicin sensitive, and 590 (4.7%) showed rifampicin resistant. Independent risk factors for MDR TB were ≤60 years age (AOR 3.0, CI 1.3-7.1); male gender (AOR 3.4, CI 1.8-6.7); overcrowding (AOR 1.6, CI 1.0-2.7); using chulha (smoke appliance) for cooking (AOR 2.5, CI 1.2-4.9), past TB treatment (AOR 5.7, CI 2.9-11.3) and past contact with MDR patient (AOR 10.7, CI 3.7-31.2). All four urban TUs (Tuberculosis Units) had the highest proportion of drug-resistant pulmonary TB. There was no statistically significant clustering, and the pattern of cases was primarily random. Most of the hotspots generated were present near the administrative boundaries of TUs, and the new ones mostly appeared in the area near the previous hotspots. A random pattern seen in cluster analysis supports the universal drug testing policy of India. Hotspot analysis helps cross administrative border initiatives with targeted active case finding and proper follow-up.

PMID:35044136 | DOI:10.4081/monaldi.2022.2026

Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(12. Vyp. 2):20-25. doi: 10.17116/jnevro202112112220.

ABSTRACT

OBJECTIVE: To study the effect of a comprehensive neurorehabilitation program based on biofeedback on the support response in poststroke patients.

MATERIAL AND METHODS: The article presents the results of treatment of 59 patients after ischemic stroke. The program included training using a force joystick for the upper limb based on a static stabilometric platform with biofeedback according to the support reaction, training in the position of the patient standing on a stabilometric platform, exercise therapy. Patients in the control group received standard therapy.

RESULTS: The use of the comprehensive program contributed to a statistically significantly better therapeutic effect, increased strength, and decreased spasticity in the paretic arm, decreased anxiety and depression, and improved cognitive functions compared with standard therapy in patients in the control group.

CONCLUSIONS: We show the efficacy of comprehensive program based on biofeedback on the support response in the restoring period of stroke.

PMID:35044122 | DOI:10.17116/jnevro202112112220

Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(12. Vyp. 2):56-61. doi: 10.17116/jnevro202112112256.

ABSTRACT

OBJECTIVE: Was to determine the proportion of patients with ischemic stroke (IS) who achieved functional independence by the end of the hospitalization, among those who underwent systemic thrombolytic therapy (STT) with two different alteplase preparations (Actilyse and Revelisa).

MATERIAL AND METHODS: An open, prospective observational non-interventional cohort study of the results of STT in patients with IS was carried out. The study included 195 patients, 123 men and 72 women aged 32 to 86 years, who received STT in the acute period of IS. Of these, 120 patients received Actilyse, 75 – Revelisa.

RESULTS: Patients who achieved independence in movement (0-2 points on the modified Rankin scale (MRS)) among those who received STT with Actilyse and Revelisa, the value of the χ² criterion was 0.014 (p=0.905), which showed that there was no statistical significance of the difference in the frequency of recovery of functional disorders on the MRS scale, in patients receiving STT with two different alteplase preparations.

CONCLUSION: After STT with alteplase preparations, patients with IS experienced a significant improvement, which was expressed in a statistically significant decrease in the severity of neurological deficit and a decrease in the degree of disability. When comparing the results of STT with two different alteplase preparations, no statistically significant differences were found in terms of mortality, survival, and independence during the acute period of IS.

PMID:35044127 | DOI:10.17116/jnevro202112112256

Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(12. Vyp. 2):5-8. doi: 10.17116/jnevro20211211225.

ABSTRACT

OBJECTIVE: To analyze mortality rates, rehabilitation potential, and features of the course of stroke in patients with COVID-19.

MATERIAL AND METHODS: The study included 50 patients in the acute period of stroke who were diagnosed with a new coronavirus infection during treatment. For comparison, we selected a group of 50 patients who had stroke during this period.

RESULTS: In the study group, the virus was identified in 38 (76%) patients by polymerase chain reaction (PCR). The onset of symptoms of acute respiratory viral infection or fever was observed on average 11 days after the onset of neurological symptoms. Only in 10 (20%) patients, a PCR smear showed a positive result in the first 24 hours after the development of a stroke. In the main group, death was observed in 30% (n=15) of cases; in the comparison group – in 6% (n=3) cases. Also, in the main group of patients, a lower degree of recovery of impaired neurological functions was noted on the National Institutes of Health Stroke Scale (NIHSS). At discharge from the hospital, 33 (66%) patients had moderate and severe disabilities according to the modified Rankin scale (3-4 points). The differences were statistically significant, as in the main group there was more pronounced disability than in the control group. Lymphopenia was noted in 26 (52%) patients of the main group on admission.

CONCLUSION: Increased mortality rate, decreased recovery of neurological functions and severe disabilities are observed in the group of patients with stroke who were infected by COVID-19. Lymphopenia in a patient with stroke can serve as a prognostic marker of the possible presence of COVID-19 and the degree of lung tissue damage.

PMID:35044119 | DOI:10.17116/jnevro20211211225

Vet Med Sci. 2022 Jan 19. doi: 10.1002/vms3.725. Online ahead of print.

ABSTRACT

BACKGROUND: Veterinarians and support staff have been reporting the negative mental health effects from client complaints (CC). A previous study was performed evaluating these effects in veterinarians however no such study has been performed on veterinary support staff (VSS).

OBJECTIV: The purpose of this study was to investigate the frequency and effects of CCs on VSS.

METHODS: A cross sectional anonymous survey using a web-based questionnaire was created evaluating the frequency, type, and effects from CC. The survey was distributed to five different VSS Facebook groups and respondents provided demographic information and reported the frequency and effects of such complaints.

RESULTS: A total of 681 questionnaires were collected during the study period but 130 were incomplete and were excluded from analysis. This resulted in 551 completed questionnaires available for review. One hundred and ninety (34.4%) VSS reported being subject to a CC in the previous 6 months with cost of care the most common reason (78.6%). Two hundred and sixty VSS (47.2%) reported feeling depressed because of CCs made against them, 295 VSS (53.5%) stated CCs negatively affected their enjoyment of their job, and 146 (26.5%) have considered changing their career because of CCs.

CONCLUSIONS: CC have detrimental effects on VSS career satisfaction, mental health and hospital practices. Further studies are warranted to mitigate the detrimental effects of CCs.

PMID:35044103 | DOI:10.1002/vms3.725

J Popul Ther Clin Pharmacol. 2022 Jan 10;28(2):e47-e53. doi: 10.47750/jptcp.2022.855. eCollection 2022.

ABSTRACT

The aim of this research is to prepare a healthy psychological course and study its impact on the levels of serum uric acid (SUA) and pessimism and depression. The research sample was limited to teaching staff of the Iraqi State Universities in Baghdad, who were retired at 63-65 years of age. Data were collected by independent group experimental approach via pre- and posttest measurements. The study sample consisted of 21 people with cases of pessimism and depression. The sample was randomly chosen based on their consent to do pre- and posttests and to be subjected to healthy psychological approach. After collecting the data obtained from the samples and processing them statistically, the results showed that the healthy psychological course had a positive effect on the levels of SUA, pessimism, and depression of the research sample.

PMID:35044115 | DOI:10.47750/jptcp.2022.855

Influenza Other Respir Viruses. 2022 Jan 19. doi: 10.1111/irv.12923. Online ahead of print.

ABSTRACT

BACKGROUND: In the United States, infection with SARS-CoV-2 caused 380,000 reported deaths from March to December 2020.

METHODS: We adapted the Moving Epidemic Method to all-cause mortality data from the United States to assess the severity of the COVID-19 pandemic across age groups and all 50 states. By comparing all-cause mortality during the pandemic with intensity thresholds derived from recent, historical all-cause mortality, we categorized each week from March to December 2020 as either low severity, moderate severity, high severity, or very high severity.

RESULTS: Nationally for all ages combined, all-cause mortality was in the very high severity category for 9 weeks. Among people 18 to 49 years of age, there were 29 weeks of consecutive very high severity mortality. Forty-seven states, the District of Columbia, and New York City each experienced at least 1 week of very high severity mortality for all ages combined.

CONCLUSIONS: These periods of very high severity of mortality during March through December 2020 are likely directly or indirectly attributable to the COVID-19 pandemic. This method for standardized comparison of severity over time across different geographies and demographic groups provides valuable information to understand the impact of the COVID-19 pandemic and to identify specific locations or subgroups for deeper investigations into differences in severity.

PMID:35044097 | DOI:10.1111/irv.12923