Tag: statistics

Int Emerg Nurs. 2022 Jan 19;61:101129. doi: 10.1016/j.ienj.2021.101129. Online ahead of print.

ABSTRACT

INTRODUCTION: Stroke care is time sensitive. Providers in the emergency department (ED) depend on advanced notification from emergency medical services (EMS) transporting patients with stroke signs and symptoms. Barriers to EMS-ED information transfer can delay patient arrival preparation that may impact decisions, diagnosis, and time-sensitive transfer to next site of care. Information gaps or loss of information in the chain of care has been noted to contribute to possible safety threats for patients with stroke symptoms.

METHODS: The aim of this project was to explore the feasibility of improving EMS-ED handover of patients with suspected stroke using a two-tiered checklist ranked in order of importance and a “time-out” upon EMS arrival to help standardize report, bridge the information gap, and promote earlier stroke management decisions. Paramedics from two local EMS agencies participated. Transmission and recorded report were measured before and after implementation followed by a satisfaction survey. Analysis also included a comparison group (control) of non-participating Fire Departments.

RESULTS: One hundred and sixty-eight potential stroke patients were transported to the ED during the 16-month intervention time frame. The pre and post intervention analysis of reported stroke symptoms showed statistically significant improvement in multiple checklist reporting areas. Noteworthy changes included improvement in reporting last time normal, current antiplatelet/anticoagulant, neurological deficits, baseline mental and functional status, medical history, code status, recent surgical history and family enroute. A post-survey demonstrated overall positive EMS-ED response to the new handover process.

CONCLUSION: The feasibility of an EMS-ED standardized handover using a hierarchical (ranked in order of importance), two-tiered checklist and time-out process can effectively bridge the gap of communication between EMS and emergency providers to help promote timely hyperacute stroke care.

PMID:35065390 | DOI:10.1016/j.ienj.2021.101129

Ticks Tick Borne Dis. 2022 Jan 15;13(2):101903. doi: 10.1016/j.ttbdis.2022.101903. Online ahead of print.

ABSTRACT

Due to the scarcity of information regarding the control of Rhipicephalus microplus on bovines with different tick burdens, tick counts and the efficacy of a commercial spray formulation (aspersion bath with organophosphate + pyrethroid) were evaluated for animals with a low and high tick burdens for 35 days in a stall test. Thirty-two crossbreed Bos taurus indicus x Bos t. taurus experimentally infested with R. microplus larvae were divided into four groups: T01 high infestation control, T02 high infestation treated, T03 low infestation control, and T04 low infestation treated. The bovines were kept individually in pens and R. microplus females were collected daily. All data were statistically analyzed with a significance level of 5% (P ≤ 0.05). For linear regressions, variables with P≤0.05 and the highest coefficients of determination (R² ≥ 0.70) were considered the best descriptors. The reliability level was 95%. Tick counts differed (P<0.0001) between T01 and T02 (high infestation control vs. treated), except at day 2 (P >0.05) post-treatment, and efficacy ranged from 85.2 to 50.6%. The number of collected engorged females was lower (P<0.0001) for T04 than for T03 (low infestation treated vs. control) animals from day 3 to 29, and efficacy ranged from 95.2 to 69.8%. In addition, tick burden and efficacy were negatively correlated for both the group of animals with a high tick burden (r = -0.5256; p = 0.0012; R² = 0.2762) and the group of animals with a low tick burden (r = -0.9817; p < 0.0001; R² = 0.9638). In conclusion, a high tick burden on bovines decreases the efficacy of the tested spray acaricide.

PMID:35065397 | DOI:10.1016/j.ttbdis.2022.101903

J Chromatogr B Analyt Technol Biomed Life Sci. 2021 Dec 29;1191:123093. doi: 10.1016/j.jchromb.2021.123093. Online ahead of print.

ABSTRACT

Essential oils have been used for centuries for their preservative properties. An example is ylang-ylang Cananga odorata [Lam.] Hook. f. & Thomson essential oil, which exists in four different distillation grades, where the fraction with the longest distillation time has the highest radical scavenging activity (RSA). Gas chromatography mass spectrometry (GC-MS) followed by multivariate statistical analysis is a powerful approach for determination of RSA. Herein the performance of such multivariate statistical analysis using three data sets derived from gas chromatography mass spectrometry (GC-MS) analysis, is compared to that achieved using two direct and fast spectroscopic techniques, for the prediction of RSA using partial least squares (PLS) regression analysis. The three GC-MS data sets were, ‘full chemical composition’, ‘total chromatogram average mass spectra (TCAMS)’ and ‘segment average mass spectra (SAMS)’, whilst two spectroscopic techniques, namely attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy and Raman spectroscopy, provided the spectroscopic data sets for comparison. PLS models created using ATR-FTIR and ‘full chemical composition’ data sets provided the lowest relative error of prediction (REP) and mean error of prediction (MEP) in validation, whilst in independent test sets, the PLS models created using ATR-FTIR and SAMS data sets delivered the lowest REP and MEP. The three GC-MS derived data sets were further compared for value in determination of compounds contributing to the RSA. PLS regression analysis of the full chemical composition data set revealed that germacrene D and (E,E)-α-farnesene were the major contributors to the RSA, whilst average mass spectrum based data sets, TCAMS and SAMS, also highlighted eugenol as another contributor to the RSA.

PMID:35065387 | DOI:10.1016/j.jchromb.2021.123093

Eur J Cancer. 2022 Jan 19;163:108-118. doi: 10.1016/j.ejca.2021.12.024. Online ahead of print.

ABSTRACT

BACKGROUND: Preclinical studies indicate that the concurrent use of inhibitors of the renin-angiotensin-aldosterone system (RAAS) may improve outcomes in broad groups of patients with cancer. There are limited data on the association between the use of RAAS inhibitors and outcomes among patients treated with immune checkpoint inhibitors (ICIs).

METHODS: We performed a retrospective study of all patients treated with an ICI in a single academic network. Of 10,903 patients, 5910 were on any anti-hypertensive medication. Of those on anti-hypertensive therapy, 3426 were prescribed a RAAS inhibitor during ICI treatment, and 2484 were prescribed other anti-hypertensive medications. The primary outcome was overall survival in the entire cohort and in sub-groups by cancer types.

RESULTS: Thoracic cancer (34%) and melanoma (16%) were the most common types of cancer. Those prescribed a RAAS inhibitor were older, more frequently male, and had more cardiovascular risk factors. In a Cox proportional hazard model, the concurrent use of RAAS inhibitors was associated with better overall survival (hazard ratio (HR):0.92, [95% Confidence Interval (CI):0.85-0.99], P = .032). Patients with gastrointestinal (HR:0.82, [95% CI: 0.67-1.01], P = .057) and genitourinary cancer (HR:0.81, [95% CI:0.64-1.01], P = .067) had a non-statistically significant better overall survival.

CONCLUSIONS: In this large retrospective study, patients with hypertension who were concomitantly taking a RAAS inhibitor during ICI therapy had better overall survival. This benefit was primarily noted among patients with gastrointestinal and genitourinary cancers. Prospective randomized trials are warranted to further evaluate and specify the benefit of RAAS inhibitors in patients with cancer who receive ICI therapy.

PMID:35065368 | DOI:10.1016/j.ejca.2021.12.024

Eur J Cancer. 2022 Jan 19;163:119-127. doi: 10.1016/j.ejca.2021.12.027. Online ahead of print.

ABSTRACT

BACKGROUND: The dose-response association between alcohol consumption and the subsequent pancreatic cancer risk by individuals’ glycaemic status is unclear.

RESEARCH DESIGN AND METHOD: This large-scale nationwide cohort study included 9,514,171 adults without cancer who underwent health examinations under the Korean National Health Insurance Service in 2009 and were followed-up until December 2017 for pancreatic cancer development. Multivariable Cox proportional hazards regression analysis was performed.

RESULTS: During a median follow-up period of 7.3 years, 12,818 patients were newly-diagnosed with pancreatic cancer. Among individuals with normoglycemia, a J-shaped association was observed between the frequency of alcohol consumption (1-2 and ≥5 days/week: hazards ratio [HR]; 95% CI, 0.91; 0.85-0.97 and 1.13; 1.002-1.27, respectively) and pancreatic cancer risk, after adjusting for potential confounders. However, in patients with impaired fasting glucose (IFG), pancreatic cancer risk increased with increased frequency and average daily amount of alcohol consumption (all P for trend <0.01). IFG combined with heavy alcohol consumption (30 g/day) was associated with 38% increased pancreatic cancer risk (HR, 1.38; 95% CI, 1.23-1.54). Diabetes was associated with an increased pancreatic cancer risk regardless of alcohol consumption and 70% increased risk even in non-drinkers (HR, 1.70; 95% CI, 1.61-1.80).

CONCLUSIONS: The J-shaped dose-response association between alcohol consumption and pancreatic cancer risk was observed only in individuals with normoglycemia, not in patients with IFG and diabetes. Complete alcohol abstinence may help reduce pancreatic cancer risk in patients with IFG and diabetes.

PMID:35065369 | DOI:10.1016/j.ejca.2021.12.027

Public Health. 2022 Jan 19;204:1-8. doi: 10.1016/j.puhe.2021.12.015. Online ahead of print.

ABSTRACT

OBJECTIVES: The objective of this study was to examine the relationship between parent-child attachment and depression in migrant children (MC), left-behind children (LBC) and non-left-behind children (NLBC) in China.

STUDY DESIGN: This was a cross-sectional study.

METHODS: In total, 4294 children (4th to 9th grade) participated in this study, including 677 MC, 1411 LBC and 2206 NLBC from 17 different schools.

RESULTS: The results showed that (1) the prevalence of depression among MC (21.0%) and LBC (14.0%) was significantly higher than that among NLBC (10.8%); (2) the quality of parent-child attachment among MC was statistically significantly lower than among LBC and NLBC (the proportion of children whose father-child and mother-child attachments were both insecure was 55.4% among MC, 29.9% among LBC and 33.7% among NLBC); and (3) depression was affected by the interaction between the group of children and parent-child attachment; compared with NLBC whose parent-child attachments were both secure, the odds ratio of depression among MC whose parent-child attachments were both insecure was 7.39, which was significantly higher than LBC (5.34) and NLBC (4.86) whose parent-child attachments were both insecure.

CONCLUSIONS: The prevalence of depression among MC and LBC was significantly higher than that among NLBC in China. The quality of parent-child attachment among MC was statistically significantly lower than that of LBC and NLBC. Secure attachment could reduce the risk of depression and insecure parent-child attachment increased the risk of depression. Depression was affected by the interaction between the group of children and parent-child attachment; migration was a significant risk factor associated with child depression.

PMID:35065353 | DOI:10.1016/j.puhe.2021.12.015

Geriatr Nurs. 2022 Jan 19;44:48-53. doi: 10.1016/j.gerinurse.2022.01.001. Online ahead of print.

ABSTRACT

BACKGROUND: Older adults who engage in arranged residential video games have the potential to gain health benefits such as increase in physical activity beyond purposeful movement with movement-based games.

METHODS: A Nintendo Wii video gaming system was implemented for six-weeks as a physical activity intervention with long-term care residents to determine the impact on exercise benefits/barriers, self-efficacy for exercise, and physical activity levels.

RESULTS: Paired t-tests revealed improvement in exercise benefits/barriers, self-efficacy for exercise, and physical activity levels, albeit none with statistical significance (all p > .05).

CONCLUSIONS: The use of the Nintendo Wii as an intervention to enhance physical activity for older adults in nursing home residents should be considered for use over a longer duration of time with older adults.

PMID:35065365 | DOI:10.1016/j.gerinurse.2022.01.001

Soc Sci Med. 2022 Jan 13;294:114722. doi: 10.1016/j.socscimed.2022.114722. Online ahead of print.

ABSTRACT

Relative income deprivation (RID) is a known risk factor for poor health. Previous research has proposed several measures to assess RID, e.g., Income Rank and the Yitzhaki Index. Hounkpatin et al. (2020) presented a new approach – the CR˜_i index – to account for the observation that individuals are more sensitive to the differences in incomes of others who are closer to them, rather than to comparisons with incomes of others far above them. Using a Japanese nationwide cohort of older adults (n = 62,438; mean [SD] age: 73.0 [5.6] years), this study compared the performance of alternative indices of RID in predicting health outcomes (depressive symptoms, functional capacity, and self-rated health), as well as the use of alternative CR˜_i index weights (α weight range: -0.9 to 0.9). When 0<α<1, higher income differences lead to a more significant increase in relative deprivation, while when -1< α <0, excessively high incomes contribute less to the relative deprivation of lower income individuals in the same reference group. Results showed that all measures of relative income deprivation were associated with deteriorating mental and physical health among older Japanese adults. However, while the CR˜_i index consistently outperformed the Yitzhaki Index, this did not hold true invariably when compared to the Income Rank – depending on the health outcome and the reference group. Also, while negative α parameters showed a good statistical fit in most models, the findings were not conclusive – the best-fitting CR˜_i weight parameters ranged from -0.9 to 0.9. Therefore, a clear direction for the contribution of higher incomes to relative deprivation could not be established based on the study population.

PMID:35065345 | DOI:10.1016/j.socscimed.2022.114722

J Sport Health Sci. 2022 Jan 19:S2095-2546(22)00019-9. doi: 10.1016/j.jshs.2022.01.004. Online ahead of print.

ABSTRACT

BACKGROUND: The trade-off between the benefits of regular physical activity (PA) and the potentially detrimental effects of augmented exposure to air pollution in highly polluted regions remains unclear. This study aimed to examine whether ambient fine particulate matter (PM_2.5) exposure modified the impacts of PA volume and intensity on hypertension risk.

METHODS: We included 54,797 participants without hypertension at baseline in a nationwide cohort of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project. PA volume and intensity were assessed by questionnaire, and high-resolution (1×1 km) PM_2.5 estimates were generated using a satellite-based model.

RESULTS: During 413,516 person-years of follow-up, 12,100 incident hypertension cases were identified. PM_2.5 significantly modified the relationship between PA and hypertension incidence (P_interaction < 0.001). Increased PA volume was negatively associated with incident hypertension in the low PM_2.5 stratum (<59.8 μg/m³, P_trend < 0.001), with a hazard ratio (95% confidence interval (95%CI)) of 0.81 (0.74-0.88) when comparing the 4^th with the 1st quartile of PA volume. However, the health benefits were not observed in the high PM_2.5 stratum (≥59.8 μg/m³, P_trend = 0.370). Moreover, compared with light PA intensity, vigorous intensity was related to a 20% (95%CI: 9%-29%) decreased risk of hypertension for participants exposed to low PM_2.5, but a 17% (95%CI: 4%-33%) increased risk for those with high PM_2.5 levels.

CONCLUSION: PA was associated with a reduced risk of hypertension only among participants with low PM_2.5 exposure. Our findings recommended regular PA to prevent hypertension in less polluted regions and reinforced the importance of air quality improvement.

PMID:35065296 | DOI:10.1016/j.jshs.2022.01.004

Int J Pediatr Otorhinolaryngol. 2022 Jan 19;154:111050. doi: 10.1016/j.ijporl.2022.111050. Online ahead of print.

ABSTRACT

OBJECTIVE: turbinate surgery in pediatric patients is gradually increasing in popularity amongst pediatric otolaryngologists. However, despite this, there is scarce information regarding this surgical procedure in children. The present research is designed with the aim of assessing changes in nasal resistance, nasal airflow and quality of life in pediatric patients undergoing turbinate radiofrequency ablation.

METHODS: A prospective uncontrolled intervention clinical trial design was followed. Children between 4 and 15 years old undergoing turbinate radiodiofrequency ablation (TRA) were consecutively selected. Children were examined preoperatively and 1, 3, 6 and 12 months after turbinate surgery. Anterior active rhinomanometry with and without nasal decongestant and examination of the turbinates and adenoid size were carried out in each follow-up visit. The SN5 quality of live survey was answered by parents.

RESULTS: 81 children were included, 28 with associated adenoidectomy. A significant improvement in quality of life was demonstrated since the first month after TRA. Regarding nasal resistance, there was an improvement 1 month after surgery, but it only reached statistical significance for the whole sample (p < 0.001)) and for the cohort of isolated turbinate surgery (p < 0.001) at 3 months, while the values for the cohort of children who underwent adenoidectomy reached significance at 6 months after surgery (p = 0.04). The difference in nasal resistance before and after decongestant was compared to the change in nasal resistance after surgery. It demonstrated a strong correlation with the change in nasal resistance at 1 month (R = 0.985; p < 0.001), 3 months (R = 0.995; p < 0.001), 6 months (R = 0.98; p < 0.001) and 12 months (R = 0.98; p < 0.001) after surgery.

CONCLUSIONS: turbinate surgery in pediatric patients seems to be a safe procedure which objectively and subjectively improves the symptoms of children suffering from nasal obstruction.

PMID:35065329 | DOI:10.1016/j.ijporl.2022.111050