Tag: statistics

Nurse Educ Today. 2021 Aug 8;106:105081. doi: 10.1016/j.nedt.2021.105081. Online ahead of print.

ABSTRACT

BACKGROUND: Traditional teaching approaches are generally teacher-directed, and students are taught in a manner that is conducive to sitting and listening. Using three-dimensional (3D) holograms has many benefits in a higher education environment. However, relevant studies on this topic are very limited.

OBJECTIVES: To confirm the efficacy of 3D holograms for educational purposes to support the academic and practical performance of nursing students.

DESIGN: A randomly allocated pretest and posttest quasi-experimental design.

SETTINGS: Mackay Medical College in Taiwan.

PARTICIPANTS: Ninety third-year nursing students at a medical school in Taiwan.

METHODS: The data were collected between January and May 2020. The participants were randomly allocated to an intervention group and a control group. The learning method used in the intervention group was a combination of a 3D hologram learning module and classroom lectures. The control group was exposed to classroom lectures without 3D holograms. The tool included hardware (Windows Mixed Reality Helmet and VR Remote Control) and software (Health Assessment® and Patient First Patient Condition VR System®). The Health Assessment and Practice Knowledge Assessment tool and the Health Assessment and Practice Techniques Performance tool were used to evaluate the effects of the study intervention on the knowledge and techniques of the students.

RESULTS: A total of 79 participants (40 in the intervention group and 39 in the control group) were included in the final statistical analysis. The response rate was 88%. Statistically significant differences in knowledge and practical learning in the health assessment and practice course were observed between the intervention group and the control group (p < .05). The η² effect level was 0.134.

CONCLUSIONS: After attending classroom lectures, the students who also attended the 3D hologram-based laboratory courses had significantly higher knowledge and practical learning scores. This approach may be used as a complementary learning tool in higher education.

PMID:34418588 | DOI:10.1016/j.nedt.2021.105081

Adv Clin Exp Med. 2021 Aug 19. doi: 10.17219/acem/137558. Online ahead of print.

ABSTRACT

BACKGROUND: Frailty syndrome and cardiovascular diseases are closely related because of the shared physiological pathway of chronic, low-intensity inflammation. Frailty syndrome may be an adverse factor in the prognosis of patients with cardiovascular disease (CVD).

OBJECTIVES: To assess the influence of frailty syndrome on patient prognosis after coronary artery bypass grafting (CABG).

MATERIAL AND METHODS: The study was conducted at the Clinic of Cardiac Surgery in Katowice and involved 180 patients (56 women, 31.11%) over 60 years of age who qualified for CABG surgery. The Tilburg Frailty Indicator (TFI) was used to assess frailty syndrome and the The World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire was used to assess quality of life. Statistical analysis was performed using R software.

RESULTS: Frailty syndrome was diagnosed in 42 patients (23.3%), including 24 men and 18 women. More than 1/3 of patients had complications during or after surgery, including 34.6% of patients without frailty syndrome and 28.6% of patients with frailty features. All of the complications occurred in 57 (31.6%) patients. Early complications accounted for 89.5% of all events – 93.3% of which occurred in patients without frailty syndrome and 75.00% in patients with frailty features (p = 0.289).

CONCLUSIONS: More than 1/3 of patients experienced complications during or after the CABG procedure. Early postoperative complications accounted for almost all of the adverse events in patients with frailty. However, frailty syndrome was a poor predictor of rehospitalization.

PMID:34418334 | DOI:10.17219/acem/137558

Pharmacoepidemiol Drug Saf. 2021 Aug 21. doi: 10.1002/pds.5347. Online ahead of print.

ABSTRACT

PURPOSE: A laboratory-based acute kidney injury (AKI) electronic-alert (e-alert) system, with e-alerts sent to the UK Renal Registry (UKRR) and collated in a master patient index (MPI), has recently been implemented in England. The aim of this study was to determine the degree of correspondence between the UKRR-MPI and AKI International Classification Disease-10 (ICD-10) N17 coding in Hospital Episode Statistics (HES) and whether hospital N17 coding correlated with 30-day mortality and emergency re-admission after AKI.

METHODS: AKI e-alerts in people aged ≥18 years, collated in the UKRR-MPI during 2017, were linked to HES data to identify a hospitalised AKI population. Multivariable logistic regression was used to analyse associations between absence/presence of N17 codes and clinicodemographic features. Correlation of the percentage coded with N17 and 30-day mortality and emergency re-admission after AKI were calculated at hospital level.

RESULTS: In 2017, there were 301,540 adult episodes of hospitalised AKI in England. AKI severity was positively associated with coding in HES, with a high degree of inter-hospital variability – AKI stage 1 mean of 48.2% [SD 14.0], vs AKI stage 3 mean of 83.3% [SD 7.3]. N17 coding in HES depended on demographic features, especially age (18-29 years vs ≥85 years OR 0.22, 95% CI 0.21-0.23), as well as sex and ethnicity. There was no evidence of association between the proportion of episodes coded for AKI with short-term AKI outcomes.

CONCLUSION: Coding of AKI in HES is influenced by many factors that result in an underestimation of AKI. Using e-alerts to triangulate the true incidence of AKI could provide a better understanding of the factors that affect hospital coding, potentially leading to improved coding, patient care and pharmacoepidemiologic research.

PMID:34418198 | DOI:10.1002/pds.5347

Head Neck. 2021 Aug 21. doi: 10.1002/hed.26844. Online ahead of print.

ABSTRACT

BACKGROUND: This study aims to develop and validate a new classification system that better predicts combined risk of neurological and neurovascular complications following CBT surgery, crucial for treatment decision-making.

METHODS: Multinational retrospective cohort study with 199 consecutive cases. A cohort of 132 CBT cases was used to develop the new classification. To undertake external validation, assessment was made between the actual complication rate and predicted risk by the model on an independent cohort (n = 67).

RESULTS: Univariate analyses showed statistically significant associations between developing a complication and the following factors: craniocaudal dimension, volume, Shamblin classification, and Mehanna types. In the multivariate prognostic model, only Mehanna type remained as a significant risk predictor. The risk of developing complications increases with increasing Mehanna type.

CONCLUSIONS: We have developed and then validated a new classification and risk stratification system for CBTs, which demonstrated better prognostic power for the risk of developing neurovascular complications after surgery.

PMID:34418219 | DOI:10.1002/hed.26844

Nurs Crit Care. 2021 Aug 21. doi: 10.1111/nicc.12706. Online ahead of print.

ABSTRACT

BACKGROUND: Prototype analyses of well-being have identified central characteristics and prototypicality for New Zealand teachers, lawyers, adolescents, and work well-being of nurses. What has not yet been explored is the broad construct of well-being in intensive care nurses.

AIMS AND OBJECTIVES: To identify intensive care nurses’ conceptions of general well-being and investigate whether their general well-being is prototypically organized.

DESIGN: Prototype analysis.

METHODS: Three linked studies conceptualize well-being in this prototype analysis. In study 1, nurses reported features of well-being. Study 2 investigated the organization of these features. Study 3 sought confirmation of prototypical organization.

RESULTS: Sixty-five New Zealand nurses participated. For study 1 (n = 23), the most frequently reported elements of well-being included physical health (n = 26), work-life balance (n = 20), and personal relationships (n = 18). For study 2 (n = 25), the highest rated elements included mental and emotional health, [general] health, work-life balance, and love. Work-life balance, physical health, and personal relationships were in the top five most frequently reported and were rated in the top 12 most central. Overall, ratings of centrality and the number of times reported were positively correlated (r = 0.33, P < .005). For study 3 (n = 17), confirmatory analyses did not reach statistical significance (P = .15).

CONCLUSIONS: Physical health, work-life balance, and personal relationships are key characteristics of well-being for intensive care nurses. Mental, emotional, and general health and work-life balance were considered most important for well-being.

RELEVANCE TO CLINICAL PRACTICE: Physical health, work-life balance, and personal relationships are key characteristics of well-being for intensive care nurses. These characteristics of the broad construct of well-being are helpful in both defining and identifying conceptual models of well-being that may be used to inform the development and measurement of well-being programmes.

PMID:34418247 | DOI:10.1111/nicc.12706

Mol Ecol. 2021 Aug 21. doi: 10.1111/mec.16133. Online ahead of print.

ABSTRACT

Recent outbreaks of emerging and re-emerging viruses have shown that timely detection of novel arboviruses with epidemic potential is essential to mitigate human health risks. There are rising concerns that an emergent JEV genotype V (GV) is circulating in Asia, against which current vaccines may not be efficacious. To ascertain if JEV GV and other arboviruses are circulating in East Asia, we conducted next-generation sequencing on 260 pools of Culex tritaeniorhynchus and Culex bitaeniorhynchus mosquitoes (6,540 specimens) collected at Camp Humphreys, Republic of Korea (ROK) in 2018. Interrogation of our data revealed a highly abundant and diverse virosphere that contained sequences from 122 distinct virus species. Our statistical and hierarchical analysis uncovered correlates of potential health, virological, and ecological relevance. Furthermore, we obtained evidence that JEV GV was circulating in Pyeongtaek and, retrospectively, in Seoul in 2016 and place these findings within the context of human and fowl reservoir activity. Sequence-based analysis of JEV GV showed a divergent genotype that is the most distant from the GIII-derived live attenuated SA14-14-2 vaccine strain and indicated likely regions responsible for reduced antibody affinity. These results emphasize recent concerns of shifting JEV genotype in East Asia and highlight the critical need for a vaccine proven efficacious against this re-emergent virus. Together, our one-health approach to Culex viral metagenomics uncovered novel insights into virus ecology and human health.

PMID:34418188 | DOI:10.1111/mec.16133

Zoo Biol. 2021 Aug 21. doi: 10.1002/zoo.21647. Online ahead of print.

ABSTRACT

A variety of insects are fed to insectivorous animals; however, nutritional analyses are often limited to adult life stages. Four species of nymph and adult female and male cockroaches (Blaberus giganteus, Blaptica dubia, Blatta lateralis, and Gromphadorhina portentosa) were analyzed for moisture, crude protein (CP), acid detergent fiber (ADF), fat, ash, and mineral content. The small sample size of this study precluded statistical analyses, however comparatively, CP in adult B. lateralis and B. dubia was greater than the CP in nymphs of the same species. Adult and nymph B. dubia had the greatest CP (96.6% and 65.3%, respectively) compared to the other three species. Inversely, fat content in adult B. lateralis and B. dubia was lower than that of nymphs of the same species. All adults contained similar levels of ADF, yet adult B. giganteus had greater ADF than nymphs; conversely, B. lateralis and B. dubia adults had less ADF than nymphs. There were differences noted in mineral parameters among the four species and life stages. Adult B. giganteus had less Ca than G. portentosa, and the lowest Ca content of the four species of nymphs and adults analyzed. This study underscores the differences in nutrient content with respect to life stage and species in previously understudied cockroaches to improve nutrient intake in captive insectivores.

PMID:34418140 | DOI:10.1002/zoo.21647

Reprod Domest Anim. 2021 Aug 21. doi: 10.1111/rda.13995. Online ahead of print.

ABSTRACT

Artificial insemination (AI) with cryopreserved semen is an important tool to preserve endangered species, including European donkey breeds. Sperm vitrification is an alternative method to conventional freezing using high cooling rates and non-permeable cryoprotectant agents (CPAs). In donkeys, sperm vitrification was firstly developed in spheres by directly dropping the sperm (30 µl) into the liquid nitrogen. The vitrification media contained a combination of sucrose and bovine serum albumin as non-permeable CPAs and resulted in better sperm parameters after warming than extenders containing glycerol. Thereafter, sperm vitrification was optimized using an aseptic protocol, which consists of volumes up to 160 µl vitrified at 300 million sperm/ml using 0.25-ml straws with outer covers, obtaining similar sperm parameters as conventional freezing for total motility (52.7 ± 15.6% versus. 58.2 ± 16.1%), progressive motility (44.3 ± 15.0% versus. 44.7 ± 18.2%) and plasma membrane integrity (49.2 ± 11.2% versus. 55.4 ± 9.0%), respectively. In order to vitrify larger volumes of sperm, a procedure using 0.5-ml straws was evaluated; however, this methodology failed when compared to conventional freezing or other vitrification protocols, obtaining poor sperm quality after warming. Recently, a new methodology was developed for warming 0.25-ml straws in a water bath and after AI using the vitrified sperm, the uterine inflammatory response solved faster, and pregnancy rates were greater (22%) than frozen semen (10%) but not statistically different. In conclusion, all these findings confirm that sperm vitrification can be performed in donkeys as an alternative to conventional freezing for AI in jennies.

PMID:34418185 | DOI:10.1111/rda.13995

J Inherit Metab Dis. 2021 Aug 21. doi: 10.1002/jimd.12428. Online ahead of print.

ABSTRACT

BACKGROUND: Niemann-Pick disease type C (NPC) is a rare, genetic, progressive neurodegenerative disorder with high unmet medical need. We investigated the safety and efficacy of arimoclomol, which amplifies the heat shock response to target NPC protein misfolding and improve lysosomal function, in patients with NPC.

METHODS: In a 12-month, prospective, randomized, double-blind, placebo-controlled, phase 2/3 trial (ClinicalTrials.gov identifier: NCT02612129), patients (2-18 years) were randomized 2:1 to arimoclomol:placebo, stratified by miglustat use. Routine clinical care was maintained. Arimoclomol was administered orally three times daily. The primary endpoint was change in 5-domain NPC Clinical Severity Scale (NPCCSS) score from baseline to 12 months.

RESULTS: Fifty patients enrolled; 42 completed. At month 12, the mean progression from baseline in the 5-domain NPCCSS was 0.76 with arimoclomol versus 2.15 with placebo. A statistically significant treatment difference in favour of arimoclomol of -1.40 (95% confidence interval: -2.76, -0.03; p = 0.046) was observed, corresponding to a 65% reduction in annual disease progression. In the prespecified subgroup of patients receiving miglustat as routine care, arimoclomol resulted in stabilization of disease severity over 12 months with a treatment difference of -2.06 in favour of arimoclomol (p = 0.006). Adverse events occurred in 30/34 patients (88.2%) receiving arimoclomol and 12/16 (75.0%) receiving placebo. Fewer patients had serious adverse events with arimoclomol (5/34, 14.7%) versus placebo (5/16, 31.3%). Treatment-related serious adverse events (n = 2) included urticaria and angioedema.

CONCLUSIONS: Arimoclomol provided a significant and clinically meaningful treatment effect in NPC and was well tolerated. This article is protected by copyright. All rights reserved.

PMID:34418116 | DOI:10.1002/jimd.12428

Equine Vet J. 2021 Aug 21. doi: 10.1111/evj.13498. Online ahead of print.

ABSTRACT

BACKGROUND: Incisional complications are a common cause of morbidity following laparotomy. Although uncommon, acute abdominal dehiscence (AAD) is a potentially fatal post-operative complication. However few AAD cases are described in the literature.

OBJECTIVES: To describe common features of cases of AAD following ventral midline laparotomy, management and outcomes.

STUDY DESIGN: Retrospective case series.

METHODS: Hospital records of horses that underwent a ventral midline laparotomy at nine hospitals in the UK, Ireland and USA over a 10-year period (2009-2019) were reviewed. Data were collected for pre-, intra- and post-operative factors that were considered relevant. Descriptive statistical analysis was performed.

RESULTS: A total of 63 cases of AAD were identified. AAD occurred due to tearing of sutures through the linea alba or rupture of the body wall adjacent to the suture line in 46 horses (73%). AAD occurred at a median of 5 days (0.5-70 days) post-operatively and broodmares accounted for 25% of the cases (n=16). Surgical site infection developed prior to AAD in 28 horses (44%); leakage of peritoneal fluid occurred in 5% of horses prior to AAD being identified. Surgical repair was performed in 27 horses (43%), 10 (16%) were treated conservatively and 26 (41%) were euthanased immediately. Repair was most frequently performed using suture (n=14), wire (n=5) or a combination (n=5). Overall survival to hospital discharge was 39% (24/63). Where surgical repair was performed, 15 horses (56%) survived to hospital discharge; 9 horses (90%) managed conservatively survived to hospital discharge.

MAIN LIMITATIONS: Follow-up was not performed for all cases following hospital discharge and some data were incompletely recorded in hospital files.

CONCLUSIONS: Previously stated causative factors for AAD were not consistent features in the present study. Surgical site infection following laparotomy and pregnant or early post-partum mares may be important risk factors for AAD and warrant further investigation.

PMID:34418125 | DOI:10.1111/evj.13498