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Statistical Methods In Medical Research
... The minimum sample size required for exploratory factor analysis is 3-10 participants per item (Plichta et al, 2013). To conduct a confirmatory factor analysis, Munro (2005) recommended 20-30 items per factor (Armitage et al, 2008). Given that the original version of the scale considers 1 dimension, 100-150 samples were required for confirmatory factor analysis. ...
... To calculate this, the following equation was used: MDC%=(MDC÷mean)×100. The MDC% is acceptable if it is smaller than 30%, and an excellent MDC% value is assumed to be below 10% (Armitage et al, 2008). ...
... This finding supports the work of other studies (Terwee et al, 2007;Ahorsu et al, 2020;Lee et al, 2020;Harper et al, 2021). These findings agree with those of other studies in this area that analysed the psychological aspects of coronavirus (Bullinger et al, 1998;Terwee et al, 2007;Armitage et al, 2008;Mokkink et al, 2010;Sousa and Rojjanasrirat, 2011;Chen et al, 2013;Plichta et al, 2013;Samitsch, 2014;Polit and Yang, 2016;Martynova et al, 2018;Fitzgerald and Zavala-Rojas, 2020). According to the first studies, the results related to constructing validity also revealed that the single-factor construct has a proper fitting (Lee, 2020;Lee et al, 2020). ...
Background/Aims
Anxiety is the primary psychological symptom associated with COVID-19 that affects health. The aim of this study was to translate and validate the Coronavirus Anxiety Scale in Azerbaijani-Turkish adults.
Methods
In this cross-sectional study, the convenience sampling method recruited 193 people from the Tabriz population in 2022. After obtaining the developer's permission, the Coronavirus Anxiety Scale translation into Azerbaijani-Turkish was performed using the forward–backward approach. Face validity was tested with 10 people through interviewing and content validity with four experts. Construct validity was assessed using exploratory and confirmatory factor analyses. To assess reliability, internal consistency was assessed using Cronbach's alpha coefficient. In addition, the intraclass correlation coefficient, standard error measurement, and minimal detectable change were used to assess its relative and absolute consistency. To establish test–retest reliability, 30 people completed the scale twice at 2-week intervals.
Results
The exploratory factor analysis extracted a cumulative variance of 45.13%. Confirmatory factor analysis showed that the scale has a good fit of information. The confirmatory factor analysis produced a one-dimensional structure and all items were satisfactorily loaded onto this single factor (ie the physiological symptoms of anxiety related to coronavirus). Cronbach's alpha was 0.67, and the intraclass correlation coefficient was 0.924. Furthermore, the standard error measurement and minimal detectable change values were 0.65 and 1.82, respectively.
Conclusions
The Azerbaijani-Turkish version of the Coronavirus Anxiety Scale is a valid and reliable scale to assess COVID-19-related anxiety and and is clinically useful for screening.
Implications for practice
The translation and validation of the Coronavirus Anxiety Scale for Azerbaijani-Turkish adults offers significant implications for allied health professionals. First, it provides a culturally adapted, reliable tool to screen for dysfunctional anxiety related to COVID-19, enabling early identification of individuals at risk. This can guide targeted interventions such as counseling or psychiatric referrals, reducing the burden of untreated anxiety. Additionally, allied health professionals can use Coronavirus Anxiety Scale scores to assess the impact of anxiety on physical health and coping behaviors, facilitating holistic care strategies. The scale's application in clinical and community settings also supports mental health monitoring during ongoing or future pandemics, improving preparedness and response efforts.
... In the realm of medical research, the complexity of human factors and their intricate interactions within the natural environment poses formidable challenges when it comes to accurately predicting health outcomes and establishing clear cause-and-effect relationships. [1] Consequently, scientists across various health disciplines encounter significant hurdles when attempting to connect positive health outcomes with specific protective or risk factors. Furthermore, the majority of observational and experimental methods are inherently flawed, susceptible to random errors, human biases, and mistakes. ...
... These probabilities enable healthcare professionals, researchers, and policymakers to make well-informed judgments and predictions within the field of medicine. [1,4] Let us consider this scenario in the area of medical research: Investigators are engaged in a study aimed at determining the efficacy of a novel drug in the treatment of a specific disease. In the initial stages of most clinical research endeavors, a question is formulated. ...
... Such a rejection implies that the observed effect or association is unlikely to have arisen solely by chance. [1,2,4] In simpler terms, if the P value in the given example is 0.04, it means that there is a 4% chance of observing the observed data or more extreme outcomes if there were truly no efficacy difference between the groups being compared. This leads to the rejection of the null hypothesis (drug efficacy is similar to placebo) and the acceptance of the research hypothesis (drug efficacy is better than placebo), indicating that the difference in drug efficacy is unlikely to be attributed to random chance alone. ...
Medical research plays a crucial role in advancing our understanding of various aspects related to health, including disease, risk factors, and patient management. However, the interpretation of research data becomes intricate when considering the notions of statistical significance and clinical relevance. It is not uncommon to interpret findings that demonstrate statistical significance as indicative of clinical relevance. To explain it in a more straightforward way, statistical significance, ascertained through statistical tests using the P value, indicates that an observed difference or association is improbable to occur by chance alone. Conversely, clinical relevance focuses on the practical implications of a finding in real-world contexts and determines whether an observed difference or relationship holds practical meaning. Recently, there have been issues and debates surrounding the idea of statistical significance as certain experts argue that its mathematical representation can be misleading when it comes to practical understanding. These experts propose the inclusion of additional measures like effect sizes and confidence intervals. A sound comprehension of both statistical and clinical dimensions is vital in order to ensure precise interpretation of data and facilitate well-informed decision-making in the practice of medicine. By doing so, it positively influences the health of individuals and communities.
... The suggested equivalence procedures for simple linear regressions are demonstrated with the data in Table 11.4 of [2]. The data include the age (X: years) and pulmonary vital capacity (Y: liters) of workers in the cadmium industry who were exposed to cadmium fumes differently. ...
... The second group of the data in [2] involves 28 workers with less than ten years of cadmium exposure and the related summary statistics are N 2 = 28, Ȳ 2 = 4.4718, X 2 = 37.7857, ̂2 X2 = 84.5448, and ̂2 2 = 0.2925. ...
... The second step utilizes a simulation study to evaluate the accuracy of exact and approximate power formulas in attaining the estimated power with the estimated sample sizes in the first step. For ease of comparison, the numerical example in [2], regarding pulmonary vital capacity for workers never exposed to cadmium and those with less than ten years of cadmium exposure, is utilized as the exemplifying framework. Specifically, the regression coefficients and variance components of the two exposure groups are Tables 1-4. ...
Traditional comparisons of slope coefficients and mean responses in linear regression analysis mainly focus on the significant difference rather than the practical equivalence. There has been a growing awareness and demand for appropriate techniques for assessing similarity and comparability in applied research. Because of the simplicity of the two one-sided tests of mean equivalence, this study describes the corresponding extensions for appraising slope coefficients and mean responses in one and two linear regression lines. The equivalence tests can help assess the negligible trends and similar responses in a single regression line and evaluate the unimportant interaction-moderation effects and comparable simple effects between two linear regression lines. Exact power and sample size formulas are also derived for design planning, and the proposed procedures have the distinct property of accommodating the random properties of both the response and predictor variables. Their usage and validity are illustrated and justified through numerical illustrations and simulation assessments.
... In this design, the researcher can evaluate any subject or phenomenon by using content analysis and semiotic analysis methods on secondary data. [20,21] In the descriptive scanning model, the researcher compiles information about the current situation on the relevant subject and enables the situation to be described from various perspectives. [22] In the study, resources and studies on artificial intelligence applications-a relatively new phenomenon-as well as the field of outpatient treatment for COPD and asthma were looked at, compiled, and then presented with an embedded pattern. ...
... In SWOT analysis, the researcher makes use of sources such as interviews, surveys and literature studies on the subject when making judgments about a phenomenon or content. [20][21][22] In the research, SWOT analysis was analyzed using qualitative methods and semiotic analysis methods of literature studies that went through the referee process and received approval. After semiotic analysis, scientific articles and findings were classified and then evaluated according to SWOT analysis (Fig. 1). ...
... Validity of SWOT analysis is discussed and accepted in literature as a semi-quantitative approach. [20][21][22] Quantitative and qualitative data are needed to make a judgment about a phenomenon or issue. Although quantitative data includes a reliability and validity method within itself, this is a bit difficult in qualitative or semi-qualitative methods. ...
This research aimed to examine the effectiveness of artificial intelligence applications in asthma and chronic obstructive pulmonary disease (COPD) outpatient treatment support in terms of patient health and public costs. The data obtained in the research using semiotic analysis, content analysis and trend analysis methods were analyzed with strengths, weakness, opportunities, threats (SWOT) analysis. In this context, 18 studies related to asthma, COPD and artificial intelligence were evaluated. The strengths of artificial intelligence applications in asthma and COPD outpatient treatment stand out as early diagnosis, access to more patients and reduced costs. The points that stand out among the weaknesses are the acceptance and use of technology and vulnerabilities related to artificial intelligence. Opportunities arise in developing differential diagnoses of asthma and COPD and in examining prognoses for the diseases more effectively. Malicious use, commercial data leaks and data security issues stand out among the threats. Although artificial intelligence applications provide great convenience in the outpatient treatment process for asthma and COPD diseases, precautions must be taken on a global scale and with the participation of international organizations against weaknesses and threats. In addition, there is an urgent need for accreditation for the practices to be carried out in this regard.
... Z-scores was calculated for each of the anthropometric values for the whole sample. The use of Z-scores permitted the comparison of the risk magnitude per 1 standard deviation (SD) change in the anthropometry, as well as sex-stratification using Fisher's Yates transformation [24]. The predictive ability of the anthropometric measurements for the cardiometabolic disorders were compared by the area under the curve (AUC) receiver-operating characteristic (ROC) curve and the 95% confidence interval (CIs) using the trapezoidal rule [25]. ...
... Data was analysed for 1921 participants aged 32 years, women 1284 (66.8%) aged 30 (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) and men 637 (33.2%) aged 38 years. The prevalence of BW was significantly higher in the general population when compared to the Fulbe and Mbororo groups for men and women. ...
Background: Whether any of the anthropometric indices are associated with cardiometabolic outcomes in indigenous Fulani African populations is not known. This study assesses anthropometric indices in predicting cardiometabolic outcomes in indigenous and non-indigenous populations.
... Оценку нормальности полученных распределений осуществляли по критерию Колмогорова-Смирнова для нормального распределения с поправкой значимости Лиллиефорса. Поскольку большинство распределений переменных были отличны от нормальных, то для анализа взаимосвязи переменных использовался метод ранговых корреляций Спирмена [11]. Для оценки внутренней согласованности опросника использовалась оценка альфы Кронбаха. ...
... В дальнейшем их ответы попарно сопоставлялись с определением взвешенного коэффициента каппа Коэна (квадратичные весы). Степень согласия между рейтерами определялась по градации Landis и Koc: каппа < 0 -низкое, каппа = 0÷0,19 -незначительное, каппа = 0,2÷0,4 -слабое, каппа = 0,4÷0,6 -умеренное, каппа = 0,6÷0,8 -значительное, каппа = 0,8 ÷ 1,00 -практически полное [11]. ...
The aim of the study is to adapt and validate the Russian version of the Clinical Assessment Interview for Negative Symptoms (CAINS). Material and methods . From 2018 to 2024, 89 people were examined: 42 men (47.2%) and 47 women (52.8%), average age 37±9.8 years. Among them, 82 patients (92.1%) were diagnosed with F20.0 according to ICD-10, 5 patients (5.6%) with F21, and 2 patients (2.3%) with F23.1. The mean duration of the mental disorder was 18 [1-42] years, with an average number of hospitalizations of 12 [1-28] times. The CAINS manual and questionnaire text, translated into Russian by a group of young psychiatrists from the RSP YPC, were utilized for assessment. Results : The Cronbach’s alpha for the total score of the questionnaire was 0.91. Convergent validity was demonstrated by a significant positive correlation between CAINS scores and the Marder PANSS factor. Confirmatory factor analysis indicated the preservation of the questionnaire’s two-factor model, explaining 55.8% of the total variance. Discriminant validity was evidenced by the more frequent absence of correlations between CAINS scores and positive and general psychopathological PANSS ratings. Inter-rater reliability was established by a sufficient level of agreement, with Cohen’s kappa coefficient, among independent raters for the majority (91%) of clinical assessments using the CAINS questionnaire. Conclusion : The obtained results demonstrate that the Russian adaptation of the Clinical Assessment Interview for Negative Symptoms (CAINS) is a valid and effective psychometric clinical interview. It can be utilized for both clinical research and everyday clinical practice when working with patients suffering from psychotic disorders within the schizophrenia spectrum.
... However, many factors affect the effect size, including the actual underlying treatment effect, biases, and other factors such as sample size, magnitude of treatment effect, variability, precision (weight of evidence), or confounding variables. 19 The impact of these factors on the effect size estimates is complex, impossible to predict, and can vary non-linearlydifferent factors can influence the effect size estimate in different directions. Therefore, it might not be surprising that the presumed linear relationship across GRADE's categories of CoE doesn't hold true. ...
... This may be a good cognitive strategy because, as stated, GRADE cannot differentiate among the magnitude of treatment effects 10,11 likely due to the nonlinear nature of all factors that unpredictably affect treatment effect size. 19 Adhering to a simple linear relationship between the probability of a true estimate of treatment effects and CoE seems easier to convert into believing that high CoE evidence is epistemologically closer to the 'truth' than the lower CoE. When people perceive that findings are true they are more likely to act in accordance with those believed information compared to disbelieved information. ...
Rationale, Aims, and Objectives
The previous studies demonstrated that the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, a leading method for evaluating the certainty (quality) of scientific evidence (CoE), cannot reliably differentiate between various levels of CoE when the objective is to accurately assess the magnitude of the treatment effect. An estimated effect size is a function of multiple factors, including the true underlying treatment effect, biases, and other nonlinear factors that affect the estimate in different directions. We postulate that non‐weighted, simple linear tallying can provide more accurate estimates of the probability of a true estimate of treatment effects as a function of CoE.
Methods
We reasoned that stable treatment effect estimates over time indicate truthfulness. We compared odds ratios (ORs) from meta‐analyses (MAs) before and after updates, hypothesising that a ratio of odds ratios (ROR) equal to 1 will be more commonly observed in higher versus lower CoE. We used a subset of a previously analysed data set consisting of 82 Cochrane pairs of MAs in which CoE has not changed with the updated MA. If the linear model is valid, we would expect a decrease in the number of ROR = 1 cases as we move from high to moderate, low, and very low CoE.
Results
We found a linear relationship between the probability of a potentially ‘true’ estimate of treatment effects as a function of CoE (assuming a 10% ROR error margin) ( R ² = 1; p = 0.001). The probability of potentially ‘true’ estimates decreases by 21% (95% CI: 18%–24%) for each drop in the rating of CoE. A linear relationship with a 5% ROR error margin was less clear, likely due to a smaller sample size. Still, higher CoE showed a significantly greater probability of ‘true’ effects (53%) compared to non‐high (i.e., moderate, low, or very low) CoE (25%); p = 0.032.
Conclusion
This study confirmed linear relationship between CoE and the probability of potentially ‘true’ estimates. We found that the probability of potentially “true” estimates decreases by about 20% for each drop in CoE (from about 80% for high to 55% for moderate to 35% to low and 15% to very low CoE).
... This is estimation is done through nonparametric, semi-parametric and parametric methods. For non-parametric lifetable method fuller details of this application can be found in the books by [54][55][56]. A text by [50,53,[57][58][59][60] provides detailed information on the derivations of the Product limit or Kaplan and Meier non parametric estimator. ...
... Another important non parametric estimator is Nelson-Aalen for its derivation can be found in the texts by [61][62][63]. Formulation of the hypothesis testing procedures can be found in books by [54,64]. Log -rank test procedures can be found in work of [65][66][67][68]. ...
Background: Miscarriage, also known as spontaneous abortion, is a significant adverse outcome of pregnancy. The risk factors associated with the transition from a normal pregnancy to a complete miscarriage before 28 weeks of gestational age have not been exhaustively established. Use of logistic regression to assess the factors associated with spontaneous abortion excludes the longitudinal and incompleteness aspects of miscarriage data. However, miscarriage is dynamical process where time until it occurs may be of interest. Objectives: This paper modeled the risk factors associated with miscarriage using survival analysis, estimated and compared survivorship of levels of categorized variables, fitted proportional hazards and accelerated failure time models and compared their inferential capacity and their efficacy in identifying risk factors. Methods: A retrospective study was conducted for pregnant women who were enrolled for antenatal care in Kakamega County General Teaching and Referral Hospital (KCGTRH) in Kakamega county, western Kenya. Pregnant women with recognized pregnancy and enrolled in the pre-natal care during the period from 1 January, 2019 up to 31 October, 2020 was recruited into the study. For descriptive analysis and estimation of survival functions, the study used Kaplan-Meier (K-M) and chi-squared test for independence. Comparison of survivorships in categorized variables was done using Kaplan-Meier curves and log-rank test. The Cox proportional hazards (PH) model and parametric models were used to analyze miscarriage data. All analysis were carried out using R software and SPSSv20. The level of significance was 5%. Results: Of the total sample 248 mothers (4.1%) miscarried, while 5729 (95.9%) were censored. The significant factors identified by log rank test were ethnicity (P=.000), levels of education (P=.048), place of residence (P=.000), employment status (P=.004), malaria status (P=.000) and UTI status (P=.000). The covariates in categorized form found significant by log rank were number of previous stillbirths (P=.000) and number of ANC visits (P=.000). The factors ethnicity, place of residence, malaria status, number of previous miscarriages, number of previous stillbirths and number of ANC visits were identified as the risk factors associated with miscarriages using cox model, parametric proportional hazards model and accelerated failure time models. The study found equivalent hazard ratios for among Cox model, parametric proportional hazards (PH) models and accelerated failure time (AFT) models. Conclusion: From the findings of this study it can be concluded that the Gompertz proportional hazards (PH) regression model demonstrates a more favorable level of conformity to the data in comparison to the Cox model and accelerated failure time (AFT) models and there is association between certain explanatory variables and the time to miscarriages. In this paper survival analysis was used to analyze miscarriage data.
... Those who had an AIM score of 3 or higher in gait ability at discharge were defined as the good recovery group, whereas those who remained at an AIM score of 2 or lower in gait ability at discharge were defined as the poor recovery group. Repeated-measures two-way ANOVA (28) was performed for differences between the group (good recovery group and poor recovery group) and gait phase (1stDS, SS, 2ndDS, and Sw) in muscle activity (rectus femoris, biceps femoris, soleus, and tibialis anterior on the paretic side) during walking. If the interaction between the two factors was significant, the Bonferroni method was used to analyze significant differences between the groups in each gait phase. ...
... The relationship between temporal EMG changes during walking and improvement of gait ability was examined. Repeated-measures two-way ANOVA (28) was performed for differences between the group (good recovery group and poor recovery group) and time (baseline and second assessments) in muscle activity during walking. The statistical analysis was performed with SPSS version 24. ...
Introduction
A knee-ankle-foot orthosis (KAFO) prevents knee buckling during walking and enables gait training for acute hemiplegic stroke patients with severe gait disturbances. Although the goal of gait training with a KAFO is to improve gait ability, that is, to acquire walking with an ankle-foot orthosis (AFO), it is not clear how gait training with a KAFO contributes to improving gait ability. Therefore, this study aimed to investigate the relationship between muscle activities during walking with a KAFO and the improvement of gait ability in hemiplegic stroke patients with severe gait disturbance.
Methods
A prospective cohort study was conducted. Fifty acute hemiplegic stroke patients who could not walk with an AFO participated. Muscle activities of the paretic rectus femoris, biceps femoris, tibialis anterior, and soleus were assessed with surface electromyogram during walking with a KAFO. Electromyograms were assessed at the beginning of gait training and at the time the Ambulation Independence Measure score improved by 3 or higher, or discharge.
Results
Even in patients with complete hemiplegia, paretic rectus femoris, biceps femoris, and soleus showed periodic muscle activity during walking with a KAFO. Twenty-three patients improved to an Ambulation Independence Measure score of 3 or higher and were able to walk with an AFO (good recovery group). At the beginning of gait training, paretic rectus femoris muscle activity during the first double-limb support phase was significantly higher in the good recovery group than in the poor recovery group. The rectus femoris muscle activity significantly increased from before to after acute rehabilitation, which consisted mainly of gait training with a KAFO.
Discussion
For acute hemiplegic stroke patients with severe disturbance, the induction and enhancement of paretic quadriceps muscle activity during walking with a KAFO play an important role in acquiring walking with an AFO.
... Statistics were used to compare the results with those attained by the previously mentioned methods [19,39]. There were no significant differences observed using the student's t-test and F-test at the 95% confidence level [55], showing that the proposed method for analyzing the tested substance in its pharmaceutical dose form is accurate and precise, as indicated in Table 6. Table 5 Greenness estimation of the developed and reference methods ...
It was the first time that a spectrofluorimetric approach for the simultaneous analysis of remdesivir and levodropropizine had been achieved. This study aims to propose an accurate and sensitive second-derivative synchronous spectrofluorimetric approach for measurement of remdesivir and levodropropizine in different matrices simultaneously without the need for prior separation. The proposed approach measured the synchronous fluorescence intensity of pharmaceuticals under research at a constant wavelength difference (Δλ) = 130 nm. For the quantitative analysis of remdesivir and levodropropizine, the peak amplitudes of the second derivative were measured at 390 and 399 nm, respectively. The procedure was completely validated and demonstrated outstanding linearity in the concentration ranges of 5–150 ng mL− 1 and 10–600 ng mL− 1 for remdesivir and levodropropizine, respectively. The new method was used to quantitatively analyze both drugs in their pharmaceutical dosage form, synthetically formulated mixture and spiked human plasma. A statistical comparison of the results with other published analytical techniques revealed no significant difference. The validation of the procedure was successfully completed in compliance with ICH guidelines. In terms of greenness, EcoScale and GAPI greenness tools were used to evaluate the analytical methodology.
... Associations were evaluated using Spearman's correlation coefficient ρ (Rho). Logistic regression, both bivariate and multivariate (stepwise method), was employed to assess the influence of multiple factors on the likelihood of lower self-confidence of GPs for prescribing antidiabetic medications with CV benefits [35,36]. The high level of confidence was considered if the GPs chose the Likert grades 4 and 5, and the low level of confidence corresponded with points 1, 2 and 3 on the Likert Scale. ...
Background
The treatment approaches of type 2 diabetes (T2D) are being transformed, due to the availability of novel antidiabetic medications, sodium-glucose co-transporter 2 inhibitors (SGLT2ins), and glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Despite their proven beneficial effects, recent research points to their insufficient prescription. This study aimed to reveal the prescription rates of SGLT2ins and GLP-1 RAs among general practitioners (GPs) in Croatia and to examine factors associated with their low self-confidence in prescribing them.
Methods
A self-designed survey questionnaire was used and delivered to the GPs’ e-mail addresses in digital format. The data on the number of individuals diagnosed with T2D and prescribed new antidiabetic medications were checked by the respondents in their electronic database. Factors associated with lower GPs` self-confidence in prescribing SGLT2ins and GLP-1 RAs were assessed by bivariate and multivariate logistic regression analyses.
Results
The study included 168 GPs (66.1% women; 49.4% specialists in family medicine) and a cohort of 23,036 individuals with T2D. The prescription rates of SGLT2ins and GLP-1 RAs were 21.0% and 14.4%, respectively. Specialists stated a higher level of self-confidence in prescribing these medications, compared to other respondents. In the multivariate models, a factor that was shown to reduce the likelihood of low GPs` self-confidence in prescribing SGLT2ins was “familiarity with the side effects of these medications” (OR = 0.03), while factors that increased this likelihood were: “being familiar with GLP-1 RAs` side effects” (OR = 4.8), “an insufficient knowledge and experience of GPs in adjusting two target outcome measures to the same patient” (OR = 2.2), and “the GPs` assumption that the new guidelines` protocol which separates two target outcome measures is useful only in some cases but not in all” (OR = 5.4). Regarding GLP-1 RAs, only one factor – “familiarity of GPs with GLP-1 RAs side effects”, was shown to reduce the probability of GPs` low self-confidence in prescribing this group of medications (OR = 0.27).
Conclusion
It is of the utmost importance to identify barriers the GPs face when prescribing these medications, as well as to suggest potential strategies to optimize their prescription.
... Using automated SPSS software (SAS Institute, Cary, NC), the data was statistically assessed. A one-way ANOVA (Analysis of Variance) test with Duncan's multiple range tests and p significance between different groups was used to evaluate the impact of various treatments [23]. ...
Background
Cirrhosis is considered as a severe liver disease that causes partial liver damage as well as total liver destruction; It remains a significant health concern. Sugar cane juice is a particularly beneficial beverage, and its waste products are crucial for treating numerous illnesses. As compared to traditional treatments, zinc-doped carbon quantum dots (Zn/CQDs) are easy-to-prepare, economically invested, high nutritive value and environmentally safe substance.
Materials & methods
This study investigated the hepatoprotective effects of zinc-doped carbon quantum dots (Zn/CQDs) against carbon tetrachloride (CCl₄)-induced liver injury in male Wistar albino rats. Zn/CQDs were synthesized using a microwave-assisted method and characterized using FTIR and XRD techniques. Meanwhile, a liver Cirrhosis model induced by carbon tetrachloride (CCl4) was utilized to determine the inhibitory effects of sugar cane juice mixed with Zn/CQDs against liver Cirrhosis. Biochemical parameters, including AST, ALT, and uric acid, were measured to assess liver function. Histopathological analysis was performed to examine liver tissue damage.
Results
In this study, Zn/CQDs were extended from 1.62 to 5.45 nm. The results demonstrated that Zn/CQDs exhibited significant hepatoprotective effects by reducing liver enzyme levels and mitigating histopathological changes. However, the study also highlighted the need for further optimization of the used vehicle delivery method, such as sugarcane juice, which is showed a marginal impact on liver function. Sugar cane juice with Zn/CQDs decreased aspartate amino transferase levels (AST) and improved the uric acid concentration. It means a protection from the toxins effect by controlling the liver enzyme levels; but also, elevated levels of alanine aminotransferase (ALT) indicate ongoing liver injury. Overall, this study provides future insights into the potential of sugar cane juice with Zn/CQDs as a high nutritive value additive to drinks and food; it is investigated for plants waste as a novel green therapeutic strategy for liver diseases. Further research is necessary to explore the underlying mechanisms of action and to optimize their formulation for clinical applications.
Conclusion
Overall, this study provides promising insights into the potential of Zn/CQDs as a novel green therapeutic strategy for liver diseases.
... If an I 2 statistic of studies is between 0 and 50%, it is considered as low heterogeneity, an I 2 statistic of 50-75% is considered to have moderate heterogeneity, and if the I 2 statistic is larger than 75%, a high degree of heterogeneity are considered in these trials. Usually, it is considered that there is no important heterogeneity if the value of I 2 across the studies is less than 50% [33,[36][37][38]. Meta-regression was done by taking sample size, study country, study design, and year of publication as a moderator. ...
Introduction
Cesarean section is one of the most common obstetric procedures performed worldwide under spinal anesthesia which is a commonly practiced rapid, simple, and safe method. Vomiting and nausea are frequent side effects of many surgical procedures. However, with cesarean sections performed under regional anesthesia, this issue occurs even more frequently. The existing evidence regarding the prevalence and associated factors of intraoperative nausea and vomiting is inconsistent. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence and associated factors of intraoperative nausea and vomiting.
Methods
This is a systematic review and meta-analysis study that was done based on studies published within the last 10 years on the prevalence and associated factors of intraoperative nausea and vomiting during cesarean section under regional anesthesia. After PubMed, Google Scholar, HINAR, Scopus, Science Direct, and grey literature extensive search for primary studies, their quality was assessed with JBI and modified Newcastle Ottawa appraisal assessment tool and data was extracted. STATAMP version 17.0 was used for all possible analyses of the study.
Results
Twenty-nine studies were met the inclusion criteria of this systematic review and meta-analysis. However, only 21 studies were included by excluding eight studies due to inappropriate method & outcomes and language other than English. The pooled prevalence of intraoperative nausea and vomiting was 36% (95% CI- 31%, 41%) with heterogeneity (I²-93.1%). Premedicated with metoclopramide, uterus exteriorization, motion sickness, preeclampsia, and intraoperative propofol were associated with the prevalence of intraoperative nausea and vomiting significantly.
Conclusion
The pooled prevalence of intraoperative nausea and vomiting during cesarean section under regional anesthesia was high (36%) which needs more strategies for prevention.
... ANOVA testing and Bonferroni pairwise comparisons were used for statistical evaluation. P values less than 0.05, were regarded as significant; when they were less than 0.001, they were considered extremely significant (Armitage et al., 2008). ...
Pharmacological research using Lipopolysaccharide (LPS) is a reliable model of acute lung injury. This study aims to compare the therapeutic efficacy of selenium nanoparticles (SeNPs) and bone-marrow-derived mesenchymal stem cells (BMSCs) against lung damage generated by lipopolysaccharides. Fifty adult male albino rats were employed and divided into 5 groups (control group, shame control group, LPS-treated group, SeNPs-treated group, and BMSCs-treated group). Histological and immunohistochemical staining for tumor necrosis factor-alpha (TNFα), Interleukin 6 (IL-6), and Caspase 3 were carried out and followed by histomorphometric analysis. Histochemical measurements of the oxidative-antioxidative markers, superoxide dismutase (SOD), glutathione peroxidase (GPx), and malondialdehyde (MDA) were performed in addition to western blotting analysis to detect the antioxidative activity of Nrf2. LPS-treated group showed distorted pulmonary architecture with the upsurge in the caspase-3, TNF-α, IL-6, and MDA along with a significant decrease in GPx, SOD, and Nrf2 in the lung homogenates. These findings were relatively improved after adding SeNPs and stem cells. On comparing BMSCs and SeNPs treated group, there was a significant decrease in caspase-3, TNF-α, and IL-6 with BMSCs treatment relative to SeNPs. Treatment with selenium nanoparticles and BMSCs has improved pulmonary changes through their antioxidant and anti-inflammatory role. The level of pulmonary regeneration exerted by BMSCs is better than selenium nanoparticles so the BMSCs may be given preference for a particular course of treatment.
... MEM spectral analysis. We assume that the time series x(t) (where t is time) is composed of systematic and fluctuating parts [23]: ...
We have carried out spectral analysis of coronavirus disease 2019 (COVID-19) notifications in all 47 prefectures in Japan. The results confirm that the power spectral densities (PSDs) of the data from each prefecture show exponential characteristics, which are universally observed in the PSDs of time series generated by nonlinear dynamical systems, such as the susceptible/exposed/infectious/recovered (SEIR) epidemic model. The exponential gradient increases with the population size. For all prefectures, many spectral lines observed in each PSD can be fully assigned to a fundamental mode and its harmonics and subharmonics, or linear combinations of a few fundamental periods, suggesting that the COVID-19 data are substantially noise-free. For prefectures with large population sizes, PSD patterns obtained from segment time series behave in response to the introduction of public and workplace vaccination programs as predicted by theoretical studies based on the SEIR model. The meaning of the relationship between the exponential gradient and the population size is discussed.
... Furthermore, the ERS [2] and NICE [8] recommended F ENO cut-off limits for asthma diagnosis in children (25 and 35 ppb, respectively) were introduced as categorical variables (</⩾25 and </⩾35 ppb, respectively) for calculating positive percent agreement (PPA), negative percent agreement (NPA) and overall agreement between the methods. Internal consistency of repeated measurements for each instrument was assessed using intraclass correlation coefficients (ICCs) [27]. The success rate to achieve valid measurements was calculated and, among valid measurements, the efficiency on each device to achieve acceptable measurements was evaluated. ...
Recent guidelines for the diagnosis of asthma in school children recommend the measurement of exhaled nitric oxide (FeNO) as part of the diagnostic algorithm. However, implementation may be hampered by the lack of FeNO devices that are affordable and usable in all health care settings. We aimed to compare the performance of two portable FeNO devices (Evernoa (EVE) and NObreath® (NOB)) to a stationary gold standard device (CLD 88 sp) in children.
One hundred and six (106) children aged 6–17 years under investigation or monitoring for asthma underwent FeNO measurements using the three devices in randomised order. All devices showed high repeatability across a wide FeNO range (2.5–191.9 ppb). Median FeNO levels were significantly lower with the portable devices (20.8 ppb [interquartile range: 9.5–43.5], 16 ppb [9–36], 22.8 ppb [13.2–55.2] for NOB, EVE and CLD, respectively (p<0.0001). Despite the proportional bias (−20% (NOB) and −40% (EVE), both devices demonstrated good overall agreement with CLD (>94%) at a cut-off level 25 ppb but lower agreement for the cut-off 35ppb. EVE required a greater number of attempts compared to NOB and CLD to achieve 2 valid measurements.
Both portable devices showed limited interchangeability with the gold standard, making them less applicable for research and disease monitoring purposes. However, good overall agreement at the ERS cut-off level suggests potential as a simple and convenient screening tool in clinical settings for initial asthma diagnosis.
... To compare the data, the recorded values were expressed as means and standard deviation (Mean ± SD). The minimal level of significance was identified at p < 0.05 [12]. Table 1 illustrates that pretreated Patients with GERD showed heartburn, epigastric pain, and significant decrease in LES pressure, residual pressure, relaxation percentage, pH, serum gastrin and mean melatonin level and a significant increase in relaxation duration and basal acid output (BAO) relative to control group. ...
Background: Gastro-Esophageal Reflux Disease (GERD) defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Many drugs are used for the treatment of GERD such as omeprazole (a proton pump inhibitor) which is a widely used antiulcer drug demonstrated to protect against esophageal mucosal injury. Melatonin has been found to protect the gastrointestinal mucosa from oxidative damage caused by reactive oxygen species in different experimental ulcer models. The aim of this study is to evaluate the role of exogenous melatonin in the treatment of reflux disease in humans either alone or in combination with omeprazole therapy. Methods: 36 persons were divided into 4 groups (control subjects, patients with reflux disease treated with melatonin alone, omeprazole alone and a combination of melatonin and omeprazole for 4 and 8 weeks) Each group consisted of 9 persons. Persons were subjected to thorough history taking, clinical examination, and investigations including laboratory, endoscopic, record of esophageal motility, pH-metry, basal acid output and serum gastrin. Results: Melatonin has a role in the improvement of Gastro-esophageal reflux disease when used alone or in combination with omeprazole. Meanwhile, omeprazole alone is better used in the treatment of GERD than melatonin alone.
... Data for multiple variable comparisons were analyzed by one-way analysis of variance (ANOVA). For the comparison of significance between groups, Duncan's test was used as a post hoc test according to the statistical package program [22]. ...
... Since the outcome is a probability, the dependent variable is bounded between 0 and 1. In logistic regression, a logit transformation (Armitage et al. 2008) is applied to the odds ratio, i.e., the probability of success divided by the probability of failure. The logistic function (Eq. ...
Machine learning for financial risk prediction has garnered substantial interest in recent decades. However, the class imbalance problem and the dilemma of accuracy gain by loss interpretability have yet to be widely studied. Symbolic classifiers have emerged as a promising solution for forecasting banking failures and estimating creditworthiness as it addresses class imbalance while maintaining both accuracy and interpretability. This paper aims to evaluate the effectiveness of REMED, a symbolic classifier, in the context of financial risk management, and focuses on its ability to handle class imbalance and provide interpretable decision rules. Through empirical analysis of a real-world imbalanced financial dataset from the Federal Deposit Insurance Corporation, we demonstrate that REMED effectively handles class imbalance, improving performance accuracy metrics while ensuring interpretability through a concise and easily understandable rule system. A comparative analysis is conducted against two well-known rule-generating approaches, J48 and JRip. The findings suggest that, with further development and validation, REMED can be implemented as a competitive approach to improve predictive accuracy on imbalanced financial datasets without compromising model interpretability.
... These characteristics may make patients more vulnerable to subsequent SREs, although the poorer prognosis might prevent the development of a subsequent SRE. 34 For better clinical application, future analysis should be applied to consider death as a competing risk. 35 In the meantime, personalized follow-up plans could be considered for patients at higher risk of developing subsequent SREs. ...
Aims
Advances in treatment have extended the life expectancy of patients with metastatic bone disease (MBD). Patients could experience more skeletal-related events (SREs) as a result of this progress. Those who have already experienced a SRE could encounter another local management for a subsequent SRE, which is not part of the treatment for the initial SRE. However, there is a noted gap in research on the rate and characteristics of subsequent SREs requiring further localized treatment, obligating clinicians to extrapolate from experiences with initial SREs when confronting subsequent ones. This study aimed to investigate the proportion of MBD patients developing subsequent SREs requiring local treatment, examine if there are prognostic differences at the initial treatment between those with single versus subsequent SREs, and determine if clinical, oncological, and prognostic features differ between initial and subsequent SRE treatments.
Methods
This retrospective study included 3,814 adult patients who received local treatment – surgery and/or radiotherapy – for bone metastasis between 1 January 2010 and 31 December 2019. All included patients had at least one SRE requiring local treatment. A subsequent SRE was defined as a second SRE requiring local treatment. Clinical, oncological, and prognostic features were compared between single SREs and subsequent SREs using Mann-Whitney U test, Fisher’s exact test, and Kaplan–Meier curve.
Results
Of the 3,814 patients with SREs, 3,159 (83%) patients had a single SRE and 655 (17%) patients developed a subsequent SRE. Patients who developed subsequent SREs generally had characteristics that favoured longer survival, such as higher BMI, higher albumin levels, fewer comorbidities, or lower neutrophil count. Once the patient got to the point of subsequent SRE, their clinical and oncological characteristics and one-year survival (28%) were not as good as those with only a single SRE (35%; p < 0.001), indicating that clinicians’ experiences when treating the initial SRE are not similar when treating a subsequent SRE.
Conclusion
This study found that 17% of patients required treatments for a second, subsequent SRE, and the current clinical guideline did not provide a specific approach to this clinical condition. We observed that referencing the initial treatment, patients in the subsequent SRE group had longer six-week, 90-day, and one-year median survival than patients in the single SRE group. Once patients develop a subsequent SRE, they have a worse one-year survival rate than those who receive treatment for a single SRE. Future research should identify prognostic factors and assess the applicability of existing survival prediction models for better management of subsequent SREs.
Cite this article: Bone Joint Res 2024;13(9):497–506.
... Results were presented as mean (n=10)±standard error. Statistical significance was determined using one-way analysis of variance [27]. All statistical analyses were conducted with SPSS version 17.0 (SPSS Inc.). ...
Objective
Cisplatin (CP) is a widely used chemotherapeutic agent, but its severe side effects impact testicular function. We investigated the potential protective effects of bilberry extract against CP-induced testicular toxicity.
Methods
Forty adult male albino rats were divided into four groups. Control animals received a single oral dose of 0.9% saline. Bilberry-treated rats received oral bilberry extract (200 mg/kg body weight [BW] dissolved in 1 mL of saline) daily for 10 consecutive days. CP-treated animals were administered a single intraperitoneal dose (7.5 mg/kg BW). Finally, a bilberry+CP group received oral bilberry extract (200 mg/kg BW) daily for 10 consecutive days, with one intraperitoneal dose of CP (7.5 mg/kg BW) on day 2. We assessed sperm count, motility, viability, and abnormalities, along with testis weight, testis weight-to-BW ratio, antioxidant activity, levels of oxidative stress markers (malondialdehyde [MDA] and hydrogen peroxide [H2O2]), sex hormones (follicle-stimulating hormone [FSH], luteinizing hormone [LH], and testosterone), and apoptotic and anti-apoptotic markers, and DNA damage. Testicular tissue underwent histopathological examination.
Results
Among CP-treated rats, significantly lower values were observed for testis weight; testis weight-to-BW ratio; levels of FSH, LH, testosterone, superoxide dismutase, catalase, glutathione S-transferase, glutathione, and B-cell lymphoma 2; and sperm count, motility, and proportion of normal sperm. CP administration was associated with higher MDA, H2O2, p53, Bax, cytochrome c, caspase 9, and caspase 3 levels, along with elevated tail moment. However, bilberry extract administration significantly improved all altered parameters.
Conclusion
Bilberry treatment demonstrated protective effects and reduced CP-induced testicular toxicity via antioxidant activity and cytoprotection.
... [2,3] Advanced statistical methods in medical research have revolutionized the way we approach health care, from personalized medicine to precision diagnostics. [4,5] Dental research is a constantly evolving field that involves the study of the anatomy, physiology, pathology, and treatment of teeth and the oral cavity. Researchers in this field employ a wide range of scientific methods, including experimental, observational, and epidemiological studies, to investigate various aspects of dental health. ...
This review provides an overview of structure equation modeling (SEM) and its applications in dental research. SEM is a statistical technique that allows researchers to examine the relationships between variables and is useful for analyzing data from a wide range of research designs, including cross-sectional, longitudinal, and experimental studies. The process involves specifying a theoretical model, testing the model with data, and evaluating the model fit. It has been used in dental research to investigate a wide range of topics, including dental diseases, oral health-related quality of life, and dental anxiety. SEM is particularly useful in modeling the relationships between various risk factors and dental diseases and also has the potential to provide a deeper understanding of the multifactorial nature of dental diseases such as periodontitis, dental caries, and oral cancer. Moreover, the insights provided can aid in the development of effective strategies for the prevention and treatment of dental diseases. It is a powerful statistical tool that can be used by dental researchers to gain a better understanding of the intricate interplay of factors that underlie dental diseases and other oral health-related outcomes.
... The discovery of new linguistic markers associated with suicide among elementary, middle, and high school students may contribute to research and practice related to suicide prevention. As our analysis is exploratory, aimed at generating hypotheses for future research, we did not apply multiple comparison corrections [29]. Future studies will need to apply more stringent statistical controls when testing these initial hypotheses to validate the findings. ...
Background
Suicide is the leading cause of death among children and adolescents in Japan. Internet search volume may be useful in detecting suicide risk. However, few studies have shown an association between suicides attempted by children and adolescents and their internet search volume.
Objective
This study aimed to examine the relationship between the number of suicides and the volume of school-related internet searches to identify the search terms that could serve as the leading indicators of suicide prevention among children and adolescents.
Methods
We used data on weekly suicides attempted by elementary, middle, and high school students in Japan from 2016 to 2020, provided by the National Police Agency. Internet search volume was weekly data for 20 school-related terms obtained from Google Trends. Granger causality and cross-correlation analysis were performed to estimate the temporal back-and-forth and lag between suicide deaths and search volume for the related terms.
Results
The search queries “I do not want to go to school” and “study” showed Granger causality with suicide incidences. The cross-correlation analysis showed significant positive correlations in the range of –2 to 2 for “I do not want to go to school” (highest value at time lag 0, r=0.28), and –1 to 2 for “study” (highest value at time lag –1, r=0.18), indicating that the search volume increased as the number of suicides increased. Furthermore, during the COVID-19 pandemic period (January-December 2020), the search trend for “I do not want to go to school,” unlike “study,” was highly associated with suicide frequency.
Conclusions
Monitoring the volume of internet searches for “I do not want to go to school” could be useful for the early detection of suicide risk among children and adolescents and for optimizing web-based helpline displays.
... Furthermore, the Hotelling's test of paired BIVA vector data (comparing baseline and repeat hydration assessment) demonstrated no significant difference of hydration status, as the 95% confidence ellipse crossed the origin (i.e., 0,0 on the RXc graph) (S13 Appendix. The Hotelling's test of paired BIVA vector data to compare baseline and end of life care assessments) [80]. The H 2 /R was not significantly associated with agitation (r s = -0.85, ...
Background
Oral fluid intake decreases in advanced cancer in the dying phase of illness. There is inadequate evidence to support the assessment, and management, of hydration in the dying. Bioelectrical impedance analysis (BIA) is a body composition assessment tool. BIA has the potential to inform clinal management in advanced cancer, by examining the relationships between hydration status and clinical variables.
Aim
BIA was used to determine the association between hydration status, symptoms, clinical signs, quality-of-life and survival in advanced cancer, including those who are dying (i.e. in the last week of life).
Materials and methods
We conducted a prospective observational study of people with advanced cancer in three centres. Advance consent methodology was used to conduct hydration assessments in the dying. Total body water was estimated using the BIA Impedance index (Height – H (m)² /Resistance – R (Ohms)). Backward regression was used to identify factors (physical signs, symptoms, quality of life) that predicted H²/R. Participants in the last 7 days of life were further assessed with BIA to assess hydration changes, and its relationship with clinical outcomes.
Results
One hundred and twenty-five people participated (males n = 74 (59.2%), females, n = 51 (40.8%)). We used backward regression analysis to describe a statistical model to predict hydration status in advanced cancer. The model demonstrated that ‘less hydration’ (lower H²/R) was associated with female sex (Beta = -0.39, p < 0.001), increased appetite (Beta = -0.12, p = 0.09), increased dehydration assessment scale score (dry mouth, dry axilla, sunken eyes - Beta = -0.19, p = 0.006), and increased breathlessness (Beta = -0.15, p = 0.03). ‘More hydration’ (higher H²/R) was associated with oedema (Beta = 0.49, p < 0.001). In dying participants (n = 18, 14.4%), hydration status (H²/R) was not significantly different compared to their baseline measurements (n = 18, M = 49.6, SD = 16.0 vs. M = 51.0, SD = 12.1; t(17) = 0.64, p = 0.53) and was not significantly associated with agitation (rs = -0.85, p = 0.74), pain (rs = 0.31, p = 0.23) or respiratory tract secretions (rs = -0.34, p = 0.19).
Conclusions
This is the first study to use bioimpedance to report a model (using clinical factors) to predict hydration status in advanced cancer. Our data demonstrates the feasibility of using an advance consent method to conduct research in dying people. This method can potentially improve the evidence base (and hence, quality of care) for the dying. Future BIA research can involve hydration assessment of cancers (according to type and stage) and associated variables (e.g., stage of illness, ethnicity and gender). Further work can use BIA to identify clinically relevant outcomes for hydration studies and establish a core outcome set to evaluate how hydration affects symptoms and quality-of-life in cancer.
... With the aid of automated SPSS software (SAS Institute, Cary, NC), the data was statistically assessed. A one-way ANOVA (Analysis of Variance) test with Duncan's multiple range tests and p significance between different groups was used to assess the impact of various therapies [18]. For CMGO the C = O peak was splitted to 1567.93 and 1639.29 cm −1 related to anti-symmetric and symmetric vibrations of COONa [9,19]. ...
This study reports a novel, eco-friendly; fast and cost-effective microwave method for synthesizing carboxymethylated graphene oxide (CMGO) from sugarcane residues. Fourier-transform infrared spectroscopy (FTIR) confirmed successful CMGO synthesis through the presence of characteristic peaks at 1567.93 and 1639.29 cm⁻¹ (COONa vibrations) and increased CH2 intensity compared to unmodified graphene oxide (GO). Furthermore, CMGO derived from sugarcane residues demonstrated potential in mitigating the side effects of toxic materials like carbon tetrachloride (CCl4). Treatment with CMGO partially reduced elevated levels of liver enzymes (ALT and AST) and nitrogenous waste products (urea and uric acid) in CCl4-induced liver damage models, suggesting an improvement in liver function despite ongoing cellular damage.This work paves the way for a sustainable and economical approach to produce functionalized graphene oxide with promising biomedical applications in alleviating toxin-induced liver injury.
Graphical abstract
... To standardize the rates the OECD 1980 Standard Population (8) was applied. For age standardisation the direct method was used as recommended e.g. by Armitage (9). The likelihood of achieving the SDG targets (4) and EU-SBSR (5) is determined by the indicators' time gap (G), i.e. the time needed to achieve an agreed target deadline related to the time remaining between the year of observation and the target year. ...
Context: The ‘Northern Dimension on Public Health and Social Well-being’ is a platform for dialogue and cooperation of countries around the Baltic Sea, established in 2003, guided by the Sustainable Development Goal 3 on Health and Social Well-being and the Strategy for the Baltic Sea Region of the European Union adopted in 2009. In this paper we determine the overall progress of the Russian Federation and its North West Federal Okrugin in particular, with regard to the reduction of mortality. Methods: For the purpose of inter-country comparison and progress over time we make use of age-standardised Potential Years of Life Lost (PYLL) applied to quantifiable strategic targets, the Sustainable Development Goal 3 on Health and Social Well-being and the European Union Strategy of the Baltic Sea Region. A gap analysis is performed to determine whether the target achievement is in delay or on track. Results: With reference to the baseline of 2009 – corresponding to the most relevant recent period 2009-2020 respectively 2009-2030 – the Russian Federation as a whole is on track achieving the two strategic targets in advance by 2.7 years. For the North West Federal Okrug around St. Petersburg and Kaliningrad bordering the Baltic Sea the target achievement is estimated to be 4.8 and 10.8 years in advance of the deadlines 2020 and 2030. In comparison to the Baltic Sea states the Russian Federation takes a middle position after Estonia, Latvia and Finland. The early target achievement is confirmed if the period 2003-2020 respectively 2003-2030 is considered. Conclusion: Although the region is progressing there may be a slowdown towards 2030. A careful analysis is required to determine to which degree the activities of the Partnership for Health and Social Well-being have contributed to the success and what should be proposed to increase the impact on premature mortality.
... For population proportions, we calculated 95% CI using the normal approximation to the binomial calculation [36]. Paired 2-tailed t tests were used to compare populations [37]. ...
Innovation in seasonal influenza vaccine development has resulted in a wider range of formulations becoming available. Understanding vaccine coverage across populations including the timing of administration is important when evaluating vaccine benefits and risks. This study aims to report the representativeness, uptake of influenza vaccines, different formulations of influenza vaccines, and timing of administration within the English Primary Care Sentinel Cohort (PCSC). We used the PCSC of the Oxford-Royal College of General Practitioners Research and Surveillance Centre. We included patients of all ages registered with PCSC member general practices, reporting influenza vaccine coverage between September 1, 2019, and January 29, 2020. We identified influenza vaccination recipients and characterized them by age, clinical risk groups, and vaccine type. We reported the date of influenza vaccination within the PCSC by International Standard Organization (ISO) week. The representativeness of the PCSC population was compared with population data provided by the Office for National Statistics. PCSC influenza vaccine coverage was compared with published UK Health Security Agency’s national data. We used paired t tests to compare populations, reported with 95% CI. The PCSC comprised 7,010,627 people from 693 general practices. The study population included a greater proportion of people aged 18-49 years (2,982,390/7,010,627, 42.5%; 95% CI 42.5%-42.6%) compared with the Office for National Statistics 2019 midyear population estimates (23,219,730/56,286,961, 41.3%; 95% CI 4.12%-41.3%; P<.001). People who are more deprived were underrepresented and those in the least deprived quintile were overrepresented. Within the study population, 24.7% (1,731,062/7,010,627; 95% CI 24.7%-24.7%) of people of all ages received an influenza vaccine compared with 24.2% (14,468,665/59,764,928; 95% CI 24.2%-24.2%; P<.001) in national data. The highest coverage was in people aged ≥65 years (913,695/1,264,700, 72.3%; 95% CI 72.2%-72.3%). The proportion of people in risk groups who received an influenza vaccine was also higher; for example, 69.8% (284,280/407,228; 95% CI 69.7%-70%) of people with diabetes in the PCSC received an influenza vaccine compared with 61.2% (983,727/1,607,996; 95% CI 61.1%-61.3%; P<.001) in national data. In the PCSC, vaccine type and brand information were available for 71.8% (358,365/498,923; 95% CI 71.7%-72%) of people aged 16-64 years and 81.9% (748,312/913,695; 95% CI 81.8%-82%) of people aged ≥65 years, compared with 23.6% (696,880/2,900,000) and 17.8% (1,385,888/7,700,000), respectively, of the same age groups in national data. Vaccination commenced during ISO week 35, continued until ISO week 3, and peaked during ISO week 41. The in-week peak in vaccination administration was on Saturdays.
The PCSC’s sociodemographic profile was similar to the national population and captured more data about risk groups, vaccine brands, and batches. This may reflect higher data quality. Its capabilities included reporting precise dates of administration. The PCSC is suitable for undertaking studies of influenza vaccine coverage.
... This power calculation was based on our prior trial using a between-subject variability of 10%, correlation coefficient of 0.75 [29], > 80% power, and two-sided alpha of 0.05. Moreover, a sample size of 18 participants per group was also sufficient to reach a power >80% to detect changes in CBF of at least 10%, using a between-subject variability of 18%, correlation coefficient of 0.68 [37][38][39], and two-sided alpha of 0.05. ...
Purpose
Short-term intake of the egg-protein hydrolysate Newtricious (NWT)-03 improved executive function, but underlying mechanisms and long-term effects, including other cognitive domains, are unknown.
Methods
A 36-week randomized controlled trial involving 44 overweight/obese individuals experiencing elevated Subjective Cognitive Failures (SCF; aged 60–75 years) assessed the impact of daily consumption of 5.7 g of NWT-03 or placebo powders on cognitive performance (psychomotor speed, executive function, memory) and Cerebral Blood Flow (CBF), a marker of brain vascular function. Cognitive performance was evaluated using a neurophysiological test battery (CANTAB) and CBF was measured using magnetic resonance imaging perfusion method Arterial Spin Labeling (ASL). Serum samples were collected to determine brain-derived neurotrophic factor (BDNF) concentrations.
Results
Anthropometrics, and energy and nutrient intakes remained stable throughout the trial. NWT-03 was well tolerated, and compliance was excellent (median: 99%; range: 87–103%). No overall intervention effects were observed on cognitive performance or CBF, but post-hoc analyses revealed significant improvements on executive function in women, but not men. Specifically, a reduction of 74 ms in reaction latency on the multitasking task (95% CI: −134 to −15; p = 0.02), a reduction of 9 between errors (95%CI: −14 to −3; p < 0.001), and a reduction of 9 total errors (95%CI: −15 to −3; p < 0.001) on the spatial working memory task were found in women. No intervention effects were observed on serum BDNF concentrations (p = 0.31).
Conclusion
Long-term consumption of NWT-03 improved multitasking abilities and working memory in women with elevated SCF. Brain vascular function remained unaffected. Sex differences in executive function require additional clarification.
... L'intervalle de confiance de l'OR a été calculé suivant la méthode directe de Wolf. Une association entre un facteur et la présence d'une malvoyance ou d'une cécité irréversible était établie quand l'OR était supérieur à 1. Cette association était qualifiée de significative quand l'intervalle de confiance de l'OR ne contenait pas 1 ; dans le cas contraire, l'association n'était pas significative (ARMITAGE P. et BERRY G., 1971). ...
La malvoyance et la cécité constituent des réalités invalidantes pour de nombreux individus et familles. Elles compromettent l’accès à l’éducation, à l’emploi rémunéré et à la productivité. La présente étude avait pour objectif de déterminer la fréquence de la cécité et de la malvoyance irréversibles aux Cliniques universitaires du Graben (CUG), ainsi que leurs facteurs favorisants.
L’étude était du type transversal, couvrant une période d’une année civile (2016). Nous nous sommes servi de l’Odd’s Ratio pour tester la dépendance entre la cécité et la malvoyance irréversibles et les différents paramètres.
Au terme de notre étude, nous avons constaté ce qui suit. La fréquence de la cécité et de la malvoyance irréversibles aux CUG est de 5,18% avec 2,53% de malvoyance et 2,65% de cécité sur un total de 3437 patients qui se sont fait donc consulter au service d’ophtalmologie.
Les causes de la cécité et de la malvoyance irréversibles sont, par ordre d’importance, les maladies de la rétine, les atrophies optiques et le glaucome. Par rapport aux différentes antécédents, l’association Diabète-Hypertension artérielle, le diabète, l’Hypertension artérielle et le traitement indigène prédisposent significativement le patient à la cécité et malvoyance irréversibles. Les tranches de 0 à 5 ans et de 60 ans plus sont les plus touchées par les déficiences visuelles irréversibles.
... OLP regression analysis was performed using SPSS Statistics version 28 (IBM Corp., Armonk, NY, USA). The 95% prediction interval in the OLP regression was calculated manually 32 using Excel (Microsoft, Redmond, WA, USA). The mean difference, 95% tolerance limits, and 95% prediction intervals for the linear regression line in the Bland-Altman plot were calculated using MATLAB R2023a (MathWorks). ...
We aimed to examine the validity of estimating spatiotemporal and ground reaction force (GRF) parameters during resisted sprinting using a robotic loading device (1080 Sprint). Twelve male athletes (age: 20.9 ± 2.2 years; height: 174.6 ± 4.2 cm; weight: 69.4 ± 6.1 kg; means ± SDs) performed maximal resisted sprinting with three different loads using the device. The step frequency and length and step‐averaged velocity, anteroposterior GRF (Fap), and the ratio of Fap to resultant GRF (RF) were estimated using the velocity and towing force data measured using the device. Simultaneously, the corresponding values were measured using a 50‐m force plate system. The proportional and fixed biases of the estimated values against those measured using the force plate system were determined using ordinary least product (OLP) regression analysis. Proportional and fixed biases were observed for most variables. However, the proportional bias was small or negligible except for the step frequency. Conversely, the fixed bias was small for step‐averaged velocity (0.11 m/s) and step length (0.04 m), whereas it was large for step frequency (0.54 step/s), Fap (16N), and RF (2.22%). For all variables except step frequency, the prediction intervals in the OLP regression dramatically decreased when the corresponding values were smoothed using a two‐step moving average. These results indicate that by using the velocity and force data recorded in the loading device, most of the spatiotemporal and GRF variables during resisted sprinting can be estimated with some correction of the fixed bias and data smoothing using the two‐step moving average.
... Table 1 presents all the statistical parameters and linearity results (25,28) . Results show high F-values (variance ratio) indicating that the regression mean of squares will increase, while residuals will decrease, increasing the steepness of the line and lowering data scatter around the line (26,29) . ...
... The outcomes are shown in terms of mean standard deviation. A single-way analysis of variation, or "ANOVA," was utilized to statistically evaluate the variance in the information [32]. These computations were performed using SPSS (version 15) computer software. ...
... Cumulative incidences of distant metastases and locoregional failure were calculated, accounting for all-cause death as a competing risk (20)(21)(22)(23). For all competing risk analyses, adjusted cause-specific hazard ratios (HRs) were calculated using a flexible parametric survival model, accounting for the inverse probability of censoring and treatment weights (20,21,(24)(25)(26). Overall survival was estimated using the Kaplan-Meier method (27,28). ...
Introduction
Limited evidence compares short-course radiotherapy (SCRT) and long-course chemoradiotherapy (LCCRT), both of which are followed by consolidative chemotherapy before radical rectal surgery. We conducted a retrospective cohort study to assess treatment response, survival outcomes, and toxicity in patients with locally advanced rectal cancer.
Materials and methods
Patients (cT3–4 and/or N+) treated with SCRT or LCCRT, consolidative chemotherapy, or total mesorectal excision between 2013 and 2021 were identified. the cause-specific cumulative incidence of disease-related treatment failure, locoregional recurrence, distant metastases, and overall survival were evaluated using flexible parametric competing risk analysis and Kaplan–Meier methods, adjusted for treatment regimens and clinicopathological factors. A pathological complete response (pCR), tumor downstaging, and toxicity have been reported.
Results
Among the 144 patients, 115 (80%) underwent curative rectal surgery. The LCCRT and SCRT groups achieved pCR in 10 (18%) and seven (12%) patients, respectively (odds ratio, 1.68; 95% confidence interval [CI], 0.59–4.78). The adjusted cause-specific hazard ratio for disease-related treatment failure with LCCRT versus SCRT was 0.26 (95% CI, 0.08–0.87). Three-year cumulative probability of disease-related treatment failure was 10.0% and 25.6% for LCCRT and SCRT, respectively. No significant differences in T-downstaging, N-downstaging, significant pathologic downstaging (ypT0-2N0), locoregional failure, distant metastasis, or overall survival were found. Late rectal toxicity occurred in 10 (15%) LCCRT and two (3%) SCRT patients, respectively.
Conclusion
LCCRT with consolidative chemotherapy demonstrated improved disease-related treatment failure compared with SCRT, despite higher late rectal toxicity. Further research is needed to assess the long-term oncologic outcomes and toxicity.
... The F-probability test was used to measure the extent of variation among groups. The study adhered to Armitage et al. [28] definition of statistical significance. The data were arranged in a tabular format and graphically shown using graphs. ...
Diabetes mellitus is a metabolic disorder described by compromised insulin synthesis or resistance to insulin inside the human body. Diabetes is a persistent metabolic condition defined by elevated amounts of glucose in the bloodstream, resulting in a range of potential consequences. The main purpose of this study was to find out how biosynthesized copper oxide nanoparticles (CuONPs) affect the blood sugar levels of diabetic albino rats induced by streptozotocin (STZ). In the current study, CuONPs were successfully biosynthesized using Saccharomyes cervisiae using an eco-friendly method. Characterization results revealed that biosynthesized CuONPs appeared at 376 nm with a spherical shape with sizes ranging from 4 to 47.8 nm. Furthermore, results illustrated that administration of 0.5 and 5 mg/kg CuONP in diabetic rats showed a significant decrease in blood glucose levels accompanied by elevated insulin levels when compared to the diabetic control group; however, administration of 0.5 mg/kg is the best choice for diabetic management. Furthermore, it was found that the group treated with CuONPs exhibited a noteworthy elevation in the HDL-C level, along with a depletion in triglycerides, total cholesterol, LDL-C, and VLDL-cholesterol levels compared to the diabetic control group. This study found that administration of CuONPs reduced hyperglycemia and improved pancreatic function as well as dyslipidemia in diabetic rats exposed to STZ, suggesting their potential as a promising therapeutic agent for diabetes treatment.
... Continuous variables were compared using t-tests while categorical variables were compared using Fisher's exact or chi-squared tests. 21 Since, in contrast to randomized clinical trials, observational clinical data obtained from a realworld study may not have balanced distributions of characteristics between active and control groups, 22 it was therefore considered necessary to account for systematic differences in baseline characteristics between different cohorts when estimating the effect of an intervention on outcomes. ...
Introduction
Multiple sclerosis (MS) is a neurodegenerative disease characterized by progressive deterioration of cognitive and physical functioning, reducing activities of daily living and quality of life (QoL). Several treatments are available that modify the course of the disease and reduce the frequency of relapses. Although effective, all treatment options are accompanied by adverse events, and this study aimed to assess the extent to which patients were involved in the choice of treatment.
Methods
Data were drawn from the Adelphi Multiple Sclerosis Disease Specific Program (DSP)™, a cross-sectional survey of healthcare practitioners (HCP) and their patients with MS in real-world clinical settings in Europe and the United States (US) between December 2020 and July 2021. HCPs reported patient demographics, clinical characteristics, current and previous treatment, and treatment outcomes. Patients voluntarily completed questionnaires reporting the physical and psychological impact of their MS and its treatment. Regression analysis with inverse probability of treatment weighting was used to compare treatment outcomes in patients actively involved in their current treatment choice with those who were not.
Results
Of a total of 692 patients, median age 40 years and 64% female, mostly diagnosed with relapsing-remitting MS, those who were involved in shared decision-making tended to choose oral therapies such as dimethyl fumarate more often than HCPs. MS had greater impact on physical and psychological functioning in patients whose HCP made treatment decisions solely. Patients involved in decision-making reported greater satisfaction with their treatment and a better QoL.
Discussion
Because no single optimal therapy exists for patients with MS, treatments should be individualized with consideration of patients’ preferences. Our study shows that shared decision-making is under-utilized in the management of MS and supports the benefits of patient involvement.
Conclusion
Patients who have an active role in treatment decision-making show improved wellbeing and QoL, and overall treatment satisfaction.
... Aunque este es un ejemplo muy particular (para un punto de corte concreto en ambas variables), si se eligieran otros dos puntos de corte, el resultado sería muy similar [4]. La realidad es que con la dicotomización siempre se pierde potencia estadística, tal y como se muestra en el siguiente apartado. ...
A very common practice in medical research, during the process of data analysis, is to dichotomise numerical variables in two groups. This leads to the loss of very useful information that can undermine the effectiveness of the research. Several examples are used to show how the dichotomisation of numerical variables can lead to a loss of statistical power in studies. This can be a critical aspect in assessing, for example, whether a therapeutic procedure is more effective or whether a certain factor is a risk factor. Dichotomising continuous variables is therefore not recommended unless there is a very specific reason to do so.
... Finally, the data were averaged over the cells CD56+ for lymphocytes; CD16+ and CD56+ for NK cells; CD16+, CD56+, and CD69+ for active NK cells; and CD16-, CD56+, and CD69-for non-NK cell lymphocytes using SPSS software version 26 (DAKO Company). The sample size was estimated using an α value of 0.05 and a study power of 89.8% based on the statistical methods in medical research by Armitage et al. [24]. One-way analysis of variance, nonparametric Kruskal-Wallis tests, and SPSS software version 26 (DAKO Company) were used for data analysis. ...
Objective:
Fetal uterine survival depends on maintaining an immune balance between the mother and fetus. This study aimed to investigate the correlation of blood peripheral natural killer (NK) cells and interferon-gamma (IFN-γ) with recurrent in vitro fertilization (IVF) failure (RIF) and recurrent pregnancy loss (RPL).
Methods:
In this case-control study, peripheral blood samples were obtained from three groups of RPL, RIF, and parous women without a history of abortion or infertility problems and analyzed by lymphocyte-based flow cytometry. Afterward, the levels of NK cells and IFN-γ were determined. All data were analyzed using one-way analysis of variance and non-parametric Kruskal-Wallis tests.
Results:
The level of IFN-γ in the RPL group was significantly higher than that in parous women and the RIF group (P<0.05), whereas its level in the RIF group was not significantly different from the control group (P>0.05). A significant correlation was found between the levels of IFN-γ and NK cells in the RPL group (r=0.481; P=0.02). However, no significant correlation was found between the levels of IFN-γ and the active NK cells in the RPL group (P=0.08). Moreover, no significant correlation was found between the levels of NK cells (whether activated or not) and IFN-γ in the RIF patients (P>0.05).
Conclusion:
Immune dysfunction may not be involved in implantation failure during IVF t may be involved in recurrent miscarriage, probably by increasing IFN-γ levels.
Background
Head acceleration is often used as a proxy measurement for concussion risk. It is unclear what factors contribute to head acceleration during a purposeful header.
Objective
The objective of this systematic is to identify what factors influence head acceleration during a header and highlight areas that have not been explored.
Methods
Studies were included if they assessed the effect of an independent variable on head acceleration during a purposeful header. There were no exclusion criteria relating to age, sex, playing level, study design, or publication date. Databases included Scopus, Web of Science, MEDLINE, EMBASE, CINAHL, SPORTDiscus and ClinicalKey, and grey literature was also searched. Searches were re-run in January 2024. Each included study underwent a risk of bias or quality assessment, using several tools owing to varied study designs (ROBINS-I, RoB2, modified Downs and Black and AXIS). Results are presented in tabular form, categorised by independent variable(s) and accompanied by a narrative results section.
Results
A total of 60 studies were included. Study designs included one-off measurements with variable(s), cohort, cross-sectional and randomised controlled trials (RCTs). Influencing factors included ball velocity and characteristics, header type, impact location, neck training interventions, fatigue protocols, neck strength, demographics, playing scenario and personal protective equipment. A wide range of heading trials and methods of measuring head acceleration were used. Results were conflicting for several variables. There was some consistent evidence that increased ball speed/mass/inflation increased head acceleration. Female players sustained greater head accelerations than males, and some evidence suggested that increased neck strength reduced head acceleration, but not in all cases. This review confirmed traditional neck strengthening is not effective in reducing head acceleration; however, adding neuromuscular exercises appeared to be effective. There was a lack of evidence investigating other systems that may affect head acceleration such as vestibular function, oculomotor performance, rate of force development and cervical spine proprioception.
Discussion
This review highlights the range of studies investigating head acceleration during a purposeful header. Included studies were of varying quality, and one limitation was the lack of transformation of the acceleration measures to a consistent frame of reference. Implications from this study suggest potential measures that may reduce head acceleration and therefore improve the safety of performing a purposeful header. These include reducing ball inflation pressure, limiting headers from long range/high speed balls (especially in children/adolescents and females) and ensuring neuromuscular exercises are incorporated into neck training programmes. Dynamic muscle strength outcomes, including measures such as rate of force development, are challenging to measure but should be considered an essential component of neck training when the aim is to reduce head acceleration in a ballistic task such as a header.
The review is registered under the PROSPERO registry (CRD42022359294).
Purpose: To investigate whether a new phospholipid-releasing soft contact lens can improve symptoms of dry eyes.Methods: The study used 2.5-3.0 kg New Zealand rabbits including both normal non-dry eye rabbits and dry eye rabbits, the latter having undergone electrocauterization of the meibomian glands to block the gland orifices. Each rabbit wore a control contact lens on one eye and a phospholipid-releasing contact lens on the other eye daily. Phospholipid-releasing and control contact lenses were provided by NEOVISION Co., Ltd. The parameters assessed included tear film break-up time, tear osmolarity, ocular surface staining, and central corneal thickness. After the experiment, the rabbits were euthanized and their conjunctival tissue was stained with Periodic Acid Schiff (PAS) to observe conjunctival goblet cells.Results: In both dry eye and normal non-dry eye rabbits, tear film break-up time was longer and tear osmolarity was lower when using the phospholipid-releasing contact lens compared to the control contact lens. The ocular surface remained unstained in normal non-dry eye rabbits while staining was observed in dry eye rabbits. There was no significant difference in central corneal thickness between the control and phospholipid-releasing contact lenses in either group. PAS staining showed no difference in conjunctival goblet cell density between the two lens types in normal non-dry eye rabbits. However, in dry eye rabbits, the conjunctival goblet cell density tended to be slightly higher with the phospholipid-releasing contact lens compared to the control lens.Conclusions: Phospholipid-releasing contact lenses may help reduce dry eye symptoms and minimize contact lens-related complications by stabilizing the tear film and lowering tear osmolarity.
Maternal diabetes mellitus is linked to neurobiological and cognitive impairments, increasing the risk of brain and cerebellar defects in diabetic pregnant rats and their offspring. Momordica charantia (bitter melon) possesses antidiabetic properties due to its bioactive compounds, including phenolics, alkaloids, proteins, steroids, inorganic compounds, and lipids. Forty pregnant rats were randomly assigned to four groups: control; M charantia (BM); diabetic (DM); and diabetic treated with M charantia (BM+DM). Diabetic maternal rats showed significantly elevated serum glucose, insulin, leptin, and homeostasis model assessment of insulin resistance (HOMA-IR) levels, with a concomitant decrease in insulin sensitivity check index (QUICKI), glucose transporter 4 (GLUT4), adenosine monophosphate-activated protein kinase (AMPK), acetylcholine (ACh), and dopamine. Oxidative stress markers in cerebellar tissue indicated increased malondialdehyde (MDA) and decreased glutathione (GSH) levels. Cerebellar tissue analysis revealed significantly reduced superoxide dismutase (SOD), catalase (CAT), B-cell lymphoma 2 (Bcl-2), and nerve growth factor (NGF), while Bcl-2-associated X protein (BAX) and glial fibrillary acidic protein (GFAP) were elevated. Histological and ultrastructural analysis of the diabetic maternal cerebellum showed moderate vacuolation of the neuropil in all cerebellar cortical layers, along with Purkinje cell degeneration and necrosis, including Nissl substance loss. Offspring of diabetic mothers exhibited multifocal Purkinje cell loss, empty baskets, and cerebellar cortical dysplasia with abnormal tissue development and organization. In conclusion, M. charantia supports central nervous system health in diabetic pregnant rats and their offspring by enhancing antioxidant markers, regulating GFAP and NGF, and mitigating apoptosis, ultimately improving cerebellar pathology and neural development.
With 40 million annual passenger flights, airports are key hubs for microbial communities from diverse geographic origins to converge, mix, and distribute. Wastewater derived from airports and aircraft represent both a potential route for the global dispersion of antimicrobial resistant (AMR) organisms and an under-utilised resource for strengthening global AMR surveillance. This study investigates the abundance and diversity of antimicrobial resistance genes (ARGs) in wastewater samples collected from airport terminals (n = 132), aircraft (n = 25), and a connected wastewater treatment plant (n = 11) at three international airports in the UK (London Heathrow, Edinburgh and Bristol). A total of 76 ARGs were quantified using high throughput qPCR (HT-qPCR) while a subset of samples (n = 30) was further analysed by metagenomic sequencing. Our findings reveal that aircraft wastewater resistomes were compositionally distinct from those observed at airport terminals, despite their similar diversity. Notably, flights originating from Asia and Africa carried a higher number of unique ARGs compared to those from Europe and North America. However, clustering of the ARG profile displayed no overall association with geography. Edinburgh terminal and pumping station wastewater had compositionally comparable resistomes to that of the connected urban wastewater treatment plant, though further research is needed to determine the relative contributions of the local population and international travellers. This study provides the first comprehensive investigation of AMR in wastewater from both aircraft and terminals across multiple international airports. Our results highlight aircraft wastewater as a potential route for cross-border AMR transmission and a valuable tool for global AMR surveillance. However, the findings also underscore the limitations and need for standardised approaches for AMR monitoring in airport environments, to effectively mitigate the global spread of AMR and enhance public health surveillance strategies.
Artificial Intelligence (AI) will transform surgery. It will alter the way that data is analyzed and, hence, will influence the way we perform research. In the preoperative setting, it will affect imaging and earlier diagnosis of tumors, lead to more accurate cancer staging and treatment decisions, and provide more precise risk assessment so that we can better inform our patients and plan the appropriate procedure. Intra-operatively, AI will help conduct the operation with augmented reality, allowing us to perform safer and more effective operations. It will also assist our anesthesia colleagues in delivering safer and more effective anesthesia. During postoperative care, AI will help predict complications, allowing for earlier interventions that could decrease patient morbidity and mortality. It will assist in the prediction of patient pain management needs. Additionally, AI will help provide appropriate patient disposition, benefiting the patient and the healthcare system.
Buku ini merupakan panduan komprehensif yang menyajikan berbagai aspek penting dalam bidang epidemiologi. Terdiri dari 12 bab, buku ini dimulai dengan pembahasan mengenai sejarah perkembangan epidemiologi yang memberikan konteks penting untuk memahami evolusi disiplin ilmu ini. Selanjutnya, pembaca akan dikenalkan pada prinsip dan metode dasar epidemiologi, desain penelitian, serta teknik pengukuran frekuensi dan asosiasi penyakit yang menjadi fondasi dalam penelitian epidemiologi. Setiap bab berfokus pada topik spesifik, termasuk epidemiologi penyakit menular dan tidak menular, epidemiologi kesehatan lingkungan, serta isu terkini seperti epidemiologi global dan konsep One Health. Buku ini juga membahas peran penting surveilans kesehatan, investigasi wabah, dan manajemen data epidemiologi, serta kesiapsiagaan dan respons terhadap bencana kesehatan masyarakat. Dengan pendekatan yang terintegrasi dan holistik, buku ini bertujuan untuk memberikan wawasan yang mendalam dan relevan bagi mahasiswa, peneliti, serta profesional di bidang kesehatan masyarakat. Melalui buku “Dasar Epidemiologi,” pembaca diharapkan dapat memahami tantangan dan peluang yang dihadapi oleh epidemiologi saat ini, serta bagaimana disiplin ini berkontribusi pada peningkatan kesehatan masyarakat secara keseluruhan.
Purpose
This study aimed to use workers’ compensation (WC) data to explore the impact of the extreme bushfires on injury/disease claim rates amongst first responders (FR) compared with other occupations and off-seasons.
Methods
Data on WC claims for FR (ambulance officers, paramedics, firefighters, police) and other occupations were obtained from WorkSafe Victoria 2005–2022. Negative binomial regression models adjusting for age, gender and number of employed people were used to estimate incident rate ratios of all injury/disease, mental, musculoskeletal and respiratory claims among FR in summer and extreme bushfires compared to off-season/summer and other occupations.
Results
There were 120,022 claims in 2005–2022; 54% were musculoskeletal injuries. Claims rates were significantly higher for all injuries/diseases, mental, musculoskeletal and respiratory conditions in FR than other occupations across off-season, summers and extreme bushfires. FR were 1.5–3.9 times more likely to claim for mental health conditions during extreme bushfires than off-season compared with other occupations. Firefighters were at increased risk of all injury/disease and mental and musculoskeletal injury claims during summer and extreme bushfires than off-seasons. Ambulance officers and paramedics had the highest claim rates, particularly in off-seasons, with a higher risk of all injury/disease and mental claims in extreme bushfires than in summers. Respiratory and mental claims were increased amongst police and other occupations during extreme bushfires.
Conclusion
Extreme bushfire events were associated with increased mental claims rates in all FR, with the highest in firefighters. Strategies to better prevent and manage injury/disease risk in FR are urgently required, particularly for mental health conditions.
Piscine lactococcosis is a disease caused by Lactococcus garvieae, L. petauri and L. formosensis. It is considered to be an emerging disease and poses a risk to global aquaculture production. Studies of the genetic diversity of Lactococcus spp. strains have epidemiological importance since they provide information on the genetic relationships between isolates and indicate geographic and temporal distribution. The aim of this study was to evaluate the genetic diversity of Brazilian Lactococcus spp. isolates obtained from native fish species using PCR-based DNA fingerprinting techniques. For this, 36 isolates were evaluated by gyrB sequencing, molecular serotyping, REP-, BOX-, and RAPD-PCR approaches. The discriminatory power and the congruence between the typing methods were calculated. After the correct taxonomic identification of the isolate, a total of 14, 5 and 17 isolates were reclassified as L. garvieae, L. formosensis and L. petauri, respectively. Lactococcus garvieae and L. petauri are related to serotype I, while L. formosensis strains were classified as serotype II. The typing methods tested are useful for evaluating the genetic diversity of isolates and a comprehensive indication of the diversity was found. Heterogeneous and homogeneous populations were observed for L. garvieae and L. petauri, respectively. Among the genotyping methods evaluated, RAPD-PCR demonstrated a greater discriminatory power for L. formosensis and L. petauri, while REP-PCR showed better results for L. garvieae strains, thus these methodologies are recommended for genotyping these bacterial species. In conclusion, Brazilian isolates of Lactococcus spp. obtained from native fish species constitute a genetically diverse population and the techniques used in this study allowed a better genetic characterization of the isolates.
The course of renovascular (resistant) arterial hypertension was analyzed in 60 patients (45 men, 15 women) with isolated atherosclerotic stenosis of the renal artery of more than 75% (group 1), and in 30 patients (26 men, 4 women) who, in addition to unilateral stenosis of the renal artery of more than 75%, also had stenoses of the brachiocephalic arteries up to 60% of the vessel diameter (group 2). The mean age of the examined patients in group 1 was 52.4 ± 6.9 years, and in group 2 it was 53.2 ± 7.4 years. Endovascular correction of hemodynamically significant stenosis of the renal artery leads to a significant decrease in systolic and diastolic blood pressure levels, a reduction in the number of antihypertensive drugs from 5-4 to a 3-component scheme in most cases, and an improvement in the functional state of the kidneys. At the end of the 2-year observation period, in patients with multifocal lesions of the renal and cerebral arteries (group 2), both systolic and diastolic blood pressure levels corresponded to “high normal” values, while in group 1 (isolated renal artery lesions) they corresponded to “normal” blood pressure levels. Patients in group 2 had metabolic disorders such as atherogenic dyslipidemia, hyperuricemia, and significant signs of renal dysfunction. The multifocal nature of atherosclerotic vascular lesions contributes to a more “severe” course of the disease, which should be taken into account when conducting treatment measures.
Two young unrelated girls with similar but not identical manifestations of immunological deficiency were found to have no measurable adenosine-deaminase (A.D.A.) enzyme activity in their red blood-cells. The red-cell A.D.A. levels in the parents of one child were about half normal and in the other set of parents about two-thirds normal, suggesting they may be heterozygous, and their affected children homozygous, for a mutant A.D.A. gene. Since the A.D.A. produced by normal lymphocytes is mainly the kind found in red cells, a causal association is postulated between the absence of A.D.A. and impaired lymphocyte function in certain patients with inherited immune disease. An alternative possibility of partial chromosomal deletion is also considered.