Effect of a Dialysis Access Coordinator on Preemptive Access Placement among Veterans: A Quality Improvement Initiative

Background and Objectives: Preemptive placement of permanent dialysis access is recommended in order to reduce the morbidity associated with central venous catheters. We assessed the effect of a dialysis access coordinator on preemptive access placement in veterans who are at high risk for end-stage renal disease (ESRD). Design, Setting, Participants, and Measurements: Pre-post evaluation of a dialysis access coordinator in the nephrology clinics of the Veterans Affairs Palo Alto. The access coordinator streamlined access referrals, prioritized surgical waiting lists and addressed patient barriers. We compared the frequency of preemptive access referral, surgery, and use for dialysis during the intervention period, July 1, 2013 to May 31, 2016, to a pre-intervention period, January 1, 2011 to December 31, 2013, among all patients with a predicted 1-year risk for ESRD ≥20%. Results: There were 156 patients in the historical cohort and 131 in the intervention cohort. The mean age was 69.9 ± 11.6 years and the mean estimated glomerular filtration rate was 14.5 ± 5.7 ml/min/1.73 m2. The intervention was associated with an 11.8% increase in access referral (p value = 0.03), and a 9.4% increase in completed access surgery (p value = 0.05). Increases in permanent access at the start of dialysis (15.2%), and functional permanent access at the start of dialysis (12.4%) did not reach statistical significance. Among patients who received access surgery, there was no significant difference in the prevalence of unused access. Conclusions: Implementation of an access coordinator was associated with a modest increase in preemptive access placement among patients who are at high risk for ESRD without increasing the prevalence of unused access.

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Assessment of Biochemical Parameters among Smokers and Tobacco Chewers to Ascertain Cardiovascular risk

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v12i1.9089 ◽

2013 ◽

Vol 12 (1) ◽

pp. 29-31

Author(s):

Dipendra Kumar Jha ◽

Dipendra Raj Pandeya ◽

Satrudhan Prasad Gupta

Keyword(s):

Cardiovascular Risk ◽

Total Cholesterol ◽

Statistical Significance ◽

Serum Total Cholesterol ◽

P Value ◽

Institute Of Medicine ◽

Mean Values ◽

Significant Difference ◽

The Mean ◽

Tobacco Chewing

Introduction: Cigarette smoking is one of the major cause and established risk factor of premature death due to respiratory and cardiovascular illness worldwide. Risk of coronary heart disease is increased by two-to four folds in smoking and tobacco chewing. Smoking and tobacco chewing leads to change in the concentration of serum total cholesterol, triglycerides, LDL, VLDL and HDL. In our present study, the main objective was to assess the blood lipid profile among smokers and tobacco chewers to ascertain cardiovascular risk in Nepal. Methods: It was a hospital based case control study carried out using data retrieved from the register maintained in the Department of Biochemistry of Institute of Medicine Teaching Hospital, Kathmandu, Nepal between 1st January, 2008 and 31st December, 2009. Of the 150 subjects enrolled in this study, 50 were current smokers, 50 were tobacco chewers and 50 were normal healthy controls. The variables collected were age, gender, total cholesterol, triglycerides, HDL, LDL, VLDL. The One way ANOVA was used to examine the statistical significant difference between groups. Post Hoc test LSD used for the comparison of means of control versus case groups. A p-value of <0.05 (two-tailed) was used to establish statistical significance. Results: The mean values of serum total cholesterol (257.5±22.6 mg/dl), LDL (186.6±24.0 mg/dl), TG (139.4±39.8 mg/dl) were significantly higher in smokers when compared to controls. In contrast to that HDL (42.9±1.5 mg/dl) was lower when compared to controls (44.8±1.9mg/dl). The mean values for TG (141.5±34.9 mg/dl), total cholesterol (260.3 ±21.2 mg/dl), LDL (188.5±26.0 mg/dl) in tobacco chewers was significantly higher when compared to controls. Conclusions: The lipid profiles are raised in tobacco chewers and smokers which may lead to higher incidence of cardiovascular disease. Medical Journal of Shree Birendra Hospital; January-June 2013/vol.12/Issue1/29-31DOI: http://dx.doi.org/10.3126/mjsbh.v12i1.9089

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brt index: an integration of biological relevance and p-value for –omics data along with demonstration in microarray data using a developed R package

10.1101/2020.02.27.968909 ◽

2020 ◽

Author(s):

Le Zheng ◽

Jin Li ◽

Peng Yu

Keyword(s):

Statistical Significance ◽

R Package ◽

Biological Data ◽

P Value ◽

Biologically Relevant ◽

Testing Framework ◽

Biological Relevance ◽

Significant Difference ◽

The Mean ◽

Type Data

AbstractSummaryp-value as an indicator of statistical significance is commonly used in biological data. However, considering p-value alone neglects the importance of effect size (i.e., the mean difference between groups) in determining the biological relevance of a “significant” difference. Here, we present a novel algorithm for computing a new statistic, the biological relevance testing (BRT) index, in the frequentist hypothesis testing framework to address this problem. We also show that the results from the BRT procedure provided a promising way to select biologically relevant features by applying it to microarray-type data.Availability and ImplementationFreely available on the web at https://CRAN.R-project.org/[email protected]

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Employing Personal Reading Logs through Short Stories to Enhance Students’ L2 Reading Comprehension Achievement

International Journal of Modern Languages And Applied Linguistics ◽

10.24191/ijmal.v3i2.7643 ◽

2019 ◽

Vol 3 (2) ◽

pp. 1

Author(s):

Eliyas Sulaiman Mohandas ◽

Nik Mastura Nik Ismail Azlan ◽

Salwa Othman ◽

Muhammad Aizat Azhari

Keyword(s):

Short Stories ◽

Reading Comprehension ◽

P Value ◽

L2 Reading ◽

Reading Score ◽

Paired Samples ◽

Significant Difference ◽

Post Test ◽

The Mean ◽

L2 Reading Comprehension

This study aims to investigate whether the use of six selected short stories throughout the duration of a 14-week course could enhance students’ reading comprehension achievement at the end of the semester. Out of the six short stories read, three were chosen as in-class assignments known as ‘Personal Reading Logs’ (hereafter, PRLs). One group of semester two Diploma students taking a reading skills course was selected through a convenience sampling method. A pre-test was conducted by having the students answer a past semester reading quiz of which the results would then be compared to their post-test (final reading exam) results. A paired samples t-test revealed no significant difference in the reading scores of the pre-test and the post-test, t (17) = -.265, p > .05. Since the p-value was bigger than 0.05, this indicated that the mean reading score of the post-test (M = 50.556) was not significantly higher than the mean reading score of the pre-test (M = 49.722). Therefore, the null hypothesis which stated that there was no difference in the mean score of the pre-test and post-test was retained. Overall, the result refuted the findings of other studies promoting the effectiveness of using short stories to enhance L2 reading comprehension achievement.

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Pattern of symptom improvement following endoscopic sinus surgery for chronic rhinosinusitis

BMC Surgery ◽

10.1186/s12893-021-01269-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Salma S. Al Sharhan ◽

Mohammed H. Al Bar ◽

Shahad Y. Assiri ◽

Assayl R. AlOtiabi ◽

Deemah M. Bin-Nooh ◽

...

Keyword(s):

Surgical Outcomes ◽

Endoscopic Sinus Surgery ◽

T Test ◽

Sinus Surgery ◽

Symptom Improvement ◽

P Value ◽

Psychological Dysfunction ◽

Significant Difference ◽

The Mean ◽

Snot 22

Abstract Background Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients. Methods This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS. Results The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value = < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value = < 0.001); ear/facial symptoms (t-test = 6.34, p-value = < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value = < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = − 2.16, df = 66, p = 0.035). Conclusion Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life. Level of evidence Prospective observational.

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Assessment of the Tissue Response to Modification of the Surface of Dental Implants with Carboxyethylphosphonic Acid and Basic Fibroblastic Growth Factor Immobilization (Fgf-2): An Experimental Study on Minipigs

Biology ◽

10.3390/biology10050358 ◽

2021 ◽

Vol 10 (5) ◽

pp. 358

Author(s):

Javier Aragoneses ◽

Ana Suárez ◽

Nansi López-Valverde ◽

Francisco Martínez-Martínez ◽

Juan Manuel Aragoneses

Keyword(s):

Surface Treatment ◽

Test Group ◽

Mean Value ◽

Control Group ◽

P Value ◽

Implant Surface ◽

Bone Contact ◽

Bone Implant ◽

Significant Difference ◽

The Mean

The aim of this study was to evaluate the effect of implant surface treatment with carboxyethylphosphonic acid and fibroblast growth factor 2 on the bone–implant interface during the osseointegration period in vivo using an animal model. The present research was carried out in six minipigs, in whose left tibia implants were inserted as follows: eight implants with a standard surface treatment, for the control group, and eight implants with a surface treatment of carboxyethylphosphonic acid and immobilization of FGF-2, for the test group. At 4 weeks after the insertion of the implants, the animals were sacrificed for the histomorphometric analysis of the samples. The means of the results for the implant–bone contact variable (BIC) were 46.39 ± 17.49% for the test group and 34.00 ± 9.92% for the control group; the difference was not statistically significant. For the corrected implant–bone contact variable (BICc), the mean value of the test group was 60.48 ± 18.11%, and that for the control group, 43.08 ± 10.77%; the difference was statistically significant (p-value = 0.035). The new bone formation (BV/TV) showed average results of 27.28 ± 3.88% for the test group and 26.63 ± 7.90% for the control group, meaning that the differences were not statistically significant (p-value = 0.839). Regarding the bone density at the interthread level (BAI/TA), the mean value of the test group was 32.27 ± 6.70%, and that of the control group was 32.91 ± 7.76%, with a p-value of 0.863, while for the peri-implant density (BAP/TA), the mean value of the test group was 44.96 ± 7.55%, and that for the control group was 44.80 ± 8.68%, without a significant difference between the groups. The current research only found a significant difference for the bone–implant contact at the cortical level; therefore, it could be considered that FGF-2 acts on the mineralization of bone tissue. The application of carboxyethylphosphonic acid on the surface of implants can be considered a promising alternative as a biomimetic coating for the immobilization of FGF-2. Despite no differences in the new bone formation around the implants or in the interthread or peri-implant bone density being detected, the biofunctionalization of the implant surface with FGF-2 accelerates the mineralization of the bone–implant interface at the cortical level, thereby reducing the osseointegration period.

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617 Who Benefits the Most from Burn Camps?

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.267 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S162-S163

Author(s):

Jennifer B Radics-Johnson ◽

Daniel W Chacon ◽

Li Zhang

Keyword(s):

Retrospective Review ◽

Burn Injury ◽

Statistical Significance ◽

Categorical Variables ◽

P Value ◽

Continuous Variables ◽

Self Evaluation ◽

Significant Difference ◽

Return Home ◽

The Impact

Abstract Introduction Burn camps provide a unique environment and activities for children that have experienced a burn-injury. Positive outcomes from attending burn camp include increased self-esteem, decreased feelings of isolation and a greater sense of self-confidence. In a 3-year retrospective review of camper evaluations from one of the largest and longest running week-long burn camps in the nation for ages 5–17, we aimed to assess if a child’s gender, age, TBSA or ethnicity affected the impact that burn camp had on a child. Methods A 3-year retrospective review of a Burn Camp’s camper evaluation forms was conducted for campers that attended burn camp between 2017–2019. Camp rosters were reviewed to determine the camper gender, age, TBSA and ethnicity. Camper self-evaluation forms completed at the end of each camp session were reviewed to record camper responses to questions regarding their opinions on the impact camp had on them as well as how camp will impact their lives once they return home. Categorical variables were summarized as frequency and percentage, and continuous variables were described as median and range. To check the relationship between two categorical variables, Chi-square test was used. To compare the continuous variable among groups, Kruskal-Wallis ANOVA was used. Statistical significance was declared based on a p value< 0.5. Results Within 2017–2019, there were 413 camper records. Participants’ demographic characteristics are summarized in Table 1. There were 208 males (50.3%) and 205 females (49.6%). The median age of campers were 11.86, 12.44 and 12.45 for 2017–2019, with the range from 5.16 years to 17.96 years. The median TBSA were 20, 20 and 18 for 2017–2019, with the range from 0.08 to 90. Collectively there were 47.7% Hispanic (n= 197); 24.2% Whites (n=100); 13.1% Black (n= 54); 4.6% Asian (n=19) and 7.7% Other (n=32). There were 395 camper self-evaluation forms submitted. Results of three questions there we were interested in are summarized collectively in Table 2. 57% of campers responded, “Yes, Definitely” to the question “After going to this event, will you feel more comfortable being around your classmates or friends?” 54% responded, “ Yes, Definitely” to the question “Do you feel more confidents in sharing your burn story with others when returning home?” and 51% responded “Yes, Definitely” to “Did you learn anything that will help you when you return home?” Conclusions In analyzing the camper responses, there was no statistically significant difference in responses comparing gender, age, TBSA or ethnicity.

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TO COMPARE THE EFFECTIVENESS OF NEBULISATION WITH ADRENALINE, 3% HYPERTONIC SALINE AND NORMAL SALINE IN BRONCHIOLITIS IN CHILDREN OF 2 TO 24 MONTHS OF AGE BASED ON CLINICAL SEVERITY SCORE AND NEBULISATION FREQUENCY.

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i2.1764 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Priyanka Jain ◽

Rakesh Jain

Keyword(s):

Hypertonic Saline ◽

Normal Saline ◽

Mean Difference ◽

Clinical Severity ◽

Research Centre ◽

P Value ◽

College Hospital ◽

Mean Values ◽

Significant Difference ◽

The Mean

Background & Method: We conducted a double blinded study at Index Medical College Hospital & Research Centre, Indore. The sample size was determined to be minimum of 120 cases as based upon previous years admission due to acute bronchiolitis. Initially, 146 cases were included in the study out of which 23 cases dropped out of the study after giving consent by guardian for participation in the study as they left against medical advice from the hospital. Result: The mean difference of CSS between 0 minutes to 60 minutes of nebulisation between groups in all cases was 0.4 ± 0.6, between 60 minutes and 4 hours was 0.8 ± 0.6, between 4 to 8 hours was 0.7 ± 0.6, between 8-12 hours was 0.6 ± 0.4, between 12-24 hours was 1.6 ± 0.9 and between 24-48 hours was 1.9 ± 0.9.The mean values and resultant p-value of ANOVA of various nebulising agents used for improvement in CSS shows significant association between various nebulising agents used along with improvement in CSS at the end of assessment at 48 hours of treatment. Conclusion: This study was conducted to establish the efficacy of each nebulisation agent (i.e. adrenaline, 3% hypertonic saline and normal saline) currently used and compare the outcomes as there is not enough evidence amongst Indian population on level of efficacy of each drug in causing improvement in symptoms and signs in various severities of bronchiolitis in early childhood. Comparison of significant improvement in mean difference in CSS at various intervals in all cases compared between groups by post hoc test revealed non-significant difference (p-value 0.700) between 3% hypertonic saline and normal saline. Keywords: nebulisation, adrenaline, bronchiolitis & clinical.

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Abstract 13131: The Priority of Coronary Arteriography and Therapeutic Hypothermia After Return of Spontaneous Circulation in Patients With Out-of-hospital Cardiac Arrest. the Result of Sos-kanto 2012 Study

Circulation ◽

10.1161/circ.130.suppl_2.13131 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Shuichi Hagiwara ◽

Kiyohiro Oshima ◽

Masato Murata ◽

Makoto Aoki ◽

Kei Hayashida ◽

...

Keyword(s):

Cardiac Arrest ◽

Therapeutic Hypothermia ◽

Statistical Significance ◽

Coronary Arteriography ◽

Spontaneous Circulation ◽

P Value ◽

Return Of Spontaneous Circulation ◽

Overall Performance ◽

The Mean ◽

Hospital Cardiac Arrest

Aim: To evaluate the priority of coronary angiography (CAG) and therapeutic hypothermia therapy (TH) after return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest (OHCA). Patients and Methods: SOS-KANTO 2012 study is a prospective, multicenter (69 emergency hospitals) and observational study and includes 16,452 patients with OHCA. Among the cases with ROSC in that study, we intended for patients treated with both CAG and TH within 24 hours after arrival. Those patients were divided into two groups; patients in whom TH was firstly performed (TH group), and the others in whom CAG was firstly done (CAG group). We statistically compared the prognosis between the two groups. SPSS Statistics 22 (IBM, Tokyo, Japan) was used for the statistical analysis. Statistical significance was assumed to be present at a p value of less than 0.05. Result: 233 patients were applied in this study. There were 86 patients in the TH group (M/F: 74/12, mean age; 60.0±15.2 y/o) and 147 in the CAG group (M/F: 126/21, mean age: 63.4±11.1 y/o) respectively, and no significant differences were found in the mean age and M/F ratio between the two groups. The overall performance categories (OPC) one month after ROSC in the both groups were as follows; in the TH group, OPC1: 21 (24.4%), OPC2: 3 (3.5%), OPC3: 7 (8.1%), OPC4: 8 (9.3%), OPC5: 43 (50.0%), unknown: 4 (4.7%), and in the CAG group, OPC1: 38 (25.9%), OPC2: 13 (8.8%), OPC3: 15 (10.2%), OPC4: 18 (12.2%), OPC5: 57 (38.8%), unknown: 6 (4.1%). There were no significant differences in the prognosis one month after ROSC between the two groups. Conclusion: The results which of TH and CAG you give priority to over do not affect the prognosis in patients with OHCA.

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Abstract P42: Active Compression Decompression-CPR in an Infant Manikin Model Using a Novel Adhesive Glove Device

Circulation ◽

10.1161/circ.118.suppl_18.s_1454-b ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Sharda Udassi ◽

Jai P Udassi ◽

Melissa Lamb ◽

Doug Theriaque ◽

Arno L Zaritsky ◽

...

Keyword(s):

Healthcare Providers ◽

Crossover Design ◽

P Value ◽

Compression Pressure ◽

Compression Depth ◽

Significant Difference ◽

The Mean ◽

Chest Decompression ◽

Acd Cpr ◽

Paired T Test

Introduction: In animals Active Compression-Decompression(ACD)-CPR improves hemodynamics compared with standard CPR (S-CPR). We evaluated the feasibility of achieving ACD-CPR with a novel, simple and inexpensive Adhesive Glove Device (AGD) in an infant manikin model using two thumb (TT) chest compression. Hypothesis: AGD-ACD CPR provides better chest decompression compared to S-CPR in an infant manikin model without excessive rescuer fatigue. Methods: Laerdal ™ Baby ALS Trainer manikin was modified to digitally record compression pressure (CP), compression depth (CD) and decompression depth (DD). The thumb portion of two oven mitts were sewn together and a Velcro adhesive patch was stitched on the underside with an encircling adjustable strap for proper fit to create the AGD. An interlocking Velcro patch was glued to the manikin chest wall. Sixteen BLS or PALS certified healthcare providers were prospectively randomized to perform either two-thumb S-CPR or AGD-ACD-CPR for 5 minutes with a 30:2 compression:ventilation ratio using a crossover design. During AGD-ACD-CPR subjects were asked to pull up during chest decompression. Rescuer heart rate (HR), respiratory rate (RR), recovery time (RT) for HR/RR to return to baseline and actual compressions delivered per minute were recorded. Subjects were blinded to data recordings. Data (mean±SEM) was analyzed using 2 sided paired t-test; p-value ≤0.05 was considered significant. Results: Chest decompression was greater with AGD-ACD-CPR; the mean DD difference was 0.11±0.02 inches, p=<0.001. Compressions given per minute were 102±21 in S-CPR group vs. 96±16 in AGD-ACD-CPR group, p=0.04. In AGD-CPR 75% and in S-CPR only 12% of subjects achieved complete recoil to or beyond baseline. There was no significant difference in CD, CP, HR, RR and RT between the groups. Conclusions: Active decompression and improved recoil was achievable with the use of our simple, inexpensive AGD in this infant CPR model. Use of our device did not result in excessive rescuer fatigue compared to S-CPR. The clinical significance of 6 less compressions/minute in the AGD-CPR group needs to be determined.

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To screen or not to screen? Vitamin D deficiency in chronic mental illness

Australasian Psychiatry ◽

10.1177/1039856217726717 ◽

2017 ◽

Vol 26 (1) ◽

pp. 56-59

Author(s):

Ivana Goluza ◽

Jay Borchard ◽

Nalin Wijesinghe ◽

Kishan Wijesinghe ◽

Nagesh Pai

Keyword(s):

Vitamin D ◽

Length Of Stay ◽

P Value ◽

Hydroxyvitamin D ◽

Psychiatric Setting ◽

Retrospective Audit ◽

Vitamin D Levels ◽

Significant Difference ◽

25 Hydroxyvitamin D ◽

The Mean

Objectives: The objective of the current study was to examine the pathology test utilisation of 25-hydroxyvitamin D (25(OH)D) within an Australian inpatient psychiatric setting. Method: A retrospective audit of 300 random hospital files of those admitted as inpatients between Nov 2014 and Nov 2015 was undertaken. Data was quantitatively analysed and described. Results: The number of inpatients who had a vitamin D determination during their admission was 37/300 (12.33%). The mean vitamin D level of those tested was 51.63 nmol/l. Of those that were tested, 18/37 (48.6%) were mildly to moderately deficient. There was a statistically significant difference in age and length of stay between those that were and were not tested for vitamin D levels, p-value <0.001 and 0.017, respectively. In addition, a simple linear regression indicated a weak association between length of stay and vitamin D levels. Conclusion: This audit highlights vitamin D screening inadequacy. More research is recommended to establish tangible benefits of supplementation, while local practice provides valuable data for education and policy purposes.

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