scholarly journals Proposing an Endotracheal Tube Selection Tool Based on Multivariate Analysis of Airway Imaging

2020 ◽  
pp. 014556131990039
Author(s):  
Yousef Aljathlany ◽  
Abdullah Aljasser ◽  
Abdullah Alhelali ◽  
Manal Bukhari ◽  
Mohammed Almohizea ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Regression Analysis ◽  
Endotracheal Tube ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Care Center ◽  
Tertiary Care ◽  
Transverse Diameter ◽  
Cross Sectional ◽  
The Mean

Objectives: We aimed to comprehensively investigate different upper airway segments in adults, determine the predictors of the size of each segment, and identify an appropriate endotracheal tube (ETT) size chart. Study Design: Retrospective chart review. Setting: Tertiary care center. Materials and Methods: The data for patients aged >18 years who underwent neck computed tomography were screened. Patients with existing tumors, trauma, or any pathology that can alter the normal airway anatomy and those with intubation, tracheostomy, or nasogastric tubes were excluded. Computed tomography software was used to measure the anteroposterior diameter (APD), transverse diameter (TD), and cross-sectional area (CSA) at the glottic, proximal subglottic, distal subglottic, and tracheal levels. Multiple regression analysis was used to identify the predictors of the airway size. Results: One hundred patients were reviewed. The TD was consistently smaller than or equal to the APD at each level in all but 3 patients. The mean CSA and TD (170 mm2 and 11.3 mm, respectively) of the glottis indicated that the glottis was most often the narrowest level, followed by the proximal subglottis where the mean CSA and TD were 192.1 mm2 and 12.7 mm, respectively. Moreover, the mean APD was the smallest at the level of the trachea (20.1 mm). Multiple regression analysis confirmed that height and sex were the predominant predictors of measurements for the 4 airway segments. In addition, age was associated with the TD and CSA of the distal subglottic and tracheal segments, respectively. Conclusion: One-third of our participants exhibited a proximal subglottic diameter that was equal to or smaller than the glottic diameter. Our findings also suggested that the height and sex of the patients are important variables for the selection of an appropriate ETT size.

scholarly journals Benefits of computed tomography in reducing mortality in emergency medicine

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 394-401 ◽  
Author(s):  
Shinya Imai ◽  
Manabu Akahane ◽  
Yuto Konishi ◽  
Tomoaki Imamura
Keyword(s):  
Computed Tomography ◽  
Emergency Medicine ◽  
Regression Analysis ◽  
Population Density ◽  
Beneficial Effect ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Utilization Rate ◽  
Cross Sectional ◽  
Ct Utilization

AbstractPerforming accurate diagnosis using computed tomography (CT) in emergency medicine may reduce mortality rates in various diseases. In this observational, correlational and cross-sectional study, we conducted multiple regression analyses to investigate the relationship between CT utilization rates and mortality. In addition, we estimated the annual net profits from CT to show the profitability of introducing a CT system in each Japanese prefecture.We conducted a multiple regression analysis to investigate correlations between CT utilization rates and mortality from each disease adjusted for the population density, number of doctors, as well as transportation time to the medical institution.The results of multiple regression analysis showed that traffic accident mortality was related to CT utilization rate and population density. Extrinsic death such as mortality due to falling, drowning and asphyxia was related to CT utilization, indicating that CT in emergency medicine reduced mortality. Moreover, the annual net profit from multi-slice CT (MSCT) was estimated as positive.Our study clearly demonstrates that CT utilization rates relate to a reduction in mortality from accidents, indicating that screening patients with CT in the emergency room has a beneficial effect and reduces mortality. Therefore, CT equipment has a beneficial effect in both emergency medicine and hospital management.

The Relationship Between The Perception of Elderly’s Health Status and Health Behaviors in Nakhon Nayok Province, Thailand

2019 ◽  
Vol 12 (1) ◽  
pp. 420-423
Author(s):  
Prapada Watcharanat ◽  
Prasong Tanpichai ◽  
Ravee Sajjasophon
Keyword(s):  
Regression Analysis ◽  
Health Status ◽  
Health Behaviors ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Statistical Significance ◽  
The Elderly ◽  
Cross Sectional ◽  
Congenital Diseases ◽  
The Relationship

Purpose: This research aims to study the relationship between perception of elderly’s health and health behaviors in Nakhon Nayok province, Thailand Methods: This research was a cross-sectional study. The questionnaire was used to collect the data. This research was conducted in Nakhon Nayok province. The sample size was 270 which applied Taro Yamane's formula at a significant level 0.05. The descriptive statistics was implemented to describe the variables by presenting the frequency, percentage, mean and standard deviation. Furthermore, multiple regression analysis was applied to analyze the relationship between perception of elderly’s health and health behaviors. The statistical significance was considered to reject Hypothesis-null at < 0.05. Results: From a total of 270 people, more than 58.22% of the elderly perceived that they had moderate health conditions. Most elderly had congenital diseases (62.2%). The multiple regression analysis results showed that health status perception and health status perception when compared to their cohort related significantly to health behavior. Conclusion: The government should support the elderly on participation, trust, engagement, and cultural concern of the people in the community, which can contribute to promoting the physical, mental and social condition of the elderly.

Prehospital Intubations Are Associated with Elevated Endotracheal Tube Cuff Pressures: A Cross-Sectional Study Characterizing ETT Cuff Pressures at a Tertiary Care Emergency Department

2021 ◽  
pp. 1-4
Author(s):  
Ruo S. Chen ◽  
Laurel O’Connor ◽  
Matthew R. Rebesco ◽  
Kara L. LaBarge ◽  
Edgar J. Remotti ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Endotracheal Tube Cuff ◽  
Cross Sectional ◽  
Tube Cuff ◽  
Respiratory Therapists ◽  
Significant Difference

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.

scholarly journals Factors Affecting Radiation Dose in Computed Tomography Angiograms for Pulmonary Embolism: A Retrospective Cohort Study

2020 ◽  
Vol 10 ◽  
pp. 74
Author(s):  
Prashant Nagpal ◽  
Sarv Priya ◽  
Ali Eskandari ◽  
Aidan Mullan ◽  
Tanya Aggarwal ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Radiation Dose ◽  
Care Center ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Analysis ◽  
Factors Affecting ◽  
Model Based ◽  
Pulmonary Angiogram ◽  
The Mean

Objectives: Computed tomography pulmonary angiogram (CTPA) is one of the most commonly ordered and frequently overused tests. The purpose of this study was to evaluate the mean radiation dose to patients getting CTPA and to identify factors that are associated with higher dose. Material and Methods: This institutionally approved retrospective study included all patients who had a CTPA to rule out acute pulmonary embolism between 2016 and 2018 in a tertiary care center. Patient data (age, sex, body mass index [BMI], and patient location), CT scanner type, image reconstruction methodology, and radiation dose parameters (dose-length product [DLP]) were recorded. Effective dose estimates were obtained by multiplying DLP by conversion coefficient (0.014 mSv•mGy−1•cm−1). Multivariate logistic regression analysis was performed to determine the factors affecting the radiation dose. Results: There were 2342 patients (1099 men and 1243 women) with a mean age of 58.1 years (range 0.2–104.4 years) and BMI of 31.3 kg/m2 (range 12–91.5 kg/m2). The mean effective radiation dose was 5.512 mSv (median – 4.27 mSv; range 0.1–43.0 mSv). Patient factors, including BMI >25 kg/m2, male sex, age >18 years, and intensive care unit (ICU) location, were associated with significantly higher dose (P < 0.05). CT scanning using third generation dual-source scanner with model-based iterative reconstruction (IR) had significantly lower dose (mean: 4.90 mSv) versus single-source (64-slice) scanner with filtered back projection (mean: 9.29 mSv, P < 0.001). Conclusion: Patients with high BMI and ICU referrals are associated with high CT radiation dose. They are most likely to benefit by scanning on newer generation scanner using advance model-based IR techniques.

scholarly journals Usefulness of the Non-Contact Tonometry in Out-Patient Screening

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Satheesh Solomon T Selvin ◽  
Chris Elsa Samson Jacob ◽  
Thomas Kuriakose
Keyword(s):  
Central Corneal Thickness ◽  
Care Center ◽  
Corneal Thickness ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Cross Sectional ◽  
Significant Difference ◽  
Iop Measurement ◽  
The Mean

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg.  The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram. 

scholarly journals Unmet Needs and Quality of Life of Caregivers of Korean Breast Cancer Survivors: A Cross-Sectional Study

2020 ◽  
Author(s):  
Jong Won Lee ◽  
Jihyoun Lee ◽  
Min Hyuk Lee ◽  
Se Kyung Lee ◽  
Wan Sung Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Regression Analysis ◽  
Cancer Survivors ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Breast Cancer Survivors ◽  
Unmet Needs ◽  
Cross Sectional

Abstract Backgroud: As the survival rates of cancer patients have been increasing due to early diagnosis and technological advances in treatment, their caregiver burden has also emerged as an important issue. In view of this situation, this study aims to investigate the unmet needs and quality of life of caregivers of Korean breast cancer survivors.Methods: A multicenter cross-sectional interview survey was performed among 160 caregivers of Korean breast cancer survivors. Caregivers who gave written informed consent to participate completed the Comprehensive Needs Assessment Tool for Cancer Caregivers and EuroQol-5 Dimensions. Data were analyzed using the t-test, ANOVA and multiple regression analysis.Results: The mean age of the caregivers was 46.4 years, 44.4% (71/160) were spouses of patients, and 52.5% (84/160) were personally taking care of cancer survivors. Unmet needs were highest in the ‘healthcare staff’ domain (mean ± SD: 1.69 ±1.11), and the item with the highest level of unmet needs was ‘needed information about the current status of the patient’s illness and its future courses’ (1.98 ± 1.04). Unmet needs were correlated with age, educational level, marital status, employment, religion and psychosocial status. Poorer quality of life was closely related to higher levels of unmet needs. In multiple regression analysis, age, employment, religion, and levels of stress and despair were closely associated with unmet needs.

Determinants of Employee Motivation

2022 ◽  
pp. 130-149
Author(s):  
Bikash Basnet ◽  
Sarah Eyaa ◽  
Nekpen Euodia Okhawere
Keyword(s):  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Employee Motivation ◽  
Expectancy Theory ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mediation Effects ◽  
Indirect Impact ◽  
The Relationship

This chapter integrates collectivism with the dimensions of the Expectancy Theory to investigate the direct and indirect impact of horizontal and vertical collectivism on employee motivation of operational and non-operational staff. Data were collected from 205 employees using a cross-sectional survey. Hypotheses were tested with multiple regression analysis. Across both employee categories, horizontal collectivism improves motivation while vertical collectivism does not have a significant impact on motivation. Mediation effects were significant in the relationship between horizontal collectivism across both employee categories. However, there were some variations in the mediation effects on the relationship between vertical collaboration and motivation across the two categories. This chapter contributes to motivation literature by integrating the Expectancy Theory with two under-investigated dimensions of collectivism to compare motivation determinants among operational and non-operational staff. This chapter presents implications for managers and policy for improving employee motivation.

Multiple regression analysis of factors influencing dominant hand grip strength in an adult Malaysian population

2011 ◽  
Vol 37 (1) ◽  
pp. 65-70 ◽  
Author(s):  
M. G. Hossain ◽  
R. Zyroul ◽  
B. P. Pereira ◽  
T. Kamarul
Keyword(s):  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Grip Strength ◽  
Multiple Regression ◽  
Hand Grip Strength ◽  
Dominant Hand ◽  
Asian Ethnicity ◽  
Malaysian Population ◽  
Hand Grip ◽  
The Mean

Grip strength is an important measure used to monitor the progression of a condition, and to evaluate outcomes of treatment. We assessed how various physical and social factors predict normal grip strength in an adult Malaysian population of mixed Asian ethnicity (254 men, 246 women). Grip strength was recorded using the Jamar dynamometer. The mean grip strength for the dominant hand was 29.8 kg for men and 17.6 kg for women. Multiple regression analysis demonstrated that the dominant hand grip strength was positively associated with height and body mass index, and negatively associated with age for both sexes. Dominant hand grip strength was related to work status for men ( p < 0.05) but not for women. However, there was no difference in grip strength among ethnic groups.

scholarly journals Explanatory histological findings for urinary protein and serum creatinine levels at renal biopsy in lupus nephritis: A cross-sectional study

2020 ◽  
Author(s):  
Eri Katsuyama ◽  
Yoshia Miyawaki ◽  
Ken-ei Sada ◽  
Yosuke Asano ◽  
Keigo Hayashi ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Lupus Nephritis ◽  
Serum Creatinine ◽  
Renal Biopsy ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Urinary Protein ◽  
Fibrinoid Necrosis ◽  
Class Iii ◽  
The Mean

Abstract Background To evaluate histological active and chronic lesions associated with proteinuria and serum creatinine (SCr) level as common clinical endpoints in many clinical trials for lupus nephritis (LN). Methods One hundred and nineteen patients from 1990 to 2015 with LN class III, IV, and V, as defined by the International Society of Nephrology/Renal Pathology Society classification, were enrolled. Multiple regression analysis was performed to explore semiquantitative histological variables related to urinary protein and SCr levels. Results The mean age of enrolled patients was 45 years and 79% were female. The mean SCr level was 0.87 mg/dl and mean urinary protein was 3.00 g/gCr at the time of the renal biopsy. Class IV (71%) was the most common type, followed by class III (17%) and class V (13%). Multicollinearity was confirmed between monocellular infiltration (variance inflation factor [VIF] = 10.22) and interstitial fibrosis (VIF = 10.29) and between karyorrhexis (VIF = 4.14) and fibrinoid necrosis (VIF = 4.29). After excluding fibrinoid necrosis and monocellular infiltration because of multicollinearity, only urinary protein level was correlated with wire loop (β−coefficient [β]: 1.09 and confidence interval [CI]: 0.35 to 1.83), and SCr level was correlated with glomerular sclerosis (β: 1.08 and CI: 0.43 to 1.74) by multiple regression analysis. Conclusion As urinary protein and SCr levels could not reflect active lesions quantitatively, they might be difficult to be evaluated for response to induction remission treatments in patients with LN.

scholarly journals Subjective well-being and month-long LF/HF ratio among deskworkers

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257062
Author(s):  
Kiko Shiga ◽  
Keisuke Izumi ◽  
Kazumichi Minato ◽  
Tatsuki Sugio ◽  
Michitaka Yoshimura ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Positive Emotion ◽  
Negative Emotion ◽  
Well Being ◽  
Satisfaction With Life Scale ◽  
Parasympathetic Nerve ◽  
Pulse Waves ◽  
The Mean

The importance of workers’ well-being has been recognized in recent years. The assessment of well-being has been subjective, and few studies have sought potential biomarkers of well-being to date. This study examined the relationship between well-being and the LF/HF ratio, an index of heart rate variability that reflects sympathetic and parasympathetic nerve activity. Pulse waves were measured using photoplethysmography through a web camera attached to the computer used by each participant. The participants were asked to measure their pulse waves while working for 4 weeks, and well-being was assessed using self-reported measures such as the Satisfaction With Life Scale (SWLS), the Positive and Negative Affect Schedule (PANAS), and the Flourishing Scale (FS). Each of the well-being scores were split into two groups according to the median value, and the LF/HF ratio during work, as well as the number of times an LF/HF ratio threshold was either exceeded or subceeded, were compared between the high and low SWLS, positive emotion, negative emotion, and FS groups. Furthermore, to examine the effects of the LF/HF ratio and demographic characteristics on well-being, a multiple regression analysis was conducted. Data were obtained from 169 participants. The results showed that the low FS group had a higher mean LF/HF ratio during work than the high FS group. No significant differences were seen between the high and low SWLS groups, the high and low positive emotion groups, or the high and low negative emotion groups. The multiple regression analysis showed that the mean LF/HF ratio during work affected the FS and SWLS scores, and the number of times the mean LF/HF ratio exceeded +3 SD had an effect on the positive emotion. No effect of the LF/HF ratio on negative emotions was shown. The LF/HF ratio might be applicable as an objective measure of well-being.

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