Pub Date : 2023-11-24DOI: 10.6000/1929-6029.2023.12.25
Goutam Barman, B. Seal, Shreya Bhunia, P. Banerjee
Recurrent events like repeated hospitalization, cancer tumour recurrences, and many others occur frequently. The follow-up on recurrent events may be stopped by a terminal event like death. It is obvious that if the frequencies of recurrent events are more, then it may lead to a terminal event and in this case terminal event becomes ‘dependent’. In this article, we study a joint modelling and analysis of recurrent events with a dependent terminal event. Here, the proportional intensity model for the recurrent events process and the proportional hazard model for the terminal event time are taken. To account for the association between recurrent events and terminal events, mixing frailty or random effect is studied rather than available pure frailty. In our case, the distribution of frailty is introduced as a mixture of folded normal distribution and gamma distribution rather than using pure gamma distribution. An estimation procedure in the joint frailty model is applied to estimate the parameters of the model. This method is close to the method of minimum chi-square rather than a complicated one. An extensive simulation study has been performed to estimate the model parameters and the performances are evaluated based on bias and MSE criteria. Further from an application point of view, the method is illustrated to a hospital readmission data for colorectal cancer patients.
{"title":"Joint Frailty Mixing Model for Recurrent Event Data with an Associated Terminal Event: Application to Hospital Readmission Data","authors":"Goutam Barman, B. Seal, Shreya Bhunia, P. Banerjee","doi":"10.6000/1929-6029.2023.12.25","DOIUrl":"https://doi.org/10.6000/1929-6029.2023.12.25","url":null,"abstract":"Recurrent events like repeated hospitalization, cancer tumour recurrences, and many others occur frequently. The follow-up on recurrent events may be stopped by a terminal event like death. It is obvious that if the frequencies of recurrent events are more, then it may lead to a terminal event and in this case terminal event becomes ‘dependent’. In this article, we study a joint modelling and analysis of recurrent events with a dependent terminal event. Here, the proportional intensity model for the recurrent events process and the proportional hazard model for the terminal event time are taken. To account for the association between recurrent events and terminal events, mixing frailty or random effect is studied rather than available pure frailty. In our case, the distribution of frailty is introduced as a mixture of folded normal distribution and gamma distribution rather than using pure gamma distribution. An estimation procedure in the joint frailty model is applied to estimate the parameters of the model. This method is close to the method of minimum chi-square rather than a complicated one. An extensive simulation study has been performed to estimate the model parameters and the performances are evaluated based on bias and MSE criteria. Further from an application point of view, the method is illustrated to a hospital readmission data for colorectal cancer patients.","PeriodicalId":73480,"journal":{"name":"International journal of statistics in medical research","volume":"67 4-5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139240701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-24DOI: 10.6000/1929-6029.2023.12.26
T. F. Raham, Haider Hussain Ali Al. Zubaidi, Abbas Oweid Olewi, Aya Ahmed Abddul-Fatah Al-Aboosi, Nassera Attia, Senaa Jaleel, Abdulkhaleq Abduljabbar Ali Ghalib Al-Naqeeb
Choosing antimicrobials is a common dilemma when the expected rate of bacterial resistance is high. The observed resistance values in unequal groups of isolates tested for different antimicrobials can be misleading. This can affect the decision to recommend one antibiotic over the other. We analyzed recalled data with the statistical consideration of unequal sample groups. Data was collected concerning children suspected to have typhoid fever at Al Alwyia Pediatric Teaching Hospital in Baghdad, Iraq. The study period extended from September 2021 to September 2022. A novel algorithm was developed to compare the drug sensitivity among unequal numbers of Salmonella typhi (S. Typhi) isolates tested with different antibacterials. According to the proposed algorithm, the predicted resistance values were more valid than the observed values. This proposed algorithm is expected to help the hospital antibiotic policy committee recommend the proper antibacterial agents for S. Typhi and further bacterial isolates.
{"title":"A Novel Algorithm for Predicting Antimicrobial Resistance in Unequal Groups of Bacterial Isolates","authors":"T. F. Raham, Haider Hussain Ali Al. Zubaidi, Abbas Oweid Olewi, Aya Ahmed Abddul-Fatah Al-Aboosi, Nassera Attia, Senaa Jaleel, Abdulkhaleq Abduljabbar Ali Ghalib Al-Naqeeb","doi":"10.6000/1929-6029.2023.12.26","DOIUrl":"https://doi.org/10.6000/1929-6029.2023.12.26","url":null,"abstract":"Choosing antimicrobials is a common dilemma when the expected rate of bacterial resistance is high. The observed resistance values in unequal groups of isolates tested for different antimicrobials can be misleading. This can affect the decision to recommend one antibiotic over the other. We analyzed recalled data with the statistical consideration of unequal sample groups. Data was collected concerning children suspected to have typhoid fever at Al Alwyia Pediatric Teaching Hospital in Baghdad, Iraq. The study period extended from September 2021 to September 2022. A novel algorithm was developed to compare the drug sensitivity among unequal numbers of Salmonella typhi (S. Typhi) isolates tested with different antibacterials. According to the proposed algorithm, the predicted resistance values were more valid than the observed values. This proposed algorithm is expected to help the hospital antibiotic policy committee recommend the proper antibacterial agents for S. Typhi and further bacterial isolates.","PeriodicalId":73480,"journal":{"name":"International journal of statistics in medical research","volume":"27 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139242505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-15DOI: 10.6000/1929-6029.2023.12.24
Danh V Nguyen, Qi Qian, Amy S. You, Esra Kurum, Connie M. Rhee, Damla Senturk
Profiling analysis aims to evaluate health care providers, including hospitals, nursing homes, or dialysis facilities among others with respect to a patient outcome, such as 30-day unplanned hospital readmission or mortality. Fixed effects (FE) profiling models have been developed over the last decade, motivated by the overall need to (a) improve accurate identification or “flagging” of under-performing providers, (b) relax assumptions inherent in random effects (RE) profiling models, and (c) take into consideration the unique disease characteristics and care/treatment processes of end-stage kidney disease (ESKD) patients on dialysis. In this paper, we review the current state of FE methodologies and their rationale in the ESKD population and illustrate applications in four key areas: profiling dialysis facilities for (1) patient hospitalizations over time (longitudinally) using standardized dynamic readmission ratio (SDRR), (2) identification of dialysis facility characteristics (e.g., staffing level) that contribute to hospital readmission, and (3) adverse recurrent events using standardized event ratio (SER). Also, we examine the operating characteristics with a focus on FE profiling models. Throughout these areas of applications to the ESKD population, we identify challenges for future research in both methodology and clinical studies.
剖析分析旨在评估医疗服务提供者，包括医院、疗养院或透析设施等与患者结果（如 30 天非计划再入院或死亡率）相关的服务提供者。固定效应（FE）分析模型在过去十年中得到了发展，其总体需求是：（a）提高准确识别或 "标记 "表现不佳的医疗服务提供者的能力；（b）放宽随机效应（RE）分析模型的固有假设；（c）考虑透析终末期肾病（ESKD）患者的独特疾病特征和护理/治疗过程。在本文中，我们回顾了 FE 方法的现状及其在 ESKD 群体中的合理性，并说明了在四个关键领域中的应用：利用标准化动态再入院率 (SDRR) 分析透析机构在以下方面的情况：（1）随时间推移（纵向）的患者住院情况；（2）确定导致再入院的透析机构特征（如人员配置水平）；（3）利用标准化事件比率 (SER) 分析不良复发事件。此外，我们还重点研究了 FE 剖析模型的运行特征。在这些应用于 ESKD 人群的领域中，我们确定了未来在方法论和临床研究方面的挑战。
{"title":"High-Dimensional Fixed Effects Profiling Models and Applications in End-Stage Kidney Disease Patients: Current State and Future Directions","authors":"Danh V Nguyen, Qi Qian, Amy S. You, Esra Kurum, Connie M. Rhee, Damla Senturk","doi":"10.6000/1929-6029.2023.12.24","DOIUrl":"https://doi.org/10.6000/1929-6029.2023.12.24","url":null,"abstract":"Profiling analysis aims to evaluate health care providers, including hospitals, nursing homes, or dialysis facilities among others with respect to a patient outcome, such as 30-day unplanned hospital readmission or mortality. Fixed effects (FE) profiling models have been developed over the last decade, motivated by the overall need to (a) improve accurate identification or “flagging” of under-performing providers, (b) relax assumptions inherent in random effects (RE) profiling models, and (c) take into consideration the unique disease characteristics and care/treatment processes of end-stage kidney disease (ESKD) patients on dialysis. In this paper, we review the current state of FE methodologies and their rationale in the ESKD population and illustrate applications in four key areas: profiling dialysis facilities for (1) patient hospitalizations over time (longitudinally) using standardized dynamic readmission ratio (SDRR), (2) identification of dialysis facility characteristics (e.g., staffing level) that contribute to hospital readmission, and (3) adverse recurrent events using standardized event ratio (SER). Also, we examine the operating characteristics with a focus on FE profiling models. Throughout these areas of applications to the ESKD population, we identify challenges for future research in both methodology and clinical studies.","PeriodicalId":73480,"journal":{"name":"International journal of statistics in medical research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139272149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-10DOI: 10.6000/1929-6029.2023.12.23
Mahmoud Alquraan, Sulaf Alazzam, Hakam Alkhateeb
Introduction: Many research studies have shown that students' evaluations of teaching(SET) are affected by different variables without testing the requirement of fair comparisons. These studies have not tested the measurement equivalency of SET surveys according to these variables. Measurement equivalency of SET refers to whether a SET survey is interpreted similarly across different groups of individuals (Variable Levels). Without evidence of measurement invariance across different variables under investigation, the SET ratings should not be compared across these variables and this is the goal of this study.
Methods: Measurement Invariance analysis of SET survey was investigated using 1649 responses to SET of four different medical core courses offered by the College of Science and College of Medicine and from different levels.
Results: The results showed the existence of teaching practices in the SET survey that are not equivalently loaded on its factor across the levels of targeted variables, and the college offered medical courses were a source of variation in basic medical science students’ evaluation of teaching effectiveness. On the other hand, teaching practices in the SET survey are equivalently loaded on its factor across course levels.
Discussion: The study results showed that the SET of medical courses is comparable to the courses only taught by the College of Medicine. These results provide evidence that medical courses are different from other courses offered by other colleges. This means that comparing SET of the College of Medicine with other colleges and colleges of medicine needs to compare SET results at the college level only.
{"title":"Using Measurement Invariance to Explore the Source of Variation in Basic Medical Science Students’ Evaluation of Teaching Effectiveness","authors":"Mahmoud Alquraan, Sulaf Alazzam, Hakam Alkhateeb","doi":"10.6000/1929-6029.2023.12.23","DOIUrl":"https://doi.org/10.6000/1929-6029.2023.12.23","url":null,"abstract":"Introduction: Many research studies have shown that students' evaluations of teaching(SET) are affected by different variables without testing the requirement of fair comparisons. These studies have not tested the measurement equivalency of SET surveys according to these variables. Measurement equivalency of SET refers to whether a SET survey is interpreted similarly across different groups of individuals (Variable Levels). Without evidence of measurement invariance across different variables under investigation, the SET ratings should not be compared across these variables and this is the goal of this study.
 Methods: Measurement Invariance analysis of SET survey was investigated using 1649 responses to SET of four different medical core courses offered by the College of Science and College of Medicine and from different levels.
 Results: The results showed the existence of teaching practices in the SET survey that are not equivalently loaded on its factor across the levels of targeted variables, and the college offered medical courses were a source of variation in basic medical science students’ evaluation of teaching effectiveness. On the other hand, teaching practices in the SET survey are equivalently loaded on its factor across course levels.
 Discussion: The study results showed that the SET of medical courses is comparable to the courses only taught by the College of Medicine. These results provide evidence that medical courses are different from other courses offered by other colleges. This means that comparing SET of the College of Medicine with other colleges and colleges of medicine needs to compare SET results at the college level only.","PeriodicalId":73480,"journal":{"name":"International journal of statistics in medical research","volume":"114 37","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135138244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-10DOI: 10.6000/1929-6029.2023.12.22
Kurdistan M. Taher Omar, Sameera Abdulsalam Othman
Objective: This research aims to compare two nonparametric functional regression models, the Kernel Model and the K-Nearest Neighbor (KNN) Model, with a focus on predicting scalar responses from functional covariates. Two semi-metrics, one based on second derivatives and the other on Functional Principle Component Analysis, are employed for prediction. The study assesses the accuracy of these models by computing Mean Square Errors (MSE) and provides practical applications for illustration.
Method: The study delves into the realm of nonparametric functional regression, where the response variable (Y) is scalar, and the covariate variable (x) is a function. The Kernel Model, known as funopare.kernel.cv, and the KNN Model, termed funopare.knn.gcv, are used for prediction. The Kernel Model employs automatic bandwidth selection via Cross-Validation, while the KNN Model employs a global smoothing parameter. The performance of both models is evaluated using MSE, considering two different semi-metrics.
Results: The results indicate that the KNN Model outperforms the Kernel Model in terms of prediction accuracy, as supported by the computed MSE. The choice of semi-metric, whether based on second derivatives or Functional Principle Component Analysis, impacts the model's performance. Two real-world applications, Spectrometric Data for predicting fat content and Canadian Weather Station data for predicting precipitation, demonstrate the practicality and utility of the models.
Conclusion: This research provides valuable insights into nonparametric functional regression methods for predicting scalar responses from functional covariates. The KNN Model, when compared to the Kernel Model, offers superior predictive performance. The selection of an appropriate semi-metric is essential for model accuracy. Future research may explore the extension of these models to cases involving multivariate responses and consider interactions between response components.
{"title":"Comparative Analysis of Predictive Performance in Nonparametric Functional Regression: A Case Study of Spectrometric Fat Content Prediction","authors":"Kurdistan M. Taher Omar, Sameera Abdulsalam Othman","doi":"10.6000/1929-6029.2023.12.22","DOIUrl":"https://doi.org/10.6000/1929-6029.2023.12.22","url":null,"abstract":"Objective: This research aims to compare two nonparametric functional regression models, the Kernel Model and the K-Nearest Neighbor (KNN) Model, with a focus on predicting scalar responses from functional covariates. Two semi-metrics, one based on second derivatives and the other on Functional Principle Component Analysis, are employed for prediction. The study assesses the accuracy of these models by computing Mean Square Errors (MSE) and provides practical applications for illustration.
 Method: The study delves into the realm of nonparametric functional regression, where the response variable (Y) is scalar, and the covariate variable (x) is a function. The Kernel Model, known as funopare.kernel.cv, and the KNN Model, termed funopare.knn.gcv, are used for prediction. The Kernel Model employs automatic bandwidth selection via Cross-Validation, while the KNN Model employs a global smoothing parameter. The performance of both models is evaluated using MSE, considering two different semi-metrics.
 Results: The results indicate that the KNN Model outperforms the Kernel Model in terms of prediction accuracy, as supported by the computed MSE. The choice of semi-metric, whether based on second derivatives or Functional Principle Component Analysis, impacts the model's performance. Two real-world applications, Spectrometric Data for predicting fat content and Canadian Weather Station data for predicting precipitation, demonstrate the practicality and utility of the models.
 Conclusion: This research provides valuable insights into nonparametric functional regression methods for predicting scalar responses from functional covariates. The KNN Model, when compared to the Kernel Model, offers superior predictive performance. The selection of an appropriate semi-metric is essential for model accuracy. Future research may explore the extension of these models to cases involving multivariate responses and consider interactions between response components.","PeriodicalId":73480,"journal":{"name":"International journal of statistics in medical research","volume":"112 51","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135137607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-10DOI: 10.6000/1929-6029.2023.12.20
Sarina Sukri, S. Riskiyani, M. Syafar
Background: A Partnership is one of the strategies for accelerating responses of Covid-19, especially in understanding the decisions made by the government and the various reactions of the community regarding the Covid-19 pandemic.
Objective: This study aims to explore partnership efforts pentahelix involving the government, academia, community, business sectors, and the media in handling Covid-19.
Methods: The qualitative study was carried out through in-depth interviews with 18 participants consisting of government, media, academics, and community elements. The participants were members of the Covid-19 Handling Task Force (Covid-19 Task Force) and people who were directly involved in handling Covid-19 in Makassar. The content analysis was performed using the collected data. The themes that emerge from the data are the pentahelix partnership with the government, community groups, academics, business sectors, and mass media. The data were collected from December 2022 to March 2023.
Results: The pentahelix partnership involves 5 parties: government, community, academics, business sectors, and the media. The partnership is accomplished through coordination, collaboration, participation, and mutual assistance. This partnership is established in the implementation of government policies in handling Covid-19 with the formation of Task Forces where the community participates in its implementation. Coordination between the government and academics regarding ways to resolve the Covid-19 case; collaboration with business sectors in providing facilities and infrastructure for handling Covid-19 activities as well as with the media that assist in disseminating information, public education, and news related to the incident of Covid-19 was adopted to implement the health policies during this pandemic.
Conclusion: handling covid-19 with pentahelix partnerships was carried out through coordination, collaboration, participation, and mutual assistance of all parties. The partnership process is a strategy for implementing health programs related to the handling of Covid-19 which are regulated by the government.
{"title":"The Pentahelix Partnership Responses during Covid-19 Pandemic in Makassar","authors":"Sarina Sukri, S. Riskiyani, M. Syafar","doi":"10.6000/1929-6029.2023.12.20","DOIUrl":"https://doi.org/10.6000/1929-6029.2023.12.20","url":null,"abstract":"Background: A Partnership is one of the strategies for accelerating responses of Covid-19, especially in understanding the decisions made by the government and the various reactions of the community regarding the Covid-19 pandemic.
 Objective: This study aims to explore partnership efforts pentahelix involving the government, academia, community, business sectors, and the media in handling Covid-19.
 Methods: The qualitative study was carried out through in-depth interviews with 18 participants consisting of government, media, academics, and community elements. The participants were members of the Covid-19 Handling Task Force (Covid-19 Task Force) and people who were directly involved in handling Covid-19 in Makassar. The content analysis was performed using the collected data. The themes that emerge from the data are the pentahelix partnership with the government, community groups, academics, business sectors, and mass media. The data were collected from December 2022 to March 2023.
 Results: The pentahelix partnership involves 5 parties: government, community, academics, business sectors, and the media. The partnership is accomplished through coordination, collaboration, participation, and mutual assistance. This partnership is established in the implementation of government policies in handling Covid-19 with the formation of Task Forces where the community participates in its implementation. Coordination between the government and academics regarding ways to resolve the Covid-19 case; collaboration with business sectors in providing facilities and infrastructure for handling Covid-19 activities as well as with the media that assist in disseminating information, public education, and news related to the incident of Covid-19 was adopted to implement the health policies during this pandemic.
 Conclusion: handling covid-19 with pentahelix partnerships was carried out through coordination, collaboration, participation, and mutual assistance of all parties. The partnership process is a strategy for implementing health programs related to the handling of Covid-19 which are regulated by the government.","PeriodicalId":73480,"journal":{"name":"International journal of statistics in medical research","volume":"111 22","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135138385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-10DOI: 10.6000/1929-6029.2023.12.21
Illia Deineko
Aim: This work aims to determine the effectiveness of the Crile procedure for optimizing the diagnosis and treatment of patients with locally advanced thyroid malignancies.
Objects: The objects of the study were the results of treatment of patients with thyroid cancer using two techniques: Crile procedure and vein resection with sealing and preservation of blood flow.
Materials and Methods: The research was carried out experimentally using Crile surgical intervention and vein resection with sealing and preservation of blood flow. The effectiveness of the treatment was assessed by observing the recurrence and mortality rates. The patient’s quality of life was assessed through the conversation and questionnaire survey.
Results and Findings: It was found that Doppler ultrasonography of the main vessels in the neck helps to establish the internal jugular vein invasion, as well as its tumour thrombosis at the preoperative stage in clinical cases of suspected extrathyroidal extension of thyroid tumours in addition to radiological methods. A thyroid gland with a tumour invaded into the internal jugular vein must be radically removed with simultaneous resection of the affected part of the vein. We proved that the Crile procedure — resection of a vein with sealing of stumps and interruption of blood flow on one side of the neck — is a safe technique. It reduces the trauma and duration of the operation and reduces the likelihood of recurrence as it does not require further plastic surgery or vascular shunting with the restoration of blood flow. At the same time, bilateral interruption of blood flow in cases of resection of both internal jugular veins can lead to serious complications and requires a blood flow restoration operation from the side of the smaller tumour invasion.
{"title":"Efficiency of the Crile Procedure in the Removal of Thyroid Malignancies Invaded into the Internal Jugular Vein","authors":"Illia Deineko","doi":"10.6000/1929-6029.2023.12.21","DOIUrl":"https://doi.org/10.6000/1929-6029.2023.12.21","url":null,"abstract":"Aim: This work aims to determine the effectiveness of the Crile procedure for optimizing the diagnosis and treatment of patients with locally advanced thyroid malignancies.
 Objects: The objects of the study were the results of treatment of patients with thyroid cancer using two techniques: Crile procedure and vein resection with sealing and preservation of blood flow.
 Materials and Methods: The research was carried out experimentally using Crile surgical intervention and vein resection with sealing and preservation of blood flow. The effectiveness of the treatment was assessed by observing the recurrence and mortality rates. The patient’s quality of life was assessed through the conversation and questionnaire survey.
 Results and Findings: It was found that Doppler ultrasonography of the main vessels in the neck helps to establish the internal jugular vein invasion, as well as its tumour thrombosis at the preoperative stage in clinical cases of suspected extrathyroidal extension of thyroid tumours in addition to radiological methods. A thyroid gland with a tumour invaded into the internal jugular vein must be radically removed with simultaneous resection of the affected part of the vein. We proved that the Crile procedure — resection of a vein with sealing of stumps and interruption of blood flow on one side of the neck — is a safe technique. It reduces the trauma and duration of the operation and reduces the likelihood of recurrence as it does not require further plastic surgery or vascular shunting with the restoration of blood flow. At the same time, bilateral interruption of blood flow in cases of resection of both internal jugular veins can lead to serious complications and requires a blood flow restoration operation from the side of the smaller tumour invasion.","PeriodicalId":73480,"journal":{"name":"International journal of statistics in medical research","volume":"113 20","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135137760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-20DOI: 10.6000/1929-6029.2023.12.19
Andrea P. Ramirez-Ortega, Víctor Juan Vera-Ponce, Cori Raquel Iturregui Paucar
Background: This study was conducted to determine access to dental services in the elderly with hypertension in Peru.
Methods: Observational, analytical, and cross-sectional design. Data used for analysis in this research was collected from the Demographic and Family Health Survey of Peru (ENDES) from 2019 to 2021.
Results: A Poisson regression analysis was performed a weighted sample for calculating prevalence ratio (PR) with their 95% confidence intervals (95%CI). The multiple regression analysis did not find among the factors associated with the probability of using the dental health service, since neither the time less than two years of hypertension (PR=0.74, 95%CI 0.53 – 1.02); nor from 2 to 4 years (PR = 0.97, CI 95% 0.86 – 1.09); neither a time of hypertension from 5 years or more (PR = 0.94, CI 95% 0.85 – 1.03) were associated.
Conclusion: The study concluded that hypertensive patient over 60 years of age, despite a previous diagnosis of hypertension or not, does not attend dental service, reflecting a lack of interest and a greater risk exposure to cardiovascular complications associated with oral health.
{"title":"Access to Dental Services among Hypertensive Elderly in Peru: Exploring Patterns and Implications","authors":"Andrea P. Ramirez-Ortega, Víctor Juan Vera-Ponce, Cori Raquel Iturregui Paucar","doi":"10.6000/1929-6029.2023.12.19","DOIUrl":"https://doi.org/10.6000/1929-6029.2023.12.19","url":null,"abstract":"Background: This study was conducted to determine access to dental services in the elderly with hypertension in Peru.
 Methods: Observational, analytical, and cross-sectional design. Data used for analysis in this research was collected from the Demographic and Family Health Survey of Peru (ENDES) from 2019 to 2021.
 Results: A Poisson regression analysis was performed a weighted sample for calculating prevalence ratio (PR) with their 95% confidence intervals (95%CI). The multiple regression analysis did not find among the factors associated with the probability of using the dental health service, since neither the time less than two years of hypertension (PR=0.74, 95%CI 0.53 – 1.02); nor from 2 to 4 years (PR = 0.97, CI 95% 0.86 – 1.09); neither a time of hypertension from 5 years or more (PR = 0.94, CI 95% 0.85 – 1.03) were associated.
 Conclusion: The study concluded that hypertensive patient over 60 years of age, despite a previous diagnosis of hypertension or not, does not attend dental service, reflecting a lack of interest and a greater risk exposure to cardiovascular complications associated with oral health.","PeriodicalId":73480,"journal":{"name":"International journal of statistics in medical research","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135569679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Adolescence is a critical period for experiencing mental disorders because this age is a transition from adolescence to adulthood, this period is also a determinant of one's mental health in the future. According to survey data from the Indonesia National Adolescent Mental Health Survey (I-NAMHS), which examined the prevalence of adolescent mental disorders in the country reveal that 1 out of 20 (5.5%) adolescents aged 10-17 years in Indonesia were diagnosed with a mental disorder. This study aimed to investigate the degree of risk of poor self-concept clarity, low self-esteem, a lack of peer support, and victims of bullying on mental-emotional disorders incidence in adolescents.
Methods: This research is an observational study using a cross-sectional design. The sample in this study were high school students aged 15-18 years (n = 390) who were randomly selected from four high schools in Kotamobagu City, North Sulawesi Province, Indonesia. The data in this study were analyzed through the Chi-Square test and multiple regression test using the SPSS version 22.0.
Results: This research shows that poor self-concept clarity (adj OR = 5.760; 95%CI = 3.173-10.458; p<0.001), low self-esteem (adj OR =3.647; 95%CI = 1.950-6.818; p<0.001), and victims of bullying (adj OR = 4.204; 95% CI =1.525-11.589; p=0.006) are related to adolescents’ mental-emotional disorders.
Conclusions: It was concluded that the factors that influence mental-emotional disorders in adolescents are poor self-concept clarity, low self-esteem, and being a victim of bullying.
目的:青春期是经历精神障碍的关键时期，因为这个年龄是从青春期过渡到成年期，这一时期也是一个人未来精神健康的决定因素。根据印度尼西亚全国青少年心理健康调查(I-NAMHS)的调查数据，该调查审查了该国青少年精神障碍的流行情况，结果显示，印度尼西亚每20名10-17岁青少年中就有1名(5.5%)被诊断患有精神障碍。本研究旨在探讨自我概念清晰度差、自尊心低、缺乏同伴支持和欺凌受害者对青少年精神情绪障碍发病率的影响程度。
方法:本研究采用横断面设计的观察性研究。本研究的样本为印度尼西亚北苏拉威西省科塔莫巴古市四所高中随机抽取的15-18岁高中生(n = 390)。本研究数据采用SPSS version 22.0
进行卡方检验和多元回归检验;结果:本研究表明:自我概念清晰度差(形容词OR = 5.760;95%ci = 3.173-10.458;p<0.001)，低自尊(adj OR =3.647;95%ci = 1.950-6.818;p<0.001)和欺凌受害者(adj OR = 4.204;95% ci =1.525-11.589;p=0.006)与青少年精神情绪障碍相关。
结论:影响青少年心理情绪障碍的因素有自我概念清晰度差、自尊心低和遭受欺凌。
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 Methods: This research is an observational study using a cross-sectional design. The sample in this study were high school students aged 15-18 years (n = 390) who were randomly selected from four high schools in Kotamobagu City, North Sulawesi Province, Indonesia. The data in this study were analyzed through the Chi-Square test and multiple regression test using the SPSS version 22.0.
 Results: This research shows that poor self-concept clarity (adj OR = 5.760; 95%CI = 3.173-10.458; p<0.001), low self-esteem (adj OR =3.647; 95%CI = 1.950-6.818; p<0.001), and victims of bullying (adj OR = 4.204; 95% CI =1.525-11.589; p=0.006) are related to adolescents’ mental-emotional disorders.
 Conclusions: It was concluded that the factors that influence mental-emotional disorders in adolescents are poor self-concept clarity, low self-esteem, and being a victim of bullying.","PeriodicalId":73480,"journal":{"name":"International journal of statistics in medical research","volume":"5 26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136032915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Give a background why this model is worthwhile by briefly highlighting the current health system and how this study may help to improve this system. This study aims to assess the impact of the MIRACLE model onquality enhancement and patient safety within healthcare settings.
Study Design: Employing a cross-sectional design, this research centers on four key variables and 19 corresponding indicators. Data were collected using a questionnaire distributed via Google Forms, targeting heads of work units at M. Djamil Central General Hospital in Padang, Indonesia.
Method: The analysis utilizes the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique to evaluate variable relationships. The variables studied are Communitarian, Apprenticing Affinity, Managing, and Quality and Patient Safety, with indicators integrated into the questionnaire.
Results: Communitarian and Apprenticing Affinity emerged as influential factors directly impacting quality of health servicesand patient safety, moderated by Managing variable. Research findings reveal a significant positive impact of the Apprenticing Affinity variable on Managing (p-value = 0.013), underlining its significance in hospital management. Moreover, Apprenticing Affinity significantly affects quality and patient safety (p-value = 0.00), highlighting its pivotal role in healthcare enhancement. Similarly, the Communitarian variable significantly influences Managing (p-value = 0.11), notably impacting quality and patient safety (p-value = 0.00). However, Managing alone does not significantly impact quality and patient safety (p-value = 0.15). Indirectly, the research unveils that the Managing-moderated Apprenticing Affinity variable lacks significant influence on quality and patient safety (p-value = 0.268). Similarly, Managing-moderated Communitarian influence does not substantially impact quality and patient safety (p-value = 0.411).
Conclusion: This study highlights the substantial impact of Communitarian and Apprenticing Affinity, moderated by Managing, on quality and patient safety. Notably, Managing alone lacks direct influence. These findings underscore the significance of cultivating collaborative, learning-oriented environments, alongside effective management practices, to bolster healthcare quality and patient safety.
{"title":"Enhancing Hospital Service Quality and Patient Safety through the MIRACLE Model: A Partial Least Squares Equation Approach","authors":"Yahya Marpaung, Dorisnita Dorisnita, Hartati Hartati, Mila Usniza, Mindi Claudia Matari","doi":"10.6000/1929-6029.2023.12.17","DOIUrl":"https://doi.org/10.6000/1929-6029.2023.12.17","url":null,"abstract":"Objective: Give a background why this model is worthwhile by briefly highlighting the current health system and how this study may help to improve this system. This study aims to assess the impact of the MIRACLE model onquality enhancement and patient safety within healthcare settings.
 Study Design: Employing a cross-sectional design, this research centers on four key variables and 19 corresponding indicators. Data were collected using a questionnaire distributed via Google Forms, targeting heads of work units at M. Djamil Central General Hospital in Padang, Indonesia.
 Method: The analysis utilizes the Partial Least Squares Structural Equation Modeling (PLS-SEM) technique to evaluate variable relationships. The variables studied are Communitarian, Apprenticing Affinity, Managing, and Quality and Patient Safety, with indicators integrated into the questionnaire.
 Results: Communitarian and Apprenticing Affinity emerged as influential factors directly impacting quality of health servicesand patient safety, moderated by Managing variable. Research findings reveal a significant positive impact of the Apprenticing Affinity variable on Managing (p-value = 0.013), underlining its significance in hospital management. Moreover, Apprenticing Affinity significantly affects quality and patient safety (p-value = 0.00), highlighting its pivotal role in healthcare enhancement. Similarly, the Communitarian variable significantly influences Managing (p-value = 0.11), notably impacting quality and patient safety (p-value = 0.00). However, Managing alone does not significantly impact quality and patient safety (p-value = 0.15). Indirectly, the research unveils that the Managing-moderated Apprenticing Affinity variable lacks significant influence on quality and patient safety (p-value = 0.268). Similarly, Managing-moderated Communitarian influence does not substantially impact quality and patient safety (p-value = 0.411).
 Conclusion: This study highlights the substantial impact of Communitarian and Apprenticing Affinity, moderated by Managing, on quality and patient safety. Notably, Managing alone lacks direct influence. These findings underscore the significance of cultivating collaborative, learning-oriented environments, alongside effective management practices, to bolster healthcare quality and patient safety.","PeriodicalId":73480,"journal":{"name":"International journal of statistics in medical research","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136293427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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