Category: Nevin Manimala

Medwave. 2022 Oct 28;22(9). doi: 10.5867/medwave.2022.09.2622.

ABSTRACT

The exponential growth of currently available evidence has made it necessary to collect, filter, critically appraise, and synthesize biomedical information to keep up to date. In this sense, systematic reviews are a helpful tool and can be reliable sources to assist in evidence-based decision-making. Systematic reviews are defined as secondary research or syntheses of evidence focused on a specific question that — based on a structured methodology — make it possible to identify, select, critically appraise, and summarize findings from relevant studies. Systematic reviews have several potential advantages, such as minimizing biases or obtaining more accurate results. The reliability of the evidence presented in systematic reviews is determined, amongst other factors, by the quality of their methodology and the included studies. To conduct a systematic review, a series of steps must be followed: the formulation of a research question using the participants, interventions, comparisons, outcomes (PICO) format; an exhaustive literature search; the selection of relevant studies; the critical appraisal of the data obtained from the included studies; the synthesis of results, often using statistical methods (meta-analysis); and finally, estimating the certainty of the evidence for each outcome. In this methodological note, we will define the basic concepts of systematic reviews, their methods, and their limitations.

PMID:36306467 | DOI:10.5867/medwave.2022.09.2622

Int J Biostat. 2022 Oct 31. doi: 10.1515/ijb-2021-0087. Online ahead of print.

ABSTRACT

Meta-analysis of binary outcome data faces often a situation where studies with a rare event are part of the set of studies to be considered. These studies have low occurrence of event counts to the extreme that no events occur in one or both groups to be compared. This raises issues how to estimate validly the summary risk or rate ratio across studies. A preferred choice is the Mantel-Haenszel estimator, which is still defined in the situation of zero studies unless all studies have zeros in one of the groups to be compared. For this situation, a modified Mantel-Haenszel estimator is suggested and shown to perform well by means of simulation work. Also, confidence interval estimation is discussed and evaluated in a simulation study. In a second part, heterogeneity of relative risk across studies is investigated with a new chi-square type statistic which is based on a conditional binomial distribution where the conditioning is on the event margin for each study. This is necessary as the conventional Q-statistic is undefined in the occurrence of zero studies. The null-distribution of the proposed Q-statistic is obtained by means of a parametric bootstrap as a chi-square approximation is not valid for rare events meta-analysis, as bootstrapping of the null-distribution shows. In addition, for the effect heterogeneity situation, confidence interval estimation is considered using a nonparametric bootstrap procedure. The proposed techniques are illustrated at hand of three meta-analytic data sets.

PMID:36306466 | DOI:10.1515/ijb-2021-0087

Am J Intellect Dev Disabil. 2022 Nov 1;127(6):455-472. doi: 10.1352/1944-7558-127.6.455.

ABSTRACT

The Nisonger Child Behavior Rating Form (NCBRF) was developed to specifically screen psychopathology and problem behavior in children and adolescents with IDD. This study aimed to update the NCBRF to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and screen for the most prevalent psychopathologies that affect children and adolescents with IDD. The authors re-aligned the existing items to fit within a DSM-5 framework, and then used the Delphi method with a panel of experts in IDD to evaluate the NCBRF items. The revision process included deleting and revising existing items and formulating new items. We obtained a final item pool after three iterations. The Delphi process and resulting item pool are described in this article.

PMID:36306412 | DOI:10.1352/1944-7558-127.6.455

Brain Behav. 2022 Oct 28:e2782. doi: 10.1002/brb3.2782. Online ahead of print.

ABSTRACT

BACKGROUND: There are few studies about the relationship between dietary patterns and aggression. The aim of this study was to assess the relationship between the main dietary patterns and aggression scores among adolescent girls in Iran.

METHODS: This cross-sectional study was conducted on 670 adolescent girls. The 168-item self-administered Semi-quantitative Food Frequency Questionnaire was used to evaluate dietary intake and to identify major dietary patterns, while factor analysis was applied. Aggression was evaluated by the validated Persian version of the Buss-Perry questionnaire. Statistical analysis was performed by crude and adjusted models.

RESULTS: Three main dietary patterns including healthy, fast food, and Western were identified. A significant positive association was found between more adherence to Western dietary pattern and the presence of a high aggression score (OR: 2.00; 95% CI: 1.32-3.05, p-_{trend =} .001); even after adjustment for potential confounders, these findings were significant.

CONCLUSION: Although Western dietary patterns were associated with increased aggression risk, there was no significant relationship between healthy and fast food dietary patterns and the prevalence of a high aggression score. Further studies, particularly longitudinal intervention studies, are required to clarify this relationship.

PMID:36306400 | DOI:10.1002/brb3.2782

Int J Gynaecol Obstet. 2022 Oct 28. doi: 10.1002/ijgo.14532. Online ahead of print.

ABSTRACT

OBJECTIVE: To study immune response of maternal Covid-19 vaccination and vertical transmission of Anti-SARS-CoV-2, S and N.

STUDY DESIGN: Retrospective study of pregnant women in Bahrain Defense Force Hospital, from March 2021 till September 2021, who were vaccinated, with Sinopharm and Pfizer/Bio NTech. Anti-N and S level from paired samples of maternal and umbilical cord blood was done at the time of delivery with Elecsys Anti-SARS-CoV-2 immunoassay. Immune response to vaccination, association with maternal and fetal factors, and the vertical transmission of antibodies were studied. Analysis was performed using SPSS (version 26.0) and Minitab (version 18) software. P-value of less than 0.05 was considered statistically significant.

RESULTS: The study included 79 pregnant women. The median gestational age for Sinopharm was 28 weeks and Pfizer was 31 weeks. 100% of the vaccinated population generated antibodies and had vertical transmission. The anti-N and S titre, and interval frequencies varied in both vaccinations. The anti-N and S and Transfer ratio are correlated statistically with maternal age, gestational age at delivery, latency period and birth weight of the neonates differently in both vaccines. Also the peak level of antibodies and transfer ratios varied.

CONCLUSION: Though variations are exhibited in both type of vaccination, the vaccinated pregnant population generated a significant level of anti-N and-S, and had vertical transmission as well.

PMID:36306398 | DOI:10.1002/ijgo.14532

Int J Gynaecol Obstet. 2022 Oct 28. doi: 10.1002/ijgo.14529. Online ahead of print.

ABSTRACT

OBJECTIVE: To associate sociodemographic characteristics and satisfaction with the support received from companions during labor and delivery.

METHOD: An analytical cross-sectional study was carried out in a maternity hospital in Fortaleza, Brazil, from March to August 2019, with 320 postpartum women. A form containing sociodemographic and obstetric questions, companion-related information, type of support provided, and the Birth Companion Support Questionnaire (BCSQ) were used to assess the frequency of social support behaviors. The Chi-square test and Fisher’s exact test were used for statistical analyses.

RESULTS: Non-pharmacological methods were associated with an unsatisfactory perception of support, but the emotional support provided by companions was positively associated with women’s satisfaction.

CONCLUSION: The study findings concerning women’s perceptions of the support received from their companions may allow improvements in the delivery of care to women in labor toward the humanization of obstetric practices.

PMID:36306395 | DOI:10.1002/ijgo.14529

J Chin Med Assoc. 2022 Oct 29. doi: 10.1097/JCMA.0000000000000833. Online ahead of print.

ABSTRACT

BACKGROUND: The World Health Organization reported that cardiovascular disease is the most common cause of death worldwide. On average, one person dies of heart disease every 26-min worldwide. Deep learning approaches are characterised by the appropriate combination of abnormal features based on numerous annotated images. The constructed CNN model can identify normal states of reversible and irreversible myocardial defects and alert physicians for further diagnosis.

METHODS: Cadmium zinc telluride single-photon emission computed tomography myocardial perfusion resting-state images were collected at Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan, and were analysed with a deep learning convolutional neural network to classify myocardial perfusion images for coronary heart diseases.

RESULTS: In these grey-scale images, the heart blood flow distribution was the most crucial feature. The deep learning technique of You Only Look Once was used to determine the myocardial defect area and crop the images. After surrounding noise had been eliminated, a three-dimensional convolutional neural network model was used to identify patients with coronary heart diseases. The prediction area under the curve, accuracy, sensitivity, and specificity were 90.97%, 87.08%, 86.49%, and 87.41%, respectively.

CONCLUSION: Our prototype system can considerably reduce the time required for image interpretation and improve the quality of medical care. It can assist clinical experts by offering accurate coronary heart disease diagnosis in practice.

PMID:36306391 | DOI:10.1097/JCMA.0000000000000833

Med Teach. 2022 Oct 28:1-7. doi: 10.1080/0142159X.2022.2138741. Online ahead of print.

ABSTRACT

BACKGROUND/PURPOSE: Feedback processes in health professions education (HPE) are not always successful. While recommendations to improve feedback provision dominate the literature, studying specific learner attributes that impact feedback uptake may also improve feedback processes. Feedback orientation is a concept from management science involving four dimensions of learner attributes and attitudes that impact their feedback uptake: utility, accountability, social awareness, and feedback self-efficacy. Feedback orientation may represent a valuable concept in HPE. We aimed to understand medical learners’ feedback orientation at different stages in their development.

METHODS: We used the Feedback Orientation Scale, a 20-item survey instrument, for a cross-sectional analysis of feedback orientation in medical students and Internal Medicine residents at one large academic center. We performed descriptive statistics and analysis of variance for data analysis.

RESULTS: We found the same factors (dimensions) to feedback orientation in our population as in management science. Overall feedback orientation scores were high and were largely consistent across trainee levels. Utility was the domain that was highest across learners, whereas feedback self-efficacy was lowest.

CONCLUSIONS: Feedback orientation represents a useful concept to explore medical learners’ attitudes toward feedback’s role in their development. The four domains can help guide further nuanced feedback research and application.[Box: see text].

PMID:36306388 | DOI:10.1080/0142159X.2022.2138741

Sci Adv. 2022 Oct 28;8(43):eabq3981. doi: 10.1126/sciadv.abq3981. Epub 2022 Oct 28.

ABSTRACT

Emergent phenomena at heterointerfaces are directly associated with the bonding geometry of adjacent layers. Effective control of accessible parameters, such as the bond length and bonding angles, offers an elegant method to tailor competing energies of the electronic and magnetic ground states. In this study, we construct unit-thick syntactic layers of cobaltites within a strongly tilted octahedral matrix via atomically precise synthesis. The octahedral tilt patterns of adjacent layers propagate into cobaltites, leading to a continuation of octahedral tilting while maintaining substantial misfit tensile strain. These effects induce severe rumpling within an atomic plane of neighboring layers, further triggering the electronic reconstruction between the splitting orbitals. First-principles calculations reveal that the cobalt ions transit to a higher spin state level upon octahedral tilting, resulting in robust ferromagnetism in ultrathin cobaltites. This work demonstrates a design methodology for fine-tuning the lattice and spin degrees of freedom in correlated quantum heterostructures by exploiting epitaxial geometric engineering.

PMID:36306366 | DOI:10.1126/sciadv.abq3981

Proc Natl Acad Sci U S A. 2022 Nov;119(44):e2203150119. doi: 10.1073/pnas.2203150119. Epub 2022 Oct 28.

ABSTRACT

This study explores how researchers’ analytical choices affect the reliability of scientific findings. Most discussions of reliability problems in science focus on systematic biases. We broaden the lens to emphasize the idiosyncrasy of conscious and unconscious decisions that researchers make during data analysis. We coordinated 161 researchers in 73 research teams and observed their research decisions as they used the same data to independently test the same prominent social science hypothesis: that greater immigration reduces support for social policies among the public. In this typical case of social science research, research teams reported both widely diverging numerical findings and substantive conclusions despite identical start conditions. Researchers’ expertise, prior beliefs, and expectations barely predict the wide variation in research outcomes. More than 95% of the total variance in numerical results remains unexplained even after qualitative coding of all identifiable decisions in each team’s workflow. This reveals a universe of uncertainty that remains hidden when considering a single study in isolation. The idiosyncratic nature of how researchers’ results and conclusions varied is a previously underappreciated explanation for why many scientific hypotheses remain contested. These results call for greater epistemic humility and clarity in reporting scientific findings.

PMID:36306328 | DOI:10.1073/pnas.2203150119