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Nevin Manimala Statistics

Nutritional supplement induced modulations in the functional connectivity of a porcine brain

Nutr Neurosci. 2023 Jan 19:1-12. doi: 10.1080/1028415X.2023.2166803. Online ahead of print.

ABSTRACT

BACKGROUND: Functional connectivity (FC) measures statistical dependence between cortical brain regions. Studies of FC facilitate understanding of the brain’s function and architecture that underpin normal cognition, behavior, and changes associated with various factors (e.g. nutritional supplements) at a large scale.

OBJECTIVE: We aimed to identify modifications in FC patterns and targeted brain anatomies in piglets following perinatal intake of different nutritional diets using a graph theory based approach.

METHODS: Forty-four piglets from four groups of pregnant sows, who were treated with nutritional supplements, including control diet, docosahexaenoic acid (DHA), egg yolk (EGG), and DHA + EGG, went through resting-state functional magnetic resonance imaging (rs-fMRI). We introduced the use of differential degree test (DDT) to identify differentially connected edges (DCEs). Simulation studies were first conducted to compare the DDT with permutation test, using three network structures at different noise levels. DDT was then applied to rs-fMRI data acquired from piglets.

RESULTS: In simulations, the DDT showed a greater accuracy in detecting DCEs when compared with the permutation test. For empirical data, we found that the strength of internodal connectivity is significantly increased for more than 6% of edges in the EGG group and more than 8% of edges in the DHA and DHA + EGG groups, all compared to the control group. Moreover, differential wiring diagrams between group comparisons provided means to pinpoint brain hubs affected by nutritional supplements.

CONCLUSION: DDT showed a greater accuracy of detection of DCEs and demonstrated EGG, DHA, and DHA + EGG supplemented diets lead to an improved internodal connectivity in the developing piglet brain.

PMID:36657164 | DOI:10.1080/1028415X.2023.2166803

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Nevin Manimala Statistics

Approach to cardiology residents clinical aptitude evaluation. Multicenter design

Gac Med Mex. 2022;158(6):376-385. doi: 10.24875/GMM.M22000716.

ABSTRACT

INTRODUCTION: To the best of our knowledge, the research herein presented is the first multicenter study in Mexico to analyze the development of clinical aptitude in medical units that train cardiologists.

OBJECTIVE: To determine the degree of development of clinical aptitude in cardiology residents at three High Specialty Medical Units.

METHODS: Multicenter, cross-sectional design. All students of the 2019-2020 academic year were included in the study. An instrument was constructed that evaluated clinical aptitude based on eight indicators and 170 items; conceptual/content validity and reliability were assessed by five cardiologists with teaching and educational research experience.

RESULTS: By indicator and year of residence, significant statistical differences were observed in the CMN20Nov academic site. At HCSXXI and INCICh, statistically significant differences were observed in one of eight indicators. Differences between R1 residents (n = 41) of all three academic sites were estimated by indicator, with statistical significance being recorded in three of eight indicators. Between R2 (n = 35) and between R3 residents (n = 43), the result was similar.

CONCLUSIONS: The degree of clinical aptitude development can be considered intermediate in all three academic sites, probably because the instrument explored problematized clinical situations that required for the residents to critically reflect on their clinical experience.

PMID:36657137 | DOI:10.24875/GMM.M22000716

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Efficacy and safety comparative study of dexrabeprazole vs. esomeprazole for the treatment of gastroesophageal reflux disease

Gac Med Mex. 2022;158(6):423-429. doi: 10.24875/GMM.M22000722.

ABSTRACT

INTRODUCTION: A national survey in the general population showed that gastroesophageal reflux disease (GERD) is highly prevalent in Mexico.

OBJECTIVE: To compare the efficacy and safety of two isomers, dexrabeprazole (10 mg) vs. esomeprazole (20 mg), in the treatment of GERD for four weeks.

METHODS: Randomized, multicenter, prospective, double-blind phase III clinical trial in two groups that included 230 patients.

RESULTS: A statistically significant decrease in the severity of GERD symptoms (heartburn, regurgitation, epigastric pain and dysphagia), evaluated using a visual analogue scale, was observed with both treatments. Mean score for dexrabeprazole on Carlsson-Dent questionnaire at 28 days was 2.12, and for esomeprazole, 3.02. Both treatments were effective, with no statistically significant difference being recorded (p < 0.05). On SF-36 health questionnaire, both were observed to improve the quality-of-life score, with no significant difference being identified. Both drugs were well tolerated, and the adverse event incidence profile was low.

CONCLUSIONS: In the treatment of non-erosive GERD, the use of dexrabeprazole at 10 mg/day is as effective as esomeprazole 20 mg/day, with the advantage that the dose is lower with an appropriate safety profile.

PMID:36657136 | DOI:10.24875/GMM.M22000722

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Nevin Manimala Statistics

Indirect impact of COVID-19 on the incidence rates of vector-borne diseases in Mexico

Gac Med Mex. 2022;158(6):349-354. doi: 10.24875/GMM.M22000712.

ABSTRACT

INTRODUCTION: SARS-CoV-2 infection spatial and temporal distribution overlaps with endemic areas of vector-borne diseases (VBD), whose surveillance in Mexico has substantially changed since the first COVID-19 confirmed case.

OBJECTIVES: To estimate and compare the incidence rates of VBDs before and after the introduction of SARS-CoV-2 in Mexico.

METHODS: Retrospective study of VBD cases from 2014 to 2021. The incidence rates of each VBD in the period before (2014-2019) and after (2020-2021) the introduction of SARS-CoV-2 in Mexico were calculated and compared.

RESULTS: Before the introduction of SARS-CoV-2, the incidence rates of VBDs were high and after the introduction of coronavirus there was a decrease in epidemiological indices; however, there was only statistically significant difference in the incidence rate of malaria (p ≤ 0.05) and other rickettsiae (p ≤ 0.05).

CONCLUSIONS: Some measures to reduce COVID-19 cases, such as social distancing, home confinement, reductions in public transport and working at home (home office), probably temporarily decreased the number of VBD cases; however, there may be a resurgence of VBDs in the near future.

PMID:36657121 | DOI:10.24875/GMM.M22000712

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Nevin Manimala Statistics

Clinical audit of the Consultation-Liaison psychiatric service of a metropolitan hospital

Australas Psychiatry. 2023 Jan 19:10398562231153006. doi: 10.1177/10398562231153006. Online ahead of print.

ABSTRACT

OBJECTIVE: The primary objective of this study was to use clinical indicators to track changes in efficiency of a Consultation-Liaison service as part of a clinical audit cycle.

METHODS: This was a clinical audit cycle. The auditing phase involved measuring the efficiency of the service. The ‘intervention’ was simply the team’s awareness and involvement in tracking these statistics. Subsequently, these indicators were re-audited.

RESULTS: In the initial audit cycle, 315 referrals to the C-L service were audited over a 3 month period, showing a 24 hour time-to-seen rate of 80% and a 36 hour time-to-seen rate of 89.2%. Upon re-auditing of 112 referrals following our intervention, 24 hr timeliness had risen to 92% and 36 hr timeliness had risen to 96.4%.

CONCLUSION: The measuring of clinical indicators of efficiency in C-L may give service improvement personnel a reflection of the functionality of a C-L service. By involving team members in the measuring and tracking of these indicators, we may be able to boost overall clinical efficiency and outcomes.

PMID:36657114 | DOI:10.1177/10398562231153006

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Nevin Manimala Statistics

Components of frailty, sarcopenia and their association with vitamin D deficiency. Cross-sectional, analytical study

Gac Med Mex. 2022;158(6):343-348. doi: 10.24875/GMM.M22000711.

ABSTRACT

INTRODUCTION: In older adults, the association of frailty and sarcopenia with vitamin D deficiency is well known, but the association of the components of frailty syndrome has been poorly studied.

OBJECTIVE: To determine the association of the components of frailty and sarcopenia with vitamin D insufficiency in older adults.

METHODS: Adults were studied, in whom age, education, marital status, history of fractures, hospitalizations, anthropometric indicators, sarcopenia, Charlson index, polypharmacy, Fried’s frailty phenotype, and plasma vitamin D were recorded; figures < 30 ng/mL were considered indicative of vitamin D insufficiency. Descriptive and inferential statistics were used for statistical analysis. The association was determined by binary logistic regression.

RESULTS: One-hundred and seventy-five adults with a mean age of 71.7 ± 6.7 years (95% CI = 60-90 years) were studied. Binary logistic regression showed that the variables associated with vitamin D deficiency were exhaustion (OR = 2.6, 95% CI = 1.0-6.5, p = 0.03), frailty (OR = 9.2, 95% CI = 2.5-34.1, p = 0.001) and pre-frailty (OR = 4.6, 95% CI = 2.1-10.0, p < 0.001).

CONCLUSION: The frail and pre-frail phenotypes, as well as exhaustion, are associated with vitamin D insufficiency.

PMID:36657111 | DOI:10.24875/GMM.M22000711

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Nevin Manimala Statistics

The effects of the PRECEDE-PROCEED model-based educational program on genital hygiene behaviors: A randomized controlled trial

Health Care Women Int. 2023 Jan 19:1-19. doi: 10.1080/07399332.2022.2164582. Online ahead of print.

ABSTRACT

In this study, we aimed to determine the effects of the PRECEDE-PROCEED model-based educational program on women’s genital hygiene behaviors. A randomized controlled trial was conducted with 120 women diagnosed with genital infections and assigned to the experimental (n = 60) and control (n = 60) groups. Educational intervention was designed based on the PRECEDE-PROCEED model and implemented in the experimental group. Data were collected three times before (pretest), right after (posttest) and 1 month after the intervention using the personal information form, Data Form for Knowledge, Attitudes, and Beliefs about Genital Hygiene and Genital Hygiene Behaviors Inventory (GHBI). After the educational intervention, the participants’ hygiene-related knowledge, attitudes and behaviors improved in the experimental group at the posttest and follow-up test from the baseline. A statistically significant difference was found between the groups. We concluded that PRECEDE-PROCEED model-based educational program positively affected the women’s genital hygiene-related knowledge, attitudes, and behaviors.

PMID:36657105 | DOI:10.1080/07399332.2022.2164582

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Nevin Manimala Statistics

Impact of an Accelerated Diagnostic Assessment Program on the Timeliness of Cancer Diagnosis and Treatment

JCO Oncol Pract. 2023 Jan 19:OP2200551. doi: 10.1200/OP.22.00551. Online ahead of print.

ABSTRACT

PURPOSE: The Accelerated Diagnostic Assessment Program (ADAP) manages patients with imaging abnormalities, with or without concomitant symptoms, where cancer is suspected. The ADAP is offered to primary care practitioners and emergency departments with cases triaged by a medical oncologist.

METHODS: We performed a retrospective patient chart review of electronic medical records from January 2019 until June 2021 to validate the program. We collected information on the referral pathways, patient demographics, wait-times, and diagnostic results. The control group consisted of outpatients who were referred for biopsy over a 1-year period outside the ADAP stream. Statistical analyses were performed using IBM SPSS software.

RESULTS: Of the 97 patients included, 54% were female, with ages ranging from 18 to 96 years. Twenty-nine percent (n = 20) of the malignant cases were incidental findings. Most patients referred to the ADAP were diagnosed with a malignancy (71%; n = 69), comprising hematologic (45%; n = 31), GI (26%; n = 18), or other cancers (29%; n = 20). The ADAP had decreased wait-times from referral to biopsy collection (17.6 days ± 10.7 [standard deviation (SD)]; n = 43) when compared with the control group (41.2 days ± 40.0 [SD]; n = 67; P < .001). ADAP patients with malignancies saw a treating specialist 7.6 ± 7.6 days [SD] after their follow-up appointment at the ADAP.

CONCLUSION: The ADAP accelerated time to biopsy in a statistically significant manner when compared with age-, referring physician-, and biopsy site-matched controls. It also outperformed national and provincial standards, suggesting that its model addresses a gap in care by providing an underserved population timely access to diagnosis and treatment.

PMID:36657095 | DOI:10.1200/OP.22.00551

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Serum Homocysteine Level and Severity of Coronavirus Disease-2019 (COVID-19)

Rom J Intern Med. 2023 Jan 19. doi: 10.2478/rjim-2023-0002. Online ahead of print.

ABSTRACT

Introduction: Coronavirus disease-2019 (COVID-19) is still a global health problem nowadays. A particular COVID-19 patients develop severe symptoms. Some biomarkers can be used to determine disease severity and improve outcome. Homocysteine is one of the novel biomarkers. The objective of this study is to determine the role of serum homocysteine level in stratifying severity of COVID-19. Methods: A cross-sectional study was conducted in Medan, Indonesia from May to December 2021. Subjects were obtained using consecutive sampling method. Inclusion criteria was COVID-19 patients aged 18 years or older and willing to participate in the study. Patients with malignancy, chronic kidney disease, thyroid disease, coronary heart disease, and who consume several medications including cholestyramine, metformin, methotrexate, fibrate, and contraceptive pill, were excluded. Data regarding demographic, laboratory, and biomarker were gathered from each subject. Statistical analyses were conducted at 95% confidence interval. Results: A total of 100 patients were enrolled. Most subjects were males (59%) and from Batak ethnicity (64%). Twenty percent subjects had severe COVID-19. The levels of serum high-sensitivity C-reactive protein (hs-CRP), D dimer, homocysteine, and procalcitonin were significantly higher in severe COVID-19 subjects. D dimer had the highest sensitivity (91.7%) and specificity (94.7%) in stratifying severe COVID-19, followed by hs-CRP (91.7% and 85.5%, respectively), homocysteine (87.5% and 78.9%, respectively), and procalcitonin (58.3% and 74.0%, respectively). Conclusion: Homocysteine can be used as a biomarker to determine COVID-19 severity.

PMID:36657014 | DOI:10.2478/rjim-2023-0002

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Nevin Manimala Statistics

A multisite transition to nursing program: an innovative approach to facilitate incoming nursing students’ academic success

Int J Nurs Educ Scholarsh. 2023 Jan 20;20(1). doi: 10.1515/ijnes-2022-0016. eCollection 2023 Jan 1.

ABSTRACT

OBJECTIVES: Evaluate effectiveness of a multisite program promoting the successful transition of baccalaureate and graduate entry (with a prior degree) students into pre-licensure curricula. Faculty concern around nursing students’ successful completion of nursing programs and passage of the nursing licensure exam stems from challenges students encounter in core courses, study habits, and civility.

METHODS: One hundred eighty-five students participated in a quasi-experimental pre-post-test mixed-methods study. Students completed content modules and open-ended surveys.

RESULTS: Most students found the program helpful. Statistically significant improvements were shown in medication calculation, reading comprehension, and medical terminology. No statistically significant improvement was shown in anatomy and physiology.

CONCLUSIONS: Our Transition to Nursing program shows promise and adds to proactive strategies in preparing students for a successful transition into nursing programs. Our innovative approach may serve as a model to nursing schools and colleges around the world to promote student success.

PMID:36656999 | DOI:10.1515/ijnes-2022-0016