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Nevin Manimala Statistics

Effectiveness of educational intervention on women’s participation to cervical cancer screening: a quasi-experimental study based on PEN-3 model

BMC Cancer. 2022 Nov 28;22(1):1226. doi: 10.1186/s12885-022-10331-x.

ABSTRACT

INTRODUCTION: Cervical cancer is one of the most common cancer types among women in developing countries. Women’s behavior in the early detection of the disease is influenced by sociocultural factors. Thus, the present study aimed to determine the effect of an educational intervention based on PEN-3 model on women’s participation in cervical cancer screening.

METHODS: The present quasi-experimental study was conducted with 160 women participants visiting health care centers in Bandar Abbas in 2021. The sampling was as a multi-stage clustering, and the participants were divided into two groups, an intervention and a control (each with 80 participants). The data collection instrument was a researcher-made questionnaire based on the PEN-3 model constructs before and 3 months after an educational intervention (a training course). The intervention involved 30 online sessions of 15-20 minutes for the intervention group while the control group did not receive any training.

RESULTS: After the educational intervention, the mean scores of knowledge, attitude, enablers, nurturers and the Pap smear test behavior in the experimental group increased significantly compared to the control group (P < 0.05). The analysis of covariance results showed that by modulating the effect of pre-test score, there was a statistically significant difference between the intervention and control groups in the post-intervention behavior score.

CONCLUSION: In the light of the present findings, it can be concluded that interventions based on the PEN-3 model with a focus on knowledge -raising, changing beliefs and identifying sociocultural and environmental factors that affect cervical cancer screening behavior can prevent cervical cancer in women.

PMID:36443696 | DOI:10.1186/s12885-022-10331-x

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The validity of neoadjuvant chemotherapy with paclitaxel plus S-1 is not inferior to that of SOX regimen for locally advanced gastric cancer: an observational study

BMC Cancer. 2022 Nov 28;22(1):1223. doi: 10.1186/s12885-022-10230-1.

ABSTRACT

BACKGROUND: Paclitaxel plus S-1(PTXS) has shown definite efficacy for advanced gastric cancer. However, the efficacy and safety of this regimen in neoadjuvant setting for locally advanced gastric cancer (LAGC) are unclear. This study aimed to compare the efficacy of neoadjuvant chemotherapy (NAC) PTXS and oxaliplatin plus S-1 (SOX) regime for patients with LAGC.

METHODS: A total of 103 patients with LAGC (cT3/4NanyM0/x) who were treated with three cycles of neoadjuvant SOX regimen (n = 77) or PTXS regimen (n = 26) between 2011 and 2017 were enrolled in this study. NAC-related clinical response, pathological response, postoperative complication, and overall survival were analyzed between the groups.

RESULTS: The baseline data did not differ significantly between both groups. After NAC, the disease control rate of the SOX group (94.8%) was comparable with that of the PTXS group (92.3%) (p = 0.641). Twenty-three cases (29.9%) in the SOX group and 10 cases (38.5%) in the PTX group got the descending stage with no statistical difference (p = 0.417). No significant differences were observed in the overall pathological response rate and the overall postoperative complication rate between the two groups (p > 0.05). There were also no differences between groups in terms of 5-year overall and disease-free survival (p > 0.05).

CONCLUSIONS: The validity of NAC PTXS was not inferior to that of SOX regimen for locally advanced gastric cancer in terms of treatment response and overall survival. PTXS regimen could be expected to be ideal neoadjuvant chemotherapy for patients with LAGC and should be adopted for the test arm of a large randomized controlled trial.

PMID:36443694 | DOI:10.1186/s12885-022-10230-1

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Nevin Manimala Statistics

Comparative plastomes and phylogenetic analysis of seven Korean endemic Saussurea (Asteraceae)

BMC Plant Biol. 2022 Nov 29;22(1):550. doi: 10.1186/s12870-022-03946-6.

ABSTRACT

BACKGROUND: Saussurea is one of the most species-rich genera in the Cardueae, Asteraceae. There are approximately 40 Saussurea species distributed in Korea, with nearly 40% of them endemics. Infrageneric relationships remain uncertain due to insufficient resolutions and low statistical support. In this study, we sequenced the plastid genomes of five Korean endemic Saussurea (S. albifolia, S. calcicola, S. diamantica, S. grandicapitula, and S. seoulensis), and comparative analyses including two other endemics (S. chabyoungsanica and S. polylepis) were conducted.

RESULTS: The plastomes of Korean endemics were highly conserved in gene content, order, and numbers. Exceptionally, S. diamantica had mitochondrial DNA sequences including two tRNAs in SSC region. There were no significant differences of the type and numbers of SSRs among the seven Korean endemics except in S. seoulensis. Nine mutation hotspots with high nucleotide diversity value (Pi > 0.0033) were identified, and phylogenetic analysis suggested that those Korean endemic species most likely evolved several times from diverse lineages within the genus. Moreover, molecular dating estimated that the Korean endemic species diverged since the late Miocene.

CONCLUSIONS: This study provides insight into understanding the plastome evolution and evolutionary relationships of highly complex species of Saussurea in Korean peninsula.

PMID:36443690 | DOI:10.1186/s12870-022-03946-6

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Multimorbidity and long-term disability and physical functioning decline in middle-aged and older Americans: an observational study

BMC Geriatr. 2022 Nov 28;22(1):910. doi: 10.1186/s12877-022-03548-9.

ABSTRACT

BACKGROUND: Multimorbidity is highly prevalent and associated with several adverse health outcomes, including functional limitations. While maintaining physical functioning is relevant for all adults, identifying those with multimorbidity at risk for faster rates of physical functioning decline may help to target interventions to delay the onset and progression of disability. We quantified the association of multimorbidity with rates of long-term disability and objective physical functioning decline.

METHODS: In the Health and Retirement Study, we computed the Multimorbidity-Weighted Index (MWI) by assigning previously validated weights (based on physical functioning) to each chronic condition. We used an adjusted negative binomial regression to assess the association of MWI with disability (measured by basic and instrumental activities of daily living [ADLs, IADLs]) over 16 years, and linear mixed effects models to assess the association of MWI with gait speed and grip strength over 8 years.

RESULTS: Among 16,616 participants (mean age 67.3, SD 9.7 years; 57.8% women), each additional MWI point was associated with a 10% increase in incidence rate of disability (IRR: 1.10; 95%CI: 1.09, 1.10). In 2,748 participants with data on gait speed and grip strength, each additional MWI point was associated with a decline in gait speed of 0.004 m/s (95%CI: -0.006, -0.001). The association with grip strength was not statistically significant (-0.01 kg, 95%CI: -0.73, 0.04). The rate of decline increased with time for all outcomes, with a significant interaction between time and MWI for disability progression only.

CONCLUSION: Multimorbidity, as weighted on physical functioning, was associated with long-term disability, including faster rates of disability progression, and decline in gait speed. Given the importance of maintaining physical functioning and preserving functional independence, MWI is a readily available tool that can help identify adults to target early on for interventions.

PMID:36443663 | DOI:10.1186/s12877-022-03548-9

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Smart glasses and telehealth services by professionals in isolated areas in Korea: Acceptability and concerns

Technol Health Care. 2022 Nov 17. doi: 10.3233/THC-220242. Online ahead of print.

ABSTRACT

BACKGROUND: Smart glass technology offers remote interaction between health professionals for telehealth, alleviating healthcare disparities in isolated areas.

OBJECTIVE: To evaluate the professionals’ perceptions of smart glass technology as a tool for telehealth and distance learning.

METHOD: This mixed-method study on health professionals in 10 different island areas in Korea involved participants experiencing a smart glass-based telehealth system using the scenario of clinical consultation with remote specialists. A group pre- and post-test design was used to examine the change in attitude and perceived importance among health professionals about using smart glasses in telehealth.

RESULTS: Forty-seven participants completed both pre-and post-evaluation of smart glasses. A positive, statistically significant change in participants’ perceptions of smart glasses regarding their implications for telehealth and distance learning (p< 0.05) was found. Fifty-one health workers provided feedback on smart glasses, and a majority expressed their expectations of quality care with telehealth using advanced technology. The main concerns were patients’ privacy issues and inadequate technology for seamless application.

CONCLUSION: The incorporation of smart glass technology offers great potential to enrich telehealth as well as distance learning for unskilled health professionals in isolated areas. Future studies are needed to increase efforts to secure a high level of acceptance for clinical consultation with remote specialists on this newly developed device.

PMID:36442222 | DOI:10.3233/THC-220242

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Alcohol and Parkinson’s Disease: A Systematic Review and Meta-Analysis

J Parkinsons Dis. 2022 Nov 25. doi: 10.3233/JPD-223522. Online ahead of print.

ABSTRACT

BACKGROUND: A substantial body of research has examined the relationship between alcohol consumption and risk of Parkinson’s disease (PD).

OBJECTIVE: To provide an updated systematic review and meta-analysis of observational studies examining the relationship between alcohol consumption and risk of PD.

METHODS: Eligible studies comparing PD risk in ever vs. never alcohol drinkers were sourced from six databases. Outcomes were pooled using standard meta-analysis techniques. Separate female and male estimates were generated from studies reporting sex-specific data. Additionally, cohort studies stratifying participants by quantity of alcohol intake were integrated in a dose-response analysis.

RESULTS: 52 studies were included, totaling 63,707 PD patients and 9,817,924 controls. Our meta-analysis supported a statistically significant overrepresentation of never drinkers among PD subjects; odds ratio (OR) for ever drinking alcohol 0.84 (95% confidence interval (CI) 0.76 – 0.92). A subgroup analysis revealed similar effect estimates in females and males. A further synthesis of seven cohort studies suggested a negative, dose-dependent association between alcohol and risk of PD.

CONCLUSION: In the absence of a known neuroprotective pathway, there may be reason to doubt a true biological effect. The role of survivor bias, selection and recall bias, misclassification, and residual confounding requires consideration. Alternatively, observations might be attributable to reverse causation if those predestined for PD alter their alcohol habits during the preclinical phase. Major limitations of our study include high between-study heterogeneity (I2 = 93.2%) and lack of adjustment for key confounders, namely smoking status.

PMID:36442208 | DOI:10.3233/JPD-223522

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Retrospective Bayesian Evidence of Null Effect in Two Decades of Alzheimer’s Disease Clinical Trials

J Alzheimers Dis. 2022 Nov 25. doi: 10.3233/JAD-220942. Online ahead of print.

ABSTRACT

Despite intense research on Alzheimer’s disease, no validated treatment able to reverse symptomatology or stop disease progression exists. A recent systematic review by Kim and colleagues evaluated possible reasons behind the failure of the majority of the clinical trials. As the focus was on methodological factors, no statistical trends were examined in detail. Here, we aim to complete this picture leveraging on Bayesian analysis. In particular, we tested whether the failure of those clinical trials was essentially due to insufficient statistical power or to lack of a true effect. The strong Bayes’ Factor obtained supported the latter hypothesis.

PMID:36442201 | DOI:10.3233/JAD-220942

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Mindfulness Prevents Depression and Psychopathology in Elderly People with Mild to Moderate Alzheimer’s Disease: A Randomized Clinical Trial

J Alzheimers Dis. 2022 Nov 24. doi: 10.3233/JAD-220889. Online ahead of print.

ABSTRACT

BACKGROUND: This longitudinal study addressed whether mindfulness practice prevents psychological and behavioral symptoms, especially mood disorders, in Alzheimer’s disease (AD).

OBJECTIVE: To assess the incidence of depression in the course of AD and to determine which non-pharmacological treatment (NPT) is most effective in preventing psychopathological symptoms.

METHODS: We conducted a longitudinal, non-inferiority and equivalence randomized clinical trial, repeated-measures design, with a control group and three experimental treatments: mindfulness, cognitive stimulation, and relaxation. Each experimental group performed three weekly sessions for two years. The pharmacological treatment of all participants was donepezil (10 mg). Participants were patients with probable AD without diagnosed depression from the public neurology services of the Canary Health Service, Spain. Psychological evaluation was performed using the Geriatric Depression Scale (GDS), Hamilton Depression Rating Scale (HDRS), and Neuropsychiatric Inventory (NPI-Q). The statistical analysis included only patients who attended at least 75% of the sessions. A nonparametric, repeated-measures analysis was performed with Kruskal-Wallis H test and between-group differences with Mann-Whitney U test with Bonferroni correction (p < 0.008). Effect size was calculated with partial eta-squared.

RESULTS: The results showed significant differences with large effect sizes (η2p>0.14) between mindfulness and the rest of the experimental groups as well as the control in the GDS, HDRS, and NPI-Q scales.

CONCLUSION: Compared to the other experimental groups, only mindfulness prevented the onset of depression and other psychopathologies in early-stage AD. Based on its effectiveness in maintaining cognitive functions and preventing psychopathology, we recommend mindfulness as the first-choice NPT for mild to moderate AD.

PMID:36442199 | DOI:10.3233/JAD-220889

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The role of serum markers PAPP-A β-hCG, AFP, and uE3 in predicting the risk of preeclampsia in early, middle, and late pregnancy

Technol Health Care. 2022 Nov 17. doi: 10.3233/THC-220523. Online ahead of print.

ABSTRACT

BACKGROUND: Preeclampsia (PE) has adverse effects on pregnant women, fetuses, and newborns [1], and accounts for 3%-10% of pregnancy-related diseases globally.

OBJECTIVE: This study aimed to screen a series of prenatal markers (pregnancy-associated plasma protein [PAPP-A], β-human chorionic gonadotropin [β-hCG], alpha fetoprotein [AFP], and estriol [uE3]) to establish a risk model and evaluate the diagnostic values of the markers for predicting PE.

METHODS: Sixty-five pregnant women were enrolled in this study. They were divided into two groups containing healthy pregnant women (n= 51, the non-PE group) and pregnant women with PE (n= 14, the PE group). According to the stage of pregnancy, the pregnant women in each group were divided into early, middle, and late pregnancy groups for statistical analysis. The levels of PAPPA-A β-hCG, AFP, and uE3 were compared among these groups. Then, a risk model was established, and PE was diagnosed using receiver operating characteristic (ROC) curve results.

RESULTS: In the early pregnancy group, the differences in the levels of PAPP-A, AFP, and uE3 between the PE and non-PE groups were statistically significant (P< 0.001, P= 0.029, and P= 0.033, respectively), while the difference in the single remaining marker was not statistically significant. A ROC curve analysis revealed that in early pregnancy, the sensitivity and specificity of PAPP-A were 76.5% and 71.4%, respectively, and the sensitivity and specificity of β-hCG were 82.4% and 57.1%, respectively. The sensitivity and specificity of the combination of the two markers for diagnosing PE were 86.3% and 57.1%, respectively.

CONCLUSION: This study demonstrated that the combination of PAPP-A and β-hCG has diagnostic value for PE in pregnant women. Accordingly, we should formulate innovative PE screening strategies to target the prevention of PE and create important conditions for predictive and preventive personalized medical treatments.

PMID:36442168 | DOI:10.3233/THC-220523

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Changes in oral pH before and after placing preformed metal crowns in primary dentition of Mexican children

Technol Health Care. 2022 Nov 17. doi: 10.3233/THC-220433. Online ahead of print.

ABSTRACT

BACKGROUND: Prefabricated metal crowns (PMCs) have been widely used in pediatric dentistry due to their great success in various clinical situations. However, it is important to know the local effects, such as changes in pH in the oral environment.

OBJECTIVE: To evaluate the pH variations before and after placement of PMCs.

METHODS: A quasi-experimental study (before and after) was performed with 32 pediatric patients who needed rehabilitation with PMCs at a pediatric dentistry clinic in a public university. Measurements were made using a pH potentiometer before PMC placement, one week after, and one month after placement. ANOVA and Pearson correlation were performed in SPSS.

RESULTS: The average age of the participants was 5.9 ± 1.6 years, and 53.1% were female. The average pH before, one week after, and one month after crown placement was 7.46 ± 0.37, 7.00 ± 0.32, and 7.1 ± 0.19, respectively. Significant differences (p< 0.05) were observed between the three pH measurements. We found differences when comparing the basal pH values to those at one week (p= 0.001) and one month (p= 0.002).

CONCLUSION: Although there were statistically significant differences in the pH change values before and after the placement of crowns, these differences may not have a clinical impact.

PMID:36442164 | DOI:10.3233/THC-220433