Category: Statistics

Crit Care Explor. 2024 Oct 25;6(11):e1171. doi: 10.1097/CCE.0000000000001171. eCollection 2024 Nov 1.

ABSTRACT

IMPORTANCE: Approximately 50% of clinicians experience excessive emotional, physical, and mental stress, with repercussions across the entire medical system. Mindfulness exercises may mitigate this excessive stress. Heart rate variability (HRV) is an objective stress measure that can quantify which mindfulness exercises provide the greatest stress reduction.

OBJECTIVES: To define the impact of specific mindfulness exercises on HRV, a surrogate for physiologic stress, and the relationship between physiologic (HRV) and subjective stress measured by the State-Trait Anxiety Inventory during a one-day mindfulness workshop.

DESIGN, SETTING, AND PARTICIPANTS: This was a prospective observational pilot study performed at a quaternary children’s hospital with diverse subspecialists of pediatric nurses, nurse practitioners, and physicians.

MAIN OUTCOMES AND MEASURES: Our primary outcome measure was change in HRV from baseline during three mindfulness exercises.

RESULTS: The grounding, deep breathing, and body scan exercises all produced statistically significant changes in HRV among our 13 female participants. The body scan exercise produced statistically significant changes in all studied HRV parameters compared with baseline. We observed significant increases in Root Mean Square of Successive Differences between normal heartbeats (p = 0.026), high frequency (p ≤ 0.001), and the parasympathetic nervous system index (p ≤ 0.001) reflecting increased parasympathetic tone (e.g., relaxation), whereas sd 2/sd 1 ratio (p ≤ 0.001) and the stress index (p = 0.004) were decreased reflecting sympathetic withdrawal (e.g., decreased stress). Subjective stress decreased after 1-day mindfulness training (44.6 to 27.2) (p < 0.001). Individuals with the largest decrease in subjective stress also had the most improvement in HRV during the body scan exercise.

CONCLUSIONS: Clinician stress levels (HRV) improved after participating in grounding, deep breathing, and body scan meditations, which may highlight their importance as stress reduction tools for clinicians. Monitoring of HRV during mindfulness exercises may provide deeper understanding of which specific exercises produce the greatest physiologic stress reduction for individual participants and the trend of these changes over time.

PMID:39466161 | DOI:10.1097/CCE.0000000000001171

J Low Genit Tract Dis. 2024 Oct 28. doi: 10.1097/LGT.0000000000000846. Online ahead of print.

ABSTRACT

OBJECTIVES/PURPOSES OF THE STUDY: The purpose of this study is to evaluate the content, delivery, and quality of medical information for vulvar lichen sclerosus on the social media platform TikTok.

MATERIALS AND METHODS: This is a descriptive, cross-sectional study. Using the third-party data scraping tool Apify, TikTok videos tagged with #lichensclerosus or “lichen sclerosus” were identified and sorted by view count. A sample of 100 videos was reviewed by 2 independent reviewers, excluding those not discussing lichen sclerosus. Videos were assessed using a coding document, the Patient Educational Materials Assessment Tool, and the DISCERN instrument. Interrater reliability was measured, and statistical analyses included Fleiss’ kappa, intraclass correlation coefficient, t tests, and Wilcoxon rank sum test with Holm-Bonferroni correction.

RESULTS: Content creators included patients (46%), health care professionals (30%), and others. Topics focused on clinical disease (52%) and treatment (48%). Evidence-based medicine was discussed in 71.7% of treatment-related videos, while 51.7% included nonevidence-based approaches, with a neutral or positive sentiment. Videos discussing topical steroids often had negative sentiments. Quality assessment revealed 61% of videos were understandable, 27% actionable, and 46% contained misinformation. Videos by health care professionals had less misinformation and higher quality scores compared to patient-generated content. Commercially biased videos were more understandable but contained more misinformation.

CONCLUSIONS: TikTok serves as a significant platform for sharing information on lichen sclerosus, but nearly half of the content contains misinformation. Health care professionals need to engage in social media to provide accurate information and counteract misinformation. Enhanced collaboration with patient advocates and careful resource sharing can improve the quality and reliability of medical information available online.

PMID:39466157 | DOI:10.1097/LGT.0000000000000846

Sci Diabetes Self Manag Care. 2024 Oct 28:26350106241290443. doi: 10.1177/26350106241290443. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of the study was to examine the characteristics and the influential effect of individual and social contextual factors on health information literacy among Chinese patients with type 2 diabetes coexisting with metabolic syndrome.

METHODS: Following convenience sampling, a total of 225 patients with type 2 diabetes coexisting with metabolic syndrome were recruited from a tertiary hospital in a suburban area of Beijing, China. Participants’ information was gathered through a set of self-reported questionnaires. Descriptive statistics, normality test, correlational analysis, univariate analysis, multiple linear regression, and logistic regression analysis were adopted to examine the potential factors of personal and social contextual resource related to health information literacy based on the health empowerment theory.

RESULTS: The health information literacy in this current sample was limited, with a mean score of 16.83 ± 2.96. Correlational analysis showed that self-management knowledge, attitude, and practice for metabolic syndrome; self-efficacy; health problem-solving; resilience; and chronic illness resources were significantly and positively related to health information literacy. Logistic regression analysis showed that self-management knowledge, health problem-solving, and the chronic illness resources were significantly correlated with health information literacy after controlling covariates.

CONCLUSIONS: Overall, the health information literacy among Chinese patients with type 2 diabetes coexisting with metabolic syndrome is suboptimal. Study findings demonstrated that personal and social contextual resources factors are significantly related to health information literacy. Health care professionals should consider strategies to enhance people’s health information literacy level and promote individuals’ health problem-solving, enhance chronic illness resources, and improve self-management knowledge when developing tailored interventions.

PMID:39466156 | DOI:10.1177/26350106241290443

Appl Neuropsychol Adult. 2024 Oct 28:1-10. doi: 10.1080/23279095.2024.2418870. Online ahead of print.

ABSTRACT

Assessment of executive and visuospatial neurocognitive domains is lacking in the Omani population, especially for elderly individuals with low educational levels. Therefore, the Towers of Kuwait-Arabic Neurocognitive Assessment (ToK-ArNA) was developed using similar psychometric features of Tower of London (ToL) test, and the unique architecture of Towers of Kuwait, with the potential to overcome the limitation of ToL color perception difficulties that might be encountered in subjects with hereditary or acquired color vision disorders. We enrolled 120 older Arabic-speaking Omanis from January 2022 to November 2022 and all participants underwent screening to ensure normal cognitive function before performing the ToL and ToK-ArNA tests. Validity, reliability, and non-parametric statistical tests were used for data analysis. A total of 85 participants, 51 men (60%) and 34 women (40%) met the inclusion criteria and completed the testing. Statistical analyses confirmed the validity and reliability of ToK-ArNA compared to ToL, with comparable total Time and Accuracy scores and more preference towered the ToK-ArNA among the participants. Despite the study limitations, these results indicate that the ToK-ArNA is a reliable and applicable executive and visuospatial function assessment tool and further studies are warranted to establish its validity in patients with various neurocognitive disorders.

PMID:39466145 | DOI:10.1080/23279095.2024.2418870

ANZ J Surg. 2024 Oct 28. doi: 10.1111/ans.19288. Online ahead of print.

ABSTRACT

INTRODUCTION: The global standard of care for hip fracture surgery is early weight-bearing, but this has not extended to other lower extremity fractures in the elderly. Patients undergoing fixation of distal femur fractures are often prescribed weight-bearing restrictions, which may lead to deconditioning and other complications. The purpose of this study was to compare the outcomes and complication rates between patients permitted early versus restricted weight-bearing following distal femur fracture fixation.

METHODS: Medline, Embase, Cochrane and Web of Science databases were searched for English language articles up to 21 October 2023, identifying 366 studies for screening. Comparative studies evaluating patients undergoing distal femur fracture fixation with early or restricted weight-bearing were included. Native knee and periprosthetic fractures were included.

RESULTS: Ten studies were included for analysis. Two studies provided Level II evidence, while the remaining eight studies provided Level III evidence. Cochrane risk of bias tools were utilized to assess study quality. Revision and complication rates were analyzed and reported as odds ratio. Sub-analysis was undertaken to address the heterogeneity in author definitions of weight-bearing. There was no statistically significant difference in the revision or complication rate between the two groups.

CONCLUSION: Early weight-bearing following distal femur fracture fixation in a predominantly elderly population does not demonstrate an increased rate of revision or complications compared to restricted weight-bearing. However, there are limitations to the available literature, and the strength of the findings is insufficient to provide strong recommendations for all patients. Future studies should employ standardized definitions and avoid partial or time-based restrictions.

PMID:39465540 | DOI:10.1111/ans.19288

Cardiol Young. 2024 Oct 28:1-5. doi: 10.1017/S1047951124026362. Online ahead of print.

ABSTRACT

INTRODUCTION: Lymphatic abnormalities have been documented on magnetic resonance lymphangiography in patients with functionally univentricular circulation.

OBJECTIVE: The aim of this study is to evaluate associations between findings on magnetic resonance lymphangiography, cardiac catheterisation and functional phenotype in patients with Fontan-Kreutzer circulation.

MATERIALS AND METHODS: Between January 2017 and October 2019, seven patients with Fontan-Kreutzer circulation (16.57 ± 7.10 years) were enrolled following ethical committee approval and attainment of informed consent. Clinical data, consecutive magnetic resonance imaging and cardiac catheterisation findings were reviewed. Qualitative lymphatic abnormality types were defined as: 1 – Little or none; 2 – Localised to the supraclavicular region; 3 – Extending into the mediastinum; and 4 – Extending into the lung. Pulmonary hypertension was defined as a transpulmonary gradient > 6 mmHg. Quantitative data were assessed using Mann-Whitney U tests, and p < 0.05 was considered statistically significant.

RESULTS: Patients with lymphatic abnormalities categorised type 1 or 2 and transpulmonary gradient ≤ 6 mmHg had a normal functional phenotype, while those with type 3 or 4 and transpulmonary gradient > 6 mmHg had a failing functional phenotype.

CONCLUSION: Magnetic resonance lymphangiography in patients with Fontan-Kreutzer circulation and pulmonary hypertension revealed lymphatic abnormalities types 3-4, indicative of a failing functional phenotype compared to patients without pulmonary hypertension. If validated in larger studies, these results suggest the potential utility of this extracardiac biomarker for improving risk stratification. Integration of lymphangiography and transpulmonary gradient with functional class, atrioventricular valve function, and ejection fraction allowed for the categorisation of three distinct functional phenotypes, which may be valuable for future analyses.

PMID:39465537 | DOI:10.1017/S1047951124026362

Eur J Paediatr Dent. 2024 Oct 1:1. doi: 10.23804/ejpd.2024.2109. Online ahead of print.

ABSTRACT

AIM: The aim of this research is examining the effectiveness of Virtual Reality (VR) in the reduction of dental anxiety in children with novel methods.

METHODS: The three arm parallel-group randomised clinical study was conducted in children aged 6-10 years. Pulpotomy procedure was performed on randomised 90 selected children (n=30 in each group; AG: group applied active distraction using VR glasses, PG: group applied passive distraction, i.e., watching cartoons on a screen mounted onto a dental unit, CG: control group). Before and after the procedure, children were administered Facial Pain Scale (FIS), Children’s Fear Rating Scale (CFSS-DS) and Frankl Behaviour Rating Scale (FBRS). The pulse rate was measured to check the anxiety levels of all treated children at five different time points. Statistical significance was determined as p<0.05.

CONCLUSION: VR has been found to positively contribute to the performance of children in adapting to dental treatment. The VR application aims to create positive attitude in children by providing them a safe atmosphere and becoming a useful tool in the dental profession.

PMID:39465519 | DOI:10.23804/ejpd.2024.2109

Mol Ecol Resour. 2024 Oct 28:e14041. doi: 10.1111/1755-0998.14041. Online ahead of print.

ABSTRACT

Across the tree of life, many organisms are able to reproduce clonally, via vegetative spread, budding or parthenogenesis. In population genetic analyses of clonally reproducing organisms, it is common practice to retain only a single representative per multilocus genotype. Though this practice of clone correction is widespread, the theoretical justification behind it has been very little studied. Here, I use individual-based simulations to study the effect of clone correction on the estimation of the genetic summary statistics H_O, H_S, F_IS, F_ST, F”_ST and D_est. The simulations follow the standard finite island model, consisting of a set of populations connected by gene flow, but with a variable rate of sexual versus asexual reproduction. The results of the simulations show that by itself, the inclusion of replicated genotypes does not lead to a deviation in the values of the summary statistics, except when the rate of sexual reproduction is less than about one in thousand. However, clone correction can introduce a strong deviation in the values of most of the statistics, when compared to a scenario of full sexual reproduction. For H_S and F_IS, this deviation can be informative about the process of asexual reproduction, but for F_ST, F”_ST and D_est, clone correction can lead to incorrect conclusions. I therefore argue that clone correction is not strictly necessary, but can in some cases be insightful. However, when clone correction is applied, it is imperative that results for both the corrected and uncorrected data are presented.

PMID:39465502 | DOI:10.1111/1755-0998.14041

Biol Trace Elem Res. 2024 Oct 28. doi: 10.1007/s12011-024-04428-6. Online ahead of print.

ABSTRACT

The purpose of the study was to examine whether magnesium (Mg) depletion score (MDS) and dietary Mg intake are associated in adults with the risk of developing Parkinson’s disease (PD). In this study, we analyzed data from the National Health and Nutrition Examination Survey (NHANES), which included 20,010 adults aged over 40 years old. To evaluate the linear association between PD and dietary intake of Mg or MDS, we conducted weighted logistic regression for univariate analysis and multivariate linear regression models. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression models. A restricted cubic spline (RCS) was drawn to visualize the nonlinear relationship between MDS/dietary Mg intake and PD. In addition, we examined the variations in the relationship between MDS and PD across different confounding factors of the association using subgroup analysis. There were 240 PD cases (1.2%), and 19770 non-PD were included in the study. We found that a higher MDS was associated with an increased risk of PD after adjusting for covariates (OR per 1-unit increase, 1.47; 95% CI, 1.16-1.86). There is insufficient evidence to support a significant statistical association between Mg intake and the risk of PD. According to nonlinear regression, high MDS was associated with higher odds of PD and lower odds of PD above 250 mg/day intake of Mg. It has been shown that Mg bioavailability may be negatively associated with PD as measured by MDS. MDS is a potential method for screening the population with PD. Maintaining adequate Mg status may be important for PD prevention.

PMID:39465480 | DOI:10.1007/s12011-024-04428-6

Obes Surg. 2024 Oct 28. doi: 10.1007/s11695-024-07551-4. Online ahead of print.

ABSTRACT

PURPOSE: Olfaction plays a vital role in regulating nutrition, avoiding potentially dangerous situations, and modulating behavior along with interpersonal relationships. Many common disorders can have a negative impact on olfaction; one of these is obesity. Bariatric surgery induces weight loss, and current evidence suggests that it can cause improvement in olfaction. However, more information is needed regarding this topic.

MATERIALS AND METHODS: One hundred eighty-five patients who underwent bariatric surgery and 184 age- and gender-matched control group who did not undergo any surgery have completed a questionnaire including items from the validated Self-Reported Mini Olfactory Questionnaire.

RESULTS: Final analysis was based on 369 patients. There was a statistically significant difference between patients before and after surgery (p < 0.05). However, there was a statistically significant difference between people who underwent surgery with < 50% excess body weight loss and the control group but none with those > 50% excess body weight loss. No significant differences were found when comparing people with and without chronic illnesses, head and neck surgery, anti-allergy drug use, and COVID-19. Before surgery, there were statistically significant differences between patients with allergic rhinitis and polyps and those without, but no significant differences were observed after surgery.

CONCLUSION: Patients had significantly improved olfactory scores post-surgery compared to before surgery. Patients who had > 50% excess body weight loss after surgery showed olfactory function as good as the general population represented by the control group. However, those with < 50% excess body weight loss had significantly worse olfactory scores compared to the general population.

PMID:39465479 | DOI:10.1007/s11695-024-07551-4