Category: Statistics

Int J Appl Basic Med Res. 2024 Apr-Jun;14(2):108-113. doi: 10.4103/ijabmr.ijabmr_520_23. Epub 2024 May 24.

ABSTRACT

BACKGROUND: Supraglottic devices have revolutionized the current practice of airway management. We compared the clinical performance of a recently introduced BlockBuster™ Laryngeal mask airway with i-gel^® in adult patients under general anesthesia.

METHODS: Following Institutional ethical clearance, the present study was conducted on 62 patients belonging to American Society of Anesthesiologists physical status 1 and 2 of either sex in the age group of 20-60 years under general anesthesia. Patients were randomly assigned to i-gel^® (I) and BlockBuster™ (B) groups (31 per group). Time for successful insertion, insertion success rate, ease of insertion, oropharyngeal leak pressures (OLPs), and complications were assessed.

RESULTS: Mean insertion time of device was less in Group I (13.52 ± 2.58 s) than that of Group B (14.10 ± 2.04 s), which was neither clinically nor statistically significant (P = 0.330). OLP in Group B (24.52 ± 2.77 cm of H2O) was found to be significantly higher compared to Group I (20.81 ± 2.56 cm of H2O) with P < 0.001. Overall insertion and first attempt success was similar (i-gel^® 31/31 [100%] and 29/31 [93.5%] and BlockBuster™ 31/31 [100%] and 29/31 [93.5%], respectively). Ease of insertion (P = 0.684) and complications (P = 0.782) of both the devices were comparable.

CONCLUSIONS: Both the devices are useful and effective for airway management in adult under general anesthesia. Having a high OLP and comparable insertion time, risk of aspiration may be further reduced with the use of BlockBuster™ in comparison to i-gel^®.

PMID:38912364 | PMC:PMC11189260 | DOI:10.4103/ijabmr.ijabmr_520_23

Int J Appl Basic Med Res. 2024 Apr-Jun;14(2):124-130. doi: 10.4103/ijabmr.ijabmr_17_24. Epub 2024 May 24.

ABSTRACT

CONTEXT: Angiogenesis, the formation of new blood vessels from preexisting vascular network, is essential for tumor growth and spread. Vascular endothelial growth factor (VEGF) is a potent angiogenic growth factor.

AIMS: To assess the expression of VEGF in invasive carcinoma of no special type and its correlation with all the known prognostic factors of breast carcinoma.

SETTINGS AND DESIGN: Descriptive.

MATERIALS AND METHODS: Mastectomy specimens were studied noting the clinical details. The formalin-fixed tissues were subjected to routine processing and hematoxylin and eosin sections and studied extensively for all the histological prognostic factors. Representative sections from each case with the tumor were subjected to immunohistochemistry (IHC) staining with VEGF, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) antibodies.

STATISTICAL ANALYSIS USED: Descriptive statistics, Chi-square tests, contingency table analysis using SPSS for Windows.

RESULTS: One hundred and twelve cases of invasive carcinoma of special type were studied to evaluate various clinicopathological parameters. The association of VEGF with clinicopathological parameters and all the known prognostic factors was studied to note its significance. VEGF overexpression was observed in 69% of the cases. It was noted that larger tumor size, higher histological grade, lymphovascular invasion, nodal involvement, tumor necrosis, high microvessel density, ER negativity, PR negativity, and HER2/neu positivity had a significant statistical association with VEGF overexpression.

CONCLUSIONS: We conclude that incorporating VEGF as a biomarker along with the known factors into a prognostic index will not only help predict clinical outcome more accurately, but also determines the patient who can be benefited with combinational therapy including anti-VEGF factors.

PMID:38912361 | PMC:PMC11189271 | DOI:10.4103/ijabmr.ijabmr_17_24

Int J Appl Basic Med Res. 2024 Apr-Jun;14(2):78-84. doi: 10.4103/ijabmr.ijabmr_431_23. Epub 2024 May 24.

ABSTRACT

BACKGROUND: Despite the widespread acknowledgment of the need and significance of soft skills (SKs) in health professions education, the subject is not emphasized enough in training students. These skills can be taught to undergraduates through roleplay. Communication skills and teamwork were taught by scenario-based roleplay and assessed in this study.

OBJECTIVES: The study aimed to implement scenario-based roleplay as a method of teaching communication skills and teamwork to undergraduate medical students and to assess their perceptions.

METHODOLOGY: A prospective study was conducted in the simulation/skills laboratory among 41 Phase I undergraduate medical students. The SKs taught during the sessions included communication skills, empathy, and teamwork.

RESULTS: The mean of the responses obtained from Gap Kalamazoo Communication Skills Checklist score in the first encounter was 27.0, 38.12 in the second encounter, and 41.24 in the third encounter. The mean scores showed a statistically significant difference between E1 and E2, E1 and E3, and E2 and E3. Posttest scores of students to self-efficacy questionnaire showed significant improvement compared to pre-test scores. Students in the present study opined that they could learn the aspects that could not have been learned in didactic lectures about communication skills and teamwork.

CONCLUSION: Scenario-based roleplay can be used as an effective method for teaching SKs such as communication skills and teamwork for undergraduate medical students. Different scenarios which replicate the real-life situations can be incorporated to help students to learn and face the real-life encounters.

PMID:38912358 | PMC:PMC11189269 | DOI:10.4103/ijabmr.ijabmr_431_23

Int J Appl Basic Med Res. 2024 Apr-Jun;14(2):114-123. doi: 10.4103/ijabmr.ijabmr_383_23. Epub 2024 May 24.

ABSTRACT

BACKGROUND: Pregnancy is the state of carrying a developing embryo or fetus within a female body. Once pregnancy is established, a range of endocrinological events appear in its maintenance, finally helping in the successful pregnancy. The complications which are usually observed in pregnancy are gestational diabetes, preeclampsia, preterm labor, and spontaneous pregnancy loss or miscarriage, while 10%-15% of clinically recognized pregnancies terminate into spontaneous miscarriage. Thus, many attempts have been made by different researchers for the diagnosis of high-risk pregnancy on altered protein pattern using placental villous tissue or follicular fluid, but these are difficult to obtain and results of different studies are not constant.

AIM: This study was designed to identify the association (if any) among serum protein(s) electrophoretic pattern and different serum hormones in normal pregnant women (controls) and gestational age-matched women with spontaneous pregnancy loss (cases).

MATERIALS AND METHODS: This study was carried out for 1½ year from October 2018 to March 2020 and included 120 participants (60 normal pregnant women and 60 women with spontaneous pregnancy loss) between 20 and 45 years of age with no mean age difference. The electrophoresis of serum was carried out using slab gel electrophoretic unit and serum thyroid-stimulating hormone (TSH), total tri-iodothyronine (TT₃), total thyroxine (TT₄), prolactin, and beta human chorionic gonadotropin (β-hCG) levels were analyzed using TSOSH AIA analyzer at Adesh University, Bathinda.

RESULTS: Significant variations in the expression of proteins with molecular weight around ~150 kDa, ~50 kDa, and ~25 kDa were observed in normal pregnant women and women with spontaneous pregnancy loss. However, the protein band of ~50 kDa was found to be highly expressed in the serum of 1^st and 2^nd trimester women experiencing spontaneous pregnancy loss. Therefore, selected protein band of ~50 kDa was further processed by ECI-mass spectrophotometry QUAD time of flight and 365 different proteins were found, out of these; 34 proteins were found to be unidentified protein products (Verified using NCBI data base). Further, TT₃, total proteins, β-hCG, and prolactin level were found to be low, whereas, TSH was found to be high in women experiencing spontaneous pregnancy loss. However, difference in the level of β-hCG in the 1^st trimester and TT₄ among normal pregnant women and women with spontaneous pregnancy loss was observed to be statistically insignificant.

CONCLUSION: This study indicated that the evaluation of serum protein variations along with hormonal profile may provide valuable information about high-risk pregnancy. Moreover, the differential expression of proteins in women with spontaneous pregnancy loss can be further explored to develop potential biomarker for the early identification of high-risk pregnancy and appropriate preventive measure.

PMID:38912357 | PMC:PMC11189267 | DOI:10.4103/ijabmr.ijabmr_383_23

Front Microbiol. 2024 Jun 7;15:1417049. doi: 10.3389/fmicb.2024.1417049. eCollection 2024.

ABSTRACT

INTRODUCTION: The accurate distinction between periprosthetic joint infections (PJI) and aseptic failures (AF) is of paramount importance due to differences in treatment. However, this could be challenging by using the current criteria. Various synovial fluid biomarkers are being assessed to improve the diagnostic accuracy. Myeloperoxidase (MPO), an enzyme contained in the granules of neutrophils, may be a promising biomarker for PJI.

METHODS: Synovial fluids of 99 patients (n = 65 PJI according to EBJIS criteria; n = 34 AF) were collected in two specialized orthopedic centers. PJI were divided into acute (n = 33) and low-grade (n = 32) according to previously published classification. An activity assay specific for active MPO was performed in each sample. Ability of MPO to correctly discriminate patients with PJI from AF was determined by ROC analysis. The best discriminating cut-off value was determined by calculating the J Youden index. For all analyses, a P value < 0.05 was considered statistically significant.

RESULTS: Active MPO was higher in PJI than AF (P < 0.0001). The ROC analysis revealed a significant area under the curve (AUC: 0.86; 95% CI: 0.78-0.93, P < 0.0001). A cut-off value of 561.9 U/mL, with good sensitivity (0.69) and specificity (0.88), discriminated between AF and PJI (accuracy 75.76%, 95% CI: 66.11-83.81%, positive likelihood ratio 5.88, 95% CI: 2.31-14.98 and negative likelihood ratio 0.35, 95%CI: 0.24-0.51). No difference in MPO levels was found between acute and chronic low-grade PJI.

CONCLUSION: The proposed assay appears to be a reliable and affordable tool for detecting the active MPO in synovial fluid, with promising characteristics of sensitivity and specificity in discriminating both acute and low-grade PJI from AF. Further studies are needed to confirm MPO diagnostic cut-off values and validate their use in the routine clinical practice.

PMID:38912350 | PMC:PMC11190362 | DOI:10.3389/fmicb.2024.1417049

Front Microbiol. 2024 Jun 7;15:1393538. doi: 10.3389/fmicb.2024.1393538. eCollection 2024.

ABSTRACT

The world’s oceans are challenged by climate change linked warming with typically highly populated coastal areas being particularly susceptible to these effects. Many studies of climate change on the marine environment use large, short-term temperature manipulations that neglect factors such as long-term adaptation and seasonal cycles. In this study, a Baltic Sea ‘heated’ bay influenced by thermal discharge since the 1970s from a nuclear reactor (in relation to an unaffected nearby ‘control’ bay) was used to investigate how elevated temperature impacts surface water microbial communities and activities. 16S rRNA gene amplicon based microbial diversity and population structure showed no difference in alpha diversity in surface water microbial communities, while the beta diversity showed a dissimilarity between the bays. Amplicon sequencing variant relative abundances between the bays showed statistically higher values for, e.g., Ilumatobacteraceae and Burkholderiaceae in the heated and control bays, respectively. RNA transcript-derived activities followed a similar pattern in alpha and beta diversity with no effect on Shannon’s H diversity but a significant difference in the beta diversity between the bays. The RNA data further showed more elevated transcript counts assigned to stress related genes in the heated bay that included heat shock protein genes dnaKJ, the co-chaperonin groS, and the nucleotide exchange factor heat shock protein grpE. The RNA data also showed elevated oxidative phosphorylation transcripts in the heated (e.g., atpHG) compared to control (e.g., atpAEFB) bay. Furthermore, genes related to photosynthesis had generally higher transcript numbers in the control bay, such as photosystem I (psaAC) and II genes (psbABCEH). These increased stress gene responses in the heated bay will likely have additional cascading effects on marine carbon cycling and ecosystem services.

PMID:38912348 | PMC:PMC11190084 | DOI:10.3389/fmicb.2024.1393538

BMC Nurs. 2024 Jun 24;23(1):424. doi: 10.1186/s12912-024-02108-3.

ABSTRACT

BACKGROUND: The ability of a nurse to make effective clinical decisions is the most important factor that can affect the treatment quality. However, several factors can affect the ability of nursing and midwifery students to make effective clinical decisions.

OBJECTIVES: This study aims to identify the confounding factors that may affect the clinical decision making of nurses and thus patient outcomes after the COVID-19 pandemic in Jordan.

METHODS: A descriptive cross-sectional design was employed in this study. An online self-administered questionnaire was distributed to 269 nursing and midwifery students selected through purposive sampling, 224 of whom completed the questionnaire. The valid and reliable nursing decision-making instrument, which consisted of 24 items, was employed to gather the data, and descriptive statistics and simple linear regression were employed for the data analysis. Data was collected from November to the end of December 2022.

RESULTS: Among the respondents, 72.8% were female, and the average age was 20.79 years (SD = 1.44). The vast majority of the respondents (94.6%) was unmarried, and 74.1% were pursuing a nursing degree. The simple linear regression analysis showed that clinical decision making had a negative and significant relationship with social media usage of an average of 6 h a day (β=-0.085). Moreover, the male nursing students obtained lower clinical decision-making scores (β= -0.408) compared with the female nursing students.

CONCLUSION: Social media usage and gender have a considerable effect on the clinical decision making of the nursing and midwifery students. Therefore, the confounding factors that can affect the clinical decision making of nurses should be discussed further, and strategies to address such factors should be implemented.

PMID:38910263 | DOI:10.1186/s12912-024-02108-3

BMC Health Serv Res. 2024 Jun 23;24(1):761. doi: 10.1186/s12913-024-11221-7.

ABSTRACT

BACKGROUND: Global digitalization significantly impacts public health by improving healthcare access for marginalized populations. In China, socioeconomic disparities and the Hukou system create significant barriers for the migrant population to access basic public health services (BPHS). This study aimed to assess how digital infrastructure construction (DIC) affects BPHS utilization among China’s migrant populations, filling a gap in the literature regarding the relationship between digital advancements and health service accessibility.

METHODS: This research used micro-level data from the 2018 China Migrants Dynamic Survey and incorporated variables aligned with the Broadband China policy to employ a comprehensive empirical strategy. It included baseline regressions, robustness checks through propensity score matching and machine learning techniques, and heterogeneity analysis to explore the differential impacts of DIC based on gender, age, education level, and Hukou status.

RESULTS: The findings revealed that DIC significantly enhances the likelihood of migrants establishing health records and registering with family doctors, demonstrating quantifiable improvements in health service utilization. Heterogeneity analysis further indicated that the beneficial impacts of DIC were more pronounced among female migrants, those with higher education levels, younger populations, and urban Hukou holders.

CONCLUSIONS: DIC plays a crucial role in bridging the accessibility gap to BPHS for migrant populations in China, contributing to narrowing health disparities and advancing social equity. These results emphasize the significance of digital infrastructure in public health strategies and offer valuable insights for policymakers, healthcare providers, and researchers. Future research should prioritize longitudinal studies on the sustained effects of DIC and tailor digital health initiatives to meet the unique needs of migrant populations, promoting inclusive health policy planning and implementation.

PMID:38910262 | DOI:10.1186/s12913-024-11221-7

BMC Infect Dis. 2024 Jun 23;24(1):623. doi: 10.1186/s12879-024-09535-2.

ABSTRACT

BACKGROUND: Sexually transmitted infections (STI) are public health problems in Ethiopia. Women have a higher chance of acquiring STI. STI complications are more severe in women compared to men. Despite that, treatment seeking for STI among women is poor. Woman empowerment and gender related factors may be playing a role for treatment seeking practice for STI. However, there are no studies that assess the association between these factors and treatment seeking practice for STI among married reproductive age women in Ethiopia. Therefore, this analysis was designed to explore this association in Ethiopia.

METHODS: This analysis used the 2016 Ethiopian demographic and health survey (EDHS) data. The 2016 EDHS collected data about STI treatment seeking practice for STI among other variables. Data was analyzed using STATA 17.0. Sampling weights were applied to improve the representativeness of the samples. Descriptive statistics were computed to describe the characteristics of the women. Binary and multivariable logistic regression models were fitted to identify the association between treatment seeking practice for STI and predictor variables. Multicollinearity was checked using variance inflation factors before running the multivariable logistic regression.

RESULTS: In this study, about 28% (95%CI: 20.87, 36.77) married reproductive age women with STI or STI symptoms sought treatment from the formal sector. Women whose husband attended secondary and higher education (AOR, 8.52; 95%CI 1.42, 51.21), and women with higher women empowerment scores (AOR 1.38, 95%CI 1.06, 1.81) had higher odds of treatment seeking for STI or STI symptoms. On the other hand, women who believe wife beating is justified had lower odds (AOR 0.32; 95%CI 0.15, 0.68) of treatment seeking for STI or STI symptoms.

CONCLUSIONS: Treatment seeking practice for STI among married reproductive age women in Ethiopia is low. The Ministry of Health and development partners shall conduct further research to identify barriers for treatment seeking practice. Gender variables (women empowerment and belief that wife beating is justified) were significantly associated with STI treatment seeking practice among married reproductive age women. STI prevention and control strategies shall include women empowerment and gender issues as essential component in STI prevention, treatment, and control activities.

PMID:38910255 | DOI:10.1186/s12879-024-09535-2

Glob Health Res Policy. 2024 Jun 24;9(1):22. doi: 10.1186/s41256-024-00361-2.

ABSTRACT

BACKGROUND: Asthma is the most common chronic respiratory illness among children in Australia. While childhood asthma prevalence varies by region, little is known about variations at the small geographic area level. Identifying small geographic area variations in asthma is critical for highlighting hotspots for targeted interventions. This study aimed to investigate small area-level variation, spatial clustering, and sociodemographic risk factors associated with childhood asthma prevalence in Australia.

METHODS: Data on self-reported (by parent/carer) asthma prevalence in children aged 0-14 years at statistical area level 2 (SA2, small geographic area) and selected sociodemographic features were extracted from the national Australian Household and Population Census 2021. A spatial cluster analysis was used to detect hotspots (i.e., areas and their neighbours with higher asthma prevalence than the entire study area average) of asthma prevalence. We also used a spatial Bayesian Poisson model to examine the relationship between sociodemographic features and asthma prevalence. All analyses were performed at the SA2 level.

RESULTS: Data were analysed from 4,621,716 children aged 0-14 years from 2,321 SA2s across the whole country. Overall, children’s asthma prevalence was 6.27%, ranging from 0 to 16.5%, with significant hotspots of asthma prevalence in areas of greater socioeconomic disadvantage. Socioeconomically disadvantaged areas had significantly higher asthma prevalence than advantaged areas (prevalence ratio [PR] = 1.10, 95% credible interval [CrI] 1.06-1.14). Higher asthma prevalence was observed in areas with a higher proportion of Indigenous individuals (PR = 1.13, 95% CrI 1.10-1.17).

CONCLUSIONS: We identified significant geographic variation in asthma prevalence and sociodemographic predictors associated with the variation, which may help in designing targeted asthma management strategies and considerations for service enhancement for children in socially deprived areas.

PMID:38910250 | DOI:10.1186/s41256-024-00361-2