Category: Statistics

J Psychosom Res. 2024 May 21:111805. doi: 10.1016/j.jpsychores.2024.111805. Online ahead of print.

ABSTRACT

OBJECTIVE: Functional somatic symptoms (FSS) accumulate within families. Exposure to family patterns of high healthcare use may induce maladaptive symptom coping and thereby potentially contribute to the transgenerational transmission of FSS. This study aimed to uncover associations between parental and child healthcare use during the child’s first years of life (age 0-4) and childhood FSS at age 5-7.

METHODS: We utilized data from the Copenhagen Child Cohort (CCC2000), a population-based birth cohort. Parent-reported FSS of their 5-7-year-old children were linked to Danish national registry data on parental and child healthcare use (including general practitioner [GP] consultations and hospital contacts) during child age 0-4 years. Logistic regression analyses were performed to investigate longitudinal associations between family healthcare use and child FSS.

RESULTS: We found an association between prior parental healthcare use and child FSS at age 5-7 (OR = 1.02, 95% CI [1.01-1.04]). Key sensitivity analyses specifically focusing on GP consultations, revealed modest but statistically significant associations between parental (OR = 1.03, 95% CI [1.02-1.05]) and child (OR = 1.18, 95% CI [1.04-1.34]) GP consultations and impairing FSS at age 5-7.

CONCLUSION: Family healthcare use, especially within the general practice, may play a role in the transgenerational transmission of FSS. Early-stage FSS identification and care might be improved through training aimed at GPs. Future research may identify vulnerable families at whom parent-focused interventions for symptom-coping could be targeted. This could potentially contribute to the prevention of transgenerational transmission of FSS.

PMID:38944597 | DOI:10.1016/j.jpsychores.2024.111805

J Pediatr Surg. 2024 Jun 8:S0022-3468(24)00354-3. doi: 10.1016/j.jpedsurg.2024.06.003. Online ahead of print.

ABSTRACT

BACKGROUND: Gunshot injuries are the leading cause of death among children in the United States. The goal of this study was to better understand if certain age groups, mechanisms of injury, and type of firearms were associated with the increasing rates of pediatric gun-related trauma. We hypothesized that the extremities were disproportionately targeted when compared with the random likelihood of striking specific body-surface areas.

METHODS: This study includes pediatric firearm-related injury (FRI) patients who presented to a single free-standing level 1 pediatric hospital or died at the scene from 2010 to 2021. The hospital data was collected prospectively as part of a level 1 trauma system electronic database. Death data was collected from the local coroner’s office.

RESULTS: Between 2010 and 2021, 1,126 pediatric FRI occurred in the geographic region studied. Demographic information available for 1,118 patients showed that 897 (80.23%) were male, and that black individuals had a statistically significant increased rate of FRI compared with white or Hispanic individuals. Mean age was 13.69 years. Most injuries were caused by handguns.

CONCLUSIONS: This data could help leaders design strategies to combat the violence, such as legislation that limits handgun access to all, especially children, and mandates safe storage of handguns. Gun-lock programs, universal background checks, and firearm-ownership education also might help stem this tide of violence.

LEVEL OF EVIDENCE: Level II Prognosis study.

PMID:38944592 | DOI:10.1016/j.jpedsurg.2024.06.003

J Surg Educ. 2024 Jun 28:S1931-7204(24)00242-3. doi: 10.1016/j.jsurg.2024.05.015. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to evaluate the instructional efficacy of a 3D Surgical Training System (3DSTS), which combines real surgical footage with high-definition 3D animations, against conventional surgical videos and textbooks in the context of orthopedic proximal humerus fracture surgeries.

DESIGN: Before the experiment, 89 participants completed a pre-educational knowledge assessment. They were then randomized into 3 groups: the 3DSTS group (n = 30), the surgical video (SV) group (n = 29), and the textbook group (n = 30). After their respective teaching courses, all participants took a posteducational assessment and completed a perceived cognitive load test. The 3DSTS group also filled out a satisfaction survey. Once all assessments were finished, the SV and textbook groups were introduced to the 3DSTS course and subsequently completed a satisfaction survey. All statistical analyses were executed using IBM SPSS version 24 (IBM Corp., Armonk, NY). For data fitting normal distribution, we employed one-way analysis of variance (one-way ANOVA) and Tukey HSD tests, whereas, for non-normally distributed data, we used Kruskal-Wallis H tests and Dunn’s tests. The significance level for all tests was set at p < 0.05.

SETTING: Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, P. R. China.

PARTICIPANTS: About 89 doctors who undergoing standardized residents training.

RESULT: The initial assessment scores among the three groups were comparable, showing no significant statistical difference. Post-education revealed a marked difference in the scores, with the 3DSTS group outperforming both the SV and textbook groups. Specifically, the 3DSTS group exhibited statistically greater improvement in areas such as procedural steps, and specialized surgical techniques compared to the SV and textbook groups. During the 3DSTS teaching process, participants reported the least perceived cognitive load and expressed strong satisfaction, highlighting that the instructional materials are well-prepared, and considering this teaching method superior and more innovative than previous courses they had encountered.

CONCLUSION: The 3D Surgical Training System, integrating real videos with 3D animations, significantly enhances orthopedic surgery education over conventional methods, providing improved comprehension, lower cognitive load, and standardized learning outcomes. Its efficacy and high participant satisfaction underscore its potential for broader adoption in surgical disciplines. This study is registered with ClinicalTrials. gov ID: ChiCTR2300074730.

PMID:38944585 | DOI:10.1016/j.jsurg.2024.05.015

HPB (Oxford). 2024 Jun 16:S1365-182X(24)01770-2. doi: 10.1016/j.hpb.2024.06.004. Online ahead of print.

ABSTRACT

BACKGROUND: CA 19-9 is an extremely useful biomarker for pancreatic ductal adenocarcinomas (PDACs). However, the optimal cut-off and prognostic significance at higher cut-offs are yet to be determined.

METHODS: Retrospective analysis included patients with PDAC who underwent curative resection from January 2010 to May 2020 at Tata Memorial Centre, Mumbai. The pretherapy CA 19-9 was dichotomized using various cut-off levels and analysed.

RESULTS: In 244 included patients, the median overall survival (OS) for those with CA19-9 level (IU/ml) < or >78, 200, 500, 1000, and 2000 was 27, 24, 23, 22, 21 months versus 18, 16, 15, 14, 13 months; respectively, and was statistically significant (p-value- 0.002, 0.001, 0.002, 0.002 and 0.004, respectively). The number of recurrences and mortality had significant correlation with CA 19-9 cut-offs. On multivariate analysis, adjuvant treatment completion (p-0.004) and decreasing or stable CA19-9 after Neoadjuvant therapy (NAT) (p- 0.031) were associated with improved OS.

CONCLUSION: The prognostic significance of CA 19-9 was observed at all the cut-off levels examined, beyond mere elevated value as per the standard cut-off level. In patients with high CA19-9 level, surgery should be offered if technically and conditionally feasible, only when a response in CA19-9 level to NAT is achieved.

PMID:38944571 | DOI:10.1016/j.hpb.2024.06.004

Dent Mater. 2024 Jun 28:S0109-5641(24)00183-0. doi: 10.1016/j.dental.2024.06.026. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the influence of calcination process on the properties of minimally processed recycled 3Y-TZP, and to compare it with its commercial counterpart.

METHODS: Non-milled 3Y-TZP waste was collected, fragmented and ball-milled to a granulometric < 5 µm. Half of the recycled powder was calcined at 900 °C. Recycled 3Y-TZP disks were uniaxially pressed and sintered to create two recycled groups: 1) Calcined and 2) Non-calcined to be compared with a commercial CAD/CAM milled 3Y-TZP. The microstructure of experimental groups was assessed through density (n = 6), scanning electron microscopy (n = 3) and energy-dispersive X-ray spectroscopy (n = 3); and the crystalline content was evaluated through X-ray diffraction (XRD) (n = 3). Optical and mechanical properties were investigated through reflectance tests (n = 10), and Vickers hardness, fracture toughness (n = 5), and biaxial flexural strength tests (n = 16), respectively. Fractographic analysis was performed to identify fracture origin and crack propagation. Statistical analyses were performed through ANOVA followed by Tukey´s test, and by Weibull statistics.

RESULTS: Particle size distribution of recycled powder revealed an average diameter of ∼1.60 µm. The relative density of all experimental groups was > 98.15 % and XRD analysis exhibited a predominance of tetragonal-phase in both recycled groups, which were similar to the crystallographic pattern of the control group. Cross-section micrographs presented flaws on the non-calcined group, and a more homogeneous microstructure for the calcined and commercial groups. Commercial samples showed lower contrast-ratio and higher translucency-parameter than the recycled groups, where non-calcined presented higher translucency-parameter and lower contrast-ratio than its calcined counterpart. The commercial group presented higher fracture toughness and characteristic strength than the recycled groups. Moreover, the calcined group exhibited higher hardness, characteristic strength, and probability of survival at higher loads than the non-calcined group. Fractographic analysis depicted the presence of microstructural flaws in the non-calcined group, which may have acted as stress-raisers and led to failures at lower flexural strengths values.

SIGNIFICANCE: The calcination process improved the microstructure, optical, and mechanical properties of the recycled 3Y-TZP.

PMID:38944559 | DOI:10.1016/j.dental.2024.06.026

J Voice. 2024 Jun 28:S0892-1997(24)00182-6. doi: 10.1016/j.jvoice.2024.06.010. Online ahead of print.

ABSTRACT

PURPOSE: To determine the efficacy of a hybrid group telepractice program in voice therapy for primary school teachers.

METHOD: The participants, consisting of 12 teachers with voice disorders (three males and nine females), participated in 11 sessions of the telepractice program, divided into one training session on vocal hygiene, five practice sessions by themselves, and five group practice sessions in 5weeks. Data on the vocal handicap index (VHI) measure was obtained pre- and post-intervention. The voice analysis included fundamental frequency (local), jitter (local), shimmer (local), harmonic-to-noise ratio (local), and maximum phonation time assessed by Praat software.

RESULT: The VHI assessment revealed a statistically significant difference (P < 0.05) in the emotional domain. There was no statistically significant difference (P > 0.05) in physical, functional, and total scores. Both males and females had no statistically significant difference (P > 0.05) in mean fundamental frequency. However, there was a statistically significant difference (P < 0.05) in jitter (local), shimmer (local), harmonics-to-noise ratio (local), and the maximum phonation time.

CONCLUSION: The group telepractice program in voice therapy for primary school teachers was effective. It could be utilized for voice therapy to prevent voice disorder problems in teachers.

PMID:38944541 | DOI:10.1016/j.jvoice.2024.06.010

Lancet. 2024 Jun 29;403(10446):2783-2784. doi: 10.1016/S0140-6736(24)01123-1.

NO ABSTRACT

PMID:38944522 | DOI:10.1016/S0140-6736(24)01123-1

Soins Gerontol. 2024 Jul-Aug;29(168):31-38. doi: 10.1016/j.sger.2024.04.010. Epub 2024 Jun 18.

ABSTRACT

Geriatric in-patient dermatoses are diverse. Few data in Morocco describe the epidemiological profile and factors associated with average length of stay (LOS). Our aim was to identify these dermatoses and determine the factors associated with LOS.

PMID:38944471 | DOI:10.1016/j.sger.2024.04.010

Thorac Surg Clin. 2024 Aug;34(3):239-247. doi: 10.1016/j.thorsurg.2024.04.001. Epub 2024 May 4.

ABSTRACT

Abuse, bullying, harassment, and discrimination are prominent workplace occurrences within cardiothoracic (CT) surgery that cause burnout and threaten the well-being of surgeons. Under-represented and marginalized groups experience higher incidences of these negative events, and CT surgery is one of the least diverse specialties. The CT surgery workforce and institutional leadership must prioritize mentorship, sponsorship, and allyship to promote a diverse and healthy specialty for surgeon recruitment, growth, and job satisfaction.

PMID:38944451 | DOI:10.1016/j.thorsurg.2024.04.001

J Appl Microbiol. 2024 Jun 29:lxae163. doi: 10.1093/jambio/lxae163. Online ahead of print.

ABSTRACT

AIMS: Shellfish production areas are classified for suitability for human consumption using counts of E.coli in shellfish samples. Two alternative laboratory methods are approved in the EU and UK for measuring E. coli in shellfish samples; the MPN and pour plate methods. These methods have inherently different statistical uncertainty and may give different counts for the same sample. Using two approaches: simulated data and spiking experiments, we investigate the theoretical properties of the two methods to determine their reliability for shellfish waters classification.

METHODS AND RESULTS: Assuming a Poisson distribution of E. coli in shellfish samples, we simulate concentrations in 10,000 samples using the MPN and pour plate methods. We show that for higher concentrations of E. coli the pour plate method becomes increasingly more reliable than the MPN method. The MPN method has higher probabilities than pour plate of generating results exceeding shellfish classification thresholds, while conversely having higher probabilities of failing to detect counts that exceed regulatory thresholds. The theoretical analysis also demonstrates that the MPN method can produce genuine extreme outliers, even when E. coli are randomly distributed within the sampled material. A laboratory spiking experiment showed results consistent with the theoretical analysis, suggesting the Poisson assumption used in the theoretical analysis is reasonable.

CONCLUSION: The large differences in statistical properties between the pour plate and MPN methods should be taken into consideration in classifying shellfish beds, with the pour plate method being more reliable over the crucial range of E. coli concentrations used to determine class boundaries.

PMID:38944416 | DOI:10.1093/jambio/lxae163