Category: Statistics

Proc Data Compress Conf. 2024 Mar;2024:123-132. doi: 10.1109/dcc58796.2024.00020. Epub 2024 May 21.

ABSTRACT

MONI (Rossi et al., JCB 2022) is a BWT-based compressed index for computing the matching statistics and maximal exact matches (MEMs) of a pattern (usually a DNA read) with respect to a highly repetitive text (usually a database of genomes) using two operations: LF-steps and longest common extension (LCE) queries on a grammar-compressed representation of the text. In practice, most of the operations are constant-time LF-steps but most of the time is spent evaluating LCE queries. In this paper we show how (a variant of) the latter can be evaluated lazily, so as to bound the total time MONI needs to process the pattern in terms of the number of MEMs between the pattern and the text, while maintaining logarithmic latency.

PMID:39157794 | PMC:PMC11328106 | DOI:10.1109/dcc58796.2024.00020

JACC Adv. 2024 Jul 27;3(9):101130. doi: 10.1016/j.jacadv.2024.101130. eCollection 2024 Sep.

ABSTRACT

BACKGROUND: The adult congenital heart disease (ACHD) population is growing and risk prediction is important to predict adverse outcome and consult patients during their lifecourse.

OBJECTIVES: This study aims to describe the long-term prognostic value of blood biomarkers in ACHD.

METHODS: In this prospective observational cohort study, 602 patients with moderate or complex ACHD were included (median age 32.5 years [IQR: 24.7-41.2], 42% female, 90% New York Heart Association I). N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive-troponin T, growth differentiation factor 15, high-sensitive-C-reactive protein, suppression of tumorigenicity-2 and galectin-3, as well as full blood count, renal function, LDL, and HDL were measured. Cox models were applied to relate the selected biomarkers with the primary end point of all-cause mortality and secondary end point of mortality or heart failure. Standardized HRs adjusted for relevant prognostic factors, including age, sex, and complexity of diagnosis, were reported.

RESULTS: Abnormal biomarker levels were present in 424 (70.4%) patients. During a median follow-up of 10.1 years, 41 (6.8%) patients died and 81 (13.5%) developed heart failure. Associations were observed between the primary and secondary end point and red cell distribution width, NT-proBNP, and growth differentiation factor 15. In a multibiomarker model, only NT-proBNP remained associated with mortality (HR: 2.74; 95% CI: 2.01-3.74). NT-proBNP significantly improved the C-statistic of the clinical prediction model (0.85-0.92). Based on NT-proBNP alone, low-risk patients could be identified. Patients with NT-proBNP <76 ng/L showed a 10-year heart failure-free survival of 98.5%.

CONCLUSIONS: Blood biomarkers have prognostic value in ACHD. NT-proBNP improves risk prediction and is able to identify low-risk patients. Its routine use should be implemented in ACHD.

PMID:39157753 | PMC:PMC11327932 | DOI:10.1016/j.jacadv.2024.101130

Res Pract Thromb Haemost. 2024 Jun 21;8(4):102483. doi: 10.1016/j.rpth.2024.102483. eCollection 2024 May.

NO ABSTRACT

PMID:39157749 | PMC:PMC11328051 | DOI:10.1016/j.rpth.2024.102483

Women Health. 2024 Aug 18:1-9. doi: 10.1080/03630242.2024.2392132. Online ahead of print.

ABSTRACT

Labor is a complex, subjective experience, and all factors that influence pain should be considered to ensure a comprehensive evaluation. This study aimed to determine whether gender roles were predictive of labor pain. The study has a descriptive and cross-sectional design. It was carried out in a delivery room of a city hospital in Turkey between September 2019 and September 2020. The study sample consisted of 231 primiparous women presenting for labor and delivery. Data were gathered with a descriptive characteristics form, Visual Analogue Scale and The Bem Sex-Role Inventory. Descriptive statistics and simple regression analysis were employed to analyze the obtained data. Regression analysis demonstrated that gender roles were predictive of labor pain in the latent, active, and transitional stages, but not in the second stage. Gender roles were most responsible for labor pain in the latent phase. Results of the study revealed that gender roles may be useful variables to predict women’s labor pain, and contributed to the relevant literature. Nurses and midwives offering care for labor pain should consider gender roles as a factor affecting labor pain. It is also necessary to individualize the supporting care given during labor.

PMID:39155140 | DOI:10.1080/03630242.2024.2392132

Vasc Endovascular Surg. 2024 Aug 18:15385744241276648. doi: 10.1177/15385744241276648. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to report the clinical presentation and treatment outcomes of patients treated for IAAD with and without abdominal aortic aneurysm (AAA) in a single academic institution in South America.

MATERIALS AND METHODS: A retrospective review of all patients with IAAD with or without concomitant AAA between January 2002 and December 2023 from a single academic hospital was performed.

RESULTS: Eighteen patients with IAAD were diagnosed of whom 13 (72.2%) were males. Median age was 63 years (range: 43-88 years). Sixteen (88.8%) patients presented with symptoms, and in two (11.1%) asymptomatic patients IAAD was an incidental finding. Ten (55.5%) patients had concomitant abdominal aortic aneurysm (AAA), with a median size of the aneurysm of 49.5 mm (range: 44-66 mm). No statistical differences in baseline characteristics were seen between patients with concomitant IAAD and AAA and patients with only IAAD. Seven (38.8%) patients presented chronic dissection, and 11 (61.1%) patients had acute dissection. Five (27.7%) patients were treated conservatively with blood pressure, pain control, and antiplatelets; endovascular surgery was performed in eight (44.4%) patients and open surgery in five (27.7%) patients. The complication rate was 22.2% (n = 4), and the mortality rate was 0%. Median follow-up was 36 months (range: 6-240 months). Complete remodeling was seen in all patients except two patients who underwent conservative treatment. Of those, one had partial remodeling, and the other no changed.

CONCLUSION: Isolated aortic dissection of the abdominal aorta is an uncommon condition, with acceptable different treatment strategies, from conservative to invasive treatments. Sometimes IAAD can concur with AAA, and when so, invasive treatment might be considered. More studies describing the natural history of AAA and its association with IAAD are warranted, as well as further research reporting long-term outcomes on aortic remodeling after different treatment modalities.

PMID:39155127 | DOI:10.1177/15385744241276648

Alcohol Clin Exp Res (Hoboken). 2024 Aug 18. doi: 10.1111/acer.15406. Online ahead of print.

ABSTRACT

Recovery from alcohol use disorder (AUD) is a dynamic process that often entails periods of drinking but has been defined primarily by abstinence. Recently, a broader interpretation of recovery was developed, including meeting the Diagnostic and Statistical Manual of Mental Disorders (DSM) remission criteria and improved psychosocial functioning. This new understanding of recovery has facilitated the development of novel theories and methodologies. This paper reviews a new theoretical perspective of recovery, Reinforcer Pathology, and two novel methodological approaches in light of this broader view of recovery. Using this theoretical framework as a foundation, we propose an alternative perspective to explain the recovery process as it relates to environmental factors and valuation of the future; we suggest that changing the environment in which substances are available (e.g., increasing non-alcohol-related activities) and extending one’s temporal window are associated with improved recovery outcomes (e.g., remission and quality of life). In this review, we discuss two novel methodological approaches. The first uses latent profile analysis to show that using a measure of Relative Reinforcement Value of Alcohol-Free Activities is associated with a greater likelihood of belonging to a high functioning/infrequent heavy drinking recovery profile. The second developed an online national sample and used an accelerated longitudinal design to study longer-term recovery of up to 12 years over a 5-year study period. Reinforcer Pathology theory, novel methods, and measures may further our understanding of recovery and begin to address critical questions for future studies. Subsequent randomized clinical trials should examine whether the suggested targets and interventions based on the theoretical model improve recovery outcomes prospectively. Measuring and promoting alcohol-free activity engagement may facilitate improved recovery outcomes, while novel methodologies permit an understanding of returning to use or remission across different recovery durations.

PMID:39155126 | DOI:10.1111/acer.15406

Asian J Endosc Surg. 2024 Oct;17(4):e13373. doi: 10.1111/ases.13373.

ABSTRACT

INTRODUCTION: This study aimed to clarify the validity of laparoscopic surgery for lower gastrointestinal perforation by comparing the clinical outcomes of laparoscopic and open emergency surgery.

METHODS: We reviewed the data of patients who underwent surgery for lower gastrointestinal perforation. Patients were categorized into two groups: the laparoscopic group who underwent laparoscopic surgery, and the open group who underwent laparotomy. Clinical and operative outcomes between the two groups were evaluated.

RESULTS: A total of 219 patients were included in the study. There were 66 and 153 patients with small bowel and colorectal perforations, respectively. The median operative time in the laparoscopic group was shorter than that in the open group (126 min vs. 146 min, p = .049). The mean amount of intraoperative blood loss was significantly lower in the laparoscopic group (50.4 mL vs. 400.1 mL, p < .001). The incidence of postoperative complication was higher in the open group (20.0% vs. 66.5%, p < .001), especially wound infection (0% vs. 26.3%, p = .002). Median hospital stays were 14 days and 24 days in the laparoscopic and open groups, respectively (p < .001). In the laparoscopic group, hospital mortality was 0%.

CONCLUSIONS: The laparoscopic approach for small bowel and colorectal perforation in an emergency setting is a safe procedure in carefully selected patients and may contribute to decreased intraoperative blood loss, shortened hospital stay, and decreased incidence of postoperative complications, especially wound infection.

PMID:39155075 | DOI:10.1111/ases.13373

Aust Health Rev. 2024 Aug 19. doi: 10.1071/AH24185. Online ahead of print.

ABSTRACT

ObjectiveHospital chief executive officers (CEOs) in Australia encounter various challenges such as financial constraints, changing regulations, and the necessity to uphold patient care standards. These challenges can contribute to rates of CEO turnover, which can disrupt healthcare organisations and affect the quality of services provided. This research aims to pinpoint the factors influencing hospital CEO turnover and explore effective strategies for retaining these vital leadersMethodsA survey was carried out among hospital CEOs throughout Australia. The survey, distributed through email and online platforms, gathered information on reasons behind turnover and methods for retaining CEOs. Data from 51 CEOs were analysed using statistical regression techniques and thematic analysis.ResultsThe findings from the survey indicated that 82.35% of CEOs identified stress and work-related pressure as the causes of turnover. Other significant factors included managing under-resourced organisations (68.62%), lack of support from the board (66.66%), and facing internal/external criticisms (58.82%). On average, respondents reported 5.16 reasons for leaving their positions with no significant differences found based on sociodemographic characteristics. It was pointed out that key ways to retain CEOs include building respect and trust between CEOs and board chairs, meeting the training and development needs of CEOs, and defining roles within the organisation. The importance of succession planning was also emphasised, with 94.12% of respondents acknowledging its significance for maintaining stability.ConclusionThe study underscores the multifaceted nature of CEO turnover in Australian hospitals influenced by organisational dynamics, performance factors, and personal elements. Effective retention strategies necessitate a culture within the organisation, defined roles, sufficient resources, and robust succession planning. Addressing these aspects can bolster leadership continuity and enhance the performance of healthcare organisations.

PMID:39155064 | DOI:10.1071/AH24185

Clin Teach. 2024 Aug 18:e13798. doi: 10.1111/tct.13798. Online ahead of print.

ABSTRACT

BACKGROUND: Teaching clinical pharmacology is often a challenge for medical schools. The benefits and popularity of active recall and spaced repetition through Anki flashcards are well-established and can offer a solution for teaching complex topics, but educators are often unfamiliar with this resource.

APPROACH: We implemented 501 faculty-generated pharmacology flashcards in five modules across the medical preclinical curriculum, available to 104 first-year students. At the end of each module, students were surveyed on the usefulness of this novel resource. The data from the cohort who had access to flashcards was compared with the previous cohort, without access, to analyse whether student use of Anki flashcards changed students’ perceptions of the pharmacology curriculum and whether there were changes in pharmacology exam performance.

EVALUATION: Seventy-five percent of the respondents rated the Anki pharmacology flashcards as ‘very useful’ or ‘somewhat useful’. Eight hundred and seventy-five responses were analysed with a natural language processing algorithm, showing that fewer students mentioned pharmacology as a difficult topic in the cardiovascular and renal modules, compared with the cohort who did not use Anki flashcards. There was not a statistically significant difference in test scores between the cohorts.

IMPLICATIONS: Anki flashcards were well-received by medical students, which might have impacted their perception of the curriculum, as evidenced by the decrease in mentions of pharmacology being a difficult topic, maintaining consistency in academic performance. Educators should consider providing flashcards to offer spaced repetition opportunities in the curriculum; an additional benefit could be increasing information equality in medical schools.

PMID:39155059 | DOI:10.1111/tct.13798

Pharmacoepidemiol Drug Saf. 2024 Aug;33(8):e5863. doi: 10.1002/pds.5863.

ABSTRACT

PURPOSE: Vaccine-associated enhanced disease (VAED) is a theoretical concern with new vaccines, although trials of authorized vaccines against SARS-CoV-2 have not identified markers for VAED. The purpose of this study was to detect any signals for VAED among adults vaccinated against coronavirus disease 2019 (COVID-19).

METHODS: In this cross-sectional study, we assessed COVID-19 severity as a proxy for VAED among 400 adults hospitalized for COVID-19 from March through October 2021 at eight US healthcare systems. Primary outcomes were admission to an intensive care unit (ICU) and severe illness (score ≥6 on the World Health Organization [WHO] Clinical Progression Scale). We compared the risk of outcomes among those who had completed a COVID-19 vaccine primary series versus those who were unvaccinated. We incorporated inverse propensity weights for vaccination status in a doubly robust regression model to estimate the causal average treatment effect.

RESULTS: The causal risk ratio in vaccinated versus unvaccinated was 0.36 (95% confidence interval [CI], 0.15-0.94) for ICU admission and 0.46 (95% CI, 0.25-0.76) for severe illness.

CONCLUSION: Among hospitalized patients, reduced disease severity in those vaccinated against COVID-19 supports the absence of VAED.

PMID:39155049 | DOI:10.1002/pds.5863