Category: Statistics

J Med Radiat Sci. 2024 Sep 1. doi: 10.1002/jmrs.820. Online ahead of print.

ABSTRACT

INTRODUCTION: Radiography students complete professional placements in various clinical settings and must adhere to distinct infection prevention and control (IPC) protocols. The aim of this study was to explore radiography students’ training, knowledge, attitudes, and practice (KAP) relating to IPC in the use of contrast media injectors in computed tomography (CT).

METHODS: An online survey study was undertaken with radiography students enrolled at two Australian universities. Survey questions related to contrast media training and KAP regarding IPC in CT. Data was summarised using descriptive statistics, with comparisons between experience in public and private practice. One free-text response question focused on non-adherence to IPC best practice, analysed using content analysis.

RESULTS: In total, 40 students completed the survey (9% response rate). Reports of IPC and contrast media equipment training was high, with disposition for further training. Regarding IPC knowledge, 65% of students responded correctly to all ‘knowledge’ items (individual scores range: 60-100%). Low consensus was observed regarding whether gloves replace the need for hand hygiene and if CT contrast tubing poses risk to healthcare workers (85% each). Mean scores ranged from 41% to 100% regarding identification of sterile syringe and tubing components. Responses to the open-ended question were categorised into four themes: ‘High non-adherence risk working conditions’, ‘attitudes and practice’, ‘knowledge’, and ‘prioritise good IPC practice’.

CONCLUSIONS: Radiography students demonstrate varied comprehension of IPC regarding contrast media equipment, and results suggest need for collaborative efforts between academic institutions and clinical training sites to integrate IPC protocols into curricula and on-site training.

PMID:39217463 | DOI:10.1002/jmrs.820

Circulation. 2024 Sep 1. doi: 10.1161/CIRCULATIONAHA.124.071110. Online ahead of print.

ABSTRACT

Background: Kidney outcomes have been variably defined using non-standardized composite endpoints in key heart failure (HF) trials, thus introducing complexity in their interpretation and cross-trial comparability. We examined the effects of steroidal mineralocorticoid receptor antagonists (MRAs), the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan, and sodium-glucose cotransporter-2 (SGLT2) inhibitors on composite kidney endpoints using uniform definitions in 6 contemporary HF trials. Methods: Individual participant-level data from trials of steroidal MRAs (EMPHASIS-HF, TOPCAT Americas), ARNI (PARADIGM-HF, PARAGON-HF), and SGLT2 inhibitors (DAPA-HF, DELIVER) were included. The standardized composite kidney endpoint was defined as a sustained decline (a reduction in estimated glomerular filtration rate (eGFR) confirmed by a subsequent measurement at least 30 days later) in eGFR by 40%, 50%, or 57%, end-stage kidney disease, or renal death. eGFR was recalculated in a standardized manner using the 2009 Chronic Kidney Disease Epidemiology Collaboration creatinine equation. Results: Among 28,690 participants across the 6 trials (median age 69 years [IQR, 62-76]; 9,656 [33.7% ] women), the proportion experiencing the composite kidney endpoint with a more stringent definition of a sustained decline in kidney function (eGFR threshold of 57%) ranged from 0.3% to 3.3%. The proportion of patients experiencing this endpoint with a less stringent definition (eGFR threshold of 40%) ranged from 1.0% and 10.0%. The steroidal MRAs doubled the risk of the composite kidney endpoint when applying the least stringent definition compared with placebo, but these effects were less apparent and no longer significant with application of more stringent definitions. ARNI appeared to consistently reduce the occurrence of the composite kidney endpoints irrespective of specific eGFR threshold applied. The potential benefits of SGLT2-inhibitors on the composite kidney endpoints appeared more apparent when defined by more stringent eGFR thresholds, although none of these effects individually were statistically significant. Conclusions: When applying standardized stringent kidney endpoint definitions, steroidal MRAs, ARNI, and SGLT2-inhibitors have either neutral or beneficial effects on kidney outcomes in HF. Applying less stringent definitions increased event rates but included acute declines in eGFR that might not ultimately reflect long-term effects on kidney disease progression.

PMID:39217458 | DOI:10.1161/CIRCULATIONAHA.124.071110

J Perinat Med. 2024 Aug 30. doi: 10.1515/jpm-2024-0258. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine a possible correlation between SARS-CoV-2 infection during pregnancy and altered fetal behavior.

METHODS: Kurjak’s antenatal neurodevelopmental test (KANET) was applied from 28 to 40 weeks in 38 gestations (group A) diagnosed with COVID-19 infection during the first week and 43 non-COVID pregnant women (group B).

RESULTS: No statistically significant differences considering maternal age (33±3.9 years for group A vs. 31±4.1 years for group B) and gestational age (33±1.6 weeks for group A compared to 33±2.1 weeks for group B) were observed. KANET scores were not different between the two groups.

CONCLUSIONS: Fetal behavior differences are not altered in women diagnosed with SARS-CoV-2 infection during the third trimester of pregnancy.

PMID:39217455 | DOI:10.1515/jpm-2024-0258

Rev Neurosci. 2024 Aug 30. doi: 10.1515/revneuro-2024-0020. Online ahead of print.

ABSTRACT

Over the past two centuries, intensive empirical research has been conducted on the human brain. As an electroencephalogram (EEG) records millisecond-to-millisecond changes in the electrical potentials of the brain, it has enormous potential for identifying useful information about neuronal transactions. The EEG data can be modelled as graphs by considering the electrode sites as nodes and the linear and nonlinear statistical dependencies among them as edges (with weights). The graph theoretical modelling of EEG data results in functional brain networks (FBNs), which are fully connected (complete) weighted undirected/directed networks. Since various brain regions are interconnected via sparse anatomical connections, the weak links can be filtered out from the fully connected networks using a process called thresholding. Multiple researchers in the past decades proposed many thresholding methods to gather more insights about the influential neuronal connections of FBNs. This paper reviews various thresholding methods used in the literature for FBN analysis. The analysis showed that data-driven methods are unbiased since no arbitrary user-specified threshold is required. The efficacy of four data-driven thresholding methods, namely minimum spanning tree (MST), minimum connected component (MCC), union of shortest path trees (USPT), and orthogonal minimum spanning tree (OMST), in characterizing cognitive behavior of the normal human brain is analysed using directed FBNs constructed from EEG data of different cognitive load states. The experimental results indicate that both MCC and OMST thresholding methods can detect cognitive load-induced changes in the directed functional brain networks.

PMID:39217451 | DOI:10.1515/revneuro-2024-0020

Biomol Biomed. 2024 Aug 31. doi: 10.17305/bb.2024.10962. Online ahead of print.

ABSTRACT

The novel deubiquitinase enzyme, motif interacting with ubiquitin-containing novel DUB family-1 (MINDY1), is highly expressed in liver cancer tissues and plays a crucial role in maintaining the stemness of liver cancer cells. Programmed death ligand-1 (PD-L1) is an immunosuppressive molecule overexpressed by tumour cells. The potential role of MINDY1 in inhibiting the stemness of liver cancer cells by deubiquitinating PD-L1 has not yet been reported. To investigate the mechanism by which MINDY1 mediates immune escape in liver cancer through the regulation of PD-L1 ubiquitination, we examined the expression levels of MINDY1 and PD-L1 in liver cancer and adjacent tissues from 50 hepatocellular carcinoma (HCC) patients using protein imprinting and immunohistochemistry. We analyzed the relationship between the expression levels of MINDY1 and PD-L1 in liver cancer tissues and their correlation with the 5-year tumor-free survival rates of patients. Subsequently, MINDY1 expression was knocked down in Huh7 cells using small interfering RNA (siRNA) interference or upregulated through transfection with a MINDY1 overexpression plasmid. The effects of MINDY1 knockdown or overexpression on the proliferation, apoptosis, migration, and invasion of HCC cells, as well as the regulation of PD-L1 binding and ubiquitination, were assessed. The 5-year tumor-free survival rates were significantly lower in both the high MINDY1 expression group and the high PD-L1 expression group (χ2 = 4.919 and 13.158, respectively). A significant difference in survival was observed between the high and low MINDY1 expression groups (χ2= 27.415). MINDY1 was found to directly interact with PD-L1, with MINDY1 gene knockdown promoting PD-L1 ubiquitination and MINDY1 overexpression inhibiting PD-L1 ubiquitination. All comparisons yielded statistically significant results (P < 0.05). In conclusion, MINDY1 inhibits the malignant progression of liver cancer by inhibiting PD-L1 ubiquitination and mediating immune escape.

PMID:39217442 | DOI:10.17305/bb.2024.10962

Psychiatr Pol. 2024 Jun 30;58(3):467-494. doi: 10.12740/PP/171620. Epub 2024 Jun 30.

ABSTRACT

OBJECTIVES: Evidence suggests that decreased dopamine secretion in mesocorticolimbic pathways could predispose to increased susceptibility to substance addiction. It has been proposed to define such a phenomenon as the reward deficit syndrome (RDS). Dopaminergic projections of the reward system receive glutaminergic projections from cortex. Research indicates that a reduction in the stimulating glutamatergic transmission on the dopaminergic system could represent an alternative phenotype of RDS. Potential source of this type of abnormality is glutamate reuptake which depends on excitatory amino acid transport proteins (EAAT) function. The most important of them is EAAT2, polymorphisms of which have been linked to several mental disorders.

METHODS: We analyzed the genetic and psychometric data of 125 young adults (n = 125) for the effect of the rs4354668 polymorphism of the SLC1A2 gene for EAAT2 on the risky or harmful drug use (RHDU). After exploratory analysis we used logistic regression models to assess the probability of RHDU in individual groups.

RESULTS: In the final model T/T variant of rs4354668 was significantly associated with a lower probability of RHDU occurrence compared to G/G variant (OR: 0.021; 95% CI: 0.001 – 0.275; p = 0.009). Other significant predictors of RHDU were smoking status and risky or harmful drinking of alcohol.

CONCLUSIONS: The results obtained may indicate a possible relationship of the risk of harmful drug use with variants of the rs4354668 polymorphism of the SLC1A2 gene for EAAT2. Subjects with the T/T variant of this polymorphism appear to be less at risk of developing drug use disorders.

PMID:39217423 | DOI:10.12740/PP/171620

BMC Psychol. 2024 Aug 31;12(1):462. doi: 10.1186/s40359-024-01957-6.

ABSTRACT

BACKGROUND: Physicians are inclined to resort to defensive medicine (DM) for self-protection due to the increasing potential risk of medical litigation. DM is globally prevalent and has become an impediment to the development of healthcare. However, there is a lack of validated tools specifically designed to assess DM in China. Therefore, this study aimed to evaluate the psychometric properties of the Chinese version of Defensive Medicine Scale (DMS) among clinicians to provide a practicable tool for relevant research.

METHODS: The present research consists of two phases. In Phase 1, DMS was administered to survey 327 physicians, and the collected data were obtained for item analysis and exploratory factor analysis. Phase 2 applied DMS to survey 323 physicians, from which the data was used for confirmatory factor analysis, and reliability and cross-cohort consistency tests. Moreover, the participants of Phase 2 were required to complete Workplace Well-Being Scale (WWBS), Career Commitment Scale (CCS), Occupational Disidentification Scale (ODS), Intent to Leave Scale (ILS), and Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10) to test the convergent validity of DMS.

RESULTS: The Chinese version of DMS consists of 10 items divided into 2 dimensions, Positive Defensive Medicine (PDM) and Negative Defensive Medicine (NDM). The confirmatory factor analysis showed that the two-factor model fitted well (χ²/df = 2.540, RMSEA = 0.069, CFI = 0.981, IFI = 0.981, TLI = 0.971, PNFI = 0.646, PCFI = 0.654, SRMR = 0.044). Furthermore, the total score and the score of each dimension for DMS had a significant negative correlation with WWBS and CCS scores, and a significant positive correlation with ODS, ILS, and DDPRQ-10 scores. The Cronbach’s α coefficients for the total DMS and PDM and NDM dimensions were 0.917, 0.935, and 0.842, respectively; the split-half reliability coefficients were 0.922, 0.947, and 0.839, respectively. In addition, DMS showed cross-gender invariance.

CONCLUSION: The Chinese version of DMS has been demonstrated to be an effective tool to assess defensive medicine among Chinese physicians with good psychometric properties.

PMID:39217402 | DOI:10.1186/s40359-024-01957-6

J Health Popul Nutr. 2024 Aug 31;43(1):134. doi: 10.1186/s41043-024-00618-z.

ABSTRACT

BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver disease.

OBJECTIVE: This study aimed to investigate the self-management ability of patients with MASLD, analyse related factors that may affect self-management ability and evaluate the impact of this ability on readmission.

METHODS: The study recruited patients with MASLD admitted to the Department of Infectious Diseases, First Affiliated Hospital of Wenzhou Medical University, between February and October 2021 using the random sampling method. The MASLD diagnosis was based on the guidelines for the prevention and treatment of MASLD. An analysis of patients’ self-management ability was conducted using the self-management ability scale for patients with MASLD. Multiple linear regression analysis was used to analyse the factors influencing this self-management ability, and the readmission rate within 1 year was tracked. The patients were rediagnosed as having MASLD upon readmission to the hospital.

RESULTS: A total of 241 baseline data items and self-management scale scores for patients with MASLD were collected and investigated. In our study, the normal score range for the self-management scale was 31-155 points, and the self-management scale scores for patients with MASLD was 91.24 ± 16.98, with a low level of self-management accounting for 52.7% and a medium level accounting for 44.8%. The results of the multiple linear regression analysis revealed that marital status, smoking history, fatty liver severity and education were the main factors affecting self-management ability (P < 0.05). The readmission rates were 18.25%, 7.48% and 0%, respectively, after 1 year of follow-up; the difference in survival distribution was statistically significant (P < 0.05).

CONCLUSION: The self-management ability of patients with MASLD is relatively low and is primarily influenced by factors such as marital status, smoking history, the severity of fatty liver disease and level of education, which also affect the readmission rate of patients within 1 year.

PMID:39217400 | DOI:10.1186/s41043-024-00618-z

BMC Psychol. 2024 Aug 31;12(1):463. doi: 10.1186/s40359-024-01946-9.

ABSTRACT

OBJECTIVES: This study aims to investigate the links between the clinical, demographic, and psychosocial factors and cancer-related worry in patients with early-stage lung cancer after surgery.

METHODS: The study utilized a descriptive cross-sectional design. Questionnaires, including assessments of cancer-related worry, symptom burden, illness perception, psychological resilience, coping modes, social support and participant characteristics, were distributed to 302 individuals in early-stage lung cancer patients after surgery. The data collection period spanned from January and October 2023. Analytical procedures encompassed descriptive statistics, independent Wilcoxon Rank Sum test, Kruskal-Wallis- H- test, Spearman correlation analysis, and hierarchical multiple regression.

RESULTS: After surgery, 89.07% had cancer-related worries, with a median (interquartile range, IQR) CRW score of 380.00 (130.00, 720.00). The most frequently cited concern was the cancer itself (80.46%), while sexual issues were the least worrisome (44.37%). Regression analyses controlling for demographic variables showed that higher levels of cancer-related worry (CRW) were associated with increased symptom burden, illness perceptions, and acceptance-rejection coping modes, whereas they had lower levels of psychological resilience, social support and confrontation coping modes, and were more willing to obtain information about the disease from the Internet or applications. Among these factors, the greatest explanatory power in the regression was observed for symptom burden, illness perceptions, social support, and sources of illness information (from the Internet or applications), which collectively explained 52.00% of the variance.

CONCLUSIONS: Healthcare providers should be aware that worry is a common issue for early stage lung cancer survivors with a favorable prognosis. During post-operative recovery, physicians should identify patient concerns and address unmet needs to improve patients’ emotional state and quality of life through psychological support and disease education.

PMID:39217397 | DOI:10.1186/s40359-024-01946-9

Crit Care. 2024 Aug 31;28(1):287. doi: 10.1186/s13054-024-05072-1.

ABSTRACT

BACKGROUND: The decision to forgo life-sustaining treatment in intensive care units (ICUs) is influenced by ethical, cultural, and medical factors. This study focuses on a population of patients with hospital-acquired bloodstream infections (HABSI) to investigate the association between patient, pathogen, center and country-level factors and these decisions.

METHODS: We analyzed data from the EUROBACT-2 study (June 2019-January 2021) from 265 centers worldwide, focusing on non-COVID-19 patients who died in the hospital or within 28 days after HABSI. We assessed whether death was preceded by a decision to forgo life-sustaining treatment, examining country, center, patient, and pathogen variables. To assess the association of each potentially important variable with the decision to forgo life-sustaining treatment, univariable mixed logistic regression models with a random center effect were performed.

RESULTS: Among 1589 non-COVID-19 patients, 519 (32.7%) died, with 191 (36.8%) following a decision to forgo life-sustaining treatment. Significant geographical differences were observed, with no reported decisions to forgo life-sustaining treatment in African countries and fewer in the Middle East compared to Western Europe, Australia, and Asia. Once a center effect was considered, only health expenditure (Odds ratio 1.79, 95%CI: 1.45-2.21, p < 0.01) and age (Odds ratio 1.02, 95%CI: 1.002-1.05, p = 0.03) were significantly associated with decisions to forgo life-sustaining treatment, while other patient and pathogen factors were not.

CONCLUSION: Economic and regional disparities significantly impact end-of-life decision-making in ICUs. Global policies should consider these disparities to ensure equitable end-of-life care practices.

PMID:39217394 | DOI:10.1186/s13054-024-05072-1