Category: Statistics

Biotechnol Genet Eng Rev. 2023 Apr 11:1-15. doi: 10.1080/02648725.2023.2200626. Online ahead of print.

ABSTRACT

To analyze the value of the combined test of the cardiac color Doppler ultrasound, the serum middle receptor pro-atrial natriuretic peptide (MR-ProANP) and the N-terminal pro-brain natriuretic peptide (NT-ProBNP) in forecasting the hypertensive left ventricular hypertrophy (LVH) and left heart failure (LHF). All patients were subjected to cardiac color Doppler ultrasound examination to obtain left atrium volume index (LAVI), left ventricular end-diastolic diameter (LVEDD), early-diastolic peak flow velocity (E), early-diastolic mean flow velocity (e’), early-diastolic peak flow velocity/early-diastolic mean flow velocity (E/e’) and left ventricular ejection fraction (LVEF). Biomarkers were performed to obtain serum MR-ProANP and NT-ProBNP concentrations, and statistical analysis was performed. The LVEF was obviously lower than that in the control group (P<0.01). The area under the receiver operating characteristic (ROC) curve (AUC) values of LVEF, E/e’, serum MR-ProANP and NT-ProBNP alone were in the range of 0.7-0.8. The AUC, sensitivity and specificity of LVEF and E/e’ combined with MR-ProANP and NT-ProBNP to diagnose hypertensive LVH and LHF were 0.892, 89.14% and 78.21%, which were higher than those of single diagnosis. In the heart failure group, LVEF was negatively correlated with serum MR-ProANP and NT-ProBNP concentrations (P<0.05), and E/e’ was positively correlated with serum MR-ProANP and NT-ProBNP concentrations (P<0.05). Pump function and ventricular remodeling in patients with hypertensive LVH and LHF are closely related to serum MR-ProANP and NT-ProBNP levels. Combination of the two testing can improve the prediction and diagnostic efficacy of LHF.

PMID:37040501 | DOI:10.1080/02648725.2023.2200626

J Magn Reson Imaging. 2023 Apr 11. doi: 10.1002/jmri.28722. Online ahead of print.

ABSTRACT

BACKGROUND: Cerebral perfusion is directly affected by systemic blood pressure, which has been shown to be negatively correlated with cerebral blood flow (CBF). The impact of aging on these effects is not fully understood.

PURPOSE: To determine whether the relationship between mean arterial pressure (MAP) and cerebral hemodynamics persists throughout the lifespan.

STUDY TYPE: Retrospective, cross-sectional study.

POPULATION: Six hundred and sixty-nine participants from the Human Connectome Project-Aging ranging between 36 and 100+ years and without a major neurological disorder.

FIELD STRENGTH/SEQUENCE: Imaging data was acquired at 3.0 Tesla using a 32-channel head coil. CBF and arterial transit time (ATT) were measured by multi-delay pseudo-continuous arterial spin labeling.

ASSESSMENT: The relationships between cerebral hemodynamic parameters and MAP were evaluated globally in gray and white matter and regionally using surface-based analysis in the whole group, separately within different age groups (young: <60 years; younger-old: 60-79 years; oldest-old: ≥80 years).

STATISTICAL TESTS: Chi-squared, Kruskal-Wallis, ANOVA, Spearman rank correlation and linear regression models. The general linear model setup in FreeSurfer was used for surface-based analyses. P < 0.05 was considered significant.

RESULTS: Globally, there was a significant negative correlation between MAP and CBF in both gray (ρ = -0.275) and white matter (ρ = -0.117). This association was most prominent in the younger-old [gray matter CBF (β = -0.271); white matter CBF (β = -0.241)]. In surface-based analyses, CBF exhibited a widespread significant negative association with MAP throughout the brain, whereas a limited number of regions showed significant prolongation in ATT with higher MAP. The associations between regional CBF and MAP in the younger-old showed a different topographic pattern in comparison to young subjects.

DATA CONCLUSION: These observations further emphasize the importance of cardiovascular health in mid-to-late adulthood for healthy brain aging. The differences in the topographic pattern with aging indicate a spatially heterogeneous relationship between high blood pressure and CBF.

LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY STAGE: 3.

PMID:37040498 | DOI:10.1002/jmri.28722

Nurs Open. 2023 Apr 11. doi: 10.1002/nop2.1745. Online ahead of print.

ABSTRACT

AIM: This study aimed to develop a tool to measure paediatric specialist nurses’ core competencies and examine the scale’s validity and reliability.

DESIGN: An exploratory quantitative study.

METHODS: This study was performed in April 2022 with 302 paediatric specialist nurses in mainland China. Items were created through a literature review, a qualitative interview, and the Delphi method. The data were evaluated using descriptive statistics, independent sample t-test, explanatory factor analysis, Pearson correlation coefficient, Cronbach’s alpha coefficient and split-half reliability.

RESULTS: The final scale consisted of five factors and 32 items. The factors were communication, coordination and judgement abilities; professional technology mastery ability; specialist knowledge mastery ability; medical-related processes; and evidence-based nursing competencies. The explained total variance of the five factors was 62.216%. The scale-level and item-level CVI of this scale was 1.00, and the mean CVR of the total scale was 0.788. The Pearson correlation coefficients of each dimension and the total dimension of the scale was 0.709-0.892, and within each dimension, it was 0.435-0.651. The Cronbach’s α of this scale was 0.944, and its split-half reliability was 0.883.

PMID:37040438 | DOI:10.1002/nop2.1745

Aesthet Surg J. 2023 Apr 11:sjad098. doi: 10.1093/asj/sjad098. Online ahead of print.

ABSTRACT

BACKGROUND: Breast Implant Illness (BII) describes a variety of symptoms reported by patients with breast implants. Biospecimens data revealed minimal statistical differences between BII and Non-BII cohorts. Baseline analysis of PROMIS data demonstrated significant differences between the BII Cohort and the two control cohorts.

OBJECTIVES: This study was designed to determine if subjects in the BII Cohort obtained any symptom improvement after explantation, whether symptom improvement was related to the type of capsulectomy, and which symptoms improved.

METHODS: A prospective blinded study enrolled 150 consecutive subjects divided equally into three cohorts. Baseline demographic data and a systemic symptoms survey, including PROMIS validated questionnaires, was obtained at baseline, 3-6 weeks, 6 months, and one year.

RESULTS: 150 patients were enrolled between 2019-2021. Follow-up at one year is 94% of BII Cohort and 77% of Non-BII and Mastopexy Cohorts. At one year, 88% of patients showed at least partial symptom improvement with a reduction of 2-20 symptoms. The PROMIS score in the BII Cohort decreased at one year for anxiety, sleep disturbances, and fatigue. Systemic symptom improvement was noted out to one year in the BII Cohort regardless of the type of capsulectomy performed.

CONCLUSIONS: Parts 1-3 in this series concluded there were no consistent differences in biospecimen results between the cohorts. Unlike the data observed in the biospecimen analysis, BII subjects had heightened symptoms and poorer PROMIS scores at baseline compared to the control cohorts. The reduction of negative expectations and a potential nocebo effect could contribute to this improvement.

PMID:37040435 | DOI:10.1093/asj/sjad098

Eur J Prev Cardiol. 2023 Apr 11:zwad111. doi: 10.1093/eurjpc/zwad111. Online ahead of print.

ABSTRACT

AIMS: LDL cholesterol (LDL-C) is a well-established risk factor for coronary artery disease (CAD). However, the optimal LDL-C level with regard to efficacy and safety remains unclear. We aimed to investigate the causal relationships between LDL-C and efficacy and safety outcomes.

METHODS: We analyzed 353,232 British from the UK Biobank and 41,271 Chinese from the China-PAR project. Linear and non-linear Mendelian randomization (MR) analyses were performed to evaluate the causal relation between genetically proxied LDL-C and CAD, all-cause mortality, and safety outcomes (including hemorrhagic stroke, diabetes mellitus, overall cancer, non-cardiovascular death, and dementia).

RESULTS: No significant non-linear associations were observed for CAD, all-cause mortality, and safety outcomes (Cochran Q P > 0.25 in British and Chinese) with LDL-C levels above the minimum values of 50 mg/dL and 20 mg/dL in British and Chinese, respectively. Linear MR analyses demonstrated a positive association of LDL-C with CAD (British: odds ratio [OR] per unit mmol/L increase, 1.75, P = 7.57 × 10-52; Chinese: OR, 2.06, P = 9.10 × 10-3). Furthermore, stratified analyses restricted to individuals with LDL-C levels less than the guidelines-recommended 70 mg/dL demonstrated lower LDL-C levels were associated with a higher risk of adverse events, including hemorrhagic stroke (British: OR, 0.72, P = 0.03) and dementia (British: OR, 0.75, P = 0.03).

CONCLUSION: In British and Chinese populations, we confirmed a linear dose-response relationship of LDL-C with CAD and found potential safety concerns at low LDL-C levels, providing recommendations for monitoring adverse events in people with low LDL-C in the prevention of cardiovascular disease.

PMID:37040432 | DOI:10.1093/eurjpc/zwad111

Int J Qual Health Care. 2023 Apr 11:mzad018. doi: 10.1093/intqhc/mzad018. Online ahead of print.

ABSTRACT

BACKGROUND: The increase in bacterial drug resistance has become a serious public health problem worldwide. The application of antibiotics involves various clinical departments, and the rational application of antibiotics is the key to improve the efficacy. In order to provide a basis for further improving the etiological submission rate and standardizing the rational use of antibiotics, this article discussed the intervention effect of multi department cooperation on improving the etiological submission rate before antibiotic treatment.

METHODS: A total of 87607 patients were involved in this study and divided into the control group (45890) and the intervention group (41717) according to whether multi-sector cooperation management was implemented. The intervention group involves the etiology examination rate before antimicrobial therapy of hospitalized patients from August to December 2021, and the control group involves it from August to December 2020. The submission rates of the two groups, and before antibiotic treatment at the unrestricted use level, the restricted use level and the special use level in departments and the timing of submission were compared and analyzed.

RESULTS: The overall differences in etiological submission rate before antibiotic treatment at the unrestricted use level (20.70% vs 55.98%), the restricted use level (38.23% vs 66.58%) and the special use level (84.92% vs 93.14%) were statistically significant before and after the intervention (P <0.05). At the more specific level, the etiological submission rates of different departments before antibiotic treatment at the unrestricted use level, the restricted use level and the special use level have all been improved, but the special activities of multi-sector cooperation management did not improve the submission timing significantly.

CONCLUSION: Multi-department cooperation can effectively improve the pathogen detection rate before antimicrobial treatment, but it is necessary to improve measures for specific departments to improve the long-term management and incentive and restraint mechanism.

PMID:37040384 | DOI:10.1093/intqhc/mzad018

PLoS One. 2023 Apr 11;18(4):e0284351. doi: 10.1371/journal.pone.0284351. eCollection 2023.

ABSTRACT

Over the past 20 years, the construct of perceived value has been the subject of much research, most of it applied to the service sector. The intangible nature of this sector requires an in-depth analysis of customer perceptions of what they give and what they receive. In this research, perceived value is applied in the context of higher education, where perceived quality faces several challenges and has a tangible component that is related to their experience when receiving the educational service, and an intangible component that is related to the image and reputation of the university. One of these challenges is the increasingly competitive environment of universities, so it is important to understand what factors influence students’ perception of value. For this purpose, several scales of perceived value were reviewed and one was selected and its psychometric properties were evaluated. For this evaluation, cultural adaptation techniques, exploratory factor analysis and confirmatory factor analysis were used. The statistical results showed the validity and reliability of the scale applied to universities in the Colombian context.

PMID:37040381 | DOI:10.1371/journal.pone.0284351

PLoS One. 2023 Apr 11;18(4):e0284270. doi: 10.1371/journal.pone.0284270. eCollection 2023.

ABSTRACT

Childhood undernutrition is a major public health challenge in sub-Saharan Africa, particularly Nigeria. Determinants of child malnutrition may have substantial spatial heterogeneity. Failure to account for these small area spatial variations may cause child malnutrition intervention programs and policies to exclude some sub-populations and reduce the effectiveness of such interventions. This study uses the Composite Index of Anthropometric Failure (CIAF) and a geo-additive regression model to investigate Nigeria’s prevalence and risk factors of childhood undernutrition. The geo-additive model permits a flexible, joint estimation of linear, non-linear, and spatial effects of some risk factors on the nutritional status of under-five children in Nigeria. We draw on data from the most recent Nigeria Demographic and Health Survey (2018). While the socioeconomic and environmental determinants generally support literature findings, distinct spatial patterns were observed. In particular, we found CIAF hotspots in the northwestern and northeastern districts. Some child-related factors (Male gender: OR = 1.315; 95% Credible Interval (CrI): 1.205, 1.437) and having diarrhoea: OR = 1.256; 95% CrI: 1.098, 1.431) were associated with higher odds of CIAF. Regarding household and maternal characteristics, media exposure was associated with lower odds of CIAF (OR = 0.858; 95% CrI: 0.777, 0.946). Obese maternal BMI was associated with lower odds of CIAF (OR = 0.691; 95% CrI: 0.621, 0.772), whereas, mothers classified as thin were associated with higher odds of CIAF (OR = 1.216; 95% CrI: 1.055, 1.411). Anthropometric failure is highly prevalent in Nigeria and spatially distributed. Therefore, localised interventions that aim to improve the nutritional status of under-five children should be considered to avoid the under-coverage of the regions that deserve more attention.

PMID:37040379 | DOI:10.1371/journal.pone.0284270

J Hosp Palliat Nurs. 2023 Apr 11. doi: 10.1097/NJH.0000000000000947. Online ahead of print.

ABSTRACT

Spiritual care can improve patients’ physical and emotional well-being, but patients at the end of life often experience their spiritual needs are not being sufficiently met by the health care professionals. This is caused by barriers among health care professionals that stem from inadequate education on spiritual care and lack of self-reflection on spiritual topics. By participating in spiritual care training, health care professionals seem to gain the knowledge, confidence, and skills they need to care spiritually for patients. The aim of this study was to evaluate the effect and experiences of a training course in spiritual care for 30 nurses working at a Danish hospice. This was done by means of both a before-and-after questionnaire and focus group interviews. The course focused primarily on the nurses and their personal and collegial reflections on spiritual care, whereas increased spiritual care for patients seemed to be a secondary outcome of the course. There was a significant statistical correlation between the nurses’ values and spirituality, and their confidence in being able to exercise spiritual care for patients. The training course facilitated spiritual empowerment, collegial spiritual care, and spiritual language among the nurses, which led to increased spiritual care for patients.

PMID:37040374 | DOI:10.1097/NJH.0000000000000947

PLoS One. 2023 Apr 11;18(4):e0277725. doi: 10.1371/journal.pone.0277725. eCollection 2023.

ABSTRACT

Avocado sunblotch viroid (ASBVd) is a subcellular pathogen of avocado that reduces yield from a tree, diminishes the appearance of the fruit by causing unsightly scarring and impedes trade because of quarantine conditions that are imposed to prevent spread of the pathogen via seed-borne inoculum. For countries where ASBVd is officially reported, permission to export fruit to another country may only be granted if an orchard can be demonstrated to be a pest free production site. The survey requirements to demonstrate pest freedom are usually defined in export protocols that have been mutually agreed upon by the trading partners. In this paper, we introduce a flexible statistical protocol for use in optimizing sampling strategies to establish pest free status from ASBVd in avocado orchards. The protocol, which is supported by an interactive app, integrates statistical considerations of multistage sampling of trees in orchards with a RT-qPCR assay allowing for detection of infection in pooled samples of leaves taken from multiple trees. While this study was motivated by a need to design a survey protocol for ASBVd, the theoretical framework and the accompanying app have broader applicability to a range of plant pathogens in which hierarchical sampling of a target population is coupled with pooling of material prior to diagnosis.

PMID:37040350 | DOI:10.1371/journal.pone.0277725