Category: Statistics

J Neurophysiol. 2024 Mar 13. doi: 10.1152/jn.00285.2023. Online ahead of print.

ABSTRACT

Neurons in sensory and motor cortices tend to aggregate in clusters with similar functional properties. Within the primate dorsal (‘where’) pathway, an important interface between three-dimensional (3D) visual processing and motor-related functions consists of two hierarchically organized areas: V3A and the caudal intraparietal (CIP) area. In these areas, 3D visual information, choice-related activity, and saccade-related activity converge, often at the single neuron level. Characterizing the clustering of functional properties in areas with mixed selectivity, such as these, may help reveal organizational principles that support sensorimotor transformations. Here we quantified the clustering of visual feature selectivity, choice-related activity, and saccade-related activity by performing correlational and parametric comparisons of the responses of well-isolated, simultaneously recorded neurons in macaque monkeys. Each functional domain showed statistically significant clustering in both areas. However, there were also domain-specific differences in the strength of clustering across the areas. Visual feature selectivity and saccade-related activity were more strongly clustered in V3A than CIP. In contrast, choice-related activity was more strongly clustered in CIP than V3A. These differences in clustering may reflect the areas’ roles in sensorimotor processing. Stronger clustering of visual and saccade-related activity in V3A may reflect a greater role in within-domain processing, as opposed to cross-domain synthesis. In contrast, stronger clustering of choice-related activity in CIP may reflect a greater role in synthesizing information across functional domains to bridge perception and action.

PMID:38478896 | DOI:10.1152/jn.00285.2023

Neurology. 2024 Apr 9;102(7):e209224. doi: 10.1212/WNL.0000000000209224. Epub 2024 Mar 13.

ABSTRACT

BACKGROUND AND OBJECTIVES: Few anecdotal cases and 1 small retrospective study during short-duration space missions suggest that headache may occur early in flight, as part of the space motion syndrome. Whether headaches may also occur at later stages of space flights is unknown. We aimed to prospectively characterize the incidence, timing, clinical features, and management of space headaches during long-duration flights.

METHODS: We prospectively evaluated the occurrence, characteristics, and evolution of space headaches and the effects of treatment and countermeasures during long-haul flights with onboard questionnaires and correlated them with prevailing temperature, pressure, and ambient O₂ and CO₂ levels, measured within the International Space Station. In addition, we analyzed retrospective headache data from a different astronaut cohort. Headache data were reported using descriptive statistics and correlation data with intraindividual logistic regression models. Astronauts were included through (inter)national aerospace organizations.

RESULTS: In the prospective study, 22/24 (91.7%) astronauts (mean ± SD age: 46.6 ± 6.5 years, 95.8% male) experienced ≥1 episode of headache during a total of 3,596 space days. A total of 378 episodes were reported (median 9; range 1-128) with detailed information on 189. Phenotypically, 170/189 (89.9%) episodes were tension-type headache (TTH) and 19/189 (10.1%) were migraine. Episodes in the first week differed from those in later periods in terms of phenotype (migraine 12/51 [23.5%] vs 7/138 [5.1%]; TTH 39/51 [86.5%] vs 131/138 [94.9%]; overall p = 0.0002) and accompanying symptoms: nausea: 17.6% vs 6.9%, p = 0.05; vomiting: 9.8% vs 0.7%, p = 0.005; nasal congestion: 52.9% vs 29.7%, p = 0.004; facial edema: 41.2% vs 1.4%, p < 0.001; and duration (p = 0.001). Severity and treatments were similar: acute antiheadache medication: 55.6%; other medication: 22.4%; and alternative treatments: 41.1%. Headache occurrence was not associated with temperature or ambient pressure/levels of O₂ and CO₂ (all p > 0.05). In the retrospective study, 23/42 (54.8%) astronauts (43.5 ± 7.2 years, 90.5% male) reported experiencing ≥1 headache episode during mission. Nasal congestion was the most common (8/33; 24.2%) accompanying symptom. Seventeen of 42 astronauts have been previously described.

DISCUSSION: Astronauts during space flights frequently experience headaches. These most often have characteristics of TTHs but sometimes have migrainous features, particularly during the first week of flight in astronauts without a history of recurrent headaches before or after the space flight.

PMID:38478846 | DOI:10.1212/WNL.0000000000209224

J Phys Ther Educ. 2023 Mar 1;37(1):38-42. doi: 10.1097/JTE.0000000000000265. Epub 2023 Jan 18.

ABSTRACT

INTRODUCTION: Since the lockdown in March 2020, the COVID-19 pandemic has inevitably affected all individuals across the world. The purpose of this study was to determine the perceived impacts of the pandemic on doctor of physical therapy (DPT) students and if there were any statistically significant differences based on minority status, gender, or class standing.

REVIEW OF LITERATURE: Literature suggested that DPT students experienced negative impacts of the pandemic on academic success and mental health. However, there is a lack of comprehensive understanding of the perceived physical, mental, financial, and academic impacts of the COVID-19 pandemic by physical therapist students nationally.

SUBJECTS: Convenience sampling was used to recruit all students enrolled in physical therapist programs in the United States.

METHODS: The research design was a cross-sectional survey administered electronically using the Alchemer survey platform with 12 Likert scale items compiled in the physical, mental, financial, and academic domains. All items were designed to evaluate the perceived impacts of the pandemic on a 5-point scale from 1 (strongly disagree) to 5 (strongly agree).

RESULTS: A total of 1,230 completed responses were received. The mean responses were 3.45 (SD 1.12), 3.48 (SD 0.92), 2.74 (SD 1.03), and 3.33 (SD 0.93) for the physical, mental, financial, and academic domains, respectively. No significant difference was found based on minority status. A statistically significant difference was found in the mental domain, with female students perceiving a more negative impact by the pandemic. First-year students reported a significantly higher negative impact in the physical domain compared with second-year students. The perceived impact in the academic domain was significantly higher for both first- and second-year students than third-year students.

CONCLUSIONS: Developing and promoting access to campus and community resources to address the challenges caused by the COVID-19 pandemic is critical to facilitating student success during and after the pandemic.

PMID:38478841 | DOI:10.1097/JTE.0000000000000265

J Phys Ther Educ. 2023 Jun 1;37(2):116-126. doi: 10.1097/JTE.0000000000000277. Epub 2023 Mar 14.

ABSTRACT

INTRODUCTION: The roles and responsibilities of the director of clinical education (DCE) are of interest in the academic physical therapist (PT) community. This study explored the impact of professional and positional task characteristics of the DCE position on task-fit misalignment within PT education programs. Task-fit explores how the tasks of a particular job align with the appropriately trained person who holds the position.

REVIEW OF THE LITERATURE: A recently published DCE Matrix highlights 2 extremes of misalignment and nonoptimal task-fit between the position and the person. Misalignment was investigated rather than alignment because negative connotations often have greater impact on behavior, decision making, and relationships. The impact of misalignment is unknown.

SUBJECTS: Program directors and DCEs among ACAPT member PT programs were surveyed.

METHODS: A qualitative grounded theory design was used. Two rounds of surveys with focused questions about the impact of task-fit misalignment. Qualitative content data analysis through a constant comparative process was followed. Respondent descriptive statistics were collected.

RESULTS: Three realms of impact were identified when misalignment of positional and professional characteristics exists. The realms include the 1) individual person holding the position; 2) academic program; or 3) physical therapy profession. There is a high level of agreement that task-fit misalignment affects each realm; variability exists about its prevalence.

DISCUSSION: There seems to be an interconnectedness of impact among the person, the program, and the profession when misalignment exists between the fit of the DCE to the job or the work environment to the DCE. Findings indicate job crafting may be necessary to evolve the nature of the DCE work toward higher director-level tasks. This is the first study of its kind to explore the impact intersection of person-job fit and task-fit and the impact on a DCE’s responsibilities. Nonrespondent or attrition bias may have limited sample size.

PMID:38478825 | DOI:10.1097/JTE.0000000000000277

J Phys Ther Educ. 2023 Jun 1;37(2):94-101. doi: 10.1097/JTE.0000000000000270. Epub 2023 Jan 30.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic saw physical therapist (PT) education programs in 2020 add virtual options to prepare students for hands-on clinical skills. The purpose of this research was to investigate student confidence, preparation, and clinical performance based on their choice of virtual or in-person laboratory immersion. Secondary analysis compared 2020 cohort outcomes with the previous cohort in 2019 (prepandemic).

REVIEW OF LITERATURE: Virtual skill acquisition has been studied with support for effectiveness in didactic and psychomotor skill acquisition. The impact on clinical education performance is unknown.

SUBJECTS: Student records from an accelerated hybrid, PT education program in 2020 (n = 91) and 2019 (n = 86).

METHODS: In this mixed-method observational study, researchers analyzed a Qualtrics survey and the PT Clinical Performance Instrument (CPI) to compare student outcomes. Statistical analyses included chi-square, two-way multivariate analysis of variance (MANOVA), and Mann-Whitney U test. MAXQDA software was used to code student and clinical instructor narrative responses from the CPI related to strengths and areas for further development.

RESULTS: All students in 2020 attended laboratory virtually for 9 full days, and 24% of students chose virtual laboratory for the remaining 8.5 days; 97% of students reported feeling confident going into their clinical experience (66% inpatient). No statistically significant differences were found based on instructional method (virtual or in-person) or clinical practice setting (inpatient or outpatient) for confidence, preparation, or CPI performance. Themes of wanting more time to prepare and more confidence in clinical decision making emerged from the qualitative analysis.

DISCUSSION AND CONCLUSION: Results indicate no statistically significant difference for virtual versus in-person laboratory and no difference compared with the 2019 cohort. Virtual instruction effectively prepared students for their clinical experiences across all settings. Although an in-person laboratory experience may be preferred, it is possible to deliver effective experiences in a virtual setting without compromising student performance. Further research is needed to confirm findings.

PMID:38478822 | DOI:10.1097/JTE.0000000000000270

J Phys Ther Educ. 2023 Sep 1;37(3):250-256. doi: 10.1097/JTE.0000000000000279. Epub 2023 Apr 21.

ABSTRACT

INTRODUCTION: All Doctor of Physical Therapy (DPT) programs in the United States prepare students to demonstrate entry-level clinical performance upon graduation. Clinical residency programs are an option for DPT graduates seeking to specialize in a practice area.

REVIEW OF LITERATURE: There is little research published on why DPT graduates decide to pursue residency education (RE) or not. This study aimed to determine factors influencing a Physical Therapist’s (PT) decision-making process in choosing to pursue a postgraduate residency.

SUBJECTS: PTs within 3 years of graduation and third-year DPT program students were surveyed. Most respondents were from DPT programs in the northeastern United States.

METHODS: A survey was created, piloted, and disseminated to various DPT programs. The survey asked participants their perceptions of motivating factors or barriers to pursuing a RE using multiple choice questions and Likert items. Descriptive statistics and frequencies were reported. One-way analysis of variances, chi-square analysis, and unpaired t tests were used.

RESULTS: Students who considered residency in their second year are 26.5× more likely to apply for a residency (P < .001). Participants strongly agreed with the statements that residency will increase confidence when practicing in their specialty area (1.39 ± 0.48), expand their knowledge as clinicians (1.39 ± 0.051), and expedite proficient practice (1.72 ± 0.057). Participants considered student burnout, the cost of residency, student loan debt, and geographical relocation as the top barriers to pursuing residency. Men were significantly more confident in their ability to apply to residency (F = 8.219, P = .005). Married individuals perceived loans or financial obligations (F = 3.607, P = .029), family obligations (F = 17.170, P < .001), and geographical limitations (F = 3.825, P = .024) as barriers more than single individuals.

DISCUSSION AND CONCLUSION: There are many variables DPT students and recent graduates consider when deciding whether to pursue RE. RPs and entry-level DPT programs should consider these factors to promote increased participation in postprofessional RE.

PMID:38478818 | DOI:10.1097/JTE.0000000000000279

J Phys Ther Educ. 2023 Sep 1;37(3):227-234. doi: 10.1097/JTE.0000000000000284. Epub 2023 May 10.

ABSTRACT

INTRODUCTION: Faculty development has been identified as an important initiative in Doctor of Physical Therapy (DPT) education. However, little is known about opportunities available for associated faculty (AF). These unique educators who make notable contributions to physical therapist education often lack formal preparation for teaching. The purpose of this study was to explore AF development opportunities across physical therapist education programs nationally.

REVIEW OF LITERATURE: Formal faculty development programs have been successful in medical and nursing education programs to enhance educator identity, skill, and retention in both core and clinical faculty. No evidence of faculty development programs for AF in physical therapy education was found in the literature.

SUBJECTS: Participants were program directors or identified faculty development leads from CAPTE accredited and in-candidacy physical therapist education programs. Seventy participants completed an anonymous survey and 10 participated in semistructured interviews following the completion of the survey.

METHODS: A parallel, convergent, mixed methods approach was used to assess the national state of formal AF development opportunities. A survey was developed to assess development opportunities available to AF. Descriptive statistics and Chi square analyses were performed to analyze quantitative data. An instrumental collective case study further explored development opportunities. Deductive and inductive thematic analysis techniques were used to analyze qualitative data from interview transcripts. Quantitative and qualitative approaches were integrated in the data analysis.

RESULTS: Survey data, aligned with interview outcomes, suggest that despite ideologic support for faculty development, low percentages of AF have access to formal development activities, and even fewer are receiving adequate breadth of educational content related to proficiency in their role.

DISCUSSION AND CONCLUSION: A lack of formal development opportunities exists for AF. Excellence in DPT education requires deeper development across all levels of faculty, including opportunities tailored specifically to the unique needs and role of AF.

PMID:38478815 | DOI:10.1097/JTE.0000000000000284

J Phys Ther Educ. 2023 Sep 1;37(3):220-226. doi: 10.1097/JTE.0000000000000286. Epub 2023 Jun 1.

ABSTRACT

INTRODUCTION: Full-time clinical education experiences (CEEs) constitute a significant component of entry-level physical therapy education. COVID-19 challenged clinical education throughout the country by affecting the availability of CEEs.

REVIEW OF LITERATURE: Research suggested that the number of clinical education spots available would stay the same. By contrast, the number of students enrolling in physical therapist (PT) and physical therapist assistant (PTA) education programs continues to rise. In response to the COVID-19 pandemic, students and faculty expressed concerns about the lack of student readiness and the availability of CEEs. The purpose of this study was to examine prepandemic factors that influenced the number of CEE slots available in Florida and the impact that the COVID-19 pandemic had on slot availability. Furthermore, researchers sought to identify factors that prevented a return to prepandemic levels of CEE spot offerings and recognize solutions to overcome those barriers. Finally, the researchers aimed to pinpoint suggestions to enhance collaborations between the clinical sites and physical therapy education programs.

SUBJECTS: Forty-eight site coordinators of clinical education (SCCEs) from various settings and regions in Florida completed the survey.

METHODS: An online survey was distributed to Florida SCCEs to ascertain their perceptions on how COVID-19 influenced clinical education. The researchers used descriptive and inferential statistics to analyze the data.

RESULTS: Clinical instructor (CI) volunteerism was the primary determinant of CEE spots available before the COVID-19 pandemic. The number of CEE spots was reduced for both PT and PTA education programs during the COVID-19 pandemic. Although the PTA slots returned to their baseline from 2019, the PT placements remained significantly lower in 2021. Social distancing and CI availability had the most considerable impact on CEE offerings. Site coordinators of clinical education also suggested that the greatest supports needed from the academic institutions were educating students on COVID-19 prevention and providing personal protective equipment (PPE) to students for their CEEs. This article also offers suggested incentives that academic sites can provide their clinical partners, such as in-services earning continuing education units, to enhance their participation in clinical education.

DISCUSSION AND CONCLUSION: All clinical education stakeholders must collaborate to provide students with the required clinical educational opportunities. Academic sites should continue to provide support, training, and incentives to CIs to enhance participation from clinical education sites. Educational programs must add content about COVID-19 to their curriculum and consider providing students with PPE during their rotations to restore the number of CEEs post-COVID-19 pandemic.

PMID:38478814 | DOI:10.1097/JTE.0000000000000286

J Phys Ther Educ. 2023 Sep 1;37(3):202-210. doi: 10.1097/JTE.0000000000000288. Epub 2023 May 17.

ABSTRACT

INTRODUCTION: Video, phone, or in-person site visits are used to assess clinical education in entry-level physical therapy education programs. The perspectives of students and clinical instructors (CIs) related to site visits were examined in this article using 2 consecutive surveys. The first included items related to in-person and phone call site visits. The second added video calls. The research purpose was to assess the CI and student perspectives on the effectiveness of site visits and explore the differences between in-person, video, and phone visits.

REVIEW OF LITERATURE: Published literature about the effectiveness of site visits is scarce. Two recent articles explored the director of clinical education and student perspectives of site visits. Future research concentrating on the clinician perspective of site visits was recommended.

SUBJECTS: A convenience sample of 104 CIs and 97 doctor of physical therapy students were recruited by email for the 2 surveys.

METHODS: A mixed-methods, triangular, validating, quantitative data model was used. Respondents answered open-ended questions and rated items on 5-point Likert scales. Descriptive and chi-square statistics were calculated, and themes were developed using qualitative analysis.

RESULTS: No significant difference was found in preference of site visit method between students and CIs. CIs rated the effectiveness of site visits similarly for all methods. Students rated in-person site visits as the most effective in the first survey and video calls as the most effective in the second survey. Qualitative analysis showed that CIs and students preferred in-person visits when the student was struggling. Considering closed-ended and open-ended questions on both surveys, CIs and students would rather meet individually with the faculty member.

DISCUSSION AND CONCLUSION: The results of this study suggest that any type of site visit can be effective; in-person visits should be considered when students are struggling, and the site visitor should meet privately with the student and CI.

PMID:38478812 | DOI:10.1097/JTE.0000000000000288

Genet Test Mol Biomarkers. 2024 Mar 13. doi: 10.1089/gtmb.2023.0457. Online ahead of print.

ABSTRACT

Aim: The matrix metalloproteinases (MMPs) inhibit tissue inhibitors of metalloproteinases (TIMPs), playing a notable role in various biological processes, and mutations in TIMP2 genes impact a variety of urinary cancers. In this study, we analyze and evaluate the potential involvement of the TIMP2 418 G/C and MMP gene polymorphism in the etiology of urinary cancer. Methodology: For suitable case-control studies, a literature search was undertaken from various database sources such as PubMed, EMBASE, and Google Scholar. Incorporated into the analysis were case-control or cohort studies that documented the correlation between TIMP2 418 G/C and urological cancers. MetaGenyo served as the tool for conducting the meta-analysis, employing a fixed-effects model. The collective odds ratios, along with their corresponding 95% confidence intervals, were calculated and presented to assess the robustness of the observed associations. Results: A total of seven studies involving controls and cases out of recorded 1265 controls and 1154 cases were analyzed to ascertain the significant association of the TIMP2 gene with urologic cancer. No statistically significant correlation was observed between allelic, recessive, dominant, and overdominant models for the genetic variant under investigation. A 95% confidence interval (CI) and odds ratio (OR) were computed for each model, considering p-values <0.05. The OR and 95% CI for the allelic model were 0.99 and 0.77-1.27, respectively, whereas the respective values were 1.00 and 0.76-1.32 for the recessive model. In the dominant contrast model, OR and 95% CI were 1.09 and 0.62-1.90, while the same were 0.93 and 0.77-1.12 for the overdominant model. A funnel plot was used to reanalyze and detect the results as statically satisfactory. Conclusions: As a result of the data obtained, the TIMP2 gene polymorphism does not correlate statistically with cancer risk. The significance of this finding can only be confirmed using a large population, extensive epidemiological research, a comprehensive survey, and a better understanding of the molecular pathways associated.

PMID:38478803 | DOI:10.1089/gtmb.2023.0457