Category: Statistics

J Orthop Sports Phys Ther. 2023 Aug 10:1-29. doi: 10.2519/jospt.2023.11982. Online ahead of print.

ABSTRACT

OBJECTIVE: Identify factors that elite sport clinicians, coaches, and athletes perceive are associated with low back pain (LBP) recovery. DESIGN: Concept mapping methodology. METHOD: Participants brainstormed, sorted (thematically) and rated (“5-point Likert scales”: importance and feasibility) statements in response to the prompt: What factors are associated with the recovery of an elite athlete from low back pain? Data cleaning, analysis (multidimensional scaling, hierarchical cluster analysis and descriptive statistics) and visual representation (cluster map and go-zone graph) were conducted following concept mapping guidelines. RESULTS: Participants (brainstorming, n=56; sorting, n=34 and rating, n=33) comprised 75% clinicians, 15% coaches and 10% athletes and represented 13 countries and 17 sports. 82 unique and relevant statements were brainstormed. Sorting resulted in six LBP recovery-related themes: 1) coach and clinician relationships, 2) inter-disciplinary team factors, 3) athlete psychological factors, 4) athlete rehabilitation journey, 5) athlete non-modifiable risk factors and 6) athlete physical factors. Participants rated important recovery factors as: athlete empowerment and psychology, coach-athlete and athlete-clinician relationships, care team communication, return to sport planning, and identifying red flags. CONCLUSIONS: Factors perceived as important to LBP recovery in elite athletes align with the biopsychosocial model of community LBP management. Clinicians should consider that an athlete’s psychology, relationships, care team communication and rehabilitation plan may be as important to their LBP recovery as the formulation of a diagnosis, or the medications, or exercises prescribed.

PMID:37561822 | DOI:10.2519/jospt.2023.11982

PLoS Comput Biol. 2023 Aug 10;19(8):e1011389. doi: 10.1371/journal.pcbi.1011389. Online ahead of print.

ABSTRACT

All but the simplest phenotypes are believed to result from interactions between two or more genes forming complex networks of gene regulation. Sleep is a complex trait known to depend on the system of feedback loops of the circadian clock, and on many other genes; however, the main components regulating the phenotype and how they interact remain an unsolved puzzle. Genomic and transcriptomic data may well provide part of the answer, but a full account requires a suitable quantitative framework. Here we conducted an artificial selection experiment for sleep duration with RNA-seq data acquired each generation. The phenotypic results are robust across replicates and previous experiments, and the transcription data provides a high-resolution, time-course data set for the evolution of sleep-related gene expression. In addition to a Hierarchical Generalized Linear Model analysis of differential expression that accounts for experimental replicates we develop a flexible Gaussian Process model that estimates interactions between genes. 145 gene pairs are found to have interactions that are different from controls. Our method appears to be not only more specific than standard correlation metrics but also more sensitive, finding correlations not significant by other methods. Statistical predictions were compared to experimental data from public databases on gene interactions. Mutations of candidate genes implicated by our results affected night sleep, and gene expression profiles largely met predicted gene-gene interactions.

PMID:37561813 | DOI:10.1371/journal.pcbi.1011389

PLoS Comput Biol. 2023 Aug 10;19(8):e1011368. doi: 10.1371/journal.pcbi.1011368. Online ahead of print.

ABSTRACT

This paper demonstrates how two different methods used to calculate population-level mobility from Call Detail Records (CDR) produce varying predictions of the spread of epidemics informed by these data. Our findings are based on one CDR dataset describing inter-district movement in Ghana in 2021, produced using two different aggregation methodologies. One methodology, “all pairs,” is designed to retain long distance network connections while the other, “sequential” methodology is designed to accurately reflect the volume of travel between locations. We show how the choice of methodology feeds through models of human mobility to the predictions of a metapopulation SEIR model of disease transmission. We also show that this impact varies depending on the location of pathogen introduction and the transmissibility of infections. For central locations or highly transmissible diseases, we do not observe significant differences between aggregation methodologies on the predicted spread of disease. For less transmissible diseases or those introduced into remote locations, we find that the choice of aggregation methodology influences the speed of spatial spread as well as the size of the peak number of infections in individual districts. Our findings can help researchers and users of epidemiological models to understand how methodological choices at the level of model inputs may influence the results of models of infectious disease transmission, as well as the circumstances in which these choices do not alter model predictions.

PMID:37561812 | DOI:10.1371/journal.pcbi.1011368

PLoS One. 2023 Aug 10;18(8):e0287966. doi: 10.1371/journal.pone.0287966. eCollection 2023.

ABSTRACT

INTRODUCTION: Tuberculosis (TB), a curable and preventable infectious disease, becomes difficult to treat if resistance against most effective and tolerable first line anti-TB drugs is developed. The objective of the present study was to evaluate the treatment outcomes and predictors of poor outcomes among drug-resistant tuberculosis (DR-TB) patients treated at a programmatic management unit of drug resistant tuberculosis (PMDT) unit, Punjab, Pakistan.

METHODS: This prospective observational study was conducted at a a PMDT unit in Multan, Punjab, Pakistan. A total of 271 eligible culture positive DR-TB patients enrolled for treatment at the study site between January 2016 and May 2017 were followed till their treatment outcomes were recorded. World Health Organization’s (WHO) defined criteria was used for categorizing treatment outcomes. The outcomes of cured and treatment completed were collectively placed as successful outcomes, while death, lost to follow-up (LTFU) and treatment failure were grouped as unsuccessful outcomes. Multivariable binary logistic regression analysis was employed for getting predictors of unsuccessful treatment outcomes. A p-value <0.05 was considered statistically significant.

RESULTS: Of the 271 DR-TB patients analysed, nearly half (51.3%) were males. The patient’s (Mean ± SD) age was 36.75 ± 15.69 years. A total of 69% patients achieved successful outcomes with 185 (68.2%) patients being cured and 2 (0.7%) completed therapy. Of the remaining 84 patients with unsuccessful outcomes, 48 (17.7%) died, 2 (0.7%) were declared treatment failure, 34 (12.5%) were loss to follow up. After adjusting for confounders, patients’ age > 50 years (OR 2.149 (1.005-4.592) with p-value 0.048 and baseline lung cavitation (OR 7.798 (3.82-15.919) with p-value <0.001 were significantly associated with unsuccessful treatment outcomes.

CONCLUSIONS: The treatment success rate (69%) in the current study participants was below the target set by WHO (>75%). Paying special attention and timely intervention in patients with high risk of unsuccessful treatment outcomes may help in improving treatment outcomes at the study site.

PMID:37561810 | DOI:10.1371/journal.pone.0287966

PLoS One. 2023 Aug 10;18(8):e0289105. doi: 10.1371/journal.pone.0289105. eCollection 2023.

ABSTRACT

BACKGROUND: The development of core competency is crucial for the success of new nurses, enabling them to deliver high-quality care. Psychological capital (PsyCap), encompassing self-efficacy, optimism, hope, and resilience, significantly influences individuals’ abilities and achievements across various professions. However, limited research has specifically examined the impact of PsyCap on the core competency of new nurses. This study aims to bridge this gap by investigating the relationship between PsyCap and core competency development in new nurses, providing valuable strategic insights for improving PsyCap and promoting core competence acquisition.

METHODS: 142 new nurses were chosen for the investigation using a convenient cluster sampling method. The questionnaire included components on socio-demographic characteristics, the Competency Inventory for Registered Nurses (CIRN), and the PsyCap Questionnaire-24 (PCQ-24). The t-test, One-Way ANOVA, Pearson correlation analysis and hierarchical multiple regression were used for statistical analysis.

RESULT: The number of valid questionnaires was 138, and the effective return rate was 97.2%. The overall mean score for core competencies was 171.01 (SD 25.34), and the PsyCap score was 104.76(SD 13.71). The PsyCap of new nurses was highly correlated with core competency, with a correlation coefficient of r = 0.7, p < 0.01. Self-efficacy of PsyCap is a significant independent predictor of core competency (adjust R2 = 0.49).

CONCLUSION: Self-efficacy in PsyCap is an important predictor of new nurses’ core competency. Nursing managers should pay sufficient attention to the cultivation and development of new nurses’ PsyCap, with particular emphasis on enhancing self-efficacy to improve their core competency.

PMID:37561799 | DOI:10.1371/journal.pone.0289105

JMIR Infodemiology. 2023 Aug 10;3:e40003. doi: 10.2196/40003.

ABSTRACT

BACKGROUND: Dental caries is the most common health condition worldwide, and nutrition and dental caries have a strong interconnected relationship. Foods and eating behaviors can be both harmful (eg, sugar) and healthful (eg, meal spacing) for dental caries. YouTube is a popular source for the public to access information. To date, there is no information available on the nutrition and dental caries content of easily accessible YouTube videos.

OBJECTIVE: This study aimed to analyze the content of YouTube videos on nutrition and dental caries.

METHODS: In total, 6 YouTube searches were conducted using keywords related to nutrition and dental caries. The first 20 videos were selected from each search. Video content was scored (17 possible points; higher scores were associated with more topics covered) by 2 individuals based on the inclusion of information regarding various foods and eating behaviors that impact dental caries risk. For each video, information on video characteristics (ie, view count, length, number of likes, number of dislikes, and video age) was captured. Videos were divided into 2 groups by view rate (views/day); differences in scores and types of nutrition messages between groups were determined using nonparametric statistics.

RESULTS: In total, 42 videos were included. Most videos were posted by or featured oral health professionals (24/42, 57%). The mean score was 4.9 (SD 3.4) out of 17 points. Videos with >30 views/day (high view rate; 20/42, 48% videos) had a trend toward a lower score (mean 4.0, SD 3.7) than videos with ≤30 views/day (low view rate; 22/42, 52%; mean 5.8, SD 3.0; P=.06), but this result was not statistically significant. Sugar was the most consistently mentioned topic in the videos (31/42, 74%). No other topics were mentioned in more than 50% of videos. Low-view rate videos were more likely to mention messaging on acidic foods and beverages (P=.04), water (P=.09), and frequency of sugar intake (P=.047) than high-view rate videos.

CONCLUSIONS: Overall, the analyzed videos had low scores for nutritional and dental caries content. This study provides insights into the messaging available on nutrition and dental caries for the public and guidance on how to make improvements in this area.

PMID:37561564 | DOI:10.2196/40003

JMIR Res Protoc. 2023 Aug 10;12:e46056. doi: 10.2196/46056.

ABSTRACT

BACKGROUND: Strokes pose a particular challenge to the health care system. Although stroke-related mortality has declined in recent decades, the absolute number of new strokes (incidence), stroke deaths, and survivors of stroke has increased. With the increasing need of neurorehabilitation and the decreasing number of professionals, innovations are needed to ensure adequate care. Digital technologies are increasingly used to meet patients’ unfilled needs during their patient journey. Patients must adhere to unfamiliar digital technologies to engage in health interventions. Therefore, the acceptance of the benefits and burdens of digital technologies in health interventions is a key factor in implementing these innovations.

OBJECTIVE: This study aims to describe the development of a discrete choice experiment (DCE) to weigh criteria that impact patient and public acceptance. Secondary study objectives are a benefit-burden assessment (estimation of the maximum acceptable burden of technical features and therapy-related characteristics for the patient or individual, eg, no human contact), overall comparison (assessment of the relative importance of attributes for comparing digital technologies), and adherence (identification of key attributes that influence patient adherence). The exploratory objectives include heterogeneity assessment and subgroup analysis. The methodological aims are to investigate the use of DCE.

METHODS: To obtain information on the criteria impacting acceptance, a DCE will be conducted including 7 attributes based on formative qualitative research. Patients with stroke (experimental group) and the general population (control group) are surveyed. The final instrument includes 6 best-best choice tasks in partial design. The experimental design is a fractional-factorial efficient Bayesian design (D-error). A conditional logit regression model and mixed logistic regression models will be used for analysis. To consider the heterogeneity of subgroups, a latent class analysis and an analysis of heteroscedasticity will be performed.

RESULTS: The literature review, qualitative preliminary study, survey development, and pretesting were completed. Data collection and analysis will be completed in the last quarter of 2023.

CONCLUSIONS: Our results will inform decision makers about patients’ and publics’ acceptance of digital technologies used in innovative interventions. The patient preference information will improve decisions regarding the development, adoption, and pricing of innovative interventions. The behavioral changes in the choice of digital intervention alternatives are observable and can therefore be statistically analyzed. They can be translated into preferences, which define the value. This study will investigate the influences on the acceptance of digital interventions and thus support decisions and future research.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/46056.

PMID:37561559 | DOI:10.2196/46056

JMIR Form Res. 2023 Aug 10;7:e47798. doi: 10.2196/47798.

ABSTRACT

BACKGROUND: As the use of social media becomes more widespread, its impact on health cannot be ignored. However, limited research has been conducted on the relationship between social media and suicide. Little is known about individuals’ vulnerable to suicide, especially when social media suicide information is extremely prevalent.

OBJECTIVE: This study aims to identify the characteristics underlying individuals’ vulnerability to suicide brought about by an increase in suicide-related tweets, thereby contributing to public health.

METHODS: A case-only design was used to investigate vulnerability to suicide using individual data of people who died by suicide and tweet data from January 1, 2011, through December 31, 2014. Mortality data were obtained from Japanese government statistics, and tweet data were provided by a commercial service. Tweet data identified the days when suicide-related tweets surged, and the date-keyed merging was performed by considering 3 and 7 lag days. For the merged data set for analysis, the logistic regression model was fitted with one of the personal characteristics of interest as a dependent variable and the dichotomous exposure variable. This analysis was performed to estimate the interaction between the surges in suicide-related tweets and personal characteristics of the suicide victims as case-only odds ratios (ORs) with 95% CIs. For the sensitivity analysis, unexpected deaths other than suicide were considered.

RESULTS: During the study period, there were 159,490 suicides and 115,072 unexpected deaths, and the number of suicide-related tweets was 2,804,999. Following the 3-day lag of a highly tweeted day, there were significant interactions for those who were aged 40 years or younger (OR 1.09, 95% CI 1.03-1.15), male (OR 1.12, 95% CI 1.07-1.18), divorced (OR 1.11, 95% CI 1.03 1.19), unemployed (OR 1.12, 95% CI 1.02-1.22), and living in urban areas (OR 1.26, 95% CI 1.17 1.35). By contrast, widowed individuals had significantly lower interactions (OR 0.83, 95% CI 0.77-0.89). Except for unemployment, significant relationships were also observed for the 7-day lag. For the sensitivity analysis, no significant interactions were observed for other unexpected deaths in the 3-day lag, and only the widowed had a significantly larger interaction than those who were married (OR 1.08, 95% CI 1.02-1.15) in the 7-day lag.

CONCLUSIONS: This study revealed the interactions of personal characteristics associated with susceptibility to suicide-related tweets. In addition, a few significant relationships were observed in the sensitivity analysis, suggesting that such an interaction is specific to suicide deaths. In other words, individuals with these characteristics, such as being young, male, unemployed, and divorced, may be vulnerable to surges in suicide-related tweets. Thus, minimizing public health strain by identifying people who are vulnerable and susceptible to a surge in suicide-related information on the internet is necessary.

PMID:37561553 | DOI:10.2196/47798

JMIR Med Educ. 2023 Aug 10;9:e44361. doi: 10.2196/44361.

ABSTRACT

BACKGROUND: The VSTEP Examination Suite is a collection of evidence-based standardized assessments for persons after stroke. It was developed by an interdisciplinary team in collaboration with clinician users. It consists of 5 standardized assessments: 2 performance-based tests using the Kinect camera (Microsoft Corp) to collect kinematics (5-Time Sit-to-Stand and 4-Square Test); 2 additional performance-based tests (10-Meter Walk Test and 6-Minute Walk Test); and 1 patient-reported outcome measure, the Activities-Specific Balance Confidence Scale.

OBJECTIVE: This study aimed to describe the development of the VSTEP Examination Suite and its evaluation as an educational tool by physical therapy students and faculty to determine its usefulness and usability.

METHODS: A total of 6 students from a Doctor of Physical Therapy program in the United States and 6 faculty members who teach standardized assessments in different physical therapy programs from the United States and Israel were recruited by convenience sampling to participate in the study. They interacted with the system using a talk-aloud procedure either in pairs or individually. The transcripts of the sessions were coded deductively (by 3 investigators) with a priori categories of usability and usefulness, and comments were labeled as negative or positive. The frequencies of the deductive themes of usefulness and usability were tested for differences between faculty and students using a Wilcoxon rank sum test. A second round of inductive coding was performed by 3 investigators guided by theories of technology adoption, clinical reasoning, and education.

RESULTS: The faculty members’ and students’ positive useful comments ranged from 83% (10/12) to 100%. There were no significant differences in usefulness comments between students and faculty. Regarding usability, faculty and students had the lowest frequency of positive comments for the 10-Meter Walk Test (5/10, 50%). Students also reported a high frequency of negative comments on the 4-Square Test (9/21, 43%). Students had a statistically significantly higher number of negative usability comments compared with faculty (W=5.7; P=.02), specifically for the 5-Time Sit-to-Stand (W=5.3; P=.02). Themes emerged related to variable knowledge about the standardized tests, value as a teaching and learning tool, technology being consistent with clinical reasoning in addition to ensuring reliability, expert-to-novice clinical reasoning (students), and usability.

CONCLUSIONS: The VSTEP Examination Suite was found to be useful by both faculty and students. Reasons for perceived usefulness had some overlap, but there were also differences based on role and experience. Usability testing revealed opportunities for technology refinement. The development of the technology by interdisciplinary teams and testing with multiple types of users may increase adoption.

PMID:37561552 | DOI:10.2196/44361

J Exp Psychol Learn Mem Cogn. 2023 Aug 10. doi: 10.1037/xlm0001270. Online ahead of print.

ABSTRACT

Linguistic phenomena (e.g., words and syntactic structure) co-occur with a wide variety of meanings. These systematic correlations can help readers to interpret a text and create predictions about upcoming material. However, to what extent these correlations influence discourse processing is still unknown. We address this question by examining whether clause type serves as a cue for discourse relations. We found that the co-occurrence of gerund-free adjuncts and specific discourse relations found in natural language is also reflected in readers’ offline expectations for discourse relations. However, we also found that clause structure did not facilitate the online processing of these discourse relations, nor that readers have a preference for these relations in a paraphrase selection task. The present research extends previous research on discourse relation processing, which mostly focused on lexical cues, by examining the role of non-semantic cues. We show that readers are aware of correlations between clause structure and discourse relations in natural language, but that, unlike what has been found for lexical cues, this information does not seem to influence online processing and discourse interpretation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37561516 | DOI:10.1037/xlm0001270