Category: Statistics

BMC Pregnancy Childbirth. 2023 Jan 9;23(1):13. doi: 10.1186/s12884-022-05302-w.

ABSTRACT

AIM: This study aimed to evaluate the effects of using the teach-back method among women with limited maternal health literacy (LMHL) on maternal health literacy(MHL), postpartum health behaviours and maternal-infant health outcomes.

METHODS: A randomized controlled study was conducted in the obstetrics department of Anhui Provincial Hospital, China. A total of 258 pregnant women with LMHL were recruited at the point of admission to the hospital for birth and randomly assigned to the control group (n = 130), where women received routine education sessions, and the teach-back group (n = 128), where women received routine education sessions plus a teach-back intervention. The two groups were assessed in terms of MHL before and after the intervention, breastfeeding execution, uptake of 42-day postpartum check-ups, complete uptake of one-time recommended vaccines, and physical health outcomes. Statistical tests were employed for data analysis.

RESULTS: There was no significant difference between the two groups in terms of MHL and other social, demographic, and medical status at baseline. After the intervention, the teach-back group had a higher level of MHL (p < 0.001), better postpartum health behaviours in terms of exclusive breastfeeding within 24 hours postpartum (x² = 22.853, p<0.001), exclusive breastfeeding within 42 days postpartum (x² = 47.735, p<0.001), uptake of 42-day postpartum check-ups (x² = 9.050, p = 0.003) and vaccination (x² = 5.586, p = 0.018) and better maternal-infant health outcomes in terms of the incidence of subinvolution of the uterus (x² = 6.499, p = 0.011), acute mastitis (x² = 4.884, p = 0.027), postpartum constipation (x² = 5.986, p = 0.014), overweight (x² = 4.531, p = 0.033) and diaper dermatitis (x² = 10.896, p = 0.001).

CONCLUSIONS: This study shows that the teach-back method is effective for enhancing MHL, leading to positive postpartum health behaviours, and improving postpartum maternal-infant health outcomes among women with LMHL. The teach-back method may play an important role in improving postpartum maternal-infant health and could be considered in maternal health education.

TRIAL REGISTRATION NUMBER: Our trial has been prospectively registered at ClinicalTrials.gov (Ref. No.: NCT04858945) and the enrollment date was 26/04/2021.

PMID:36624440 | DOI:10.1186/s12884-022-05302-w

BMC Oral Health. 2023 Jan 10;23(1):11. doi: 10.1186/s12903-023-02712-w.

ABSTRACT

BACKGROUND: To investigate if 5-LO selective inhibitor (MK-886) could be used for systemic treatment of experimentally induced apical periodontitis in a mouse model.

METHODS: Twenty-four C57BL/6 mice were used. After coronal opening, a solution containing Escherichia coli LPS (1.0 µg/µL) was inoculated into the root canals of the lower and upper right first molars (n = 72 teeth). After 30 days apical periodontitis was established, and the animals were treated with MK-886 (5 mg/kg), a 5-LO inhibitor, for 7 and 14 days. The tissues were removed for histopathological and histometric analyses, evaluation of osteoclast number and gene expression for receptor activator of nuclear factor kappa-B (Tnfrsf11a), receptor activator of nuclear factor kappa-B ligand (Tnfsf11), osteoprotegerin (Tnfrsf11b), tartrate-resistant acid phosphatase (Acp5), matrix metalloproteinase-9 (Mmp9), cathepsin K (Ctsk) and calcitonin receptor (Calcr). Statistical data analysis was performed using Kruskal Wallis followed by Dunn’s tests (α = 0.05).

RESULTS: Administration of MK-886 for 7 days exerted no effect on apical periodontitis progression compared to LPS inoculation without treatment (p = 0.3549), while treatment for 14 days exacerbated bone loss (p < 0.0001). Administration of MK-886 enhanced osteoclastogenesis signaling and osteoclast formation within 7 days (p = 0.0005), but exerted no effect at 14 days (p > 0.9999). After 7 days of treatment, MK-886 induced mRNA expression for Acp5 (p = 0.0001), Calcr (p = 0.0003), Mmp9 (p = 0.0005) and Ctsk (p = 0.0008), however no effect in those gene expression was observed after 14 days (p > 0.05).

CONCLUSION: Systemic treatment with MK-886 exacerbated LPS-induced apical periodontitis in a mouse model.

PMID:36624436 | DOI:10.1186/s12903-023-02712-w

BMC Psychiatry. 2023 Jan 9;23(1):19. doi: 10.1186/s12888-022-04422-z.

ABSTRACT

BACKGROUND: Decision-making deficits have been reported in suicide attempters and may be a neuropsychological trait of vulnerability to suicidal behavior. However, little is known about how neural activity is altered in decision-making. This study aimed to investigate the neural responses in suicide attempters with mental disorders during social decision-making. Electroencephalography (EEG) were recorded from 52 patients with mental disorders with past suicide attempts (SAs = 26) and without past suicide attempts (NSAs = 26), as well as from 22 age- and sex- matched healthy controls (HCs) during the Ultimatum Game (UG), which is a typical paradigm to investigate the responses to fair and unfair decision-making.

METHODS: MINI 5.0 interview and self report questionnaire were used to make mental diagnosis and suicide behavior assessment for individuals. Event-related potential (ERP) and phase-amplitude coupling (PAC) were extracted to quantify the neural activity. Furthermore, Spearman correlation and logistic regression analyses were conducted to identify the risk factors of suicidal behavior.

RESULTS: ERP analysis demonstrated that SA patients had decreased P2 amplitude and prolonged P2 latency when receiving unfair offers. Moreover, SA patients exhibited greater negative-going feedback-related negativity (FRN) to unfair offers compared to fair ones, whereas such a phenomenon was absent in NSA and HC groups. These results revealed that SA patients had a stronger fairness principle and a disregard toward the cost of punishment in social decision-making. Furthermore, theta-gamma and beta-gamma PAC were involved in decision-making, with compromised neural coordination in the frontal, central, and temporal regions in SA patients, suggesting cognitive dysfunction during social interaction. Statistically significant variables were used in logistic regression analysis. The area under receiver operating characteristic curve in the logistic regression model was 0.91 for SA/HC and 0.84 for SA/NSA.

CONCLUSIONS: Our findings emphasize that suicide attempts in patients with mental disorders are associated with abnormal decision-making. P2, theta-gamma PAC, and beta-gamma PAC may be neuro-electrophysiological biomarkers associated with decision-making. These results provide neurophysiological signatures of suicidal behavior.

PMID:36624426 | DOI:10.1186/s12888-022-04422-z

BMC Womens Health. 2023 Jan 9;23(1):8. doi: 10.1186/s12905-023-02160-2.

ABSTRACT

BACKGROUND: Stress urinary incontinence (SUI) is a common public health issue that negatively impacts the quality of life for women worldwide, of which early detection and rehabilitation are consequently pivotal. The aim of this study is to establish a simple nomogram for identifying women at risk of postpartum SUI.

METHODS: A retrospective study was conducted in a tertiary specialized hospital in Shanghai, China. The study included only women with singleton, full-term, and vaginal deliveries. 2,441 women who delivered from July 2019 to November 2019 were included in the training cohort, and 610 women who delivered from January 2022 to February 2022 were included in the validation cohort. SUI was determined by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF). Univariate and multifactorial logistical regression were used to identify independent risk factors for postpartum SUI and further construct the nomogram accordingly. Based on concordance statistics (C-statistics), calibration curves, and decision curve analyses, we evaluated the performance of the nomogram in the training cohort and the validation cohort. In addition, the model was validated internally in the training cohort through cross-validation.

RESULTS: There were no significant statistically differences in important baseline data such as age, pre-pregnancy BMI, and parity between the training and validation cohorts. SUI was observed in 431 (17.6%) and 125 (20.5%) women in the training and validation cohorts, respectively. According to the regression analysis, age, parity, second stage of labor, infant weight, and forceps delivery were included in the nomogram. The nomogram had a C-statistic of 0.80 (95% confidence interval [CI] 0.74-0.85) for predicting SUI. C-statistics were stable in both internally cross-validated training cohort (mean 0.81) and validation cohort (0.83 [95% CI 0.79-0.87]). The nomogram’s calibration curve was near the ideal diagonal line. Additionally, the model exhibited a positive net benefit from the decision curve analysis.

CONCLUSION: We have created a nomogram that can be utilized to quantify the risk of postpartum SUI for women with vaginal delivery. The model might contribute to predicting early postpartum SUI, thereby facilitating the management of SUI.

PMID:36624424 | DOI:10.1186/s12905-023-02160-2

BMC Med Imaging. 2023 Jan 10;23(1):7. doi: 10.1186/s12880-022-00955-7.

ABSTRACT

OBJECTIVES: Myocardial strain is reported to be a sensitive indicator of myocardial mechanical changes in patients with hypertrophic cardiomyopathy (HCM). The changes in the mechanics of the myocardium of normal wall thickness (< 12 mm) have yet to be well studied. This study aimed to evaluate the function of myocardial segments of normal thickness in patients with HCM.

METHODS: Sixty-three patients with HCM and 30 controls were retrospectively enrolled in this retrospective study. Cine imaging, native and post-contrast T1 maps, T2 maps, and late gadolinium enhancement were performed. In addition, regional myocardial strain was assessed by cardiac magnetic resonance-tissue tracking. Strain parameters were compared between the controls and HCM patients with segments of the myocardium of normal thickness. Subgroup analysis was conducted in obstructive and non-obstructive HCM. Lastly, p < 0.05 was considered statistically significant.

RESULTS: In normal-thickness myocardial segments of HCM (n = 716), diastolic peak strain rates (PSRs) were significantly lower than in the control group (n = 480) (radial, – 2.43 [- 3.36, – 1.78] vs. – 2.67 [- 3.58, – 1.96], p = 0.002; circumferential, 1.28 [1.01,1.60] vs. 1.39 [1.14, 1.78], p < 0.001; and longitudinal, 1.16 [0.75,1.51] vs. 1.28 [0.90, 1.71], p < 0.001). The normal-thickness segments showed no significant difference in systolic PSRs between HCM and the controls. In the subgroup analysis, significantly decreased diastolic PSRs were noted in both obstructive and non-obstructive HCM, compared with the controls (p < 0.05).

CONCLUSIONS: Diastolic changes in myocardial mechanics were observed in normal-thickness segments of HCM, occurring before morphological remodeling and systolic dysfunction developed. This finding contributed to a better understanding of the mechanical pathophysiology of HCM with preserved left ventricular ejection fraction. It may potentially aid in predicting disease progression and risk stratification.

PMID:36624416 | DOI:10.1186/s12880-022-00955-7

BMC Med Imaging. 2023 Jan 9;23(1):5. doi: 10.1186/s12880-023-00962-2.

ABSTRACT

PURPOSE: To evaluate whether deep learning reconstruction (DLR) accelerates the acquisition of 1.5-T magnetic resonance imaging (MRI) knee data without image deterioration.

MATERIALS AND METHODS: Twenty-one healthy volunteers underwent MRI of the right knee on a 1.5-T MRI scanner. Proton-density-weighted images with one or four numbers of signal averages (NSAs) were obtained via compressed sensing, and DLR was applied to the images with 1 NSA to obtain 1NSA-DLR images. The 1NSA-DLR and 4NSA images were compared objectively (by deriving the signal-to-noise ratios of the lateral and the medial menisci and the contrast-to-noise ratios of the lateral and the medial menisci and articular cartilages) and subjectively (in terms of the visibility of the anterior cruciate ligament, the medial collateral ligament, the medial and lateral menisci, and bone) and in terms of image noise, artifacts, and overall diagnostic acceptability. The paired t-test and Wilcoxon signed-rank test were used for statistical analyses.

RESULTS: The 1NSA-DLR images were obtained within 100 s. The signal-to-noise ratios (lateral: 3.27 ± 0.30 vs. 1.90 ± 0.13, medial: 2.71 ± 0.24 vs. 1.80 ± 0.15, both p < 0.001) and contrast-to-noise ratios (lateral: 2.61 ± 0.51 vs. 2.18 ± 0.58, medial 2.19 ± 0.32 vs. 1.97 ± 0.36, both p < 0.001) were significantly higher for 1NSA-DLR than 4NSA images. Subjectively, all anatomical structures (except bone) were significantly clearer on the 1NSA-DLR than on the 4NSA images. Also, in the former images, the noise was lower, and the overall diagnostic acceptability was higher.

CONCLUSION: Compared with the 4NSA images, the 1NSA-DLR images exhibited less noise, higher overall image quality, and allowed more precise visualization of the menisci and ligaments.

PMID:36624404 | DOI:10.1186/s12880-023-00962-2

BMC Psychiatry. 2023 Jan 9;23(1):18. doi: 10.1186/s12888-023-04516-2.

ABSTRACT

BACKGROUND: Individuals with type 1 diabetes (T1DM) may experience sleep problems, usually due to low blood sugar levels during sleep or performance of blood sugar management (e.g., blood sugar monitoring). This study aimed to identify the disease-related characteristics, psychosocial aspects, and related factors underlying sleep quality in patients with T1DM.

METHODS: This study employed a descriptive research design. The participants were 159 individuals with T1DM who completed online questionnaires. The data were analyzed using descriptive statistics, correlations, and multiple regression analyses.

RESULTS: The average score for depression in T1DM patients was 23.77 (SD 5.31), and sleep quality received a score of 4.58 (SD 3.22). Depression was positively correlated with sleep quality and negatively correlated with the total resilience score. The factors linked to depression in T1DM patients were duration of disease, sleep latency, sleep duration, sleep disturbance, and resilience-acceptance of self and life sub-factors, with an explanatory power of 44.4% for the depression variance. The associated factors with sleep quality in T1DM patients were complications, resilience-personal competence sub-factors, and depression, with an explanatory power of 37.4% for sleep quality variance.

CONCLUSIONS: The results of this study suggest that to improve sleep quality in patients with T1DM, it is necessary to develop and support disease management to prevent complications and implement interventions for improving resilience and reducing negative emotions such as depression.

PMID:36624402 | DOI:10.1186/s12888-023-04516-2

BMC Bioinformatics. 2023 Jan 9;24(1):8. doi: 10.1186/s12859-022-05123-w.

ABSTRACT

BACKGROUND: The differential network (DN) analysis identifies changes in measures of association among genes under two or more experimental conditions. In this article, we introduce a pseudo-value regression approach for network analysis (PRANA). This is a novel method of differential network analysis that also adjusts for additional clinical covariates. We start from mutual information criteria, followed by pseudo-value calculations, which are then entered into a robust regression model.

RESULTS: This article assesses the model performances of PRANA in a multivariable setting, followed by a comparison to dnapath and DINGO in both univariable and multivariable settings through variety of simulations. Performance in terms of precision, recall, and F1 score of differentially connected (DC) genes is assessed. By and large, PRANA outperformed dnapath and DINGO, neither of which is equipped to adjust for available covariates such as patient-age. Lastly, we employ PRANA in a real data application from the Gene Expression Omnibus database to identify DC genes that are associated with chronic obstructive pulmonary disease to demonstrate its utility.

CONCLUSION: To the best of our knowledge, this is the first attempt of utilizing a regression modeling for DN analysis by collective gene expression levels between two or more groups with the inclusion of additional clinical covariates. By and large, adjusting for available covariates improves accuracy of a DN analysis.

PMID:36624383 | DOI:10.1186/s12859-022-05123-w

BMC Cardiovasc Disord. 2023 Jan 9;23(1):8. doi: 10.1186/s12872-022-03015-8.

ABSTRACT

BACKGROUND: Pulmonary vein isolation (PVI) is recommended to treat paroxysmal and persistent atrial fibrillation (AF). This analysis aimed to assess the hospital efficiency of single-shot cryoballoon ablation (CBA) and point-by-point radiofrequency ablation (RFA).

METHODS: The discrete event simulation used PVI procedure times from the FREEZE Cohort study to establish the electrophysiology (EP) lab occupancy time. 1000 EP lab days were simulated according to an illustrative German hospital, including 3 PVI cases per day using CBA at one site and RFA at the other.

RESULTS: The analysis included 1560 CBA patients and 1344 RFA patients from the FREEZE Cohort. Some baseline patients’ characteristics were different between groups (age, AF type, and some concomitant diseases), without being statistically associated to ablation procedure time. Mean procedure time was 122.2 ± 39.4 min for CBA and 160.3 ± 53.5 min for RFA (p < 0.0001). RFA was associated with a more than five-fold increase of cumulative overtime compared to CBA over the simulated period (1285 h with RFA and 253 h with CBA). 70.7% of RFA lab days included overtime versus 25.7% for CBA. CBA was associated with more days with an additional hour at the end of the EP lab shift compared to RFA (47.8% vs 11.5% days with one hour left, respectively).

CONCLUSION: CBA is faster and more predictable than point-by-point RFA, and enables improvements in EP lab efficiency, including: fewer cumulative overtime hours, more days where overtime is avoided and more days with remaining time for the staff or for any EP lab usage. Clinical trial registration NCT01360008 (first registration 25/05/2011).

PMID:36624380 | DOI:10.1186/s12872-022-03015-8

BMC Med Res Methodol. 2023 Jan 9;23(1):7. doi: 10.1186/s12874-022-01794-4.

ABSTRACT

BACKGROUND: The proportion of patients with diabetic retinopathy (DR) has grown with increasing number of diabetes mellitus patients in the world. It is among the major causes of blindness worldwide. The main objective of this study was to identify contributing risk factors of DR among people with type II diabetes mellitus.

METHOD: A sample of 191 people with type II diabetes mellitus was selected from the Black Lion Specialized Hospital diabetic unit from 1 March 2018 to 1 April 2018. A multivariate stochastic regression imputation technique was applied to impute the missing values. The response variable, DR is a categorical variable with two outcomes. Based on the relationship derived from the exploratory analysis, the odds of having DR were not necessarily linearly related to the continuous predictors for this sample of patients. Therefore, a semiparametric model was proposed to identify the risk factors of DR.

RESULT: From the sample of 191 people with type II diabetes mellitus, 98 (51.3%) of them had DR. The results of semiparametric regression model revealed that being male, hypertension, insulin treatment, and frequency of clinical visits had a significant linear relationships with the odds of having DR. In addition, the log- odds of having DR has a significant nonlinear relation with the interaction of age by gender (for female patients), duration of diabetes, interaction of cholesterol level by gender (for female patients), haemoglobin A1c, and interaction of haemoglobin A1c by fasting blood glucose with degrees of freedom [Formula: see text], respectively. The interaction of age by gender and cholesterol level by gender appear non significant for male patients. The result from the interaction of haemoglobin A1c (HbA1c) by fasting blood glucose (FBG) showed that the risk of DR is high when the level of HbA1c and FBG were simultaneously high.

CONCLUSION: Clinical variables related to people with type II diabetes mellitus were strong predictive factors of DR. Hence, health professionals should be cautious about the possible nonlinear effects of clinical variables, interaction of clinical variables, and interaction of clinical variables with sociodemographic variables on the log odds of having DR. Furthermore, to improve intervention strategies similar studies should be conducted across the country.

PMID:36624377 | DOI:10.1186/s12874-022-01794-4