Category: Statistics

Dermatol Ther. 2022 Aug 30:e15796. doi: 10.1111/dth.15796. Online ahead of print.

ABSTRACT

BACKGROUND: Psoriasis is a papulosquamous disorder that causes significant social and psychological trauma to the patient. It is characterized by the presence of erythematous, indurated plaques covered with silvery-white scales. Despite the availability of several systemic agents that have been approved for the treatment of psoriasis, usually there are some residual lesions and there is a need to treat them for cosmetic reasons or symptomatic control.

AIMS: 1. Treatment of resistant localized psoriatic plaques or residuals after systemic treatment. 2. Recently, some intralesional agents have been used successfully for the treatment of psoriatic plaques as 5-FU, methotrexate, and botulinum toxin type-A, and nearly for 4 decades, no study focused on the effect of intralesional corticosteroids in the treatment of these psoriatic plaques. We decided to highlight their role and compare intralesional Triamcinolone to intralesional 5-FU regarding efficacy and safety in the treatment of plaque psoriasis.

METHODS: This study included 24 patients with localized plaque psoriasis. Each patient was treated by split-body therapy where one psoriatic plaque was treated with intralesional 5FU and another plaque with intralesional TAC. A total of three injections were given at two- week intervals and follow up was regularly every 2 weeks up to 12 weeks.

RESULTS: There was a statistically significant difference between both groups (p = 0.008) as the response rate on 5-FU side was 12.5% with no response, 29.2% with a moderate response, 41.7% with an excellent response, and 16.7% with a complete clearance, while on the TAC side it was16.7% with a moderate response, 20.8% with an excellent response and 62.5% with a complete clearance. Hyperpigmentation was the most irritating side effect of 5-FU that occurred. Pain, during and after injection, was greater in 5-FU group. Hypopigmentation and atrophy only occurred in TAC group in some patients but it seems to be reversible and not disfiguring.

CONCLUSION: 1-Intralesional TAC injection may have more efficacy and less side effects than 5-FU injection in the treatment of localized plaque psoriasis. Hyperpigmentation and pain were the most irritating side effects of 5-FU 2-Intralesional TAC can be effective in the treatment of localized psoriatic plaques with minimal side effects, especially in patients not suitable for systemic agents.

PMID:36039604 | DOI:10.1111/dth.15796

Stat Med. 2022 Sep 10;41(20):4079. doi: 10.1002/sim.9518.

NO ABSTRACT

PMID:36039613 | DOI:10.1002/sim.9518

Clin Exp Emerg Med. 2022 Aug 31. doi: 10.15441/ceem.21.164. Online ahead of print.

ABSTRACT

OBJECTIVE: Since onsite education is difficult due to the COVID-19 pandemic, official development assistance (ODA) projects have implemented online training of trainers (ToT) for emergency medical experts and staff. This study aims to share and discuss the ToT experience and its results in Uzbekistan.

METHODS: We trained emergency medical advanced course instructors through online ToT among emergency medical service experts in Uzbekistan as a part of an ODA project. After the ToT, instructors were selected based on written tests, video monitoring of practice, and simulation performance. They operated the emergency medical course including lectures, practices, and simulations for 5 days. We tested the trainees through written tests before and after the course. They were surveyed regarding the course contents, its relevance, and their satisfaction with the course.

RESULTS: Six instructors were selected after the online ToT program. They educated 68 emergency medical workers through the three training courses. The total score of the pretest was 129.2±34.8, and the posttest score was 170.8±31.2, which was significantly higher (P<0.05). The satisfaction calculated by adding the values of survey items for this curriculum was 28.0 (interquartile range, 26.0-30.0), and there was no statistical difference regarding trainee satisfaction between the three courses (P=0.148).

CONCLUSION: Instructors trained by online ToT programs could provide an in-person emergency medical advanced course.

PMID:36039600 | DOI:10.15441/ceem.21.164

Clin Chem Lab Med. 2022 Aug 31. doi: 10.1515/cclm-2022-0447. Online ahead of print.

ABSTRACT

OBJECTIVES: Cellular analysis of body fluids (BF) has clinical relevance in several medical conditions. The objective of this study is twofold: (1) evaluate the analytical performance of the BF mode of Mindray BC-6800 Plus compared to manual counts under microscopy and (2) analyse if the high-fluorescent cell counts provided by the analyser (HF-BF) are useful to detect malignancy.

METHODS: A total of 285 BF was analysed: 250 corresponding to patients without neoplasia and 35 to patients with malignant diseases. Manual differential counts were performed in BF with ≥250 cells/μL. Percentages and absolute counts were obtained on the BC-6800Plus for total nucleated cells (TC-BF), mononuclear, polymorphonuclear and HF-BF. Statistical analysis was performed using Mann-Whitney U-test, Spearman’s correlation, Passing-Bablok regression, Bland-Altman graph and ROC curve.

RESULTS: To compare manual and automatic total cell counts, samples were divided in three groups: <250, 250-1,000 and >1,000 cells/μL. Correlation was good in all cases (r=0.72, 0.73 and 0.92, respectively) without significant differences between both methods (p=0.65, 0.39 and 0.30, respectively). The concordance between methods showed values of 90%. Considering malignant samples, median HF-BF values showed significant higher values (102 cells/μL) with respect to non-malignant (4 cells/μL) (p<0.001). The cut-off value of 8.5 HF-BF/μL was able to discriminate samples containing malignant cells showing sensitivity and specificity values of 89 and 71%, respectively. Considering both, HF-BF and TC-BF values, sensitivity and specificity values were 100 and 53%, respectively.

CONCLUSIONS: This study reveals that the Mindray BC-6800Plus offers an accurate and acceptable performance, showing results consistent with the manual method. It is recommended to consider both HF-BF and TC-BF values for the screening of the microscopic evaluation to ensure the detection of all malignant samples.

PMID:36039597 | DOI:10.1515/cclm-2022-0447

Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2022 Jul 28;47(7):910-919. doi: 10.11817/j.issn.1672-7347.2022.220135.

ABSTRACT

OBJECTIVES: Many neuropsychiatric diseases are related to the abnormal development of brain tissue in infants. This study aims to analyze the changes in the parameters of magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) in brain development of infants aged from 2 months to 2 years old, and to explore the value of MRS combined with DTI in evaluating brain development of infants aged from 2 months to 2 years old.

METHODS: A total of 116 normal infants, who received whole brain MRS and DTI examinations after delivery in Children Hospital of Shanxi Province from September 2020 to May 2021, were selected and were divided into a group A (n=7, at the age of 2-6 months), a group B (n=28, at the age of 7-12 months), a group C (n=41, at the age of 13-18 months), and a group D (n=40, at the age of 19-24 months). After collecting the MRS and DTI data, statistical analysis was performed to compare DTI parameters and MRS metabolic products ratio.

RESULTS: There were significant differences in the DTI parameters of frontal lobe, temporal lobe, occipital lobe, hind limb of internal capsule, fore limb of internal capsule, knee of corpus callosum, splenium of corpus callosum, and optic radiation among the 4 groups (P<0.05 or P<0.01). The values of fractional anisotropy (FA) showed an upward trend from the group A to the group D, while the values of apparent diffusion coefficient (ADC), axial diffusivity (AD), and radial diffusivity (RD) showed a downward trend, and the changes of parameters tended to slow down with age. In the left or right lentiform nucleus, the ratio of choline (Cho)/creatine (Cr) was decreased from the group A to the group D, and the group D was significantly lower than the group A and B (all P<0.01). The ratio of Cho/N-acetyl aspartate (NAA) was decreased from the group A to the group D, and the group D was significantly lower than the group A, B, and C (left lentiform nucleus, P<0.05 or P<0.01) or the group A, B (right lentiform nucleus, both P<0.01). The ratio of glutamine/glutamate (Glx)/Cr was decreased from the group A to the group D, and the group D was significantly lower than the group A, B and C (P<0.05 or P<0.01). The ratio of myo-inositol (mI)/Cr was increased from the group A to the group D, and the group D was significantly higher than the group A, B, and C (P<0.05 or P<0.01). The ratio of NAA/Cr was increased from the group A to the group D, and the group B, C, and D were significantly higher than the group A (P<0.05 or P<0.01). The ratios of mI/Cr and NAA/Cr in different brain regions from the group A to the group D showed an upward trend, and the ratios of Cho/Cr, Cho/NAA, and Glx/Cr showed a downward trend. The variation of each parameter tends to decrease with age.

CONCLUSIONS: MRS and DTI can detect the brain development of infants aged from 2 months to 2 years old, and provide a basis for predicting brain diseases.

PMID:36039588 | DOI:10.11817/j.issn.1672-7347.2022.220135

Mol Ecol Resour. 2022 Aug 30. doi: 10.1111/1755-0998.13706. Online ahead of print.

ABSTRACT

Despite the popularity of discriminant analysis of principal components (DAPC) for studying population structure, there has been little discussion of best practise for this method. In this work, I provide guidelines for standardising the application of DAPC to genotype datasets. An often-overlooked fact is that DAPC generates a model describing genetic differences among a set of populations defined by a researcher. Appropriate parameterisation of this model is critical for obtaining biologically meaningful results. I show that the number of leading PC axes used as predictors of among population differences, p_axes , should not exceed the k – 1 biologically informative PC axes that are expected for k effective populations in a genotype dataset. This k – 1 criterion for p_axes specification is more appropriate compared to the widely used proportional variance criterion, which often results in a choice of p_axes ≫ k – 1. DAPC parameterised with no more than the leading k – 1 PC axes: (1) is more parsimonious; (2) captures maximal among-population variation on biologically relevant predictors; (3) is less sensitive to unintended interpretations of population structure; and (4) is more generally applicable to independent sample sets. Assessing model fit should be routine practise and aids interpretation of population structure. It is imperative that researchers articulate their study goals, that is, testing a priori expectations versus studying de novo inferred populations, because this has implications on how their DAPC results should be interpreted. The discussion and practical recommendations in this work provide the molecular ecology community a roadmap for using DAPC in population genetic investigations.

PMID:36039574 | DOI:10.1111/1755-0998.13706

J Osteopath Med. 2022 Aug 30. doi: 10.1515/jom-2022-0016. Online ahead of print.

ABSTRACT

CONTEXT: With the surge of the novel coronavirus (SARS-CoV-2 [COVID-19]), the modality of teaching anatomy has shifted from in-person cadaveric dissection to virtual lessons for incoming first-year medical students. As a result, we aim to assess the impact that this curriculum change has on student perspectives.

OBJECTIVES: This study aims to understand the relative effect of a virtual anatomy course implemented during the pandemic (2019-2020) on the confidence, skills, and perspectives of first-year medical students compared to medical students who had traditional in-person anatomy at Rowan University School of Osteopathic Medicine (Rowan SOM) in Stratford, New Jersey.

METHODS: The authors developed a 14-question survey to target gross anatomy students of the Classes of 2023 and 2024 at Rowan SOM. The Class of 2024 had a virtual anatomy lab compared to the Class of 2023, who had an in-person anatomy lab in their first year of medical school. The responses were analyzed to understand the difference between a hands-on cadaver lab and a virtual anatomy lab utilizing SPSS.

RESULTS: The survey was administered to approximately 400 people, from which we received 149 responses (37.3%). Among all responses, 36.2% (n=54) belonged to the Class of 2023 who encountered hands-on cadaver experience, whereas 63.8% (n=95) belonged to the Class of 2024 who gained virtual anatomy lab experience. An independent t-test statistical analysis was utilized. Under the confidence domain, when students were asked about the understanding of trauma after their respective anatomy labs, 64.0% of the Class of 2023 (n=50) showed significantly higher confidence with p<0.001, compared to 15.4% for the Class of 2024 (n=78). Under the skills domain, the Class of 2023 (n=50) felt more comfortable with ultrasound (64.0%), identifying all of the pertinent anatomical structures and their respective locations on imaging (72.0%), and identifying the pathology (90.0%) with respective p values of <0.001, <0.001, and 0.004. Only 36.9% of Class of 2024 respondents shared similar comfort with ultrasound (n=84), 30.9% identifying pertinent anatomical structures (n=84) and 65.4% in identifying pathology (n=84). Under the attitude domain, the Class of 2023 (n=50) had more respect toward the human body with their hands-on cadaver experience (88.0%) than the Class of 2024 (n=89, 33.3%).

CONCLUSIONS: Based on current results, it can be established that medical students who had in-person cadaveric dissection had a favorable attitude toward their anatomy course compared to students who had virtual anatomy during the COVID-19 pandemic.

PMID:36039567 | DOI:10.1515/jom-2022-0016

Int J Rheum Dis. 2022 Aug 30. doi: 10.1111/1756-185X.14431. Online ahead of print.

ABSTRACT

AIM: The current study was undertaken to evaluate the influence of breastfeeding on the development and outcome measures of juvenile idiopathic arthritis (JIA). The second aim was to determine the consequences of particular sociodemographic and sociocultural characteristics and nutritional behavior of early childhood on JIA.

METHODS: The study includes the patients diagnosed with JIA and regularly followed up at the Department of Pediatric Rheumatology in Istanbul University-Cerrahpasa. The comparison group consisted of healthy subjects and patients with juvenile systemic lupus erythematosus (jSLE). A face-to-face survey method was conducted with the parents of the participants between February 1, 2021, and September 1, 2021.

RESULTS: The mean age of the JIA cohort (n = 324) was 12.2 ± 4.7 years, with a female ratio of 64.8%. The breastfeeding rate differed from the control groups (253 healthy subjects and 88 patients with jSLE) but was higher with a value of 94.8%. There was no difference between the groups (P = .097, P = .064) or within the subgroups of JIA (P = .12) regarding breastfeeding duration. Cow’s milk introduction time (P = .02, P = .0001), household pet-keeping (P = .001), income level (P = .0001), maternal literacy (P = 0.013) made a statistical difference vs the control groups.

CONCLUSION: No relationship was established between the rate or duration of breastfeeding and the development or severity of JIA. The early introduction of cow’s milk was found to be higher in the patient cohorts. The income level and maternal literacy appeared to be relevant with the high disability and damage scores, and frequent relapse rates. Secondhand smoking, higher in JIA, may prompt the basis of primary preventable strategies in JIA.

PMID:36039559 | DOI:10.1111/1756-185X.14431

Psychiatr Serv. 2022 Aug 30:appips202100629. doi: 10.1176/appi.ps.202100629. Online ahead of print.

ABSTRACT

The U.S. Veterans Health Administration developed a suicide prediction statistical model and implemented a novel clinical program, Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment (REACH VET). This high-value suicide prevention program aims to efficiently identify patients at risk and connect them with care. Starting in April 2017, national REACH VET metric data were collected from electronic health records to evaluate required task completion. By October 2020, 98% of veterans identified (N=6,579) were contacted by providers and had their care evaluated. In the nation’s largest health care system, it was feasible to implement a clinical program based on a suicide prediction model.

PMID:36039552 | DOI:10.1176/appi.ps.202100629

Brain Behav. 2022 Aug 30:e2745. doi: 10.1002/brb3.2745. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study aimed to examine the effect of group assertive training on self-esteem and quality of life among spouses of drug-abusing patients.

METHODS: This randomized clinical trial assignment study with a control group. The statistical population included all spouses of drug users referring to private addiction treatment centers in Tehran-Iran in 2020 and the sample included 50 spouses of drug users who were selected by simple random sampling from among the volunteers. They were randomly divided into two groups control and experimental, each group consisting of 25 people.

RESULTS: The results of data analysis showed that group assertive training increased self-esteem and quality of life in spouses of drug-abusing patients in the experimental group compared to the witness group (p < .001).

CONCLUSION: As a result, group assertive training is effective in increasing the self-esteem and quality of life among the spouses of drug-abusing patients.

PMID:36039547 | DOI:10.1002/brb3.2745