Category: Statistics

Am J Health Behav. 2021 Sep 30;45(5):895-901. doi: 10.5993/AJHB.45.5.9.

ABSTRACT

Objectives: The overuse of smartphones affects physical, social, and psychological well-being. However, research on smartphone addiction and anxiety disorders is scarce. Therefore, the objective of this study was to investigate the association between anxiety and smartphone addiction risk in Korean adolescents. Methods: This study used a cross-sectional survey method. We used the Revised Children’s Manifest Anxiety Scale to assess anxiety symptoms and we used the Korean Smartphone Addiction Proneness Scale index to evaluate the degree of high-risk or at-risk for smartphone addiction. Results: Analyses were performed for 1733 adolescents, including 771 boys and 962 girls. The high-risk or at-risk group for smartphone addiction accounted for 20.1% (p < .0001). Total anxiety scale score, as well as physiological anxiety, oversensitivity, and social concern categories were statistically different among levels of smartphone addiction risk (all ps < .0001). Multivariate analysis showed that poor self-reported health level, higher risk of smartphone addiction, having fewer close friends, caffeine drink consumption, female sex, and alcohol use were associated with greater anxiety. Conclusions: Management of smartphone addiction seems to be essential for proper psychological health. There is an urgent need to develop a way to prevent smartphone addiction on a social level.

PMID:34702436 | DOI:10.5993/AJHB.45.5.9

Am J Health Behav. 2021 Sep 30;45(5):856-866. doi: 10.5993/AJHB.45.5.6.

ABSTRACT

Objectives: In this study, we determine the validity and reliability of the Muscularity Oriented Eating Test (MOET) among Turkish university students, thereby creating the MOET-TR. Methods: First, the MOET was translated by using the translation-back translation method for cultural equivalence. Then, the validity and reliability analyses were performed on 460 university students. To analyze the stability of the scale over time, the MOET-TR was applied to approximately 20% of the sample number for a second time after 2-4 weeks. Results: The one-factor structure of the MOET-TR demonstrated a good agreement with the fix index values. Cronbach’s for the MOET-TR was 0.88, and the ICC value was 0.84. In addition, we found a positive statistically significant relationship between the total scores obtained from the DMS, EAT-40, REZZY, and IPAQ-Short forms used to evaluate the convergent divergent validity of the MOET-TR (p < .05). Conclusions: The MOET-TR is suitable for the Turkish culture and can be used to identify individuals who have muscularity oriented eating disorders, who are uncomfortable with their body shape, and who turn their body shapes into a social phobia.

PMID:34702433 | DOI:10.5993/AJHB.45.5.6

Hum Hered. 2021 Oct 26:1-9. doi: 10.1159/000519098. Online ahead of print.

ABSTRACT

Many complex diseases are caused by single nucleotide polymorphisms (SNPs), environmental factors, and the interaction between SNPs and environment. Joint tests of the SNP and SNP-environment interaction effects (JMA) and meta-regression (MR) are commonly used to evaluate these SNP-environment interactions. However, these two methods do not consider genetic heterogeneity. We previously presented a random-effect MR, which provided higher power than the MR in datasets with high heterogeneity. However, this method requires group-level data, which sometimes are not available. Given this, we designed this study to evaluate the introduction of the random effects of SNP and SNP-environment interaction into the JMA, and then extended this to the random effect model. Likelihood ratio statistic is applied to test the JMA and the new method we proposed in this paper. We evaluated the null distributions of these tests, and the powers for this method. This method was verified by simulation and was shown to provide similar powers to the random effect meta-regression method (RMR). However, this method only requires study-level data which relaxed the condition of the RMR. Our study suggests that this method is more suitable for finding the association between SNP and diseases in the absence of group-level data.

PMID:34700323 | DOI:10.1159/000519098

Ear Hear. 2021 Oct 12. doi: 10.1097/AUD.0000000000001140. Online ahead of print.

ABSTRACT

OBJECTIVES: Humans can hear up to 20 kHz. Emerging evidence suggests that hearing in the extended high frequencies (EHFs; >8 kHz) contributes to speech perception in noise. The objective of the present study was to describe the features of EHF hearing impairment in young adults with normal standard audiograms (0.25-8 kHz). Specifically, the study goals were to: (1) characterize the EHF hearing impairment and identify potential risk factors; (2) elucidate the age-related changes in EHF hearing; (3) determine the effect of EHF hearing impairment on speech-in-noise recognition; and (4) examine the extent to which EHF hearing impairment influences cochlear functioning in the standard frequencies.

DESIGN: Hearing thresholds at standard frequencies and EHFs (10, 12.5, 14, and 16 kHz), and speech recognition thresholds (SRTs) using digit triplets in multi-talker babble were measured in both ears from 222 participants (19-38 years; n = 444 ears) with normal audiograms (≤20 dB HL at standard frequencies). Test-retest measurement of hearing thresholds was obtained in a subset of 50 participants (100 ears), and clinical distortion product otoacoustic emissions (f2 frequency = 2, 3, 4, and 5 kHz) were recorded in 49 participants (98 ears).

RESULTS: Forty-two of 222 participants had EHF hearing impairment (>20 dB HL for at least one EHF in either ear). Only seven individuals with EHF impairment had significant case history and/or listening-in-noise complaints. A breakpoint in the threshold-age function was observed for the EHFs for males but not for females. Linear mixed models revealed a significant effect of age, pure-tone averages for speech frequencies (0.5, 1, 2, and 4 kHz), and EHFs and group (NH versus EHF hearing impairment) independent of each other on the SRTs. Individuals with EHF hearing impairment had less measurable emissions and when present, had a lower magnitude of otoacoustic emissions relative to NH controls. There was no difference in hearing thresholds, SRTs, or otoacoustic emissions between earphone users and nonusers.

CONCLUSIONS: The hearing thresholds for the EHFs exhibit signs of early auditory aging. Age-related deterioration in auditory function can be observed in the third decade of human life. A breakpoint in the threshold-age function suggests that rapid aging processes are operational at a relatively younger age (21 years) for males. The audibility of EHFs contributes to speech-in-noise recognition. EHF hearing impairment independent of age and speech frequencies can affect speech-in-noise recognition. Reduced distortion product otoacoustic emissions in the standard frequencies may suggest preclinical cochlear degeneration in individuals with EHF hearing impairment.

PMID:34700326 | DOI:10.1097/AUD.0000000000001140

Skin Pharmacol Physiol. 2021 Oct 26. doi: 10.1159/000520172. Online ahead of print.

ABSTRACT

BACKGROUND: Studies on mice and aging human hair follicles provide compelling evidence that graying of hair results from premature differentiation of Melanocyte stem cells (MeSC) in the niche/bulge.

OBJECTIVE: To analyze whether differentiation of melanocyte stem cells is responsible for premature graying of hair (PGH).

METHODS: Twenty- five patients of PGH (n=25) attending dermatology department were recruited. Five unpigmented and five pigmented hairs were obtained per patient by separating individual follicles by 1 mm punch biopsies. The hairs were dissected at a distance of 2 mm from the bulb to separate the stem cells (upper segment) (US) from the melanocytes (lower segment) (LS). RNA was extracted from hair follicle segments US and LS, and expression of GP100, Tyrosinase (TYR) and Tyrosinase related protein-1 (TYRP1) genes was quantified using Qiagen one-step RT-PCR kit.

RESULTS: We found melanogenesis gene expression in both temporary (US) and permanent (LS) segments of unpigmented and pigmented hair follicles. When compared between the US and LS of white hair, the expression of TYR and GP100 was much higher in US than LS, suggestive of melanogenesis in the bulge. Similarly, when compared between white and black US, the expression of all three genes was higher in white US than black US, although not statistically significant.

LIMITATIONS: Low samples size and lack of data pertaining to the expression of genes at protein level are the limitations of current study.

CONCLUSION: Even though this pilot study data yielded key information about the expression of GP100, TYR and TYRP-1 at mRNA level, further studies quantifying the expression of these genes at protein level are needed to provide additional clues to further address the results in detail.

PMID:34700322 | DOI:10.1159/000520172

Oral Oncol. 2021 Oct 23;122:105551. doi: 10.1016/j.oraloncology.2021.105551. Online ahead of print.

ABSTRACT

OBJECTIVE: To report the early experience using an automated chatbot (Chats)for patient-reported outcomes (PRO) and symptom self-managementinhead and neck cancer (HNC) patients undergoing radiation treatment (RT).

METHODS: Patients aged ≥ 18 yearsdiagnosed with HNC who were scheduled to begin RT were given the option to use Chats from June 2018 to June 2019. Enrolled patients received chat notifications two days before weekly on-treatment visitsand every 1-4 weeks after RT for an additional 4 months. After the first in-person follow-up visit, participants completed an electronic usability and satisfaction questionnaire.

RESULTS: Of 95 patients who agreed to participate, 84 were eligible for analysis.Participantswere significantly younger than patients who declined participation (mean age 61.3 vs 68.3 years;p-value < 0.001). Patient engagement with Chats was highest at 67% during the first month and declined over time (p-value = 0.004). Concordance between PRO and clinician-reported outcomes (CRO) was fair, ranging from 0.10 to 0.43 (Cohen κ statistics). The most commonly under-reported symptoms were salivary duct inflammation (53%), xerostomia (41%), and mucositis (37%). 89% (39 of 44) of patients who completed surveys found Chats easy to use, and 61% reported that Chats helped with symptom self-management and reduced the need to call the care team.

CONCLUSIONS: These early results suggest that an interactive chatbot is feasible and provides support for HNC patients during and after RT. Chats identified discordance between PRO and CRO. Further study is required to measure benefits of Chats in a larger population.

PMID:34700280 | DOI:10.1016/j.oraloncology.2021.105551

Sex Med. 2021 Oct 23;9(6):100427. doi: 10.1016/j.esxm.2021.100427. Online ahead of print.

ABSTRACT

INTRODUCTION: Vaginal laxity or the sensation of vaginal looseness affects anywhere from 24% to 50% of postpartum women.

AIM: To evaluate the efficacy and safety of the ThermiVa (ThermiAesthetics, TX, USA) monopolar radiofrequency device in the treatment of vulvovaginal laxity and sexual dysfunction METHODS: The TIGHT study was a prospective single blinded randomized sham-control trial conducted over 3 sites in Australia and India. The study included parous woman over the age of 18 who complained of vaginal laxity/looseness. Participants were randomized into a treatment group and a sham group. Patients in the treatment group were treated with an active probe, whereas, women in the placebo group were treated with sham probes that only reached subtherapeutic temperatures.

MAIN OUTCOME MEASURES: Subjective success was determined by improvement in the Female Sexual Function Index (FSFI), Vaginal Laxity Questionnaire (VLQ), Vaginal Flatus Score (VFS), and the Vaginal laxity Bother Score (VLBS). Objective success was measured via the Modified Oxford Score (MOS) and Genital Hiatus (GH) length.

RESULTS: Sixty-three participants were recruited (sham n = 29, treatment n = 34). In the treatment group, FSFI scores improved at 3 months (mean difference 8-points, P value .02), and at 6 months (mean difference 5-points, P value .07). At baseline 89.7% and 87.2% of patients in the sham and treatment groups, respectively, classified themselves as “loose” on the VLQ. At 6 months 73.1% of patients in the sham group still identified as “loose” compared to 32.4% of patients in the active group (P value .01). Subjective success was also noted in the VLBS (P value .02). Results pertaining to VLFS, MOS, and GH did not reveal statistically significant results.

CONCLUSION: Treatment with ThermiVa was associated with a modest subjective improvement in vaginal laxity and sexual dysfunction and proved to be safe over the 6-month trial period. Pather K, Dilgir S, Rane A. The ThermiVa In Genital Hiatus Treatment (TIGHT) Study. Sex Med 2021;XX:XXXXXX.

PMID:34700288 | DOI:10.1016/j.esxm.2021.100427

Int J Nurs Stud. 2021 Oct 1;125:104094. doi: 10.1016/j.ijnurstu.2021.104094. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative nausea and vomiting are common uncomfortable symptoms experienced by patients. Besides drugs, non-pharmaceutical therapies such as herbal medicine therapy are available. Ginger has played a therapeutic role in patients undergoing chemotherapy and pregnant women, but results from postoperative patients are inconsistent.

OBJECTIVES: The aim of this study was to examine and evaluate the preventive effect of ginger on postoperative nausea and vomiting.

DESIGN: A systematic review and meta-analysis of randomized controlled trials METHODS: Two independent researchers searched Chinese and English databases from their inception dates to November 2020. The Chinese databases used were CNKI and SinoMed, and the English databases used were PubMed, Embase, and the Cochrane Library. We only included randomized controlled trials. The primary outcomes were nausea score, presented as standard mean difference, and the number of vomiting episodes, presented as risk ratio. The secondary outcomes were side effects and antiemetic drug use, presented as risk ratios. We used the random-effects model.

RESULTS: Fourteen randomized trials with a total of 1,506 patients were pooled. At the different time points, the control group had higher postoperative nausea scores than the experimental group, and the differences were significant between the ginger and placebo groups at 2, 6, and 12 h after operation, with standard mean differences and 95% confidence intervals of -1.10 and -1.95 to -0.25, -1.54 and -3.05 to -0.03, and -2.04 and -3.67 to -0.41, respectively. Except in the recovery room, no statistically significant correlation was found between ginger intake and postoperative vomiting, postoperative nausea and vomiting, or antiemetic drug use.

CONCLUSION: The results of this meta-analysis demonstrate that ginger can reduce postoperative nausea but showed no significant difference in the incidence rates of postoperative vomiting, postoperative nausea and vomiting, and antiemetic drug use. More high-quality and rigorous trials are needed to elucidate the relationship between ginger intake and the reduction in the incidence of postoperative nausea and vomiting.

PROTOCOL REGISTRATION: CRD42020220916.

PMID:34700257 | DOI:10.1016/j.ijnurstu.2021.104094

Nurse Educ Pract. 2021 Sep 30;57:103215. doi: 10.1016/j.nepr.2021.103215. Online ahead of print.

ABSTRACT

AIM: This study aimed to measure the impact of a dedicated EBP module on the knowledge, skills and capability for EBP of students undertaking the inaugural MSc in Nursing: Advanced Practice programme in the KSA.

BACKGROUND: Evidence-based practice (EBP) yields multiple benefits for all key stakeholders of healthcare. Key to this are healthcare professionals armed with necessary EBP knowledge and skills. Nurses, the largest professional group in healthcare, can be instrumental in effecting sustained EBP implementation. In the Kingdom of Saudi Arabia (KSA) achieving this is hindered by a chronic shortage of nurses and a heavy reliance on expatriate nurses who are often a transient workforce, resulting in a high turnover. The Government of Saudi Arabia 2030 Vision aspires to address the indigenous nurse shortage and the quality of healthcare. In 2017 the inaugural MSc in Nursing: Advanced Practice programme was established in the KSA to prepare Saudi nurses for emerging advanced practice roles. A dedicated EBP module was a core component of the programme.

METHODS: A pre-experimental pilot study conducted over 18-months collected data from the same participants at three different points. Two validated EBP questionnaires measuring EBP Beliefs and EBP Implementation were administered to post-graduate students undertaking the MSc in Nursing: Advanced Practice programme in one Higher Education Institution in the KSA. Descriptive, inferential and correlational statistics were employed to analyse the demographic data, group mean scores and distribution on the EBP scales, as well the correlation between EBP Beliefs and EBP Implementation.

FINDINGS: Findings demonstrated that the educational intervention did improve participants’ EBP beliefs and implementation. Participants reported positive beliefs about EBP at all 3 data collection points (M = 57.4 SD = 7.0; M = 62.54 SD = 7.21; M = 55.31 SD = 15.81, respectively). EBP implementation was low prior to undertaking the module but improved thereafter as illustrated across the 3 data collection points (M = 15.14 SD = 11.9; M = 27.64 SD = 14.35; M = 25.9 SD = 20.43). On both measures, higher scores indicate higher EBP beliefs and implementation.

CONCLUSION: This study established the EBP Beliefs and EBP Implementation of a sample of postgraduate nursing students in the KSA. Findings revealed a substantial improvement in both EBP Beliefs and EBP Implementation following the EBP module. Findings support the use of a dedicated module to prepare nurses to use EBP and to practice at an advanced level while simultaneously preparing them for leadership roles in healthcare in KSA. In so doing, this will help to advance the healthcare goals of the KSA 2030 vision.

PMID:34700260 | DOI:10.1016/j.nepr.2021.103215

Med Image Anal. 2021 Sep 30;75:102252. doi: 10.1016/j.media.2021.102252. Online ahead of print.

ABSTRACT

Evidence of the non stationary behavior of functional connectivity (FC) networks has been observed in task based functional magnetic resonance imaging (fMRI) experiments and even prominently in resting state fMRI data. This has led to the development of several new statistical methods for estimating this time-varying connectivity, with the majority of the methods utilizing a sliding window approach. While computationally feasible, the sliding window approach has several limitations. In this paper, we circumvent the sliding window, by introducing a statistical method that finds change-points in FC networks where the number and location of change-points are unknown a priori. The new method, called cross-covariance isolate detect (CCID), detects multiple change-points in the second-order (cross-covariance or network) structure of multivariate, possibly high-dimensional time series. CCID allows for change-point detection in the presence of frequent changes of possibly small magnitudes, can assign change-points to one or multiple brain regions, and is computationally fast. In addition, CCID is particularly suited to task based data, where the subject alternates between task and rest, as it firstly attempts isolation of each of the change-points within subintervals, and secondly their detection therein. Furthermore, we also propose a new information criterion for CCID to identify the change-points. We apply CCID to several simulated data sets and to task based and resting state fMRI data and compare it to recent change-point methods. CCID may also be applicable to electroencephalography (EEG), magentoencephalography (MEG) and electrocorticography (ECoG) data. Similar to other biological networks, understanding the complex network organization and functional dynamics of the brain can lead to profound clinical implications. Finally, the R package ccid implementing the method from the paper is available from CRAN.

PMID:34700242 | DOI:10.1016/j.media.2021.102252