Category: Statistics

Turk J Med Sci. 2021 Apr 12. doi: 10.3906/sag-2010-237. Online ahead of print.

ABSTRACT

AIM: Headache is one of the most common neurological symptoms. It adversely affects daily life, reduces the workforce, and has high health costs. Managing this symptom in primary care will free up secondary and tertiary health services to better treat patients who need follow-up by specialists. In the present study, we aim to show the rate at which this problem can be solved in primary care for patients who applied tertiary care services with a headache for the first time.

MATERIALS AND METHODS: Our research is a cross-sectional study of 207 patients who applied to the neurology clinics for the first time with headache. Two questionnaires were prepared by the researchers. IBM SPSS 21 was used for statistical analysis, and the level of significance was p<0.05.

RESULTS: The opinions of the patients on the evaluability of headache in primary care were compared. Family physicians and neurologists gave similar responses about the disease management, at a rate of 96.6%, this was found to be statistically significant and shows strong agreement. Both groups of physicians thought that 70% of patients, on average, who applied to the neurology clinics with headache could be managed in primary care. However, only 9.2% of the patients share this opinion with physicians. Primary headache cases constitute most of the cases that are thought to be solved in primary care. It was revealed that the number of patients seeking primary care with this complaint was lower than expected.

CONCLUSION: Patients with headache applied tertiary care instead of primary care for different reasons. Both neurologists and family physicians stated that most patients evaluated in tertiary care could be managed in primary care.

PMID:33843173 | DOI:10.3906/sag-2010-237

J Pediatr Gastroenterol Nutr. 2021 Jan 14. doi: 10.1097/MPG.0000000000003047. Online ahead of print.

ABSTRACT

OBJECTIVES: While the algorithm to diagnose celiac disease (CD) in children with elevated anti-transglutaminase IgA (TGA-IgA) titers (> 10 times upper limit of normal, ULN) is well defined, the management of children with low TGA-IgA values represents a clinical challenge. We aimed to identify the diagnostic value of persistently low positive TGA-IgA titers in predicting CD in children.

METHODS: We retrospectively analyzed children with symptoms or signs of CD, not eligible for a no-biopsy approach. We included children with at least two TGA-IgA measurements, EMA assessment and esophagogastroduodenoscopy (EGD) with biopsies. TGA-IgA values were provided as multiples of upper limit normal (ULN). Patients were classified in groups according to median TGA-IgA values: A (TGA-IgA>1 ≤ 5 x ULN; defined as “low-positive”), B (TGA-IgA > 5 < 10 x ULN; “moderate-positive”) and C (controls).

RESULTS: Data of 281 children were analyzed. Of 162 children in Group A, CD was diagnosed in 142 (87.7%), while normal duodenal mucosa was found in 20. In Group B, all 62 children (100%) received a CD diagnosis. Group C included 57 controls. EMA were undetectable in 31 (15%) of mucosal atrophy cases. On the ROC curve (AUC = 0.910), a mean value of 1.7 ULN showed a sensitivity of 81.4% and specificity of 81.8% to predict mucosal damage.

CONCLUSIONS: Repeated low or moderate TGA-IgA values (< 5 ULN or <10 ULN) are good predictors of a CD diagnosis. Symptomatic children with persistently low positive TGA-IgA titers should undergo EGD regardless of their EMA status.

PMID:33843181 | DOI:10.1097/MPG.0000000000003047

Stat Med. 2021 Apr 11. doi: 10.1002/sim.8976. Online ahead of print.

ABSTRACT

We propose a multithreshold change plane regression model which naturally partitions the observed subjects into subgroups with different covariate effects. The underlying grouping variable is a linear function of observed covariates and thus multiple thresholds produce change planes in the covariate space. We contribute a novel two-stage estimation approach to determine the number of subgroups, the location of thresholds, and all other regression parameters. In the first stage we adopt a group selection principle to consistently identify the number of subgroups, while in the second stage change point locations and model parameter estimates are refined by a penalized induced smoothing technique. Our procedure allows sparse solutions for relatively moderate- or high-dimensional covariates. We further establish the asymptotic properties of our proposed estimators under appropriate technical conditions. We evaluate the performance of the proposed methods by simulation studies and provide illustrations using two medical data examples. Our proposal for subgroup identification may lead to an immediate application in personalized medicine.

PMID:33843100 | DOI:10.1002/sim.8976

J Prosthodont. 2021 Apr 12. doi: 10.1111/jopr.13363. Online ahead of print.

ABSTRACT

To evaluate the correlation between students’ achieved grades in a preclinical fixed prosthodontics course and their performance in the same discipline’s clinical courses MATERIALS AND METHODS: This study was conducted in 2019 on seventy-six students who passed all preclinical and clinical fixed prosthodontics courses. Their final examination grades in preclinical and clinical prosthodontics courses were compiled and made anonymous. The Statistical Package for the Social Sciences (SPSS Version 23) was used to analyze the data. Descriptive statistics and correlation coefficient were used to assess the relation between preclinical and clinical grades RESULTS: A statistically significant positive correlation existed between the students’ preclinical and combined clinical final examination grades (r = 0.45, p<0.001). In relation to sex, females showed a significantly higher correlation (r = 0.56, p = 0.001) compared to males (r = 0.25, p = 0.1). In addition, students’ clinical grade prediction from their preclinical performance was 20.5% CONCLUSION: These findings emphasize the importance of preclinical courses and suggest that maximizing preclinical years’ efforts can reflect positively on students’ competence in their future clinical practice. This article is protected by copyright. All rights reserved.

PMID:33843102 | DOI:10.1111/jopr.13363

Dermatol Ther. 2021 Apr 11:e14957. doi: 10.1111/dth.14957. Online ahead of print.

ABSTRACT

Keratinizing skin cancers including actinic keratoses (AK), in situ squamous cell carcinoma/Bowen’s disease/intraepidermal carcinoma (IEC), invasive cutaneous squamous cell carcinoma (cSCC) and keratoacanthoma share similar dermatoscopic features and also reveal different patterns that asist in their diagnosis. Recently epidemiological studies reveal the association between antihypertensive drugs and skin cancer risk, especially cSCC. This study aims to determine the dermatoscopic features of keratinizing skin cancer in patients using antihypertensive drug and compare with non-users. A total of 46 patient with 64 keratinizing skin cancer lesions were included in the study. The demographic, clinical characteristic of patients, the number, duration, localization and dermatoscopic features from each lesion were collected. First, we evaluated the dermatoscopic features according to the histopathologic diagnosis. Then, all patients were divided into two groups as users of antihypertensive drugs and non-users. The dermatoscopic features were compared in terms of antihypertensive drug usage and histopathologic diagnosis in antihypertensive drug users and non-users, separately. The users of anti-hypertensive drugs were 22 (47,8%) and non-users 24 (52,2%). Of the total 64 lesions including 47 AK, 5 IEC, 10 cSCC and 2 keratoacanthoma were evaluated. White structureless area was found statistically significant in cSCC lesions of patients using antihypertensive drugs (p=0.004). This finding in cSCC may be a clue for antihypertensive drug usage and these drugs may be a predisposan factor for dermal fibrosis. Regardless of histopathology, dermatoscopic features show no statistically difference between antihypertensive drug users and non-users (p>0.05). Clearer results can be obtained by conducting more detailed and long-term studies. This article is protected by copyright. All rights reserved.

PMID:33843141 | DOI:10.1111/dth.14957

J Texture Stud. 2021 Apr 12. doi: 10.1111/jtxs.12600. Online ahead of print.

ABSTRACT

OBJECTIVES: Due to the importance of providing the appropriate fluid consistency for effective management of swallowing problems (dysphagia) in infants, this project sought to determine the effect of three commercially available thickening agents on the resulting thickened consistencies of commonly prescribed, ready to feed infant formulas.

METHODS: Nine ready-to-feed infant formulas were thickened with three different thickening agents to nectar and honey consistencies following manufacturer’s instructions and their resulting thickness was measured via line spread test. The nine formulas with nothing added to them (thin liquids) and the 27 target-nectar and 27 target-honey samples together created 63 unique samples for comparison. A series of one-way ANOVA analyses were conducted to determine if the resulting thickness (as measured by line spread test values) for target categories of nectar and honey consistencies was significantly influenced by the type of thickening agent used.

RESULTS: The achieved thickness of the formula samples as measured by line spread test values was statistically significantly different for the three different types of thickening agents used to achieve a target nectar consistency, F (2, 24) = 15.55, p < .001, partial eta squared = .709. Additionally, the achieved thickness of the formula samples was statistically significantly different for the three different types of thickening agents used to achieve a target honey consistency, F (2, 24) = 16.18, p < .001, partial eta squared = .709.

CONCLUSIONS: The results of this study reveal that the choice of thickening agent impacts the resulting thickness of ready to feed infant formula.

PMID:33843078 | DOI:10.1111/jtxs.12600

J Sch Health. 2021 Apr 11. doi: 10.1111/josh.13025. Online ahead of print.

ABSTRACT

BACKGROUND: Determination of adequate school nurse staffing is a complex process. School nurse-to-student ratios and the health services school nurses provide to students should be considered. The purpose of this study was to examine the impact of North Carolina school nurse-to-student ratios and school nurse health services on the health and education outcomes (eg, absences, grades, self-management) of students receiving services for asthma and diabetes.

METHODS: This study of all 115 school districts in North Carolina used the Annual School Health Services Report Survey from 2011 to 2016. Descriptive statistics for health services, programs and outcomes, and generalized linear modeling were used to estimate the association of ratios and health services with asthma and diabetes outcomes.

RESULTS: By the 2015-2016 school year, the average ratio decreased to 1:1086 in North Carolina public schools. Annually, 100,187 students received services for asthma, 3832 students received services for type 1 diabetes, and 913 students received services for type 2 diabetes. Lower ratios and nurse health services were associated with improved student outcomes, including decreased absences (p = .05), improved grades (p = .05), and student self-management of their health condition (p = .05).

CONCLUSIONS: Lower school nurse-to-student ratios and services were associated with improvements in students’ health and education outcomes.

PMID:33843082 | DOI:10.1111/josh.13025

J Clin Apher. 2021 Apr 12. doi: 10.1002/jca.21900. Online ahead of print.

ABSTRACT

BACKGROUND: Peripheral venous access has been promoted as the safest, quickest, and most easily achievable route for performing apheresis procedures by the American Society for Apheresis’ Choosing Wisely campaign. The current literature regarding catheter size and selection for both draw and return access is limited. Furthermore, the Infusion Nurses Society recommends using the smallest gauge catheter possible for the prescribed therapy in order to limit vein trauma and phlebitis. Since there is a lack of evidence to guide selection of catheter size for return access during therapeutic apheresis procedures (TAPs) for patients with chronic conditions, this pilot study seeks to compare the performance of a 20-gauge fenestrated (20G) catheter to a standard 18-gauge (18G) intravenous catheter.

METHODS: This non-inferiority pilot study randomized 26 subjects during 74 TAPs to either 20G fenestrated catheter or 18G standard catheter.

RESULTS: There were no statistically significant differences for variables associated with the efficiency of the TAPs comparing 20G to 18G catheter for inlet rate (P = .8666), return pressure (P = .9427), blood processed (P = .4318), or total procedure time (P = .3184).

CONCLUSION: The results from this pilot study suggest that 20G fenestrated catheter is non-inferior to 18G standard catheters. Additional studies with increased power are warranted to confirm these findings.

PMID:33843086 | DOI:10.1002/jca.21900

Atten Percept Psychophys. 2021 Apr 11. doi: 10.3758/s13414-021-02252-x. Online ahead of print.

ABSTRACT

The occupancy model (OM) was proposed to explain how the spatial arrangement of dots in sparse random patterns affects their perceived numerosity. The model’s central thesis maintained that each dot seemingly fills or occupies its surrounding area within a fixed radius r_o and the total area collectively occupied by all the dots determines their apparent number. Because the perceptual system is not adapted for the precise estimation of area, it looks likely that the OM is just a convenient computational algorithm that does not necessarily correspond to the processes that actually take place in the perceptual system. As an alternative, the proximity model (PM) was proposed, which instead relies on a binomial function with the probability β characterizing the perceptual salience with which each element can be registered by the perceptual system. It was also assumed that the magnitude of β is proportional to the distance between a dot and its nearest neighbor. A simulation experiment demonstrated that the occupancy area computed according to the OM can almost perfectly be replicated by the mean nearest neighbor distance. It was concluded that proximity between elements is a critical factor in determining their perceived numerosity, but the exact algorithm that is used for the measure of proximities is yet to be established.

PMID:33843029 | DOI:10.3758/s13414-021-02252-x

Cardiol J. 2021 Apr 12. doi: 10.5603/CJ.a2021.0038. Online ahead of print.

NO ABSTRACT

PMID:33843038 | DOI:10.5603/CJ.a2021.0038