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Nevin Manimala Statistics

Interventions to support decision making in people considering germline genetic testing for BRCA 1/2 pathogenic and likely pathogenic variants: A scoping review

J Genet Couns. 2023 Jun 16. doi: 10.1002/jgc4.1738. Online ahead of print.

ABSTRACT

Pathogenic and likely pathogenic variants in BRCA1 and BRCA2 (BRCA1/2) are medically actionable and may inform hereditary breast and ovarian cancer (HBOC) treatment and prevention. However, rates of germline genetic testing (GT) in people with and without cancer are suboptimal. Individuals’ knowledge, attitudes, and beliefs may influence GT decisions. While genetic counseling (GC) provides decision support, the supply of genetic counselors is insufficient to meet demand. Accordingly, there is a need to explore the evidence on interventions that aim to support BRCA1/2 testing decisions. We conducted a scoping review of PubMed, CINAHL, Web of Science, and PsycINFO using search terms related to HBOC, GT, and decision making. First, we screened records to identify peer-reviewed reports that described interventions to support BRCA1/2 testing decisions. Next, we reviewed full-text reports and excluded studies that lacked statistical comparisons or enrolled previously tested individuals. Finally, we extracted study characteristics and findings into a table. All records and reports were reviewed independently by two authors; decisions were tracked in Rayyan, and discrepancies were resolved through discussion. Of 2116 unique citations, 25 met the eligibility criteria. Articles were published between 1997 and 2021 and described randomized trials and nonrandomized, quasi-experimental studies. Most studies tested technology-based (12/25, 48%) or written (9/25, 36%) interventions. Nearly half (12/25, 48%) of interventions were designed to complement traditional GC. Of the interventions compared to GC, 75% (6/8) increased or had a noninferior effect on knowledge, and 67% (4/6) decreased or had a noninferior effect on decisional conflict. Intervention effects on GT uptake were mixed, which may reflect evolving eligibility criteria for GT. Our findings suggest novel interventions may promote informed GT decision making, but many were developed to complement traditional GC. Trials that assess the effects of decision support interventions in diverse samples and evaluate implementation strategies for efficacious interventions are warranted.

PMID:37328917 | DOI:10.1002/jgc4.1738

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Improving the consistency of experimental swine dysentery inoculation strategies

Vet Res. 2023 Jun 16;54(1):49. doi: 10.1186/s13567-023-01180-y.

ABSTRACT

Swine dysentery (SD) caused by pathogenic Brachyspira spp. is an economic challenge for the swine industry. In research settings, experimental reproduction of swine dysentery typically relies on intragastric inoculation which has shown variable success. This project aimed to improve the consistency of the experimental inoculation protocol used for swine dysentery in our laboratory. Over six experiments, we evaluated the influence of group housing in inoculated pigs using a frozen-thawed broth culture of strongly hemolytic B. hyodysenteriae strain D19 (Trial A), compared the relative virulence of B. hyodysenteriae strains D19 and G44 (Trial B), compared inoculum volumes (50 mL vs 100 mL) for G44 and B. hampsonii 30446 (Trial C), and performed three independent trials evaluating intragastric inoculation using different oral inoculation methods: oral feed balls (Trial D), and oral syringe bolus of 100 mL (Trial E) or 300 mL (Trial F). Intragastric inoculation with a fresh broth culture of B. hyodysenteriae strain G44 resulted in a shorter incubation period and a higher proportionate duration of mucohemorrhagic diarrhea (MMHD) compared to D19. Intragastric inoculation with either 50 or 100 mL of B. hampsonii 30446 or B. hyodysenteriae (G44) were statistically equivalent. Oral inoculation with 100 mL or 300 mL also yielded similar results to intragastric inoculation but was more expensive due to the additional work and supplies associated with syringe training. Our future research will use intragastric inoculation with 100 mL of a fresh broth culture containing B. hyodysenteriae strain G44 as it yields a high incidence of mucohaemorrhagic diarrhea with a reasonable cost.

PMID:37328906 | DOI:10.1186/s13567-023-01180-y

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Trueness of cone-beam computed tomography-derived skull models fabricated by different technology-based three-dimensional printers

BMC Oral Health. 2023 Jun 16;23(1):397. doi: 10.1186/s12903-023-03104-w.

ABSTRACT

BACKGROUND: Three-dimensional (3D) printing is a novel innovation in the field of craniomaxillofacial surgery, however, a lack of evidence exists related to the comparison of the trueness of skull models fabricated using different technology-based printers belonging to different cost segments.

METHODS: A study was performed to investigate the trueness of cone-beam computed tomography-derived skull models fabricated using different technology based on low-, medium-, and high-cost 3D printers. Following the segmentation of a patient’s skull, the model was printed by: (i) a low-cost fused filament fabrication printer; (ii) a medium-cost stereolithography printer; and (iii) a high-cost material jetting printer. The fabricated models were later scanned by industrial computed tomography and superimposed onto the original reference virtual model by applying surface-based registration. A part comparison color-coded analysis was conducted for assessing the difference between the reference and scanned models. A one-way analysis of variance (ANOVA) with Bonferroni correction was applied for statistical analysis.

RESULTS: The model printed with the low-cost fused filament fabrication printer showed the highest mean absolute error ([Formula: see text]), whereas both medium-cost stereolithography-based and the high-cost material jetting models had an overall similar dimensional error of [Formula: see text] and [Formula: see text], respectively. Overall, the models printed with medium- and high-cost printers showed a significantly ([Formula: see text]) lower error compared to the low-cost printer.

CONCLUSIONS: Both stereolithography and material jetting based printers, belonging to the medium- and high-cost market segment, were able to replicate the skeletal anatomy with optimal trueness, which might be suitable for patient-specific treatment planning tasks in craniomaxillofacial surgery. In contrast, the low-cost fused filament fabrication printer could serve as a cost-effective alternative for anatomical education, and/or patient communication.

PMID:37328901 | DOI:10.1186/s12903-023-03104-w

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Nevin Manimala Statistics

On weighted k-mer dictionaries

Algorithms Mol Biol. 2023 Jun 17;18(1):3. doi: 10.1186/s13015-023-00226-2.

ABSTRACT

We consider the problem of representing a set of [Formula: see text]-mers and their abundance counts, or weights, in compressed space so that assessing membership and retrieving the weight of a [Formula: see text]-mer is efficient. The representation is called a weighted dictionary of [Formula: see text]-mers and finds application in numerous tasks in Bioinformatics that usually count [Formula: see text]-mers as a pre-processing step. In fact, [Formula: see text]-mer counting tools produce very large outputs that may result in a severe bottleneck for subsequent processing. In this work we extend the recently introduced SSHash dictionary (Pibiri in Bioinformatics 38:185-194, 2022) to also store compactly the weights of the [Formula: see text]-mers. From a technical perspective, we exploit the order of the [Formula: see text]-mers represented in SSHash to encode runs of weights, hence allowing much better compression than the empirical entropy of the weights. We study the problem of reducing the number of runs in the weights to improve compression even further and give an optimal algorithm for this problem. Lastly, we corroborate our findings with experiments on real-world datasets and comparison with competitive alternatives. Up to date, SSHash is the only [Formula: see text]-mer dictionary that is exact, weighted, associative, fast, and small.

PMID:37328897 | DOI:10.1186/s13015-023-00226-2

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Clinical and epidemiological characteristics of 369 patients with pelvic fractures in Eastern Zhejiang Province of China: a retrospective study

BMC Musculoskelet Disord. 2023 Jun 16;24(1):495. doi: 10.1186/s12891-023-06632-2.

ABSTRACT

BACKGROUND: Data on the epidemiological characteristics and prognostic factors of patients with pelvic fractures are lacking, particularly in China. This study aimed to summarise the clinical and epidemiological characteristics of patients with pelvic fractures in eastern Zhejiang Province, China, and to identify risk factors for poor prognosis.

METHODS: The clinical data of 369 patients with pelvic fractures admitted to the Ningbo No. 6 Hospital between September 2020 and September 2021 were retrospectively analysed. Data on the demographic characteristics; fracture classification; injury time, cause, and site; treatment plan; and prognosis were collected using the Picture Archiving and Communication System and the Hospital Information System. Differences in constituent proportions were analysed using the chi-square test. Logistic regression analysis was used to identify factors affecting patient prognosis. Statistical significance was set at p ≤ 0.05.

RESULTS: Among the 369 patients, there were 206 men and 163 women, at a ratio of 1.26:1, and the average age was 53.64 ± 0.78 years. More than 50% of patients were aged 41-65 years. The average length of hospital stay was 18.88 ± 1.78 days. The three most common causes of pelvic fractures were traffic accidents (51.2%), falls from height (31.44%), and flat-ground falls (14.09%). There were significant differences in the distribution of the three causes of injury depending on age (p < 0.001), sex (p < 0.001), and occupation (p < 0.0001). Most patients were manual workers (48.8%). Furthermore, most patients (n = 262, 71.0%) underwent surgical treatment for pelvic fractures. Postoperative complications occurred in 26 patients (7.05%), and infection was the main complication (73.08%). Age (p = 0.013), occupation (p = 0.034), cause of injury (p = 0.022), treatment options (p = 0.001), and complications (p < 0.0001) were independent factors affecting the prognosis of patients with pelvic fractures. One death (0.027%) occurred, which was due to severe blood loss.

CONCLUSIONS: Age, occupation, cause of injury, treatment options and complications were factors affecting patient prognosis. In addition, changes in blood flow and prevention of infection warrant attention.

PMID:37328894 | DOI:10.1186/s12891-023-06632-2

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MicroRNA-361-5p acts as a biomarker for carotid artery stenosis and promotes vascular smooth muscle cell proliferation and migration

BMC Med Genomics. 2023 Jun 16;16(1):134. doi: 10.1186/s12920-023-01563-2.

ABSTRACT

BACKGROUND: Vascular smooth muscle cells (VSMCs) dysfunction participates in carotid artery stenosis (CAS). The study aimed to examine the expression pattern of miR-361-5p in CAS patients, and explore its role in VSMCs proliferation and migration.

METHODS: qRT-PCR was performed for the detection of miR-361-5p in serum samples of 150 CAS cases and 150 healthy people. Multiple logistic regression analysis and receiver operating characteristic (ROC) curve was accomplished to detect diagnostic value via SPSS 21.0 statistical software. Cell function of VSMCs was evaluated. Target association was predicted through bioinformatic analysis and confirmed via luciferase activity.

RESULTS: Serum miR-361-5p was enhanced in CAS cases and was positively correlated with CAS degree. Logistic regression analysis determined the independent influence of miR-361-5p in CAS, and ROC curve demonstrated its diagnostic value with AUC of 0.892. miR-361-5p promoted VSMCs proliferation and migration, but the influence was counteracted by TIMP4.

CONCLUSIONS: MiR-361-5p is a promising biomarker for CAS, and can be used as a potential target for early diagnosis and treatment of CAS. MiR-361-5p can promote VSMCs proliferation and migration via targeting TIMP4.

PMID:37328892 | DOI:10.1186/s12920-023-01563-2

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Nursing, midwifery, and allied health professions research capacities and cultures: a survey of staff within a university and acute healthcare organisation

BMC Health Serv Res. 2023 Jun 16;23(1):647. doi: 10.1186/s12913-023-09612-3.

ABSTRACT

BACKGROUND: There is an increasing focus on the development of research capacity and culture in Nursing, Midwifery and Allied Health Professions (NMAHP). However, better understanding of the existing research success and skills, motivators, barriers, and development needs of NMAHP professionals is required to inform this development. This study sought to identify such factors within a university and an acute healthcare organisation.

METHODS: An online survey, incorporating the Research Capacity and Culture tool, was administered to NMAHP professionals and students at a university and an acute healthcare organisation in the United Kingdom. Ratings of success/skill levels of teams and individuals were compared between professional groups using Mann-Whitney U tests. Motivators, barriers, and development needs were reported using descriptive statistics. Descriptive thematic analysis was used for open-ended text responses.

RESULTS: A total of 416 responses were received (N&M n = 223, AHP n = 133, Other n = 60). N&M respondents were more positive than their AHP counterparts about the success/skill levels of their teams. There were no significant differences between N&M and AHP in their ratings of individual successes/skills. Finding and critically reviewing relevant literature were identified as specific individual strengths; with weaknesses in securing research funding, submitting ethics applications, writing for publication, and advising less experienced researchers. The main motivators for research were to develop skills, increased job satisfaction, and career advancement; whilst barriers included lack of time for research and other work roles taking priority. Key support needs identified included mentorship (for teams and individuals) and in-service training. Open-ended questions generated main themes of ‘Employment & staffing’, ‘Professional services support’, ‘Clinical & academic management’, ‘Training & development’, ‘Partnerships’ and ‘Operating principles’. Two cross-cutting themes described issues common to multiple main themes: ‘Adequate working time for research’ and ‘Participating in research as an individual learning journey’.

CONCLUSIONS: Rich information was generated to inform the development of strategies to enhance research capacity and culture in NMAHP. Much of this can be generic but some nuances may be required to address some specific differences between professional groups, particularly related to perceived team success/skills and priorities identified for support and development.

PMID:37328877 | DOI:10.1186/s12913-023-09612-3

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Utilization of insecticide-treated nets and associated factors among childbearing women in Northern Nigeria

Malar J. 2023 Jun 16;22(1):184. doi: 10.1186/s12936-023-04620-4.

ABSTRACT

BACKGROUND: Studies have explored the correlates of insecticide-treated nets in Nigeria. The few studies that focused on Northern Nigeria mostly examined individual correlates, but largely ignored the community correlates. Also, the persistence of armed insurgencies in the region calls for more research attention. This study examines the utilization and the associated individual and community factors of insecticide-treated nets in Northern Nigeria.

METHODS: The study adopted a cross-sectional design. Data were extracted from the 2021 Nigeria Malaria Indicator Survey (NMIS). A weighted sample size of 6873 women was analysed. The outcome variable was the utilization of insecticide-treated nets. The explanatory variables selected at the individual/household level were maternal age, maternal education, parity, religion, sex of head of household, household wealth, and household size. The variables selected at the community level were the type of place of residence, geo-political zone of residence, the proportion of children under five who slept under a bed net, the proportion of women aged 15-49 who heard malaria media messages, and the community literacy level. Two variables, namely, the number of mosquito bed nets in the household, and the number of rooms used for sleeping were included for statistical control. Three multilevel mixed-effect regression models were fitted.

RESULTS: The majority of childbearing women (71.8%) utilized insecticide-treated nets. Parity and household size were the significant individual/household characteristics associated with the utilization of insecticide-treated nets. The proportion of under-five children in the community who slept under mosquito bed nets, and the geopolitical zone of residence were significant community correlates of the use of insecticide-treated nets. In addition, the number of rooms for sleeping, and the number of mosquito bed nets in the households were significantly associated with the utilization of insecticide-treated nets.

CONCLUSION: Parity, household size, number of sleeping rooms, number of treated bed nets, geo-political zone of residence, and proportion of under-five children sleeping under bed nets are important associated factors of the utilization of insecticide-treated nets in Northern Nigeria. Existing malaria preventive initiatives should be strengthened to target these characteristics.

PMID:37328856 | DOI:10.1186/s12936-023-04620-4

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The association between how medical students were selected and their perceived stress levels in Year-1 of medical school

BMC Med Educ. 2023 Jun 16;23(1):443. doi: 10.1186/s12909-023-04411-0.

ABSTRACT

BACKGROUND: The prevalence of medical students’ mental distress is high. While schools apply various methods to select a well-performing and diverse student population, little is known about the association between different selection methods and the well-being of these students during medical school. The present retrospective multi-cohort study assessed whether students selected by high grades, assessment, or weighted lottery showed different stress perception levels in Year-1 of medical school.

METHODS: Of 1144 Dutch Year-1 medical students, 650 (57%) of the cohorts 2013, 2014, and 2018 who were selected by high grades, assessment, or weighted lottery completed a stress perception questionnaire (PSS-14). A multilevel regression analysis assessed the association between selection method (independent variable) and stress perception levels (dependent variable) while controlling for gender and cohort. In a post-hoc analysis, academic performance (optimal vs. non-optimal) was included in the multilevel model.

RESULTS: Students selected by assessment (B = 2.25, p < .01, effect size (ES) = small) or weighted lottery (B = 3.95, p < .01, ES = medium) had higher stress perception levels than students selected by high grades. Extending the regression model with optimal academic performance (B=-4.38, p < .001, ES = medium), eliminated the statistically significant difference in stress perception between assessment and high grades and reduced the difference between weighted lottery and high grades from 3.95 to 2.45 (B = 2.45, p < .05, ES = small).

CONCLUSIONS: Selection methods intended to create a diverse student population – assessment and lottery – are associated with higher stress perception levels in Year-1 of medical school. These findings offer medical schools insights into fulfilling their responsibility to take care of their students’ well-being.

PMID:37328850 | DOI:10.1186/s12909-023-04411-0

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Scientific creativity and innovation ability and its determinants among medical postgraduate students in Fujian province of China: a cross sectional study

BMC Med Educ. 2023 Jun 16;23(1):444. doi: 10.1186/s12909-023-04408-9.

ABSTRACT

BACKGROUND: Graduate education is the main approach to training high-level innovative elites. With the expansion of the scale of graduate education in China, it has gradually emerged that the lack of innovation ability of graduate students is recognized as the primary problem in graduate education. How to comprehensively improve the quality of postgraduate teaching has become the core task of educational reform and development. However, data about the current cultivation and development of the innovative ability of graduate students in China is limited.

METHODS: A questionnaire survey was conducted among medical postgraduate students. Descriptive statistics and multiple regression analysis methods were used to analyze the data to describe the current innovation ability in advanced medical education and potential influence factors.

RESULTS: A total of 1241 medical students were surveyed, according to the results of questionnaire data analysis. The proportion of subjects who participated in the College Student’s Entrepreneurship and Innovation program or any other scientific research programs are fairly high which are 46.82% and 29.20% respectively. Most of the participants are observed with high levels of self-motivation and active learning and have good performance in creative thinking. However, only a small number of participants (16.6%) reported academic achievements such as publications. Most of the students are satisfied with the current scientific research environment and think that the current postgraduate training system is qualified for the cultivation of innovation ability, and expects the inclusion of course specialized in systemic medicine and medical informatics in the curricula. Multiple logistic regression results showed that among the factors studied, gender, medical specialties, and types of master’s degrees are associated with cognition & skills, academic performance, and creativity.

CONCLUSIONS: It will be important to incorporate more techniques for creating and improving creativity in the curricula of the current postgraduate education, especially for courses such as systemic medicine and informatics. Guidance in earlier school life can stimulate creativity and an early introduction to scientific research work will facilitate innovative thinking and behavior. Scientific research programs such as the National Innovation and Entrepreneurship Training for the universities of PRC have been widely implemented in the undergraduate education system throughout the country. However, the training effectiveness of the current scientific research programs is worth improving.

PMID:37328847 | DOI:10.1186/s12909-023-04408-9