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Nevin Manimala Statistics

Knowledge and attitudes towards cervical cancer prevention among women in Khartoum state, Sudan

Womens Health (Lond). 2023 Jan-Dec;19:17455057231166286. doi: 10.1177/17455057231166286.

ABSTRACT

BACKGROUND: Cervical cancer is considered the third leading cause of death among women worldwide, and human papillomavirus was identified as a major causative agent for developing cervical cancer.

OBJECTIVES: This study aimed to assess the knowledge and attitudes towards cervical cancer prevention among women in Khartoum state, Sudan.

DESIGN: A community-based cross-sectional study implemented in Khartoum state, Sudan, from 1 August 2020 to 1 September 2020.

METHODS: We conducted a descriptive cross-sectional community-based study using an electronic questionnaire for data collection. Descriptive statistics, frequency, mean, and percentage were computed.

RESULTS: The study included 716 female participants with a mean age of 27.6 + 8.7 years. 580 (81.0%) and 229 (32.0%) had heard about cervical cancer and Pap test, respectively. cervical cancer was assumed related to alcohol consumption 109 (15.2%), giving birth to many children 51 (7.1%), ageing 118 (16.5%), and having many sexual partners 335 (46.8%). In addition, 300 (41.9%) attributed cervical cancer to having human papillomavirus infection, 256 (35.6%) to the prolonged use of contraceptives, and 162 (22.6%) to smoking. Knowledge about the best time to be vaccinated against human papillomavirus, 110 (15.4%) stated it is better after marriage. Regression models to predict the effectors on participants’ knowledge and attitudes showed a low standard deviation of the estimates with higher values of the adjusted R2 [R: 0.041, 0.017, and 0.006; std: 1.527, 0.417, and 0.426]. This indicates the combined influence of occupation, educational level, family income, and marital status on the participant’s knowledge and attitude levels.

CONCLUSION: This study revealed that the participant’s knowledge and attitudes levels are mainly driven by their occupation, educational level, family income, and marital status altogether. This underscores the need for a countrywide community engagement campaign through health education and raising awareness sessions, and massive social media to sensitize the community and healthcare providers about the risk of cervical cancer and the available prevention and control measures.

PMID:37070544 | DOI:10.1177/17455057231166286

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Nevin Manimala Statistics

Premature conclusions about the signal-to-noise ratio in structural equation modeling research: A commentary on Yuan and Fang (2023)

Br J Math Stat Psychol. 2023 Apr 18. doi: 10.1111/bmsp.12304. Online ahead of print.

ABSTRACT

In a recent article published in this journal, Yuan and Fang (British Journal of Mathematical and Statistical Psychology, 2023) suggest comparing structural equation modeling (SEM), also known as covariance-based SEM (CB-SEM), estimated by normal-distribution-based maximum likelihood (NML), to regression analysis with (weighted) composites estimated by least squares (LS) in terms of their signal-to-noise ratio (SNR). They summarize their findings in the statement that “[c]ontrary to the common belief that CB-SEM is the preferred method for the analysis of observational data, this article shows that regression analysis via weighted composites yields parameter estimates with much smaller standard errors, and thus corresponds to greater values of the [SNR].” In our commentary, we show that Yuan and Fang have made several incorrect assumptions and claims. Consequently, we recommend that empirical researchers not base their methodological choice regarding CB-SEM and regression analysis with composites on the findings of Yuan and Fang as these findings are premature and require further research.

PMID:37070527 | DOI:10.1111/bmsp.12304

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Prognostic factors and an innovative nomogram model for patients with hepatocellular carcinoma treated with postoperative adjuvant transarterial chemoembolization

Ann Med. 2023 Dec;55(1):2199219. doi: 10.1080/07853890.2023.2199219.

ABSTRACT

PURPOSE: The purpose of this study was to estimate the clinical efficacy and identify the best beneficiaries of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) in hepatocellular carcinoma (HCC).

PATIENTS AND METHODS: A total of 749 HCC patients who underwent surgical resection (380 underwent PA-TACE, 369 had resection only) with a high risk of recurrence were reviewed retrospectively. Patients receiving PA-TACE were randomly split into development and validation cohorts. Univariate and multivariate analyses were performed in the development cohort. A novel model for PA-TACE-insensitivity prediction was built based on univariate and multivariate analysis and was multi-dimensionally validated in the validation set and all samples.

RESULTS: After propensity score matching (PSM), in the early-recurrence group, no significant improvement in RFS was achieved with PA-TACE compared to radical hepatic resection alone. PA-TACE insensitive patients were considered as the PA-TACE non-benefit population and were associated with six clinicopathological factors: AFP, node number, tumor capsule, Ki-67 index, MVI, and complications in the development cohort. These factors were incorporated into a nomogram model, which reliably predicted PA-TACE insensitivity, with concordance indices of 0.874 and 0.897 for the development and validation cohort, respectively. In the overall sample, PA-TACE did not significantly improve patients’ RFS and OS in the high-score group, while the low-score group had statistical significance. Recurrence pattern diversity was also found to be a factor leading to PA-TACE insensitivity.

CONCLUSION: We constructed a new PA-TACE-insensitivity prediction model with potential clinical value. The good predictive performance and availability would allow this model to effectively screen PA-TACE beneficiaries.KEY MESSAGESThe independent influencing factors of PA-TACE insensitivity in patients who received PA-TACE were analyzed to construct a predictive model and its clinical application performance was verified with multi-dimensional methods.PA-TACE treatment should be avoided for patients with high scores according to this model, while it should be cautiously recommended for patients with low scores after multiple considerations.Compared with other related models, this model has obvious advantages in versatility and effectiveness. It can effectively screen the best benefit population of PA-TACE and provide a reliable reference for the selection of precise treatment plans for patients after radical resection of hepatocellular carcinoma.

PMID:37070467 | DOI:10.1080/07853890.2023.2199219

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Pharmacovigilance analysis of cardiac risks associated with Bruton tyrosine kinase inhibitors

Expert Opin Drug Saf. 2023 Apr 18. doi: 10.1080/14740338.2023.2204226. Online ahead of print.

ABSTRACT

BACKGROUND: Bruton tyrosine kinase inhibitors (BTKIs) can be associated with several cardiac risks.

RESEARCH DESIGN AND METHODS: This study was conducted based on records from a large spontaneous reporting database, the Food and Drug Administration Adverse Event Reporting System, for cardiac events reported for several BTKI agents. Reporting odds ratio and information components based on statistical shrinkage transformation were utilized to measure disproportionality.

RESULTS: The final number of records for BTKI-related cardiac events was 10 320. Death or life-threatening events occurred in 17.63% of all associated cardiac records. Significant reporting was captured between BTKI (total/specific) and cardiac events, with the strongest association for ibrutinib. A total of 47 positive signals were evacuated for ibrutinib, with atrial fibrillation being the most commonly reported one. Concomitantly, cardiac failure congestive, cardiac disorder, arrhythmia, pericardial effusion, and atrial flutter, were also noticed for relatively stronger signal and disproportionality. Atrial fibrillation was over-reported in the 3 groups (ibrutinib, acalabrutinib, zanubrutinib), and acalabrutinib had statistically significant lower reporting compared with ibrutinib.

CONCLUSIONS: Receiving ibrutinib, acalabrutinib or zanubrutinib might increase the chance of cardiac complications, with ibrutinib posing the highest risk. The type of cardiotoxicity involved in ibrutinib was highly variable.

PMID:37070462 | DOI:10.1080/14740338.2023.2204226

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Computed tomography-derived membranous septum length as predictor of conduction abnormalities and permanent pacemaker implantation after TAVI: A meta-analysis of observational studies

Catheter Cardiovasc Interv. 2023 Apr 18. doi: 10.1002/ccd.30666. Online ahead of print.

ABSTRACT

BACKGROUND: Permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) is associated with higher risk of mortality and rehospitalization for heart failure. Efforts to prevent conduction abnormalities (CA) requiring PPI after TAVI should be made. The membranous septum (MS) length and its interaction with implantation depth (ID-ΔMSID) could provide useful information about the risk of CA/PPI following TAVI.

OBJECTIVES: To identify MS length and ΔMSID as predictors of CA/PPI following TAVI.

METHODS: Study-level meta-analysis of studies published by September 30, 2022.

RESULTS: Eighteen studies met our eligibility including 5740 patients. Shorter MS length was associated with a significantly higher risk of CA/PPI (per 1 mm decrease: odds ratio [OR] 1.60, 95% confidence interval [CI] 1.28-1.99, p < 0.001). Similarly, lower ΔMSID was associated with a significantly higher risk of CA/PPI (per 1 mm decrease: OR 1.75, 95% CI 1.32-2.31, p < 0.001). Meta-regression analyses revealed a statistically significant modulation of the effect of shorter MS length and lower ΔMSID on the outcome (CA/PPI) by balloon postdilatation (positive regression coefficients with p < 0.001); with increasing use of balloon postdilatation, the effect of shorter MS length and lower ΔMSID on the outcome increased. MS length and ΔMSID demonstrated excellent discriminative abilities, with diagnostic ORs equaling 9.49 (95% CI 4.73-19.06), and 7.19 (95% CI 3.31-15.60), respectively.

CONCLUSION: Considering that short MS length and low ΔMSID are associated with higher risk of CA and PPI, we should include measurement of MS length in the pre-TAVI planning with MDCT and try to establish optimal ID values before the procedure to avoid CA/PPI.

PMID:37070459 | DOI:10.1002/ccd.30666

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Assessment of the potential prophylactic and therapeutic effects of kaempferol on experimental Trichinella spiralis infection

J Helminthol. 2023 Apr 18;97:e36. doi: 10.1017/S0022149X23000184.

ABSTRACT

Currently, no effective treatment is available for trichinellosis, a zoonotic parasitic disease caused by infection with the genus Trichinella. Kaempferol (KPF), a dietary flavonoid, has been documented to have anti-parasitic effects and various medicinal uses. Thus, this study aimed to investigate the efficacy of KPF in preventing and treating the intestinal and muscular phases of trichinellosis in mice compared with albendazole (ABZ). To achieve this, mice were divided into six groups: negative control; positive control; KPF prophylaxis; KPF treatment; ABZ treatment; and a combination of ABZ and KPF. Parasitological, histopathological and immunohistochemical evaluations were conducted to assess the effectiveness of the treatments. The parasitological assessment involved counting small intestinal adult worms and encysted muscle larvae. Additionally, the histopathological evaluation used the haematoxylin and eosin staining method for intestinal and muscular sections and picrosirius red stain for muscular sections. Moreover, the immunohistochemical expression of the intestinal NOD-like receptor-pyrin domain containing 3 (NLRP3) was evaluated. The group treated with combined drugs demonstrated a statistically significant reduction in the count of adults and encysted larvae (P < 0.05), a remarkable improvement in the inflammation of the intestines and muscles and a decrease in the thickness of the larvae’s capsular layer. Additionally, the highest reduction in NLRP3 expression was observed in this group. Based on this study, KPF shows promise as an anti-trichinellosis medication that, when taken with ABZ, has a synergistic impact by modulating inflammation and larval capsule formation.

PMID:37070392 | DOI:10.1017/S0022149X23000184

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The effect of differently modulated communications on the covid-19 pandemic in the young population

Riv Psichiatr. 2023 Mar-Apr;58(2):50-58. doi: 10.1708/4022.39974.

ABSTRACT

BACKGROUND: Media communication during the covid-19 pandemic has been relevant for the population to receive information about the ongoing number of cases, deaths, and social restriction measures. Notably, the effects of the communication methods on young adults during the covid-19 pandemic have not been studied. Therefore the present study aimed to investigate the influence of communication modality about covid-19 on the perception of risk and judgment among young adults.

METHODS: A double-blind cross-sectional study was designed. Three hundred four subjects (age range19-25 years old) saw a 4-minute video concerning data communication on the covid-19 pandemic and compiled an online questionnaire about their perceptions. Two videos were randomized, one presenting the covid-19 data negatively (HARD video) while the other showed a positive ongoing resolution of the pandemic (SOFT video). Association tests and nominal logistic regression were used to evaluate differences in responses among the two groups.

RESULTS: The two videos lead to different reactions. Participants showed higher disagreement concerning the video content in the “SOFT” group compared to the “HARD” group. The responses of the “SOFT” group were more to be optimistic (OR=2.87, 95% CI 1.311-6.27) than those who had seen the “HARD” video. The sense of helplessness was lower in the “SOFT” compared “HARD” group (OR=3.02, 95% CI 1.311-6.96). The perception of fear was higher for the “HARD” group (OR=2.91, 95% CI 1.21-7-02).

DISCUSSION: The modality of data presentation influenced the perception and feelings about the covid-19 pandemic. Likely, pre-existing perception of a pessimistic perspective was present in both groups; thus, the video did not lead to any change in the behavior.

CONCLUSIONS: The phobic or counter-phobic reactions shown in the study participants highlighted the importance of the reliability of the information received and how previous feelings may influence the perception of the information.

PMID:37070331 | DOI:10.1708/4022.39974

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A comparative study of short-term effectiveness of “SkyWalker” robot-assisted versus traditional total knee arthroplasty

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023 Apr 15;37(4):404-409. doi: 10.7507/1002-1892.202212016.

ABSTRACT

OBJECTIVE: To compare the short-term effectiveness of “SkyWalker” robot-assisted total knee arthroplasty (TKA) and traditional TKA.

METHODS: A clinical data of 54 patients (54 knees) with TKA who met the selection criteria between January 2022 and March 2022 was retrospectively analyzed. Among them, 27 cases underwent traditional TKA (traditional operation group) and 27 cases underwent “SkyWalker” robot-assisted TKA (robot-assisted operation group). There was no significant difference between the two groups ( P>0.05) in terms of gender, age, body mass index, osteoarthritis side, disease duration, and preoperative Knee Society Score (KSS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), visual analogue scale (VAS) score, hip-knee-ankle angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), and posterior proximal tibial angle (PPTA). The operative time, intraoperative bleeding volume, surgery-related complications, the KSS, WOMAC, and VAS scores before operation and at 6 months after operation, and Forgotten Joint Score (FJS) at 6 months after operation were recorded. X-ray films were taken to review the prosthesis position and measure HKA, LDFA, MPTA, and PPTA. The differences of the clinical and imaging indicators between before and after operation were calculated and statistically analyzed.

RESULTS: The operations were completed successfully in both groups. There was no significant difference in the operative time and intraoperative bleeding volume between the two groups ( P>0.05). After operation, 1 case of incision nonunion and 1 case of heart failure occurred in the traditional operation group, while no surgery-related complications occurred in the robotic-assisted operation group. The incidences of surgical complications were 7.4% (2/27) in the traditional operation group and 0 (0/27) in the robotic-assisted operation group, with no significant difference ( P=0.491). Patients in both groups were followed up 6 months. KSS score, WOMAC score, VAS score, and ROM significantly improved in both groups at 6 months after operation when compared with preoperative ones ( P<0.05). There was no significant difference between the two groups ( P>0.05) in the differences between the pre- and post-operative values of the clinical indicators and FJS scores at 6 months after operation. X-ray films showed that the lower extremity force lines of the patients improved and the knee prostheses were in good position. Except for LDFA in the robot-assisted operation group, HKA, LDFA, MPTA, and PPTA significantly improved in both groups at 6 months after operation when compared with the preoperative ones ( P<0.05). There was no significant difference between the two groups in the differences between the pre- and post-operative values of the radiological indicators ( P>0.05).

CONCLUSION: The “SkyWalker” robot-assisted TKA is one of the effective methods for the treatment of knee osteoarthritis and had good short-term effectiveness. But the long-term effectiveness needs to be further studied.

PMID:37070305 | DOI:10.7507/1002-1892.202212016

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Effect of Treadmill Backward Walking Training on Motor Capacity in Cerebral Palsy: A Randomized Controlled Study

Ann Rehabil Med. 2023 Apr 18. doi: 10.5535/arm.22154. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate treadmill backward walking training (BWT) effects on walking speed, balance, mobility, and walking endurance in children with cerebral palsy (CP).

METHODS: The study evaluated 41 children with CP (age, 6-18; Gross Motor Function Classification System levels I and II). They were randomly allocated into control and BWT groups. BWT was applied (two sessions/week, 15 min/session for 8-week) to BWT group after the neurodevelopmental-based physiotherapy program routinely followed by all participants while the control group did not receive BWT. 10-Meter Walk Test (10MWT), Pediatric Balance Scale (PBS), Timed Up and Go Test (TUG), and Two-Minute Walk Test (2MWT) were selected as outcome measures for assessing walking speed, balance, mobility and endurance respectively.

RESULTS: In BWG, 2MWT distance (3.5%), PBS (3.5%) increased significantly, and TUG decreased by 5.1% (all p<0.001) after training, 10MWT was shorter by 6.1% for BWG, corresponding to 7.4% faster walking speed (p<0.01). Control group assessment variations were stationary and not statistically significant.

CONCLUSION: Backward treadmill walking training induces small but statistically significant motor capacity improvements in children with CP.

PMID:37070285 | DOI:10.5535/arm.22154

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Impact of a daily legume-based meal on dietary and nutritional intake in a group of omnivorous adults

Nutr Bull. 2023 Apr 18. doi: 10.1111/nbu.12613. Online ahead of print.

ABSTRACT

Adopting eco-friendly diets will demand the consumption of more plant-based protein food sources such as legumes. However, assessing the impact of such a dietary shift on the dietary and nutritional intake of traditionally omnivorous populations is needed. The objective of this study was to assess the impact of substituting a traditional omnivorous-based lunch for a vegetarian, legume-based meal on the daily dietary and nutritional intake in a group of omnivorous adults in the city of Porto, Portugal. Nineteen, non-vegetarian, healthy young adults consumed a vegetarian, legume-based meal from Monday to Friday, for 8 consecutive weeks. Socio-demographic data, health status, lifestyle-related information and anthropometric parameters were recorded. Three-day food records were used to collect food intake at baseline and week 8. European Food Safety Authority and World Health Organization reference values were used to assess nutritional inadequacies. Variables were described as medians (P25 and P75 ). Wilcoxon signed-rank and Mann-Whitney tests were used for statistical comparisons. A p-value of <0.05 was considered statistically significant. Participants consumed 38.0 (P25 = 35.0; P75 = 40.0) meals, resulting in an intake of 84.5 g (P25 = 74.9; P75 = 98.4) of cooked legumes per meal, meaning 11 subjects (57.9%) met the Portuguese guidelines for legume consumption (≥80 g/day of legumes). The current dietary intervention did not seem to aggravate the prevalence of nutritional inadequacies for the macro- and micronutrients tested, except for the case of vitamin B12 (52.6% [95% CI: 28.9-75.6] vs. 78.9% [95% CI: 54.4-94.0]). This could be linked to the reduction of dietary sources of this vitamin which is an expected consequence of vegetarian meals. Dietary changes towards grain legume-based diets are desirable yet need to be carefully implemented to prevent exacerbating potential nutrient inadequacies, especially of vitamin B12 .

PMID:37070278 | DOI:10.1111/nbu.12613