Tag: statistics

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2024 Apr;36(4):353-357. doi: 10.3760/cma.j.cn121430-20240109-00025.

ABSTRACT

OBJECTIVE: To investigate the predictive value of left ventricular global longitudinal peak strain (GLPS) for the prognosis of septic patients.

METHODS: A prospective cohort study was conducted. Patients diagnosed with sepsis and admitted to the intensive care unit (ICU) of the First Affiliated Hospital, Sun Yat-sen University from December 2018 to November 2019 were enrolled. The patient characteristics, cardiac ultrasound parameters [left ventricular ejection fraction (LVEF), right ventricular ejection fraction (RVEF), four-dimensional ejection fraction (4DEF), GLPS] and cardiac biomarkers [N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT)] within 24 hours of ICU admission, organ support therapies, severity of illness, and prognostic indicators were documented. The differences in clinical parameters between patients with varying outcomes during ICU hospitalization were assessed. Pearson correlation analysis was employed to explore the correlation between GLPS and other cardiac systolic parameters, as well as the associations between various cardiac systolic parameters and sequential organ failure assessment (SOFA) score. Receiver operator characteristic curve (ROC curve) was drawn to analyze the predictive capacity of cardiac ultrasound parameters and cardiac biomarkers for death during ICU hospitalization in septic patients.

RESULTS: A total of 50 septic patients were enrolled, with 40 surviving and 10 dying during ICU hospitalization, resulting in a mortality of 20.0%. All patients in the death group were male. Compared with the survival group, the patients in the death group were older, had a higher prevalence of diabetes mellitus, and received continuous renal replacement therapy (CRRT) more frequently, additionally, they exhibited more severe illness and had longer length of ICU stay. The levels of GLPS and cTnT in the death group were significantly elevated as compared with the survival group [GLPS: -7.1% (-8.5%, -7.0%) vs. -12.1% (-15.5%, -10.4%), cTnT (μg/L): 0.07 (0.05, 0.08) vs. 0.03 (0.02, 0.13), both P < 0.05]. However, no statistically significant difference was found in other cardiac ultrasound parameters or cardiac biomarkers between the two groups. Pearson correlation analysis revealed a negative correlation between GLPS and LVEF (r = -0.377, P = 0.014) and 4DEF (r = -0.697, P = 0.000), while no correlation was found with RVEF (r = -0.451, P = 0.069). GLPS demonstrated a positive correlation with SOFA score (r = 0.306, P = 0.033), while LVEF (r = 0.112, P = 0.481), RVEF (r = -0.134, P = 0.595), and 4DEF (r = -0.251, P = 0.259) showed no significant correlation with SOFA score. ROC curve analysis indicated that the area under the ROC curve (AUC) of GLPS for predicting death during ICU hospitalization in septic patients was higher than other cardiac systolic parameters, including LVEF, RVEF, and 4DEF, as well as cardiac biomarkers NT-proBNP and cTnT (0.737 vs. 0.628, 0.556, 0.659, 0.580 and 0.724). With an optimal cut-off value of -14.9% for GLPS, the sensitivity and negative predictive value reached to 100%.

CONCLUSIONS: GLPS < -14.9% within 24 hours of ICU admission in septic patients indicated a reduced risk of death risk during ICU hospitalization, while also correlating with the severity of organ dysfunction in this patient population.

PMID:38813627 | DOI:10.3760/cma.j.cn121430-20240109-00025

Adv Physiol Educ. 2024 May 30. doi: 10.1152/advan.00064.2024. Online ahead of print.

ABSTRACT

With the rise of online instruction, a better understanding of the factors that contribute to belonging and motivation in these contexts is essential to creating optimal learning environments. Although group work is known to be beneficial to student success, few studies have investigated its role in the context of asynchronous online courses. The present study addresses this gap through a survey of 146 undergraduate students in an asynchronous online physiology lab over two semesters, one with required group work and one without group work. Students were surveyed to evaluate the influence of group work on their motivation and sense of belonging, as well as their perceptions of inclusive and exclusive features of the course. Students assigned to groups had a higher sense of belonging (P = 0.006) and beliefs about their competence (P = 0.002) and perceived lower effort and psychological costs associated with the course (P = 0.04 and 0.04 respectively) compared to students not assigned to groups. Students assigned to groups reported that peer interactions made them feel included in the course (70% of coded responses) while those not assigned to groups valued instructor interactions (51% of coded responses) as inclusive. Negative peer interactions were commonly reported as exclusive by students assigned to groups (28% of coded responses) while a lack of peer interactions (23% of coded responses) made students not assigned to groups feel excluded. These data indicate that assigning groups in asynchronous online courses is an effective way to increase student motivation and perceptions of belonging.

PMID:38813606 | DOI:10.1152/advan.00064.2024

World J Gastrointest Endosc. 2024 May 16;16(5):259-272. doi: 10.4253/wjge.v16.i5.259.

ABSTRACT

BACKGROUND: Esophageal chromoendoscopy with iodine solution is important for detecting early esophageal cancer. The effect of routine treatment for lesions lightly stained with Lugol’s iodine solution is limited, and the addition of natural substances to a regular diet is becoming increasingly common. Vinegar has antitumor effects as reported in previous studies.

AIM: To evaluate whether vinegar supplementation could improve the prognosis of patients with lightly stained esophageal lesions.

METHODS: This prospective single-centre trial included consecutive patients with lightly stained lesions between June 2020 and April 2022. Patients in the experimental group received increased amounts of vinegar for 6 months. The primary outcome of the study was the clinical therapeutic effect. Complications related to vinegar ingestion and adverse events were also recorded in detail.

RESULTS: A total of 166 patients were included in the final analysis. There was no significant difference in the baseline data between the two groups. Intention-to-treat (ITT) analysis demonstrated that the rates at which endoscopic characteristics improved were 33.72% in the experimental group and 20.00% in the conventional group (P = 0.007); and the rates at which biopsy pathology improved were 19.77% and 8.75%, respectively (P = 0.011). Additional vinegar consumption had a statistically protective effect on the rate at which endoscopic characteristics improved [hazard ratio (HR) _ITT = 2.183, 95%CI: 1.183-4.028; HR_{per-protocol (PP)} = 2.307, 95%CI: 1.202-4.426] and biopsy pathology improved (HR_ITT = 2.931, 95%CI: 1.212-7.089; HR_PP = 3.320, 95%CI: 1.295-8.507). No statistically significant effect of increased vinegar consumption on preventing high-grade intraepithelial neoplasia or early cancer was observed (HR_ITT = 0.382, 95%CI: 0.079-1.846; HR_PP = 0.382, 95%CI: 0.079-1.846). The subgroup analyses indicated that the overall therapeutic improvement of endoscopic characteristics and biopsy pathology seemed more obvious in older (age > 60) male patients with small lesions (lesion size ≤ 0.5 cm). Three patients in the experimental group reported acid regurgitation and heartburn. No adverse event during gastroscopy were recorded during follow-up.

CONCLUSION: A moderately increased ingestion of vinegar could not directly reduce the risk of esophageal cancer in the mucosa dysplasia population, but it improved the endoscopic characteristics and ameliorated the biopsy pathology to a certain extent. Further research is needed to verify the effect of nutritional intervention on precancerous esophageal lesions.

PMID:38813576 | PMC:PMC11130546 | DOI:10.4253/wjge.v16.i5.259

Front Psychol. 2024 May 10;15:1371766. doi: 10.3389/fpsyg.2024.1371766. eCollection 2024.

ABSTRACT

The development of motor competence is thought to be a crucial precursor to raising the trajectory of PA throughout a person’s life. The objectives of this study are to determine motor competence and the daily time of moderate and vigorous physical activity of students in 5th and 6th grade elementary in Chile, and to establish whether there are differences in motor competence according to sex and compliance with physical activity recommendations. 368 schoolchildren (M = 11.10 years; 54.3% girls) participated. To assess motor competence, the MOBAK 5-6 test was used. Physical activity was measured using ActiGraph wGT3X-BT® accelerometers. Boys (M = 3.65, SD = 2.14) showed better performance than girls (M = 2.39, SD = 1.80) in Object Control (p ≤ 0.001, PS = 0.67). For Self-Movement, the girls (M = 2.72, SD = 2.14) performed better than the boys (M = 2.40, SD = 1.86); however, there were no significant differences between the two sexes (p = 0.257). Boys (M = 48.4, SD = 22.8) presented more daily minutes of moderate and vigorous physical activity than girls (M = 35.9, SD = 16.9), with statistically significant differences (p ≤ 0.001, PS = 0.67). About MC according to compliance with the physical activity recommendations, only in Object Control there is a statistically significant difference (p ≤ 0.001; PS = 0.29) between the students who comply with the recommendations (M = 4.28, SD = 2.12) and those who do not achieve the recommended minutes (M = 2.67, SD = 1.29). By contrast, an analysis of Self-Movement found no significant difference (complies: M = 2.73, SD = 1.97; does not comply: M = 2.54, SD = 2.04; p = 0.408) between the two groups. It is necessary to generate instances that develop motor competence in all its dimensions to promote higher levels of moderate to vigorous physical activity.

PMID:38813558 | PMC:PMC11135206 | DOI:10.3389/fpsyg.2024.1371766

Turk J Med Sci. 2023 Oct 10;53(6):1776-1785. doi: 10.55730/1300-0144.5747. eCollection 2023.

ABSTRACT

BACKGROUND/AIM: Community-acquired pneumonia (CAP) is one of the leading infectious causes of mortality, and diabetes mellitus is a globally prevalent disease. Consequently, the cooccurrence of these two disorders can be common and create challenging medical conditions. Therefore, it was aimed to compare the various aspects of CAP in diabetic and nondiabetic patients, in order to have a comprehensive and comparative picture of the differences.

MATERIALS AND METHODS: In this cross-sectional study, CAP patients with and without diabetes were assessed for clinicoradiological signs, laboratory features, disease severity, and pneumonia outcomes.

RESULTS: Analyzed herein were 172 CAP patients (77 had diabetes and 95 were nondiabetic). Clinical and radiological signs of pneumonia were mostly similar between the groups, except for purulent sputum, which was more prevalent among the nondiabetic patients. The laboratory results were also mostly similar. However, analysis of the outcomes and prognosis showed different results. The diabetic patients had a longer mean duration of hospital stay (8.52 days vs. 7.93 days, p = 0.015), higher median pneumonia severity based on the CURB-65 criteria (3 vs. 2, p = 0.016), and higher intensive care unit (ICU) admission requirement (22.1% vs. 7.3%, p = 0.004). Moreover, the mortality rate for the diabetic patients was nonsignificantly higher (16.8% vs. 15.7%, p = 0.453). Furthermore, the results of the logistic regression analysis showed that the diabetic patients had significantly higher odds of experiencing more severe forms of pneumonia (adjusted odds ratio (AOR): 5.77, 95% CI: 2.52-13.20), requiring ICU hospitalization (AOR: 3.56, 95% CI: 1.39-9.11), and having a longer hospital stay (AOR: 2.01, 95% CI: 1.09-3.71). In addition, although there was no significant relationship between the severity of pneumonia and the amount of glycated hemoglobin (HbA1c) in the diabetic patients (p = 0.940), the higher level of HbA1c in the nondiabetic patients was significantly correlated with a higher severity of pneumonia (p = 0.002).

CONCLUSION: While diabetic patients with CAP have the same clinicoradiological and laboratory features as nondiabetic patients, the presence of diabetes can significantly worsen the outcomes and prognosis of pneumonia.

PMID:38813518 | PMC:PMC10760569 | DOI:10.55730/1300-0144.5747

Turk J Med Sci. 2023 Oct 12;53(6):1614-1620. doi: 10.55730/1300-0144.5730. eCollection 2023.

ABSTRACT

BACKGROUND/AIM: This study investigated the possible degeneration in cochlear morphology induced by preeclampsia (PE) and the therapeutic/preventive effect of vitamin D (Vit D) and magnesium sulfate (MgSO₄) used separately and together on feto-maternal outcomes.

MATERIALS AND METHODS: We created PE in rats using a reduced uterine perfusion pressure (RUPP) animal model and recorded blood pressure (BP), embryonic survival (ES), and embryonic weight (EW) and evaluated cochlear morphology by electron microscopy.

RESULTS: The PE group had elevated BP, a decreased number and weight of live pups, and significant degeneration in the cochlea compared to the sham group. In the PEV group, we observed significant beneficial effects of Vit D supplementation at 14.5 and 19.5 dpc in terms of BP (p < 0.05), EW (p < 0.001), and cochlear degeneration compared to the PE group. In the PEM group, BP (p < 0.05) and cochlear degeneration nearly reached the level found in the sham group. However, although the EW was statistically different in the PE group, it did not reach sham group levels. We also observed that BP returned to sham level (p < 0.01) and noticed significant increases in the EW (p < 0.0001) and ES (p = 0.017) in the PEMV group compared to the PE group. According to the scanning electron microscope results, combined administration of VitD and MgSO₄ is more effective than separate administration in improving cochlear degeneration induced by PE.

CONCLUSION: The administration of Vit D and MgSO₄ during pregnancy has beneficial effects on PE pathology and may play a significant role in preventing PE-related complications, including cochlear degeneration.

PMID:38813514 | PMC:PMC10760567 | DOI:10.55730/1300-0144.5730

Turk J Med Sci. 2023 Oct 25;53(6):1840-1851. doi: 10.55730/1300-0144.5754. eCollection 2023.

ABSTRACT

BACKGROUND/AIM: The cause and treatment of electrical status epilepticus during sleep (ESES), one of the epileptic encephalopathies of childhood, is unclear. The aim of this study was to evaluate possible microstructural abnormalities in the brain using advanced magnetic resonance imaging (MRI) techniques in ESES patients with and without genetic mutations.

MATERIALS AND METHODS: This research comprised 12 ESES patients without structural thalamic lesions (6 with genetic abnormalities and 6 without) and 12 healthy children. Whole-exome sequencing was used for the genetic mutation analysis. Brain MRI data were evaluated using tractus-based spatial statistics, voxel-based morphometry, a local gyrification index, subcortical shape analysis, FreeSurfer volume, and cortical thickness. The data of the groups were compared.

RESULTS: The mean age in the control group was 9.05 ± 1.85 years, whereas that in the ESES group was 9.45 ± 2.72 years. Compared to the control group, the ESES patients showed higher mean thalamus diffusivity (p < 0.05). ESES patients with genetic mutations had lower axial diffusivity in the superior longitudinal fasciculus and gray matter volume in the entorhinal region, accumbens area, caudate, putamen, cerebral white matter, and outer cerebellar areas. The superior and middle temporal cortical thickness increased in the ESES patients.

CONCLUSION: This study is important in terms of presenting the microstructural evaluation of the brain in ESES patients with advanced MRI analysis methods as well as comparing patients with and without genetic mutations. These findings may be associated with corticostriatal transmission, ictogenesis, epileptogenesis, neuropsychiatric symptoms, cognitive impairment, and cerebellar involvement in ESES. Expanded case-group studies may help to understand the physiology of the corticothalamic circuitry in its etiopathogenesis and develop secondary therapeutic targets for ESES.

PMID:38813507 | PMC:PMC10760578 | DOI:10.55730/1300-0144.5754

Eur J Cancer. 2024 May 15;206:114118. doi: 10.1016/j.ejca.2024.114118. Online ahead of print.

ABSTRACT

BACKGROUND: Despite contributions provided by the recent clinical trials, several issues and challenges still remain unsolved in adjuvant colon cancer (CC). Hence, further studies should be planned to better refine risk assessment as well as to establish the optimal treatment strategy in the adjuvant setting. However, it is necessary to request adequate, contemporary and relevant variables and report them homogeneously in order to bring maximal information when analyzing their prognostic value.

MATERIAL AND METHODS: The project was devised to gain a consensus from experts engaged in the planning, accrual and analyses of stage II and III CC clinical trials, to identify mandatory and recommended baseline variables in order to i) harmonize future data collection worldwide in clinical trials dedicated to adjuvant treatment of CC; ii) propose guidance for Case Report Forms to be used for clinical trials in this setting. A total of 72 questions related to variables that should be reported and how to report them in adjuvant clinical trials were approved and then voted to reach a final consensus from panelists.

RESULTS: Data items on patient-related factors, histopathological features, molecular profile, circulating biomarkers and blood analyses were analyzed and discussed by the whole expert panel. For each item, we report data supporting the acquired consensus and the relevant issues that were discussed. Nineteen items were deemed to be mandatory for resected stage III patients and 24 for resected stage II disease. In addition, 9 and 4 items were judged as recommended for stage III and II, respectively.

CONCLUSION: In our opinion, these 28 variables should be used and uniformly reported in more comprehensive CRFs as research groups design future clinical trials in the field of adjuvant colon cancer.

PMID:38810317 | DOI:10.1016/j.ejca.2024.114118

Reprod Biomed Online. 2024 Mar 21;49(2):103947. doi: 10.1016/j.rbmo.2024.103947. Online ahead of print.

ABSTRACT

RESEARCH QUESTION: What are the efficacy, safety and reproductive outcomes of intrauterine balloon stent placement for 4 or 6 weeks after hysteroscopic adhesiolysis?

DESIGN: This retrospective cohort study was conducted at a university-affiliated hospital, and included 155 women with moderate to severe intrauterine adhesions who underwent hysteroscopic adhesiolysis between March 2016 and December 2019. Participants were divided according to whether the heart-shaped balloon stent was left in place for 4 (group 1) or 6 (group 2) weeks after surgery. Stents removed at the second-look hysteroscopy 4 or 6 weeks after surgery were sent for culturing of common bacteria. The incidence of adhesion reformation, adhesion score reduction, bacterial colonization of the intrauterine balloon stent, live birth rate and time to live birth were analysed.

RESULTS: Group 2 had a significantly lower adhesion reformation rate (45.7% versus 28.2%, P = 0.024) and a more significant reduction in adhesion score (5.2 ± 2.1 versus 6.3 ± 2.2, P = 0.003) compared with group 1. However, no statistical difference was observed in the percentage of bacterial colonization of the intrauterine balloon stent (55.9% versus 66.7%, P = 0.174), live birth rate (52.4% versus 42.3%, P = 0.331) or time to live birth (hazard ratio 1.09, 95% confidence interval 0.60-1.96, P = 0.778) between the two groups.

CONCLUSIONS: Extending intrauterine balloon stent use from 4 to 6 weeks further reduces the adhesion reformation rate after hysteroscopic adhesiolysis in patients with moderate to severe intrauterine adhesion. No increase in bacterial colonization of the balloon stent was observed. Extending the duration of intrauterine balloon stent placement did not significantly affect live birth rates.

PMID:38810315 | DOI:10.1016/j.rbmo.2024.103947

Med Phys. 2024 May 29. doi: 10.1002/mp.17190. Online ahead of print.

ABSTRACT

BACKGROUND: As radiotherapy techniques advance, so do planning methods for multi-target intracranial SRS cases. Multi-target-single-isocenter (MTSI) planning offers high-precision beam delivery with shortened duration. However, accommodating all targets in a single Patient-Specific-Quality-Assurance (PSQA) with QA devices like SRS MapCHECK (SRS MC) is generally impractical.

PURPOSE: Consequently, we conducted PSQA, using a custom script, by relocating each Target or Neighboring-Target-Group (T-NTG) relative to the beam isocenter on the PSQA device, ensuring each target’s dose coverage at high precision.

METHODS: SRS treatment plans use 6MV-FFF beams, consisting of four Volumetric Modulated ARC Therapy (VMAT) arcs, including one full-arc and three half arcs with couch-kicks. A custom script calculated T-NTG coordinates relative to the beam isocenter. QA verification plans were created for each T-NTG, redefining the beam isocenter for precise alignment with the center of the SRS MC. CBCT images were acquired during PSQA for SRS MC alignment, and gamma-index analysis (GIA) was performed. A single-tail paired t-test assessed the passing rate (PR) for 75 QA verification plans.

RESULTS: GIA with l.0 mm/2.0% criteria for each QA plan yielded a PR > 95.5%, with an average of 98.9%. Plans achieving PR > 99.0% and > 97.0% constituted 63% and 92% of studied plans, respectively. Statistical significance was observed in a t-test with an ideal PR value of 100%, while insignificance was found with a PR value of 99%, suggesting that PSQA for individual targets consistently approaches 99% PR. In MTSI cases using 6MV-FFF beams, targets within the lateral dose-fall-off region require careful verification for acceptability. Our clinical study on individual T-NTG relocation demonstrates that the presented PSQA methods are generally acceptable, supported by a statistically insignificant PR against a 99% PR value.

CONCLUSIONS: Presented statistical analysis results indicate that the proposed PSQA approach can serve as a reliable tool in clinical settings.

PMID:38810282 | DOI:10.1002/mp.17190