Tag: statistics

Nurs Older People. 2023 Nov 1. doi: 10.7748/nop.2023.e1455. Online ahead of print.

ABSTRACT

BACKGROUND: In the UK, people with delirium superimposed on dementia may be cared for by mental health nurses, however there is little in the literature about the experience of caring for people with the condition from the perspective of mental health nurses.

AIM: To illuminate the experiences of mental health nurses caring for people with delirium superimposed on dementia and to explore how mental health nurses ‘know’ the people they care for using ‘aesthetic ways of knowing’.

METHOD: A mixed-methods design was used guided by the principles of activity theory. Participants were registered mental health nurses with experience of caring for people with delirium superimposed on dementia within a 24-hour care environment, including an NHS mental health foundation trust and care homes. Data were collected in two ways and at two different time points: first via semi-structured interviews (n=7), second via a questionnaire (n=25). Thematic analysis of the qualitative data was paired with simple descriptive statistics of the quantitative data to describe participants’ experience.

FINDINGS: This article discusses one finding from the larger study, which was undertaken as part of the author’s PhD, in relation to the way in which mental health nurses ‘know’ the people they care for. Overall, participants showed a preference for aesthetic ways of knowing, rather than the use of formal assessment tools or scores. Participants experienced caring for people with delirium superimposed on dementia by valuing the person and concentrating on their behaviours, responses and personality, thus enabling them to anticipate and/or recognise potential triggers, precipitating factors and any changes in behaviours.

CONCLUSION: The ways in which mental health nurses know the people they care for influences their care delivery. Mental health nurses’ use of aesthetic ways of knowing should be recognised and valued as a way of better understanding and supporting the person with delirium superimposed on dementia.

PMID:37909070 | DOI:10.7748/nop.2023.e1455

Pediatrics. 2023 Nov 1:e2023063289. doi: 10.1542/peds.2023-063289. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Youth with either autism spectrum disorder (ASD) or gender dysphoria (GD) alone have also been shown to be at greater risk for mental health (MH) concerns; however, very little research has considered how cooccurring ASD and GD may exacerbate MH concerns. The purpose of this study was to examine associations between ASD, GD, and MH diagnoses (anxiety, depression, eating disorder, suicidality, and self-harm) among US adolescent populations.

METHODS: This is a secondary analysis of a large administrative dataset formed by 8 pediatric health system members of the PEDSnet learning health system network. Analyses included descriptive statistics and adjusted mixed logistic regression models testing for associations between combinations of ASD and GD diagnoses and MH diagnoses as recorded in the patient’s electronic medical record.

RESULTS: Based on data from 919 898 patients aged 9 to 18 years, adjusted mixed logistic regression indicated significantly greater odds of each MH diagnosis among those with ASD alone, GD alone, and cooccurring ASD/GD diagnoses compared with those with neither diagnosis. Youth with cooccurring ASD/GD were at significantly greater risk of also having anxiety (average predicted probability, 0.75; 95% confidence interval, 0.68-0.81) or depression diagnoses (average predicted probability, 0.33; 95% confidence interval, 0.24-0.43) compared with youth with ASD alone, GD alone, or neither diagnosis.

CONCLUSIONS: Youth with cooccurring ASD/GD are more likely to also be diagnosed with MH concerns, particularly anxiety and depression. This study highlights the need to implement developmentally appropriate, gender-affirming MH services and interventions for youth with cooccurring ASD/GD.

PMID:37909059 | DOI:10.1542/peds.2023-063289

Front Neurol. 2023 Oct 16;14:1259737. doi: 10.3389/fneur.2023.1259737. eCollection 2023.

ABSTRACT

OBJECTIVES: The primary objective of the present investigation was to meticulously examine the efficacy of high-quality nursing care (HQN) on neurological restoration, amelioration of adverse psychological states, and augmentation of quality of life in geriatric patients diagnosed with acute cerebral infarction (ACI).

METHODS: A cohort of 240 patients, afflicted by ACI and admitted to our healthcare institution between February 2020 and March 2023, were incorporated into this longitudinal prospective analysis. Employing a random number table methodology, the patient cohort was bifurcated into a control group (n = 120) receiving conventional care and an observation group (n = 120) receiving HQN. Comparisons were conducted between the two cohorts concerning neurological functionality [as quantified by the National Institutes of Health Stroke Scales (NIHSS) and Barthel Index (BI) scores], psychological wellbeing [utilizing the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores], overall quality of life [assessed via the Generic Quality of Life Inventory-74 (GQOLI-74) scores], and self-perceived burden [evaluated through the Self-Perceived Burden Scale (SPBS)]. Further assessments included patient satisfaction and incidence of complications, both in the pre- and post-interventional phases.

RESULTS: Post-intervention, the observation group demonstrated superior outcomes compared to the control group, as evidenced by diminished NIHSS and SPBS scores and elevated BI metrics. Moreover, SAS and SDS scores in both groups manifested a decline post-intervention; however, the decrement was statistically more pronounced in the observation group (P < 0.05). Similarly, all dimensions of GQOLI-74 showed an upward trend in both cohorts, yet the increase was significantly more substantial in the observation group (P < 0.05). Furthermore, the observation group exhibited a reduced frequency of complications coupled with heightened levels of nursing satisfaction.

CONCLUSION: The implementation of HQN in the geriatric population afflicted by ACI markedly enhances neurological recuperation, attenuates adverse psychological states, and ameliorates overall quality of life. The intervention is also associated with a diminution in complication rates and an increase in nursing satisfaction, thereby substantiating its clinical utility.

PMID:37909031 | PMC:PMC10613641 | DOI:10.3389/fneur.2023.1259737

Front Oncol. 2023 Oct 16;13:1276037. doi: 10.3389/fonc.2023.1276037. eCollection 2023.

ABSTRACT

BACKGROUND: A survival benefit has been seen for both adjuvant nab-paclitaxel plus gemcitabine (AG) and S-1 chemotherapy compared to gemcitabine (GEM) for resectable pancreatic cancer in the APACT (2019) and JASPAC01 trials (2016), respectively. However, supporting evidence regarding the effectiveness of AG or S-1 compared to gemcitabine in real-world clinical practice remains lacking.

METHODS: Our study included all 246 pancreatic cancer patients who underwent surgical treatment and received postoperative adjuvant chemotherapy with AG, S-1, or GEM except for those meeting exclusion criteria (R2 resection, neoadjuvant therapy, or synchronous malignancy) at Tianjin Medical University Cancer Institute and Hospital from June 2015 to July 2021. The primary outcome was overall survival (OS) and recurrence-free survival (RFS).

RESULTS: In total, 246 patients were included, of whom 54(22%) received adjuvant AG, 103(41%) received adjuvant S-1, and 89(37%) received adjuvant GEM. Adjuvant S-1 was associated with a prolonged OS compared to GEM (median OS S-1 vs GEM: 27.0 vs 20.0 months; HR: 0.65, P = .016) and a significantly prolonged RFS compared to GEM (median RFS S-1 vs GEM: 20.0 vs 8.2 months; HR: 0.58, P = .002). After adjusting for known prognostic factors in multivariate Cox regression analysis, this survival benefit persists and is consistent in most subgroups in our subgroup analysis. However, no statistically significant differences in OS or RFS were seen between patients treated with AG and patients treated with GEM.

CONCLUSIONS: In this retrospective real-world study, adjuvant S-1 chemotherapy was associated with improved survival compared to GEM while no differences in OS or RFS were observed for AG compared to GEM.

PMID:37909023 | PMC:PMC10613992 | DOI:10.3389/fonc.2023.1276037

Front Pediatr. 2023 Oct 16;11:1247455. doi: 10.3389/fped.2023.1247455. eCollection 2023.

ABSTRACT

PURPOSE: The purpose of this study was to observe whether developmental dysplasia of the hip (DDH) affects the development of the femoral head growth plate and to analyze the risk factors.

METHODS: We selected female patients aged between 11 and 20 years with unilateral DDH and unclosed femoral head growth plate (s). The selected patients underwent anteroposterior radiography of the hip joint to compare the degree of development of the femoral head growth plate on both sides and to identify risk factors that affect the development of the growth plate in the femoral head.

RESULTS: We included 48 female patients with unilateral DDH, with an average age of 14 years (range: 11.1-18.5 years) and an average BMI of 20.4 kg/m² (range: 15.5 kg/m²-27.9 kg/m²). Among them, 23 patients had earlier development of the femoral head growth plate on the affected side than on the healthy side, while the degree of development of the femoral head growth plate in 25 patients was the same as that on the contralateral side. When the Tönnis angle was greater than 29.5°C and/or the Reimers migration index was greater than 48.5%, there was a statistically significant difference in the acceleration of femoral head growth plate development.

CONCLUSION: An abnormal relative position of the acetabulum-femoral head caused by DDH can accelerate closure of the femoral head growth plate in immature female patients. The risk factors are a Tönnis angle greater than 29.5°C and/or Reimers migration index greater than 48.5%.

PMID:37908967 | PMC:PMC10613681 | DOI:10.3389/fped.2023.1247455

Cureus. 2023 Sep 30;15(9):e46263. doi: 10.7759/cureus.46263. eCollection 2023 Sep.

ABSTRACT

Background A dental implant is one of the most commonly used treatments to replace missing teeth. A reasonable number of implant cases necessitate using a bone graft before or at the time of implant placement. This study aims to evaluate the quality and readability of online patient-centered information about implant bone grafts. Methodology This cross-sectional study used Google, Yahoo, and Bing search engines. The keywords were entered to screen 900 websites. The DISCERN, Journal of the American Medical Association (JAMA), and Health on the Net (HON) code tools evaluated the included websites for quality. The Flesch reading-ease score (FRES), Flesch-Kincaid grade level, and simple measure of gobbledygook tests measured readability. Statistical analysis was done using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results A total of 161 websites were included; 65 (40.4%) of the included websites belonged to a university or medical center. Only five (3.1%) websites were exclusively related to dental implant treatments. DISCERN showed moderate quality for 82 (50.9%) websites. There was a statistical difference between commercial and non-profit organization websites. In the JAMA evaluation, currency was the most commonly achieved in 67 (41.6%) websites. For the HON code, four (2.5%) websites were certified. Based on FRES, the most common readability category was “fair difficult,” accounting for 64 (39.8%), followed by “standard” in 56 (34.8%) websites. Conclusions The study findings suggest that English-language patient-centered information about implant bone grafts is challenging to comprehend and of low quality. Hence, there is a need to establish websites that provide trustworthy, high-quality information on implant bone grafts.

PMID:37908962 | PMC:PMC10615150 | DOI:10.7759/cureus.46263

Genome Res. 2023 Oct 31. doi: 10.1101/gr.277864.123. Online ahead of print.

ABSTRACT

Differential polyadenylation sites (PAs) critically regulate gene expression, but their cell type-specific usage and spatial distribution in the brain have not been systematically characterized. Here, we present Infernape, which infers and quantifies PA usage from single-cell and spatial transcriptomic data and show its application in the mouse brain. Infernape uncovers alternative intronic PAs and 3′-UTR lengthening during cortical neurogenesis. Progenitor-neuron comparisons in the excitatory and inhibitory neuron lineages show overlapping PA changes in embryonic brains, suggesting that the neural proliferation-differentiation axis plays a prominent role. In the adult mouse brain, we uncover cell type-specific PAs and visualize such events using spatial transcriptomic data. Over two dozen neurodevelopmental disorder-associated genes such as Csnk2a1 and Mecp2 show differential PAs during brain development. This study presents Infernape to identify PAs from scRNA-seq and spatial data, and highlights the role of alternative PAs in neuronal gene regulation.

PMID:37907328 | DOI:10.1101/gr.277864.123

BMJ Open. 2023 Oct 31;13(10):e074440. doi: 10.1136/bmjopen-2023-074440.

ABSTRACT

OBJECTIVES: We aimed to explore the psychometric properties of the first known online asynchronous multiple mini-interview (MMI) designed for fairness with subgroup analyses by key characteristics, usability and acceptability.

DESIGN: Cross-discipline multimethod evaluation.

SETTING: One UK University.

PARTICIPANTS: Applicants to nursing, midwifery and paramedic science undergraduate programmes during 2021-2022.

PRIMARY, SECONDARY OUTCOME MEASURES: Psychometric properties (internal consistency, construct validity, dimensionality) were assessed using Cronbach’s alpha (α), parallel analysis (PA), Schmid-Leiman transformation and ordinal confirmatory factor analysis (CFA). Usability and acceptability were evaluated using descriptive statistics and conventional content analysis.

METHODS: The system was configured in a seven question 4 min MMI. Applicants’ videorecorded their answers which were later assessed by interviewers and scores summed. Applicants and interviewers completed online evaluation questionnaires.

RESULTS: Performance data from 712 applicants determined good-excellent reliability for the asynchronous MMI (mean α 0.72) with similar results across subgroups (gender, age, disability/support needs, UK/non-UK). PA and factor analysis results suggested there were seven factors relating to the MMI questions with an underlying general factor that explained the variance in observed candidate responses. A CFA testing a seven-factor hierarchical model showed an excellent fit to the data (Confirmatory Fit Index=0.99), Tucker Lewis Index=0.99, root mean square error (RMSE) =0.034). Applicants (n=210) viewed the flexibility, relaxed environment and cost savings advantageous. Interviewers (n=65) reported the system to be intuitive, flexible with >70% time saved compared with face-to-face interviews. Reduced personal communication was cited as the principal disadvantage.

CONCLUSIONS: We found that the asynchronous MMI was reliable, time-efficient, fair and acceptable and building fairness in was lost-cost. These novel, insights are applicable across health professions selection internationally informing the future configuration of online interviews to ensure workforces represent the societies they serve.

PMID:37907294 | DOI:10.1136/bmjopen-2023-074440

J Neurointerv Surg. 2023 Oct 31:jnis-2023-020850. doi: 10.1136/jnis-2023-020850. Online ahead of print.

ABSTRACT

BACKGROUND: Infarct growth on multimodal imaging is a common lead outcome in phase 2 proof-of-concept and dose-optimization neuroprotective agent stroke trials. However, the effect size in infarct growth reduction that correlates with clinically meaningful differences in clinical global disability outcomes has not been well delineated.

METHODS: A systematic literature search identified all endovascular thrombectomy randomized trials reporting magnitude of treatment effect on both infarct growth reduction and increase in functional independence (modified Rankin Scale (mRS) 0-2). Data aggregation determined the size of infarct growth reductions salient to four types of clinically meaningful effect sizes of increase in functional independence: (1) the minimal clinically important difference (MCID)-outcome specific; (2) the MCID-practice changing; (3) the realistic target difference; and (4) the reasonable comparability effect size.

RESULTS: A systematic search identified four trials enrolling 612 imaged participants. Across the trials, the amount of functional independence (mRS 0-2) increase associated with each 1 mL reduction in infarct growth was mean 2.3±0.6%. An infarct growth reduction of 0.57 mL correlated with the mRS 0-2 increase MCID of 1.3%. Infarct growth reductions of 2.27 mL, 4.35 mL, and 6.53 mL correlated with realistic effect and reasonable comparability effects sizes of mRS 0-2 increases of 5%, 10%, and 15%, respectively.

CONCLUSION: In formal meta-analysis of randomized treatment trials, every 1 mL reduction in infarct growth was associated with a 2.3% increase in functional independence (mRS 0-2) at 3 months. This conversion factor can inform selection of infarct growth effect size targets for phase 2 trials of neuroprotective agents.

PMID:37907282 | DOI:10.1136/jnis-2023-020850

J Neurol Surg A Cent Eur Neurosurg. 2023 Oct 31. doi: 10.1055/a-2201-8370. Online ahead of print.

ABSTRACT

BACKGROUND: Pituitary adenoma (PA) is a common intracranial endocrine cancer, but no precise target has been found for the effective prediction and treatment of PA.

METHODS: qRT‒PCR analysis showed that circMFN2 could affect the expression of miR-146a-3p in PA samples. Moreover, we used Western blotting to evaluate the expression levels of TRAF6 and NF-κB markers. The EdU assay, scratch wound-healing assay, and matrigel invasion assay were performed to assess the potential function of this pathway in PA cells. Based on the bioinformatics analysis including KEGG, GO analysis and microarray analysis, we evaluated the efficacy of circMFN2 as a potential biomarker for diagnosing PA, and we aimed to determine it mechanism of action in PA cells.

RESULTS: Our findings indicate that there is a significant increase in the expression of circMFN2 in tissues, serum, and exosomes in the invasive group compared to the non-invasive and normal groups. Furthermore, this difference was statistically significant both preoperatively and postoperatively. To clarify its function, we downregulated this gene, and the experimental results suggested that the motility and proliferative capacity were reduced in vitro. In addition, rescue assays showed that miR-146a-3p could successfully reverse the inhibitory effect of circMFN2 knockdown on motility and proliferation in PA cells. Moreover, down-regulation of circMFN2 and miR-146a-3p significantly changed the expression of TRAF6 and NF-κB.

CONCLUSION: This study identified that circMFN2 regulates miR-146a-3p to promote adenoma development partially via the TRAF6/NF-κB pathway and may be a potential therapeutic target for pituitary adenoma.

PMID:37907264 | DOI:10.1055/a-2201-8370