Tag: statistics

Updates Surg. 2023 Jul 10. doi: 10.1007/s13304-023-01573-w. Online ahead of print.

ABSTRACT

Loop ileostomy is commonly performed after LAR with TME to temporarily protect the anastomosis. Usually, defunctioning stoma is closed after 1-6 months, although sometimes it becomes definitive de facto. The aim of this study is to investigate the long-term risk of no-reversal of protective ileostomy after LAR for middle-low rectal cancer and the predictive risk factors. A retrospective analysis of a consecutive cohort of patients who underwent curative LAR with covering ileostomy for extraperitoneal rectal cancer in two colorectal units was performed. A different policy for scheduling stoma closure was applied between centers. All the data were collected through an electronic database (Microsoft Excel^®). Descriptive statistical analysis was performed using Fisher’s exact and Student’s t test. Multivariate logistic regression analysis was conducted. Two-hundred twenty-two patients were analysed: reversal procedure was carried out in 193 patients, in 29 cases stoma was never closed. The mean interval time from index surgery was 4.9 months (Center1: 3 vs. Center2: 7.8). At the univariate analysis, mean age and tumor stage were significantly higher in the “no-reversal” group. Unclosed ostomies were significantly lower in Center 1 than Center 2 (8% vs. 19.6%). At the multivariate analysis female gender, anastomotic leakage and Center 2 had significant higher risk of unclosed ileostomy. Currently, no clinical recommendations have been established and the policy of scheduling stoma reversal is variable. Our study suggests that an established protocol could avoid closure delay, decreasing permanent stomas. Consequently, ileostomy closure should be weighed as standardized step in cancer therapeutic pathway.

PMID:37428410 | DOI:10.1007/s13304-023-01573-w

Qual Life Res. 2023 Jul 10. doi: 10.1007/s11136-023-03475-1. Online ahead of print.

ABSTRACT

PURPOSE: In research people are often asked to fill out questionnaires about their health and functioning and some of the questions refer to serious health concerns. Typically, these concerns are not identified until the statistician analyses the data. An alternative is to use an individualized measure, the Patient Generated Index (PGI) where people are asked to self-nominate areas of concern which can then be dealt with in real-time. This study estimates the extent to which self-nominated areas of concern related to mood, anxiety and cognition predict the presence or occurrence of brain health outcomes such as depression, anxiety, psychological distress, or cognitive impairment among people aging with HIV at study entry and for successive assessments over 27 months.

METHODS: The data comes from participants enrolled in the Positive Brain Health Now (+ BHN) cohort (n = 856). We analyzed the self-nominated areas that participants wrote on the PGI and classified them into seven sentiment groups according to the type of sentiment expressed: emotional, interpersonal, anxiety, depressogenic, somatic, cognitive and positive sentiments. Tokenization was used to convert qualitative data into quantifiable tokens. A longitudinal design was used to link these sentiment groups to the presence or emergence of brain health outcomes as assessed using standardized measures of these constructs: the Hospital Anxiety and Depression Scale (HADS), the Mental Health Index (MHI) of the RAND-36, the Communicating Cognitive Concerns Questionnaire (C3Q) and the Brief Cognitive Ability Measure (B-CAM). Logistic regressions were used to estimate the goodness of fit of each model using the c-statistic.

RESULTS: Emotional sentiments predicted all of the brain health outcomes at all visits with adjusted odds ratios (OR) ranging from 1.61 to 2.00 and c-statistics > 0.73 (good to excellent prediction). Nominating an anxiety sentiment was specific to predicting anxiety and psychological distress (OR 1.65 & 1.52); nominating a cognitive concern was specific to predicting self-reported cognitive ability (OR 4.78). Positive sentiments were predictive of good cognitive function (OR 0.36) and protective of depressive symptoms (OR 0.55).

CONCLUSIONS: This study indicates the value of using this semi-qualitative approach as an early-warning system in predicting brain health outcomes.

PMID:37428407 | DOI:10.1007/s11136-023-03475-1

Appl Biochem Biotechnol. 2023 Jul 10. doi: 10.1007/s12010-023-04637-0. Online ahead of print.

ABSTRACT

Gibberellic acid (GA₃) is a natural hormone present in some plants used in agricultural formulations as a growth regulator. Currently, its production on an industrial scale is performed by submerged fermentation using the fungus Gibberella fujikuroi, which is associated with low yields, leaving the purification stages with high costs. An alternative is solid-state fermentation (SSF), which makes it possible to obtain higher concentrations of product using low-cost substrates, such as agroindustrial by-products. This research investigated the use of raw rice bran (RRB) and barley malt residue (BMR) as substrates for GA₃ production by the fungus Gibberella fujikuroi. Through two statistical designs, the effect of moisture (50 to 70 wt.%) and medium composition (RRB content between 30 and 70 wt.% to a mass ratio between RRB and BMR) was first evaluated. Using the best conditions previously obtained, the effect of adding glucose (carbon source, between 0 and 80 g·L^-1) and ammonium nitrate-NH₄NO₃-(nitrogen source, between 0 and 5 g·L^-1) on GA₃ productivity was analyzed. The best yield was obtained using 30 wt.% RRB and 70 wt.% BMR for a medium with 70 wt.% of moisture after 7 days of process. It was also found that higher concentrations of NH₄NO₃ favor the GA₃ formation for intermediate values of glucose content (40 g·L^-1). Finally, a kinetic investigation showed an increasing behavior in the GA₃ production (10.1 g·kg of substrate^-1 was obtained), with a peak on the seventh day and subsequent tendency to stabilization.

PMID:37428388 | DOI:10.1007/s12010-023-04637-0

Methods Mol Biol. 2023;2680:245-251. doi: 10.1007/978-1-0716-3275-8_15.

ABSTRACT

Planarians are a model animal for the study of regeneration and homeostasis. Understanding how planarians control their cellular balance is key to the knowledge of their plasticity. Both apoptotic and mitotic rates can be quantified in “whole mount” planarians. Apoptosis is usually analyzed through terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL), a technique that detects cell death by identifying DNA breaks. In this chapter we detail a protocol to analyze apoptotic cells in paraffin sections of planarians, which enables a more accurate cellular visualization and quantification than in “whole mount.”

PMID:37428382 | DOI:10.1007/978-1-0716-3275-8_15

Methods Mol Biol. 2023;2680:81-91. doi: 10.1007/978-1-0716-3275-8_5.

ABSTRACT

Whole-mount in situ hybridization (WISH) is an extremely useful technique for visualizing specific mRNA targets and solving many biological questions. In planarians, this method is really valuable, for example, for determining gene expression profiles during whole-body regeneration and analyzing the effects of silencing any gene to determine their functions. In this chapter, we present in detail the WISH protocol routinely used in our lab, using a digoxigenin-labelled RNA probe and developing with NBT-BCIP. This protocol is basically that already described in Currie et al. (EvoDevo 7:7, 2016), which put together several modifications developed from several laboratories in recent years that improved the original protocol developed in the laboratory of Kiyokazu Agata in 1997. Although this protocol, or slight modifications of it, is the most common protocol in the planarian field for NBT-BCIP WISH, our results show that key steps such as the use and time of NAC treatment to remove the mucus need to be taken into account depending on the nature of the gene analyzed, especially for the epidermal markers.

PMID:37428372 | DOI:10.1007/978-1-0716-3275-8_5

Methods Mol Biol. 2023;2680:67-79. doi: 10.1007/978-1-0716-3275-8_4.

ABSTRACT

The capability to simultaneously apply different molecular tools to visualize a wide variety of changes in genetic expression and tissue composition in Schmidtea mediterranea has always been of great interest. The most commonly used techniques are fluorescent in situ hybridization (FISH) and immunofluorescence (IF) detection. Here, we describe a novel way to perform both protocols together adding the possibility to combine them with fluorescent-conjugated lectin staining to further broaden the detection of tissues. We also present a novel lectin fixation protocol to enhance the signal, which could be useful when single-cell resolution is required.

PMID:37428371 | DOI:10.1007/978-1-0716-3275-8_4

Cogn Process. 2023 Jul 10. doi: 10.1007/s10339-023-01145-1. Online ahead of print.

ABSTRACT

Geometric knowledge is one of the important mathematical skills acquired by children at a young age and is a major area of future mathematical learning; however, there is no direct research on the factors influencing kindergarteners’ early geometric knowledge. The pathways model to mathematics was modified to examine the cognitive mechanisms underlying geometric knowledge in Chinese kindergarten children aged 5-7 (n = 99). Quantitative knowledge, visual-spatial processing, and linguistic abilities were stepped into hierarchical multiple regression models. The results revealed that after age, sex, and nonverbal intelligence were statistically controlled, visual perception, phonological awareness, and rapid automatized naming in linguistic abilities significantly predicted the variation in geometric knowledge. For quantitative knowledge, neither dot comparison nor number comparison test could be a significant precursor of geometry skills. The findings indicate that visual perception and linguistic abilities, not quantitative knowledge, account for the geometric knowledge of kindergarten children.

PMID:37428367 | DOI:10.1007/s10339-023-01145-1

Obes Surg. 2023 Jul 10. doi: 10.1007/s11695-023-06725-w. Online ahead of print.

ABSTRACT

INTRODUCTION: Obesity is associated with pelvic floor disorders (PFD). Sleeve gastrectomy (SG) is one of the most effective weight loss methods. Although SG has been found to improve urinary incontinence (UI) and overactive bladder (OAB), its impact on fecal incontinence (FI) remains controversial.

MATERIALS AND METHODS: This prospective, randomized study involved 60 female patients with severe obesity who were randomly assigned to two groups: the SG group and the diet group. The SG group underwent SG, while the diet group received a low-calorie, low-lipid diet for 6 months. The patients’ condition was assessed before and after the study using three questionnaires: the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), the Overactive Bladder 8-Question Awareness Tool (OAB-V8), and the Wexner Score (CCIS).

RESULTS: After 6 months, the SG group had a significantly higher percentage of total weight loss (%TWL) compared to the diet group (p<0.01). Both groups showed a decrease in the ICIQ-FLUTS, OAB-V8, and CCIS scores (p<0.05). UI, OAB, and FI improved significantly in the SG group (p<0.05), but no improvement was observed in the diet group (p>0.05). The correlation between %TWL and PFD was statistically significant but weak, with the strongest correlation between %TWL and ICIQ-FLUTS score and the weakest correlation between %TWL and CCIS score (p<0.05).

CONCLUSIONS: We recommend bariatric surgery for the treatment of PFD. However, given the weak correlation between %TWL and PFD after SG, further research should explore factors other than %TWL that are effective in recovery, particularly in relation to FI.

PMID:37428362 | DOI:10.1007/s11695-023-06725-w

J Racial Ethn Health Disparities. 2023 Jul 10. doi: 10.1007/s40615-023-01696-1. Online ahead of print.

ABSTRACT

ChatGPT represents an advanced conversational artificial intelligence (AI), providing a powerful tool for generating human-like responses that could change pharmacy prospects. This protocol aims to describe the development, validation, and utilization of a tool to assess the knowledge, attitude, and practice towards ChatGPT (KAP-C) in pharmacy practice and education. The development and validation process of the KAP-C tool will include a comprehensive literature search to identify relevant constructs, content validation by a panel of experts for items relevancy using content validity index (CVI) and face validation by sample participants for items clarity using face validity index (FVI), readability and difficulty index using the Flesch-Kincaid Readability Test, Gunning Fog Index, or Simple Measure of Gobbledygook (SMOG), assessment of reliability using internal consistency (Cronbach’s alpha), and exploratory factor analysis (EFA) to determine the underlying factor structures (eigenvalues, scree plot analysis, factor loadings, and varimax). The second phase will utilize the validated KAP-C tool to conduct KAP surveys among pharmacists and pharmacy students in selected low- and middle-income countries (LMICs) (Nigeria, Pakistan, and Yemen). The final data will be analyzed descriptively using frequencies, percentages, mean (standard deviation) or median (interquartile range), and inferential statistics like Chi-square or regression analyses using IBM SPSS version 28. A p<0.05 will be considered statistically significant. ChatGPT holds the potential to revolutionize pharmacy practice and education. This study will highlight the psychometric properties of the KAP-C tool that assesses the knowledge, attitude, and practice towards ChatGPT in pharmacy practice and education. The findings will contribute to the potential ethical integration of ChatGPT into pharmacy practice and education in LMICs, serve as a reference to other economies, and provide valuable evidence for leveraging AI advancements in pharmacy.

PMID:37428357 | DOI:10.1007/s40615-023-01696-1

Med Decis Making. 2023 Jul 10:272989X231182436. doi: 10.1177/0272989X231182436. Online ahead of print.

ABSTRACT

PURPOSE: Older adults are prone to cognitive impairment, which may affect their ability to engage in aspects of shared decision making (SDM) and their ability to complete surveys about the SDM process. This study examined the surgical decision-making processes of older adults with and without cognitive insufficiencies and evaluated the psychometric properties of the SDM Process scale.

METHODS: Eligible patients were 65 y or older and scheduled for a preoperative appointment before elective surgery (e.g., arthroplasty). One week before the visit, staff contacted patients via phone to administer the baseline survey, including the SDM Process scale (range 0-4), SURE scale (top scored), and the Montreal Cognitive Assessment Test version 8.1 BLIND English (MoCA-blind; score range 0-22; scores < 19 indicate cognitive insufficiency). Patients completed a follow-up survey 3 mo after their visit to assess decision regret (top scored) and retest reliability for the SDM Process scale.

RESULTS: Twenty-six percent (127/488) of eligible patients completed the survey; 121 were included in the analytic data set, and 85 provided sufficient follow-up data. Forty percent of patients (n = 49/121) had MoCA-blind scores indicating cognitive insufficiencies. Overall SDM Process scores did not differ by cognitive status (intact cognition $\overline{x}$ = 2.5, s = 1.0 v. cognitive insufficiencies $\overline{x}$ = 2.5, s = 1.0; P = 0.80). SURE top scores were similar across groups (83% intact cognition v. 90% cognitive insufficiencies; P = 0.43). While patients with intact cognition had less regret, the difference was not statistically significant (92% intact cognition v. 79% cognitive insufficiencies; P = 0.10). SDM Process scores had low missing data and good retest reliability (intraclass correlation coefficient = 0.7).

CONCLUSIONS: Reported SDM, decisional conflict, and decision regret did not differ significantly for patients with and without cognitive insufficiencies. The SDM Process scale was an acceptable, reliable, and valid measure of SDM in patients with and without cognitive insufficiencies.

HIGHLIGHTS: Forty percent of patients 65 y or older who were scheduled for elective surgery had scores indicative of cognitive insufficiencies.Patient-reported shared decision making, decisional conflict, and decision regret did not differ significantly for patients with and without cognitive insufficiencies.The Shared Decision Making Process scale was an acceptable, reliable, and valid measure of shared decision making in patients with and without cognitive insufficiencies.

PMID:37427547 | DOI:10.1177/0272989X231182436