Tag: statistics

BMC Public Health. 2023 Jan 19;23(1):134. doi: 10.1186/s12889-023-15008-z.

ABSTRACT

BACKGROUND: Appropriate gestational weight gain (GWG) is essential for maternal and fetal health. For twin pregnancies among Caucasian women, the Institute of Medicine (IOM) guidelines can be used to monitor and guide GWG. We aimed to externally validate and compare the IOM guidelines and the recently released guidelines for Chinese women with twin pregnancies regarding the applicability of their recommendations on total GWG (TGWG).

METHOD: A retrospective cohort study of 1534 women who were aged 18-45 years and gave birth to twins at ≥ 26 gestational weeks between October 2016 and June 2020 was conducted in Guangzhou, China. Women’s TGWG was categorized into inadequate, optimal, and excess per the IOM and the Chinese guidelines. Multivariable generalized estimating equations logistic regression was used to estimate the risk associations between TGWG categories and adverse neonatal outcomes. Cohen’s Kappa coefficient was calculated to evaluate the agreement between the IOM and the Chinese guidelines.

RESULTS: Defined by either the IOM or the Chinese guidelines, women with inadequate TGWG, compared with those with optimal TGWG, demonstrated higher risks of small-for-gestational-age birth and neonatal jaundice, while women with excess TGWG had a higher risk of delivering large-for-gestational-age infants. The agreement between the two guidelines was relatively high (Kappa coefficient = 0.721). Compared with those in the optimal TGWG group by both sets of the guidelines, women classified into the optimal group by the Chinese guidelines but into the inadequate group by the IOM guidelines (n = 214) demonstrated a statistically non-significant increase in the risk of all the adverse neonatal outcomes combined.

CONCLUSIONS: The IOM and the Chinese guidelines are both applicable to Chinese women with twin pregnancies.

PMID:36658532 | DOI:10.1186/s12889-023-15008-z

BMC Med Educ. 2023 Jan 19;23(1):42. doi: 10.1186/s12909-023-04006-9.

ABSTRACT

BACKGROUND: Undergraduate medical curricula often fail to integrate experiential learning methodologies. Thus, a pilot series of interactive pathology lessons was designed and implemented in an attempt to promote experiential learning.

METHODS: Thirty pre-graduate medical students voluntarily participated in the interactive study groups at the First Department of Pathology of the National and Kapodistrian University of Athens, Medical School. A questionnaire was designed to investigate the satisfaction of students regarding their participation in pathology study groups and to identify the characteristics that shape students’ perceptions of the foundations of medical education. Descriptive statistics (mean values) were used to describe the students’ evaluations of the pathology study groups, and thematic analysis was conducted to investigate the data collected using open-ended questions.

RESULTS: Interactions with the professor and the option of co-observing the slides using dual-view optical microscopes and virtual slides were each evaluated as “Excellent” by ≅ 95% of the students. Four overarching themes were identified regarding the core characteristics of medical education according to the students’ perspectives: 1) educational background in medical education, 2) interaction with educators in medical education, 3) educational material in medical education and 4) assessment in medical education.

CONCLUSIONS: The high rates of acceptance of the pathology study groups reflect the desire and need for active learning methodologies to be implemented in modern medical education. Nearly all the students mentioned the need for practical skill acquisition, the integration of theory into practice and ethics in medical education. The success of these optional pathology study groups highlights the need for similar modalities to be incorporated into the main medical education curriculum.

PMID:36658528 | DOI:10.1186/s12909-023-04006-9

BMC Womens Health. 2023 Jan 19;23(1):26. doi: 10.1186/s12905-022-02152-8.

ABSTRACT

BACKGROUND: Abortion stigma likely affects the terminology abortion patients, providers and the public use or avoid using to refer to abortion care. Knowing the terminology people seeking abortion prefer could help inform the language used in clinical interactions and improve patients’ experiences with abortion care. However, research in the U.S. has not examined patients’ preferences in this area or whether terminology preferences vary by participant characteristics, in the way that experiences of stigma vary across different contexts and communities. This study aims to describe preferred terminology among people presenting for abortion care and to explore the pregnancy-related characteristics associated with these preferences.

METHODS: We surveyed abortion patients about their experiences accessing abortion care, including preferred terms for the procedure. Respondents could mark more than one term, suggest their own term, or indicate no preference. We recruited people ages 15-45 seeking abortion from four U.S. abortion facilities located in three states (California, Illinois, and New Mexico) from January to June 2019. We used descriptive statistics and multivariable multinomial logistic regression to explore associations between respondents’ pregnancy-related characteristics and their preferred terminology.

RESULTS: Among the 1092 people approached, 784 (77%) initiated the survey and 697 responded to the terminology preference question. Most participants (57%, n = 400) preferred only one term. Among those participants, “abortion” (43%) was most preferred, followed by “ending a pregnancy” (29%), and “pregnancy termination” (24%). In adjusted multivariable models, participants who worried “very much” that other people might find out about the abortion (29%) were significantly more likely than those who were “not at all” worried (13%) to prefer “ending a pregnancy” over having no preference for a term (adjusted relative risk ratio: 2.68, 95% Confidence Interval: 1.46-4.92).

CONCLUSIONS: People seeking abortion have varied preferences for how they want to refer to their abortions, in particular if they anticipate abortion stigma. Findings can be useful for clinicians and researchers so that they can be responsive to people’s preferences during clinical interactions and in the design and conduct of abortion research.

PMID:36658525 | DOI:10.1186/s12905-022-02152-8

BMC Complement Med Ther. 2023 Jan 19;23(1):16. doi: 10.1186/s12906-023-03833-z.

ABSTRACT

BACKGROUND: Considerable number of people still use opium worldwide and many believe in opium’s health benefits. However, several studies proved the detrimental effects of opium on the body, especially the cardiovascular system. Herein, we aimed to provide the first evidence regarding the effects of opium use on one-year major adverse cardiovascular events (MACE) in the patients with ST-elevation MI (STEMI) who underwent primary PCI.

METHODS: We performed a propensity score matching of 2:1 (controls: opium users) that yielded 518 opium users and 1036 controls. Then, we performed conventional statistical and machine learning analyses on these matched cohorts. Regarding the conventional analysis, we performed multivariate analysis for hazard ratio (HR) of different variables and MACE and plotted Kaplan Meier curves. In the machine learning section, we used two tree-based ensemble algorithms, Survival Random Forest and XGboost for survival analysis. Variable importance (VIMP), tree minimal depth, and variable hunting were used to identify the importance of opium among other variables.

RESULTS: Opium users experienced more one-year MACE than their counterparts, although it did not reach statistical significance (Opium: 72/518 (13.9%), Control: 112/1036 (10.8%), HR: 1.27 (95% CI: 0.94-1.71), adjusted p-value = 0.136). Survival random forest algorithm ranked opium use as 13th, 13th, and 12th among 26 variables, in variable importance, minimal depth, and variable hunting, respectively. XGboost revealed opium use as the 12th important variable. Partial dependence plot demonstrated that opium users had more one-year MACE compared to non-opium-users.

CONCLUSIONS: Opium had no protective effects on one-year MACE after primary PCI on patients with STEMI. Machine learning and one-year MACE analysis revealed some evidence of its possible detrimental effects, although the evidence was not strong and significant. As we observed no strong evidence on protective or detrimental effects of opium, future STEMI guidelines may provide similar strategies for opium and non-opium users, pending the results of forthcoming studies. Governments should increase the public awareness regarding the evidence for non-beneficial or detrimental effects of opium on various diseases, including the outcomes of primary PCI, to dissuade many users from relying on false beliefs about opium’s benefits to continue its consumption.

PMID:36658513 | DOI:10.1186/s12906-023-03833-z

Diabetes Metab Res Rev. 2023 Jan 19:e3616. doi: 10.1002/dmrr.3616. Online ahead of print.

ABSTRACT

AIMS: To develop and validate a risk prediction model for Chinese patients with type 2 diabetes with the recurrence of diabetes foot ulcers (DFU) based on systematic review and meta-analysis.

METHODS: A prospective analysis was performed with 1333 participants and followed up for 60 months. Three models were analyzed using derived cohort. The risk factors were screened by meta-analysis and logistic regression, and the missing variables were interpolated by multiple imputation. The internal validation was performed by the bootstrap procedure, validation cohort was applied to the external validation. The performance of model was evaluated the area under the discrimination receiver Operating Characteristic Curve (ROC). The calibration and discrimination methods were used for the validation cohort. The variables were selected according to their clinical and statistical importance to construct the nomograms.

RESULTS: Three models were developed and validated. Model 1 included seven social and clinical indicators like Sex, DM duration, Previous DFU, Location of ulcer, Smoker, History of amputation and Foot deformity. Model 2 included four more indicators besides those in Model 1, which were Statin agents used, Antiplatelet agents used, SBP and BMI. Model 3 added further laboratory indicators to Model 2 such as LDL-C, HbA1C, FIB and BUN. In the derivation cohort, 20.1% (206/1027) participants with DFU were recurred as compared to the validation cohort, which was 38.2% (117/306). The AUC in the derivation cohort for Models1-3 were 0.781 (0.744-0.817), 0.843 (0.813-0.873) and 0.899 (0.876-0.922) respectively. The Youden index for Model 1-3 were 0.430, 0.559 and 0.653 respectively. Model 3 showed the highest sensitivity and specificity. All models performed well for both discrimination and calibration.

CONCLUSION: Model 1-2 were non-invasive, which indicated their role in general screening for patients at the high-risk of recurrence DFU. However, Model 3 offered a more specific screening due to its best performance in predicting the risk of DFU recurrence amongst three models. This article is protected by copyright. All rights reserved.

PMID:36657181 | DOI:10.1002/dmrr.3616

Physiol Meas. 2023 Jan 19. doi: 10.1088/1361-6579/acb4dd. Online ahead of print.

ABSTRACT

OBJECTIVE: Pulse wave velocity (PWV) is a key diagnostic parameter of the cardiovascular system state. However, the approaches aimed at the PWV characterization often suffer from inevitable drawbacks. The statistical results demonstrating how closely the PWV in the radial artery (RA) and the respiration phase correlate, as well as the RA PWV evolution during breath-holding (BH), have not been presented in the literature yet. The aims of this study are: a) to propose a simple robust technique for measuring RA PWV, b) to reveal the phase relation between the RA PWV and spontaneous breathing, c) to disclose the BH influence on the RA PWV.

APPROACH: The high-resolution remote breathing monitoring method, Sorption-Enhanced Infrared Thermography (SEIRT), and the described new technique aimed at measuring RA PWV, were used synchronously, and their measurement data were processed simultaneously.

MAIN RESULTS: Spontaneous breathing leaves a synchronous “trace” on the RA PWV. The close linear correlation of the respiration phase and the phase of concomitant RA PWV changes is statistically confirmed in 5 tested persons (Pearson’s r is of the order of 0.5-0.8, P<0.05). The BH appreciably affects the RA PWV. A phenomenon showing that the RA PWV is not indifferent to hypoxia is observed for the first time.

SIGNIFICANCE: The proposed technique for the RA PWV characterization has high prospects in biomedical diagnostics. The presented pilot study deserves attention in the context of mutual respiratory and cardiovascular systems interplay. It may also be useful in cases where the peripheral pulse wave propagation helps assess the respiratory function.

PMID:36657177 | DOI:10.1088/1361-6579/acb4dd

Nutr Neurosci. 2023 Jan 19:1-12. doi: 10.1080/1028415X.2023.2166803. Online ahead of print.

ABSTRACT

BACKGROUND: Functional connectivity (FC) measures statistical dependence between cortical brain regions. Studies of FC facilitate understanding of the brain’s function and architecture that underpin normal cognition, behavior, and changes associated with various factors (e.g. nutritional supplements) at a large scale.

OBJECTIVE: We aimed to identify modifications in FC patterns and targeted brain anatomies in piglets following perinatal intake of different nutritional diets using a graph theory based approach.

METHODS: Forty-four piglets from four groups of pregnant sows, who were treated with nutritional supplements, including control diet, docosahexaenoic acid (DHA), egg yolk (EGG), and DHA + EGG, went through resting-state functional magnetic resonance imaging (rs-fMRI). We introduced the use of differential degree test (DDT) to identify differentially connected edges (DCEs). Simulation studies were first conducted to compare the DDT with permutation test, using three network structures at different noise levels. DDT was then applied to rs-fMRI data acquired from piglets.

RESULTS: In simulations, the DDT showed a greater accuracy in detecting DCEs when compared with the permutation test. For empirical data, we found that the strength of internodal connectivity is significantly increased for more than 6% of edges in the EGG group and more than 8% of edges in the DHA and DHA + EGG groups, all compared to the control group. Moreover, differential wiring diagrams between group comparisons provided means to pinpoint brain hubs affected by nutritional supplements.

CONCLUSION: DDT showed a greater accuracy of detection of DCEs and demonstrated EGG, DHA, and DHA + EGG supplemented diets lead to an improved internodal connectivity in the developing piglet brain.

PMID:36657164 | DOI:10.1080/1028415X.2023.2166803

Gac Med Mex. 2022;158(6):376-385. doi: 10.24875/GMM.M22000716.

ABSTRACT

INTRODUCTION: To the best of our knowledge, the research herein presented is the first multicenter study in Mexico to analyze the development of clinical aptitude in medical units that train cardiologists.

OBJECTIVE: To determine the degree of development of clinical aptitude in cardiology residents at three High Specialty Medical Units.

METHODS: Multicenter, cross-sectional design. All students of the 2019-2020 academic year were included in the study. An instrument was constructed that evaluated clinical aptitude based on eight indicators and 170 items; conceptual/content validity and reliability were assessed by five cardiologists with teaching and educational research experience.

RESULTS: By indicator and year of residence, significant statistical differences were observed in the CMN20Nov academic site. At HCSXXI and INCICh, statistically significant differences were observed in one of eight indicators. Differences between R1 residents (n = 41) of all three academic sites were estimated by indicator, with statistical significance being recorded in three of eight indicators. Between R2 (n = 35) and between R3 residents (n = 43), the result was similar.

CONCLUSIONS: The degree of clinical aptitude development can be considered intermediate in all three academic sites, probably because the instrument explored problematized clinical situations that required for the residents to critically reflect on their clinical experience.

PMID:36657137 | DOI:10.24875/GMM.M22000716

Gac Med Mex. 2022;158(6):423-429. doi: 10.24875/GMM.M22000722.

ABSTRACT

INTRODUCTION: A national survey in the general population showed that gastroesophageal reflux disease (GERD) is highly prevalent in Mexico.

OBJECTIVE: To compare the efficacy and safety of two isomers, dexrabeprazole (10 mg) vs. esomeprazole (20 mg), in the treatment of GERD for four weeks.

METHODS: Randomized, multicenter, prospective, double-blind phase III clinical trial in two groups that included 230 patients.

RESULTS: A statistically significant decrease in the severity of GERD symptoms (heartburn, regurgitation, epigastric pain and dysphagia), evaluated using a visual analogue scale, was observed with both treatments. Mean score for dexrabeprazole on Carlsson-Dent questionnaire at 28 days was 2.12, and for esomeprazole, 3.02. Both treatments were effective, with no statistically significant difference being recorded (p < 0.05). On SF-36 health questionnaire, both were observed to improve the quality-of-life score, with no significant difference being identified. Both drugs were well tolerated, and the adverse event incidence profile was low.

CONCLUSIONS: In the treatment of non-erosive GERD, the use of dexrabeprazole at 10 mg/day is as effective as esomeprazole 20 mg/day, with the advantage that the dose is lower with an appropriate safety profile.

PMID:36657136 | DOI:10.24875/GMM.M22000722