Tag: statistics

Nutr Metab (Lond). 2023 Mar 9;20(1):14. doi: 10.1186/s12986-023-00736-1.

ABSTRACT

BACKGROUND: The associations between obesity and abnormalities of upper and lower extremity arteries remain to be elucidated. This study is aimed to investigate whether general obesity and abdominal obesity are associated with upper and lower extremity artery diseases in a Chinese community population.

METHODS: This cross-sectional study included 13,144 participants in a Chinese community population. The associations between obesity parameters and abnormalities of upper and lower extremity arteries were evaluated. Multiple logistic regression analysis was used to assess the independence of associations between obesity indicators and abnormalities of peripheral arteries. Nonlinear relationship between body mass index (BMI) and risk of ankle-brachial index (ABI) ≤ 0.9 was evaluated using a restricted cubic spline model.

RESULTS: The prevalence of ABI ≤ 0.9 and interarm blood pressure difference (IABPD) ≥ 15 mmHg in the subjects was 1.9% and 1.4% respectively. Waist circumference (WC) was independently associated with ABI ≤ 0.9 (OR 1.014, 95% CI 1.002-1.026, P = 0.017). Nevertheless, BMI was not independently associated with ABI ≤ 0.9 using linear statistical models. Meanwhile, BMI and WC were independently associated with IABPD ≥ 15 mmHg respectively (OR 1.139, 95% CI 1.100-1.181, P < 0.001, and OR 1.058, 95% CI 1.044-1.072, P < 0.001). Furthermore, prevalence of ABI ≤ 0.9 was displayed with a U-shaped pattern according to different BMI (< 20, 20 to < 25, 25 to < 30, and ≥ 30). Compared with BMI 20 to < 25, risk of ABI ≤ 0.9 was significantly increased when BMI < 20 or ≥ 30 respectively (OR 2.595, 95% CI 1.745-3.858, P < 0.001, or OR 1.618, 95% CI 1.087-2.410, P = 0.018). Restricted cubic spline analysis indicated a significant U-shaped relationship between BMI and risk of ABI ≤ 0.9 (P for non-linearity < 0.001). However, prevalence of IABPD ≥ 15 mmHg was significantly increased with incremental BMI (P for trend < 0.001). Compared with BMI 20 to < 25, the risk of IABPD ≥ 15 mmHg was significantly increased when BMI ≥ 30 (OR 3.218, 95% CI 2.133-4.855, P < 0.001).

CONCLUSIONS: Abdominal obesity is an independent risk factor for upper and lower extremity artery diseases. Meanwhile, general obesity is also independently associated with upper extremity artery disease. However, the association between general obesity and lower extremity artery disease is displayed with a U-shaped pattern.

PMID:36894935 | DOI:10.1186/s12986-023-00736-1

JMIR Med Educ. 2023 Mar 9;9:e43988. doi: 10.2196/43988.

ABSTRACT

BACKGROUND: Teaching medicine is a complex task because medical teachers are also involved in clinical practice and research and the availability of cases with rare diseases is very restricted. Automatic creation of virtual patient cases would be a great benefit, saving time and providing a wider choice of virtual patient cases for student training.

OBJECTIVE: This study explored whether the medical literature provides usable quantifiable information on rare diseases. The study implemented a computerized method that simulates basic clinical patient cases utilizing probabilities of symptom occurrence for a disease.

METHODS: Medical literature was searched for suitable rare diseases and the required information on the respective probabilities of specific symptoms. We developed a statistical script that delivers basic virtual patient cases with random symptom complexes generated by Bernoulli experiments, according to probabilities reported in the literature. The number of runs and thus the number of patient cases generated are arbitrary.

RESULTS: We illustrated the function of our generator with the exemplary diagnosis “brain abscess” with the related symptoms “headache, mental status change, focal neurologic deficit, fever, seizure, nausea and vomiting, nuchal rigidity, and papilledema” and the respective probabilities from the literature. With a growing number of repetitions of the Bernoulli experiment, the relative frequencies of occurrence increasingly converged with the probabilities from the literature. For example, the relative frequency for headache after 10.000 repetitions was 0.7267 and, after rounding, equaled the mean value of the probability range of 0.73 reported in the literature. The same applied to the other symptoms.

CONCLUSIONS: The medical literature provides specific information on characteristics of rare diseases that can be transferred to probabilities. The results of our computerized method suggest that automated creation of virtual patient cases based on these probabilities is possible. With additional information provided in the literature, an extension of the generator can be implemented in further research.

PMID:36892938 | DOI:10.2196/43988

JMIR Public Health Surveill. 2023 Mar 9;9:e43893. doi: 10.2196/43893.

ABSTRACT

BACKGROUND: A life-course immunization approach would enhance the quality of life across all age groups and improve societal well-being. The herpes zoster (HZ) vaccine is highly recommended for older adults to prevent HZ infection and related complications. The proportions of willingness to receive the HZ vaccine varies across countries, and various kinds of factors, including sociodemographics and individual perceptions, influence the willingness to vaccinate.

OBJECTIVE: We aim to estimate the HZ vaccination willingness rate and identify factors associated with vaccine uptake willingness across all World Health Organization (WHO) regions.

METHODS: A global systematic search was performed on PubMed, Web of Science, and the Cochrane Library for all papers related to the HZ vaccine published until June 20, 2022. Study characteristics were extracted for each included study. Using double arcsine transformation, vaccination willingness rates with 95% CIs were pooled and reported. The willingness rate and associated factors were analyzed by geographical context. Associated factors were also summarized based on Health Belief Model (HBM) constructs.

RESULTS: Of the 26,942 identified records, 13 (0.05%) papers were included, covering 14,066 individuals from 8 countries in 4 WHO regions (Eastern Mediterranean Region, European Region, Region of the Americas, and Western Pacific Region). The pooled vaccination willingness rate was 55.74% (95% CI 40.85%-70.13%). Of adults aged ≥50 years, 56.06% were willing to receive the HZ vaccine. After receiving health care workers’ (HCWs) recommendations, 75.19% of individuals were willing to get the HZ vaccine; without HCWs’ recommendations, the willingness rate was only 49.39%. The willingness rate was more than 70% in the Eastern Mediterranean Region and approximately 55% in the Western Pacific Region. The willingness rate was the highest in the United Arab Emirates and the lowest in China and the United Kingdom. The perception of HZ severity and susceptibility was positively associated with vaccination willingness. The perceived barriers to vaccination willingness (main reasons for unwillingness) included low trust in the effectiveness of the HZ vaccine, concerns about safety, financial concerns, and being unaware of the HZ vaccine’s availability. Older individuals, those having lower education, or those having lower income levels were less likely to willing to be vaccinated.

CONCLUSIONS: Only 1 in 2 individuals showed a willingness to be vaccinated against HZ. The willingness rate was the highest in the Eastern Mediterranean Region. Our findings show the critical role HCWs play in promoting HZ vaccination. Monitoring HZ vaccination willingness is necessary to inform public health decision-making. These findings provide critical insights for designing future life-course immunization programs.

PMID:36892937 | DOI:10.2196/43893

Psychol Aging. 2023 Mar 9. doi: 10.1037/pag0000735. Online ahead of print.

ABSTRACT

In recent years, the use of implicit mechanisms based on statistical learning (SL) has emerged as a strong factor in biasing visuospatial attention, so that target selection is improved at frequently attended locations and distractor filtering is facilitated at frequently suppressed locations. Although these mechanisms have been consistently described in younger adults, similar evidence in healthy aging is scarce. Therefore, we studied the learning and persistence of SL of target selection and distractor suppression in younger and older adults in visual search tasks where the frequency of target (Experiment 1) or distractor (Experiment 2) was biased across spatial locations. The results show that SL of target selection was preserved in the older adults so, similar to their younger counterparts, they showed a strong and persistent advantage in target selection at locations more frequently attended. However, unlike young adults, they did not benefit from implicit SL of distractor suppression, so that distractor interference was maintained throughout the experiment independently of the contingencies associated with distractor locations. Taken together, these results provide novel evidence of distinct developmental patterns for SL of task-relevant and task-irrelevant visual information, likely reflecting differences in the implementation of proactive suppression attentional mechanisms between younger and older adults. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:36892906 | DOI:10.1037/pag0000735

J Appl Physiol (1985). 2023 Mar 9. doi: 10.1152/japplphysiol.00739.2022. Online ahead of print.

ABSTRACT

Young non-Hispanic Black adults have reduced microvascular endothelial function compared with non-Hispanic White counterparts, but the mechanisms are not fully elucidated. The purpose of this study was to investigate the effect of endothelin-1 A receptor (ET_AR) and superoxide on cutaneous microvascular function in young non-Hispanic Black (n=10) and White (n=10) adults. Participants were instrumented with four intradermal microdialysis fibers: 1) lactated Ringer’s (control), 2) 500 nM BQ-123 (ET_AR antagonist), 3) 10 μM tempol (superoxide dismutase mimetic), and 4) BQ-123 + tempol. Skin blood flow was assessed via laser-Doppler flowmetry (LDF), and each site underwent rapid local heating from 33°C to 39°C. At the plateau of local heating, 20 mM L-NAME [nitric oxide (NO) synthase inhibitor] was infused to quantify NO-dependent vasodilation. Data are mean ± standard deviation. NO-dependent vasodilation was decreased in non-Hispanic Black compared with non-Hispanic White young adults (p < 0.01). NO-dependent vasodilation was increased at BQ-123 sites (73 ± 10% NO) and at BQ-123 + tempol sites (71 ± 10 %NO) in non-Hispanic Black young adults compared with control (53 ± 13 %NO, p = 0.01). Tempol alone had no effect on NO-dependent vasodilation in non-Hispanic Black young adults (63 ± 14 %NO, p = 0.18). NO-dependent vasodilation at BQ-123 sites was not statistically different between non-Hispanic Black and White (80 ± 7 %NO) young adults (p = 0.15). ET_AR contribute to reduced NO-dependent vasodilation in non-Hispanic Black young adults independent of superoxide, suggesting a greater effect on NO synthesis rather than NO scavenging via superoxide.

PMID:36892887 | DOI:10.1152/japplphysiol.00739.2022

J Allied Health. 2023 Spring;52(1):e23-e29.

ABSTRACT

PURPOSE: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation and persistent respiratory symptoms, which may negatively affect the individual’s quality of life. Pulmonary rehabilitation is considered the standard of care for subjects with COPD. The health care professionals staffing pulmonary rehabilitation programs are charged with educating subjects about their chronic lung disease. The purpose of this pilot study was to describe the perceived learning needs of subjects with COPD.

METHODS: This descriptive study recruited 15 participants diagnosed with COPD who were enrolled or who had recently completed a hospital-based outpatient pulmonary rehabilitation program. The coordinator administered a 40-question survey individually to the participants; all participants returned completed surveys. The survey asked, “Personally, how interested are you in learning about…,” followed by the list of 40 educational topics related to COPD. The 40 educational topics were divided into five categories. Participants read the written survey at their own pace and individually provided their level of interest on a 5-point Likert scale. The data were uploaded to SPSS Statistical Software and descriptive statistics were obtained.

RESULTS: For the topic items, the mean and mode scores and the frequency that the mode score occurred were reported. Topics related to survival skills generated the highest mean score among the respondents: mean, mode, and mode frequency scores of 4.80, 5, and 86.7% respectively. Topics on lifestyle issues generated the lowest mean score: mean, mode, and mode frequency of 1.79, 1, and 73.3% respectively.

CONCLUSIONS: This study suggests subjects with COPD are interested in learning about managing their disease.

PMID:36892864

J Allied Health. 2023 Spring;52(1):e17-e21.

ABSTRACT

PURPOSE: The purpose of this study was to determine if a statistically significant difference existed between student perceptions of virtual (online) vs traditional in-person IPE simulation.

METHODS: Students (n = 397) from eight health professions at one northeastern university attended either a virtual or an in-person IPE session during the spring 2021 semester. Students were allowed to choose which session type to attend. A total of 240 students attended one of 15 virtual sessions, and 157 came to an in-person session (n = 22). After the sessions, an anonymous 16 question face-validated survey was sent to each students’ university email account. The survey included 12 Likert-scale questions, 2 demographic questions, and 2 open-ended questions. Descriptive statistics and independent t-tests were completed. Statistical significance set at p < 0.05.

RESULTS: Survey response rate was 27.9% (n = 111/397). In-person training had higher mean scores for Likert questions; however, there was not a statistically significant difference. All student responses were rated favorably for both training types (≥ 3.07/4). Themes were evident and included positive experiences with learning the roles of other professions (n = 20/67); communication either between the health care team members or with the patient/family (n = 11/67); and collaborating with other members of the health care team (n = 11/67).

CONCLUSION: Orchestrating IPE activities across multiple programs and numerous students can be challenging, but the flexibility and scalability of virtual sessions may offer an IPE alternative that students find equally satisfying when compared to in-person learning.

PMID:36892863

J Allied Health. 2023 Spring;52(1):44-50.

ABSTRACT

PURPOSE: The purposes of this study were to: 1) report levels of self-perceived grit among students in accredited Doctor of Physical Therapy (DPT) programs; 2) explore comparisons between grit and personal student factors; and 3) compare grit scores of DPT student to students in other healthcare professions.

METHODS: 1,524 enrolled students were surveyed from accredited DPT programs in the US in this cross-sectional research study. Surveys consisted of the 12-item Grit-O questionnaire and an additional questionnaire asking for a report of personal student factors. Non-parametric inferential statistics were conducted to compare Grit-O scores across categories of gender identity, age groups, year in school, race/ethnicity, and employment status of respondents. One-sample t-tests were used to compare DPT grit scores to those of students in other health professions previously reported in the literature.

RESULTS: DPT students from 68 programs responded to the surveys reporting mean grit score of 3.95 (± 0.45 SD) and median grit score of 4.00 (interquartile range [IQR] 3.75-4.25). Grit-O subscores in consistency of interest and perseverance of effort had median scores of 3.67 (IQR 3.17- 4.00) and 4.50 (IQR 4.17-4.67), respectively. Consistency of interest subscores were significantly greater in older students, and perseverance of effort subscores were statistically greater in African American respondents. In comparison to other studies, DPT grit scores were greater than nursing and pharmacy students and were comparable to medical students.

CONCLUSION: DPT students who responded to our surveys perceive themselves as possessing relatively high levels of grit, especially in perseverance of effort.

PMID:36892860

J Allied Health. 2023 Spring;52(1):1.

ABSTRACT

Artificial intelligence (AI) technologies to help authors improve the preparation and quality of their manuscripts are increasing rapidly in number and sophistication, including tools to assist with writing, grammar, language, references, statistical analysis, and reporting standards. The release of ChatGPT, a new open source, natural language processing tool that is designed to simulate human conversation in response to prompts or questions, has prompted both excitement and concerns about potential misuse.

PMID:36892853

J Cardiopulm Rehabil Prev. 2023 Mar 10. doi: 10.1097/HCR.0000000000000781. Online ahead of print.

ABSTRACT

PURPOSE: Chronic kidney disease (CKD) is common in heart failure (HF). Chronic kidney disease often worsens the prognosis and impairs the management of patients with HF. Chronic kidney disease is frequently accompanied by sarcopenia, which limits the benefits of cardiac rehabilitation (CR). The aim of this study was to evaluate the impact of CR on cardiorespiratory fitness in HF patients with reduced ejection fraction (HFrEF) according to the CKD stage.

METHODS: We conducted a retrospective study including 567 consecutive patients with HFrEF, who underwent a 4-wk CR program, and who were evaluated by cardiorespiratory exercise test before and after the program. Patients were stratified according to their estimated glomerular filtration rate (eGFR). We performed multivariate analysis looking for factors associated with an improvement of 10% in peak oxygen uptake (V˙o2peak).

RESULTS: Thirty-eight percent of patients had eGFR <60 mL/min/1.73m². With decreasing eGFR, we observed deterioration in V˙o2peak, first ventilatory threshold (VT1) and workload and an increase in brain natriuretic peptide levels at baseline. After CR, there was an improvement in V˙O2peak (15.3 vs 17.8 mL/kg/min, P < .001), VT1 (10.5 vs 12.4 mL/kg/min, P < .001), workload (77 vs 94 W, P < .001), and brain natriuretic peptide (688 vs 488 pg/mL, P < .001). These improvements were statistically significant for all stages of CKD. In a multivariate analysis predicting factors associated with V˙o2peak improvement, renal function did not interfere with results.

CONCLUSIONS: Cardiac rehabilitation is beneficial in patients with HFrEF with CKD regardless of CKD stage. The presence of CKD should not prevent the prescription of CR in patients with HFrEF.

PMID:36892848 | DOI:10.1097/HCR.0000000000000781