Tag: statistics

Rev Bras Enferm. 2022 Nov 28;76Suppl 1(Suppl 1):e20220171. doi: 10.1590/0034-7167-2022-0171. eCollection 2022.

ABSTRACT

OBJECTIVES: to assess the level of anxiety of nurses in an emergency room in view of the new Coronavirus and describe the relationship between the degrees of anxiety and their sociodemographic variables.

METHODS: quantitative descriptive-correlational study with a sample of 60 nurses. A questionnaire was used as a data collection instrument based on the Hamilton Anxiety Assessment Scale.

RESULTS: the nurses’ average anxiety is mild. A statistically significant relationship was found between anxiety and the variables “sex” and “children”, with women having higher levels of anxiety than men, and nurses who do not have children showing mild, moderate, or severe anxiety.

CONCLUSIONS: COVID-19 triggers anxiety in nurses, sometimes at pathological levels. Being female and not having children increase the anxiety experienced. Sex can be considered the determining factor for the level of anxiety experienced.

PMID:36449963 | DOI:10.1590/0034-7167-2022-0171

Dental Press J Orthod. 2022 Nov 28;27(5):e222190. doi: 10.1590/2177-6709.27.5.e222190.oar. eCollection 2022.

ABSTRACT

OBJECTIVE: To investigate the influence of dynamic visualization of cone beam computed tomography (CBCT) scans on orthodontist’s assessment of positioning status and prognosis of interradicular mini-implants (MI).

METHODS: Three MI positions were virtually simulated in thirty CBCT volumes: (1) MI 1 mm from the lamina dura (LD), (2) MI touching the LD and (3) MI overlapping the LD. Each position was exposed to orthodontists (n = 35) as panoramic reconstruction, sagittal reconstruction and a sequence of axial slices. Each orthodontist evaluated the MI position (relationship with the LD) and scored the prognosis using a four-point scale (the higher the score, the better the prognosis). Kappa, Friedman and Nemenyi statistics were used.

RESULTS: Statistically significant associations were detected between the prognosis scores and the type of image visualized (p<0.05). The dynamic visualization of the CBCT volume (axial slices) was associated with higher scores for prognosis and more reliable evaluation of MI positioning. Inconsistent outcomes were more frequently associated with panoramic and sagittal reconstructions.

CONCLUSION: The dynamic visualization of axial slices allowed orthodontists to perform better assessment of MI position and considerably affected prognosis judgment.

PMID:36449961 | DOI:10.1590/2177-6709.27.5.e222190.oar

Arq Bras Cardiol. 2022 Oct;119(5 suppl 1):35-42. doi: 10.36660/abc.20220423.

ABSTRACT

BACKGROUND: The consolidation of new educational paradigms requires the implementation of innovative strategies to transform students into competent professionals.

OBJECTIVES: To assess knowledge and satisfaction of medical students before and after the use of a new humanized digital model of active learning, called virtual case-based learning (VCBL).

METHODS: This was a descriptive, documentary analysis of the teaching-learning process of medical students. Data obtained from theoretical knowledge assessment and satisfaction evaluation questionnaires applied in 2018 and 2019 were analyzed, and the new VCBL was compared with the traditional active methodology PBL (problem-based learning). Descriptive and association analyses were made using the Statistical Package for the Social Sciences.

RESULTS: A total of 167 evaluation forms administered to medical students were analyzed. In the evaluation of theoretical knowledge, the 2018 and the 2019 student groups had a mean of 41.7% and 73.3%, respectively (p<0.001). Among the students who responded to the satisfaction evaluation form, 76.0% gave the highest rating to question one, and 83.0% to question two. Nearly 70.0% of students positively evaluated knowledge acquisition with the Paciente 360 platform; 78.0% reported to feel prepared for working in outpatient care; and 94.0% positively evaluated the new method.

CONCLUSION: In this initial study, the results indicate that the new active method for humanized digital medical education, the VCBL, can help in the betterment of the teaching-learning process, promoting knowledge and satisfaction by the students.

PMID:36449957 | DOI:10.36660/abc.20220423

Arq Bras Cardiol. 2022 Oct;119(5 suppl 1):22-26. doi: 10.36660/abc.20220446.

ABSTRACT

BACKGROUND: Studies have shown a low accuracy of urgent care physicians in interpreting electrocardiogram (ECG) in severe cardiovascular conditions.

OBJECTIVE: To evaluate the effectiveness of an ECG learning method in internal medicine internships and to know the perception of interns regarding learning before and after the methodology.

METHODS: This study used a database with the results of an ECG pre- and post-test of the classes in the internal medicine internship from 2017 to 2022. A qualitative questionnaire was sent with questions for self-assessment of perception of learning.

RESULTS: The study included a total of 227 students, 161 of whom (70.9%) were female. The mean age was 26.4 ± 4.2 years old. The pre-test mean was 3.75 ± 2.0 points, and the post-test mean was 8.48 ± 1.5 points, showing a statistically significant difference, even after stratification by sex, age, and course period (p < 0.001 for all comparisons). Sixty-nine (30%) of the students responded to the qualitative questionnaire. The three predominant feelings prior to learning were despair, fear, and insecurity. After the Club, the predominant feelings were security, tranquility, and confidence.

CONCLUSION: The level of prior knowledge regarding ECG was low among students in the medical internship, and the proposed methodology was effective for learning ECG, regardless of age, sex, or course period. It was possible to transform negative beliefs regarding ECG learning and make learning meaningful and enjoyable. A more incisive look at medical courses for learning the ECG in a more practical and contextualized way can improve this scenario.

PMID:36449955 | DOI:10.36660/abc.20220446

Arq Bras Cardiol. 2022 Oct;119(5 suppl 1):14-21. doi: 10.36660/abc.20220419.

ABSTRACT

BACKGROUND: Teaching of clinical reasoning (CR) can be facilitated by educational strategies guided by illness script theory.

OBJECTIVE: To evaluate the effects of an educational strategy guided by illness script theory on the diagnostic accuracy of chest pain in medical students.

METHODS: Experimental study in 3 phases, with 18 third-year medical students completing phase 3. Phases 1 and 2 had 27 students. In phase 1, each participant solved 8 clinical cases (6 of chest pain and 2 distractors). In phase 2, participants were divided into 2 groups, which distinctly trained 3 of the chest pain diagnoses from phase 1. In phase 3, after 1 week, each participant solved 8 new cases, with the same diagnoses as phase 1. Case resolution time and diagnostic accuracy were evaluated. The significance level adopted for statistical analysis was p < 0.05.

RESULTS: In phase 3, both groups showed improved diagnostic accuracy and reduced case resolution time for the trained diagnoses, with no transfer of learning. For these diagnoses, the diagnostic accuracy scores in phases 1 and 3 were: group 1 = 1.00, IQR [0.00 to 1.00] versus 2.00, IQR [2.00 to 2.50], p = 0.017 and group 2 = 1.00, IQR [0.66 to 1.17] versus 3.00, IQR [1.33 to 3.00], p = 0.006. Case resolution times in seconds were: group 1: 485, IQR [450 to 583] versus 318, IQR [284 to 418], p = 0.027 and group 2: 655, IQR [543 to 740] versus 408, IQR [337 to 569], p = 0.010.

CONCLUSION: The proposed strategy seems to contribute to improved diagnostic accuracy, and it may be considered for teaching CR.

PMID:36449954 | DOI:10.36660/abc.20220419

Rev Col Bras Cir. 2022 Nov 28;49:e20223363. doi: 10.1590/0100-6991e-20223363-en. eCollection 2022.

ABSTRACT

INTRODUCTION: anastomotic leak (AL) after colectomy for colorectal cancer (CRC) is a life-threatening complication. This systematic review and meta-analysis aimed to evaluate the preoperative risk factors for AL in patients submitted to colectomy.

METHODS: the bibliographic search covered 15 years and 9 months, from 1st January 2005 to 19th October 2020 and was performed using PubMed, Cochrane Library, Scopus, Biblioteca Virtual em Saúde, Europe PMC and Web of Science databases. The inclusion criteria were cross-sectional, cohort and case-control studies on preoperative risk factors for AL (outcome). The Newcastle-Ottawa scale was used for bias assessment within studies. Meta-analysis involved the calculation of treatment effects for each individual study including odds ratio (OR), relative risk (RR) and 95% confidence intervals (95% CI) with construction of a random-effects model to evaluate the impact of each variable on the outcome. Statistical significance was set at p<0.05.

RESULTS: cross-sectional studies were represented by 39 articles, cohort studies by 21 articles and case-control by 4 articles. Meta-analysis identified 14 main risk factors for AL in CRC patients after colectomy, namely male sex (RR=1.56; 95% CI=1.40-1.75), smoking (RR=1.48; 95% CI=1.30-1.69), alcohol consumption (RR=1.35; 95% CI=1.21-1.52), diabetes mellitus (RR=1.97; 95% CI=1.44-2.70), lung diseases (RR=2.14; 95% CI=1.21-3.78), chronic obstructive pulmonary disease (RR=1.10; 95% IC=1.04-1.16), coronary artery disease (RR=1.61; 95% CI=1.07-2.41), chronic kidney disease (RR=1.34; 95% CI=1.22-1.47), high ASA grades (RR=1.70; 95% CI=1.37-2.09), previous abdominal surgery (RR=1.30; 95% CI=1.04-1.64), CRC-related emergency surgery (RR=1.61; 95% CI=1.26-2.07), neoadjuvant chemotherapy (RR=2.16; 95% CI=1.17-4.02), radiotherapy (RR=2.36; 95% CI=1.33-4.19) and chemoradiotherapy (RR=1.58; 95% CI=1.06-2.35).

CONCLUSIONS: important preoperative risk factors for colorectal AL in CRC patients have been identified based on best evidence-based research, and such knowledge should influence decisions regarding treatment.

PMID:36449942 | DOI:10.1590/0100-6991e-20223363-en

Rev Col Bras Cir. 2022 Nov 28;49:e20223319. doi: 10.1590/0100-6991e-20223319_en. eCollection 2022.

ABSTRACT

OBJECTIVE: to assess the role of autopsy in the diagnosis of missed injuries (MI) and definition of trauma quality program goals.

METHOD: Retrospective analysis of autopsy reports and patient’s charts. Injuries present in the autopsy, but not in the chart, were defined as “missed”. MI were characterized using Goldman’s criteria: Class I, if the diagnosis would have modified the management and outcome; Class II, if it would have modified the management, but not the outcome; Class III, if it would not have modified neither the management nor the outcome. We used Mann-Whitney’s U and Pearson’s chi square for statistical analysis, considering p<0.05 as significant.

RESULTS: We included 192 patients, with mean age of 56.8 years. Blunt trauma accounted for 181 cases, and 28.6% were due to falls from the same level. MI were diagnosed in 39 patients (20.3%). Using Goldman’s criteria, MI were categorized as Class I in 3 (1.6%) and Class II in 11 (5.6%). MI were more often diagnosed in the thoracic segment (25 patients, 64.1% of the MI). The variables significantly associated (p<0.05) to MI were: time of hospitalization < 48 h, severe trauma mechanism, and not undergoing surgery or computed tomography. At autopsy, the values of ISS and NISS were higher in patients with MI.

CONCLUSION: the review of the autopsy report allowed diagnosis of MIs, which did not influence outcome in their majority. Many opportunities of improvement in quality of care were identified.

PMID:36449941 | DOI:10.1590/0100-6991e-20223319_en

JMIR Form Res. 2022 Nov 30;6(11):e42126. doi: 10.2196/42126.

ABSTRACT

BACKGROUND: The use of web-based methods to seek health information is increasing in popularity. As web-based health information (WHI)-seeking affects health-related decision support and chronic symptom self-management, WHI-seeking from online sources may impact health care decisions and outcomes, including care-seeking decisions. Patients who are routinely connected to physicians are more likely to receive better and more consistent care. Little is known about whether WHI-seeking impacts the frequency at which patients engage with health care providers.

OBJECTIVE: Our primary objective was to describe the associations between the use of web-based methods to seek information about one’s own health and the time since last engaging with a health care provider about one’s own health. Additionally, we aimed to assess participants’ trust in health care organizations to contextualize our findings.

METHODS: We analyzed data from US adults participating in the nationally representative Tufts Equity in Health, Wealth, and Civic Engagement Survey (N=1034). Bivariate associations between demographic characteristics and health information-seeking methods were assessed with Pearson chi-squared tests. Bivariate associations of Medical Mistrust Index (MMI) scores with each health information-seeking method and time since provider engagement were assessed with F tests and adjusted Wald tests. We fit a multivariable logistic regression model to assess the association between WHI-seeking within the 12 months prior to survey (alone or in combination with provider-based methods versus provider only) and engagement with a provider more than 1 year prior to the time of survey, adjusting for age, race and ethnicity, sex, education, insurance coverage, and MMI.

RESULTS: Age, race and ethnicity, educational attainment, health insurance source, MMI, and time since provider engagement were each significantly associated with the health information-seeking method in bivariate analyses. Compared to using only provider-based health information seeking methods, WHI-based methods alone or in combination with provider-based methods were associated with a 51% lower likelihood (odds ratio 0.49, 95% CI 0.27-0.87) of engaging with a provider within the previous year. Participants who used WHI-seeking methods alone and those who had not engaged with a health care provider within the previous year demonstrated a higher mean MMI score; however, MMI was not a significant predictor of time since engagement with a provider in the multivariable analysis.

CONCLUSIONS: Our findings from a nationally representative survey suggest that for those who use WHI-seeking methods (alone or in combination with provider-based information-seeking methods), there is a statistically significant lower likelihood of engaging with a provider in a year compared to those who only use provider-based methods. Future research should consider the intent of a person’s visit with a provider, trust in health care systems, methods of provider engagement, and specific web-based platforms for health information.

PMID:36449328 | DOI:10.2196/42126

Phys Chem Chem Phys. 2022 Nov 30. doi: 10.1039/d2cp04236c. Online ahead of print.

ABSTRACT

The relationship between protein sequence and its thermodynamic stability is a critical aspect of computational protein design. In this work, we present a new theoretical method to calculate the free energy change (ΔΔG) resulting from a single-point amino acid mutation to alanine in a protein sequence. The method is derived based on physical interactions and is very efficient in estimating the free energy changes caused by a series of alanine mutations from just a single molecular dynamics (MD) trajectory. Numerical calculations are carried out on a total of 547 alanine mutations in 19 diverse proteins whose experimental results are available. The comparison between the experimental ΔΔG_exp and the calculated values shows a generally good correlation with a correlation coefficient of 0.67. Both the advantages and limitations of this method are discussed. This method provides an efficient and valuable tool for protein design and engineering.

PMID:36449314 | DOI:10.1039/d2cp04236c

J Clin Ultrasound. 2022 Nov 30. doi: 10.1002/jcu.23409. Online ahead of print.

ABSTRACT

OBJECTIVE: The most significant complication in familial mediterranean fever (FMF) patients is dysfunction and organ failure developing depending on amyloid deposition in organs. The golden standard for showing amyloid deposition is the biopsy; however, tissue stiffness was examined by shear wave elastography as a non-invasive method in a restricted number of studies conducted, and it is considered that amyloid deposition can be shown indirectly. In our study, we aimed to indirectly evaluate amyloid deposition in organs with Shear wave and Doppler ultrasonography and to reveal its relationship with MEFV gene mutation analysis.

METHOD: 42 FMF patients with normal thyroid and renal function tests and 35 participants with no FMF symptoms were included in our study. FMF patients were grouped depending on their MEFV mutation analyses. Thyroid, salivary glands, and renal parenchymal tissue stiffness were evaluated by shear wave elastography. Thyroidal artery and both renal artery resistances were evaluated by Doppler ultrasonography.

RESULTS: Both parotis gland, thyroid and renal parenchymal stiffness and arterial vascular resistances in the patient group were found higher than the control group. A significant difference was not found in any parameters in classification based on gender. Tissue stiffness and vascular resistance values in the patient group with M694V homozygote mutation were found statistically significantly higher than the other mutation groups (p < 0.001).

CONCLUSION: Our study shows that identifying genetic mutation type in FMF patients will help determine possibly amyloidosis risk. Imaging of tissue stiffness by shear wave elastography and evaluation of vascular resistance by Doppler can be useful for routine screening of those patients.

PMID:36449313 | DOI:10.1002/jcu.23409