Tag: statistics

Korean J Gastroenterol. 2022 Oct 25;80(4):177-185. doi: 10.4166/kjg.2022.077.

ABSTRACT

BACKGROUND/AIMS: Endoscopic stenting is an evolving treatment for symptomatic Crohn’s strictures. Several case series and small studies have reported its efficacy. Future studies can be designed based on a systematic review of the evaluation of efficacy. Hence, this meta-analysis was conducted to assess the critical role of stents in the management of intestinal strictures associated with Crohn’s disease (CD).

METHODS: A literature search of various databases from 2000 to February 2022 was conducted for studies evaluating the outcome of stents in patients with CD-related stricture. The outcomes assessed included technical and clinical success, adverse events, symptom recurrence, and the need for a surgical resection. Pooled event rates across studies were expressed with summative statistics.

RESULTS: Ten studies with 170 patients were included in the present analysis. The pooled event rates for technical success, clinical success, stent migration, and post-procedural pain were 98.2% (95% CI, 95.8-100), 71.3% (95% CI, 57.4-85.1), 32% (95% CI, 0.0-65.3) and 20.2% (95% CI, 4.1-36.2), respectively. The cumulative recurrence rate and need for surgery were 40.1% (95% CI, 20.3-59.9) and 8.6% (95% CI, 1.7-15.5), respectively. Subgroup analysis showed that partially-covered (PC) self-expanding metallic stent (SEMS) was significantly better than fully-covered SEMS with a lower stent migration rate and symptom recurrence rate.

CONCLUSIONS: Overall efficacy of stents in the management of CD-related stricture remains moderate with a low complication rate. Among the stents, PC-SEMS may be associated with a more favorable outcome. Future studies will be needed to determine the long-term benefits of endoscopic stenting.

PMID:36281550 | DOI:10.4166/kjg.2022.077

Korean J Intern Med. 2022 Oct 25. doi: 10.3904/kjim.2022.050. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: To identify changes in symptoms and pulmonary sequelae in patients with coronavirus disease 2019 (COVID-19).

METHODS: Patients with COVID-19 hospitalized at seven university hospitals in Korea between February 2020 and February 2021 were enrolled, provided they had ≥ 1 outpatient follow-up visit. Between January 11 and March 9, 2021 (study period), residual symptom investigations, chest computed tomography (CT) scans, pulmonary function tests (PFT), and neutralizing antibody tests (NAb) were performed at the outpatient visit (cross-sectional design). Additionally, data from patients who already had follow-up outpatient visits before the study period were collected retrospectively.

RESULTS: Investigation of residual symptoms, chest CT scans, PFT, and NAb were performed in 84, 35, 31, and 27 patients, respectively. After 6 months, chest discomfort and dyspnea persisted in 26.7% (4/15) and 33.3% (5/15) patients, respectively, and 40.0% (6/15) and 26.7% (4/15) patients experienced financial loss and emotional distress, respectively. When the ratio of later CT score to previous ones was calculated for each patient between three different time intervals (1-14, 15-60, and 61-365 days), the median values were 0.65 (the second interval to the first), 0.39 (the third to the second), and 0.20 (the third to the first), indicating that CT score decreases with time. In the high-severity group, the ratio was lower than in the low-severity group.

CONCLUSIONS: In COVID-19 survivors, chest CT score recovers over time, but recovery is slower in severely ill patients. Subjects complained of various ongoing symptoms and socioeconomic problems for several months after recovery.

PMID:36281537 | DOI:10.3904/kjim.2022.050

Ann Lab Med. 2023 Mar 1;43(2):174-179. doi: 10.3343/alm.2023.43.2.174.

ABSTRACT

BACKGROUND: Development of an accessible method to routinely evaluate the clonality of strains is needed in microbiology laboratories. We compared the discriminatory power of the Fourier-transform infrared (FTIR) spectroscopy-based IR Biotyper (Bruker Daltonics GmbH, Bremen, Germany) to matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), using whole-genome sequencing (WGS) as the reference method.

METHODS: Eighty-three extended-spectrum β-lactamase-producing Escherichia coli isolates were tested using WGS, MALDI-TOF MS, and IR Biotyper. Simpson’s diversity index (SDI), a statistical analysis for testing the homogeneity of a dendrogram, and the adjusted Rand index (aRI) were used to compare the discriminatory ability between typing tests.

RESULTS: The SDI (95% confidence interval) was 0.969 (0.952-0.985) for WGS, 0.865 (0.807-0.924) for MALDI-TOF MS, and 0.974 (0.965-0.983) for IR Biotyper. Compared with WGS, IR Biotyper showed compatible diversity, whereas MALDI-TOF MS did not. The concordance and aRI improved from 66.3% to 84.3% and from 0.173 to 0.538, respectively, for IR Biotyper versus MALDI-TOF MS with WGS as the reference method. IR Biotyper showed substantially improved performance in strain typing compared with MALDI-TOF MS.

CONCLUSIONS: IR Biotyper is useful for diversity analysis with improved discriminatory power over MALDI-TOF MS in comparison with WGS as a reference method. IR Biotyper is an accessible method to evaluate the clonality of strains and could be applied in epidemiological analysis during an outbreak of a health care facility, as well as for research on the transmission of resistant bacteria in community settings.

PMID:36281511 | DOI:10.3343/alm.2023.43.2.174

Phys Sportsmed. 2022 Oct 24:1-8. doi: 10.1080/00913847.2022.2136984. Online ahead of print.

ABSTRACT

OBJECTIVE: Gradual onset injuries (GOIs) in recreational cyclists are common but not well described. The aim of this study is to describe the clinical characteristics of GOIs (main anatomical regions, specific anatomical sites, specific GOIs, tissue type, severity of GOIs, and treatment modalities) of GOIs among entrants participating in a community-based mass participation-cycling event over 5 years.

METHODS: During the 2016-2020 Cape Town Cycle Tour, 62,758 consenting race entrants completed an online pre-race medical screening questionnaire. 1879 reported GOIs in the previous 12 months. In this descriptive epidemiological study, we report frequency (% entrants) of GOIs by anatomical region/sites, specific GOI, tissue type, GOI severity, and treatment modalities used.

RESULTS: The main anatomical regions affected by GOIs were lower limb (47.4%), upper limb (20.1%), hip/groin/pelvis (10.0%), and lower back (7.8%). Specifically, GOI were common in the knee (32.1%), shoulder (10.6%), lower back (7.8%) and the hip/buttock muscles (5.2%). The most common specific GOI was anterior knee pain (17.2%). 57.0% of GOIs were in soft tissue. Almost half (43.9%) of cyclists with a GOI reported symptom duration >12 months, and 40.3% of GOIs were severe enough to reduce/prevent cycling. Main treatment modalities used for GOIs were rest (45.9%), physiotherapy (43.0%), stretches (33.2%), and strength exercises (33.1%).

CONCLUSION: In recreational cyclists, >50% of GOIs affect the knees, shoulders, hip/buttock muscles and lower back, and 40% are severe enough to reduce/prevent cycling. Almost 45% of cyclists with GOIs in the lower back; or hip/groin/pelvis; or lower limbs; or upper limb reported a symptom duration of >12 months. Risk factors associated with GOIs need to be determined and preventative programs for GOIs need to be designed, implemented, and evaluated.

PMID:36281474 | DOI:10.1080/00913847.2022.2136984

Biomed Res Int. 2022 Oct 15;2022:2545830. doi: 10.1155/2022/2545830. eCollection 2022.

ABSTRACT

The global malaria morbidity and mortality witnessed an increase from 2019 to 2020 partly due to disruptions in control programs’ activities imposed by the COVID-19 pandemic. Therefore, there is still a significant burden of malaria in Cameroon which needs attention from all fronts to attain elimination goals. It is normally expected that a typical forest ecology that has undergone urbanization and subjected to high rates of ecological instabilities should also have a shift from characteristic perennial malaria transmission and a shift in the type of malaria endemicity plaguing such distorted forest ecology. In this observational comparative study, we randomly enrolled participants from rural and urban settings of a forest zone during a low malaria transmission period, which coincided with the onset of COVID-19 pandemic. An optimized structured questionnaire was employed, to collect socio-demographic data and associated risk factors. The CareStart™ Malaria HRP2 antigen test was performed on participants from both settings to determine the prevalence of community asymptomatic malaria. Of 307 participants, 188 (61.0%) were from the rural, while 119 (38.8%) from the urban community. The overall prevalence of asymptomatic malaria (27.0%) detected Plasmodium falciparum antigen in 83 participants. The urban community’s prevalence was 4.2% (5 positives) while the rural community’s was 41.5% (78 positives). In simple logistic regression models, rural forest community and farm around the house were statistically significant predictors of testing positive (coefficient 2.8, 95% CI 1.8-3.7, p value<0.001) and (coefficient 3.1, 95% CI 1.1-5.1, p value =0.003), respectively. In the multivariate model, the strongest predictor of testing positive was living in a rural community, with p < 0.001 and odds ratio of 10.9 (95% CI, 3.8-31.8). These results indicate that during a low transmission period, the prevalence of asymptomatic malaria differs between depleted urban and rural forested settings, suggesting a need for strategic target intervention for the control of asymptomatic malaria.

PMID:36281461 | PMC:PMC9587908 | DOI:10.1155/2022/2545830

Biomed Res Int. 2022 Oct 15;2022:6565620. doi: 10.1155/2022/6565620. eCollection 2022.

ABSTRACT

OBJECTIVE: Primary bladder tumors have a high degree of malignancy. To investigate the expression of human papillomavirus type 16 (HPV-16) in primary bladder tumors and the loss of cell differentiation and to explore the significance of HPV-16 detection, it is expected to be a disease. Treatment provides a theoretical basis.

METHODS: Fifty-seven patients with primary bladder tumors admitted to our hospital from January 2019 to January 2022 were selected as the research subjects, and they were divided into HPV-related groups according to the human papillomavirus (HPV) infection status (n = 28) and HPV unrelated group (n = 29). The general data of patients were collected, the expression of HPV-16 in bladder tissue samples was detected, and the correlation between pathological parameters and HPV-16 expression was analyzed.

RESULTS: Among HPV subtypes, HPV 16 subtype accounted for the highest proportion, followed by HPV-18 and HPV-6 subtypes; there was no significant difference in tumor stage (stage 1, stage a, stage 2a) between the HPV-related group and the HPV-unrelated group (stage 1, stage a, and stage 2a). P > 0.05); there was no significant difference in postoperative pathological expression (high expression and low expression) of patients (P > 0.05); there was no statistical difference in age and gender between HPV-related and HPV-unrelated groups (P > 0.05), HPV-related group and HPV-unrelated group compared daily regular drinking and smoking status, the difference was statistically significant (P < 0.05); HPV-16 expression was not correlated with tumor differentiation degree and age of patients (P > 0.05); the area under the curve (AUC) of HPV-16 for judging primary bladder tumor expression and cellular molecular deletion was 0.891, with a sensitivity of 83.94% and a specificity of 88.57%.

CONCLUSION: HPV-16 is an upper, expressed in primary bladder tumors and will participate in the differentiation and loss of cells, which can provide effective guidance and basis for the diagnosis of primary bladder tumors, which is an important factor for judging the pathological stage and prognosis of patients and can provide a theoretical reference for the formulation of therapeutic measures.

PMID:36281460 | PMC:PMC9587909 | DOI:10.1155/2022/6565620

Adv Med Educ Pract. 2022 Oct 17;13:1305-1319. doi: 10.2147/AMEP.S368128. eCollection 2022.

ABSTRACT

BACKGROUND AND OBJECTIVES: The aim of this study was to investigate in the millennium medical student generation the influence of the curriculum (problem-based curriculum [PBC] vs science-based curriculum [SBC]), gender and semester level on medical students’ motives to study medicine, their attitudes toward their career and in this regard their view about their study condition in university.

METHODS: Semi-structured qualitative interviews with 28 medical students were performed and analyzed using Mayring’s content analysis. Based on these results, a quantitative questionnaire for a nationwide survey was developed using a mixed-method-approach and send to most medical faculties in Germany. Data from n=1053 students entered statistical analysis.

RESULTS: Humanistic ideals prevailed in the choice to enter medical school and to become a physician. PBC students were found to be significantly (p<0.001) more idealistic and patient oriented, and they regard their curriculum more competitive than SBC-students (p<0.001). A balanced work and family life is essential for all students but particularly important for the PBC – group, male and undergraduate students. The majority of students wanted to work with patients and omitted patient-distant line of work. Undergraduate SBC-students saw their studies as old-fashioned citing lack of patient contact (p<0.001 compared to PBC), which eased in the graduate study part.

CONCLUSION: This study found major differences in student’s perceptions depending on curriculum type. PBC-students were more idealistic, and humanistic ideals prevailed in comparison to SBC. For both, close patient contact is essential in their training. Particularly for female students, lifestyle factors and a balanced work-life-integration outweigh career ambitiousness. This study offers an important insight to policy makers and educators to understand the motivation and perceptions of the millennial student generation regarding their studies and future career plans, which should be considered in educational policies.

PMID:36281458 | PMC:PMC9587722 | DOI:10.2147/AMEP.S368128

Ther Innov Regul Sci. 2022 Oct 24. doi: 10.1007/s43441-022-00468-z. Online ahead of print.

ABSTRACT

When simultaneous comparisons are performed, a procedure must be employed to control the overall level (also known as the Type I Error rate). Hochberg’s stepwise testing procedure is often used and here determination of the sample size needed to achieve a specified power for two pairwise comparisons when observations follow a normal distribution is addressed. Three different scenarios are considered: subsets defined by a baseline criterion, two treatments compared to a control, or one set of subjects nested within the other. The solutions for these three scenarios differ and are examined. The sample sizes for the differences in success probabilities for binomial distributions are presented using the asymptotic normality. The sample sizes and power using Hochberg’s procedure are compared to the corresponding results using the Bonferroni approach.

PMID:36280651 | DOI:10.1007/s43441-022-00468-z

J Cancer Educ. 2022 Oct 25. doi: 10.1007/s13187-022-02230-3. Online ahead of print.

ABSTRACT

The purpose of study was to screen for health hazards related to sun exposure and to examine the effectiveness of a sun safety multicomponent intervention designed specifically for the Egyptian farmers. A multicomponent interventional study was conducted among 128 farmers from three villages in Zagazig district, Sharkia Governorate, Egypt, from January to July 2022. It passed through three phases: phase 1: assessment of participants’ risk of skin cancer and vision screening; phase 2: filling a semi-structured questionnaire assessing sun exposure hazards and sun safety knowledge, behavior, and barriers; and phase 3: conducting multicomponent intervention composed of education session, providing sun safety supplies and reminders then evaluate the effect of this intervention after one month. Most of participants had moderate risk for skin cancer (69.0%), history of photokeratitis (77.3%), cataract (15.6%), and bad/very bad self-reported overall eyesight (43.0%). After intervention, there was a statistically significant improvement in the participants’ awareness regarding sun exposure-related hazards, all knowledge items about sun safety measures (p < 0.01) and some sun safety behaviors (p < 0.05) including wearing protective clothing, minimization of direct sunlight exposure, taking breaks, plentiful water intake, regular self-checking of skin, wearing wide brimmed hats, and job rotation. Furthermore, there was a statistically significant improvement in all sun protection barriers (p < 0.01) except sunscreen and sunglasses related barriers (p ˃ 0.05). The multicomponent intervention composed of education session, providing sun safety supplies and reminders was effective in increasing awareness of farmers with sun exposure hazards and improving their knowledge and behavior towards sun safety measures.

PMID:36280650 | DOI:10.1007/s13187-022-02230-3

J Echocardiogr. 2022 Oct 25. doi: 10.1007/s12574-022-00592-7. Online ahead of print.

ABSTRACT

Right ventricular function is strongly associated with clinical outcomes in many conditions, and the evaluation of right ventricle (RV) structure and function in patients with cardiopulmonary disorders is an essential component of clinical management. The objective of this study was to determine the normal ranges of right ventricular longitudinal strain (RVLS) measurements derived by two-dimensional (2D) speckle tracking echocardiography (STE) through a systematic review and meta-analysis. A systematic review was performed using PubMed, Cochrane, ClinicalKey, and CINAHL. Search terms covered the concepts of right ventricle, strain, speckle-tracking, and 2D echocardiography with additional filtering for humans and adults over the last decade. The RV four-chamber longitudinal strain (RV4CLS), RV free wall longitudinal strain (RVFWLS), and free wall longitudinal segmental strain values of healthy individuals without cardiopulmonary diseases from 28 studies were assessed. Weighted means were estimated using random-effects models in a meta-analysis. The results show for RV4CLS -24,91%[CI – 25.94; – 23.88, I² 98%], for RVFWLS -27.63%[CI – 28.78; – 26.48, I² 98%], for basal RVFWLS -26.65%[CI – 30.57; – 22.73, I² 99%], mid RVFWLS -27.61%[CI – 30.99; – 24.22, I² 99%] and apical RVFWLS -24.54%[CI – 26.70; – 22.38, I² 98%]. This systematic review and meta-analysis showed longitudinal strain values of 2D STE derived RV. No clear reference value for RV strain can be distilled from the literature search due to high statistical heterogeneity between the studies. However, all results of our analysis suggest that the lower reference values for RVLS in the current recommendations with a cut-off value of – 20% is underestimated.

PMID:36280647 | DOI:10.1007/s12574-022-00592-7