Tag: statistics

Res Nurs Health. 2021 Aug 26. doi: 10.1002/nur.22179. Online ahead of print.

ABSTRACT

Breastfeeding self-efficacy is a relevant predictor of exclusive breastfeeding during the first six months of life. The Prenatal Breastfeeding Self-Efficacy Scale (PBSES) is a 20-item tool developed to determine breastfeeding self-efficacy during pregnancy. Our study aimed to assess the structural validity and psychometric characteristics of the PBSES and to explore item reduction according to the statistical criteria for parsimony and incremental validity. In this study, conducted in six hospitals in eastern Spain, we recruited 1183 women with healthy, full-term, single-birth newborns. Data on sociodemographic, breastfeeding-related variables, and the PBSES, were obtained from self-administered questionnaires during the third trimester of pregnancy, at postpartum discharge, and 5 months postpartum, and from a phone survey 12 months postpartum. Item reduction was conducted after revising the PBSES item floor and ceiling effects, interitem correlations, and item-score relationships with breastfeeding-status variables during follow-up. The factorial structure of the short form of the PBSES (PBSES-SF) was tested using both exploratory and confirmatory approaches. After item reduction, the confirmatory factor analysis of the 12 remaining items of the PBSES-SF revealed adequate fit statistics for a three-factor structure and a second-order factor. Internal consistency was measured using the Cronbach’s α coefficient of the PBSES-SF (0.86). We provided evidence on the discriminant validity of the PBSES-SF by comparing its scores between known groups, convergent validity by examining its correlations with other variables, and predictive validity by assessing the association of PBSES-SF scores with breastfeeding behavior at critical points in time during the first postpartum year.

PMID:34437707 | DOI:10.1002/nur.22179

J Anim Ecol. 2021 Aug 26. doi: 10.1111/1365-2656.13578. Online ahead of print.

ABSTRACT

1. Body condition is an important concept in behaviour, evolution and conservation, commonly used as a proxy of an individual’s performance, for example in the assessment of environmental impacts. Although body condition potentially encompasses a wide range of health state dimensions (nutritional, immune or hormonal status), in practice most studies operationalize body condition using a single (univariate) measure, such as fat storage. One reason for excluding additional axes of variation may be that multivariate descriptors of body condition impose statistical and analytical challenges. 2. Structural equation modelling (SEM) is used in many fields to study questions relating multidimensional concepts, and we here explain how SEM is a useful analytical tool to describe the multivariate nature of body condition. In this “How To” paper, we show how SEM can be used to resolve different challenges in analysing the multivariate nature of body condition, such as (i) variable reduction and conceptualization, (ii) specifying the relationship of condition to performance metrics, (iii) comparing competing causal hypothesis, and (iv) including many pathways in a single model to avoid stepwise modelling approaches. We illustrated the use of SEM on a real-world case study, and provide R-code of worked examples as a learning tool. 3. We compared the predictive power of SEM with conventional statistical approaches that integrate multiple variables into one condition variable: multiple regression and principal component analysis. We show that model performance on our dataset is higher when using SEM, and led to more accurate and precise estimates compared to conventional approaches. 4. We encourage researchers to consider SEM as a flexible framework to describe the multivariate nature of body condition and thus understand how it affects biological processes, thereby improving the value of body condition proxies for predicting organismal performance. Finally, we highlight that it can be useful for other multidimensional ecological concepts as well, such as immunocompetence, oxidative stress and environmental conditions.

PMID:34437709 | DOI:10.1111/1365-2656.13578

R I Med J (2013). 2021 Sep 1;104(7):55-58.

ABSTRACT

PURPOSE: Concern about the decline in physician scientists has generated interest in promoting research participation among medical students. This study aimed to examine perceptions of research and research-oriented careers among college-level baccalaureate-MD (BA/MD) students at one institution in the United States.

METHODS: A cross-sectional survey was distributed to a sample of 241 BA/MD students. Descriptive statistics were used to examine research perceptions of participants.

RESULTS: The response rate was 52% (126/241). Most respondents conducted scientific research in high school and were interested in research-oriented careers. Most students participated in a research program (research course, faculty mentorship, or research grant), disseminated their research, and believed that research programs would be helpful for their research participation. The most common perceived barriers were a lack of time, interest, and prior research experience.

CONCLUSIONS: College-level BA/MD students had positive perception of research-oriented careers and found student research programs helpful. However, addressing key barriers such as lack of time, interest and experience will help expand BA/MD student engagement in research.

PMID:34437667

Arch Pathol Lab Med. 2021 Aug 26. doi: 10.5858/arpa.2020-0779-EP. Online ahead of print.

ABSTRACT

CONTEXT.—: Acquiring objective, timely, and comprehensive feedback on resident diagnostic performance is notoriously difficult.

OBJECTIVE.—: To implement a custom software application (Resident Case Tracker) to improve evaluative diagnostic analysis for residency programs.

DESIGN.—: Residents and faculty use a graphical user interface with restricted access to their own cases and evaluations. For each sign-out, residents enter their diagnoses and comments for each case. Faculty are provided a sign-out queue to review the resident diagnosis and select their level of agreement alongside optional comments. After sign-out, residents can review the agreement level and comments for each case, overall sign-out statistics, and organ-specific performance, and they have the option of opening and reviewing groups of cases by agreement status. A sign-out evaluation is automatically generated and stored alongside additional reports. Administrative access allows privileged users to readily review data analytics at both an individual and residency-wide global level.

RESULTS.—: A marked increase in completed evaluations and feedback was noted in the initial 36 months of implementation. During a 3-year academic period, faculty completed individual feedback on 33 685 cases and 1073 overall sign-out evaluations.

CONCLUSIONS.—: Resident Case Tracker is an invaluable tool for our residency program and has provided unparalleled feedback and data analytics. Throughout residency, trainees have access to each completed sign-out with the ability to learn from discrepant cases while also monitoring improvements in diagnostic acumen over time. Faculty are able to assess resident milestones much more effectively while more readily identifying residents who would benefit from targeted study.

PMID:34437701 | DOI:10.5858/arpa.2020-0779-EP

PLoS One. 2021 Aug 26;16(8):e0256801. doi: 10.1371/journal.pone.0256801. eCollection 2021.

ABSTRACT

Minimal residual disease (MRD) appeared to be a potent prognostic indicator in patients with Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL), with potential value in informing individualized treatment decisions. Hence, we performed herein a systemic literature review and meta-analysis to comprehensively address the prognostic value of MRD in Ph+ ALL. Systematic literature review was conducted in PubMed, Embase, and Cochrane databases with the data access date up to September 23, 2020. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated with fixed-effects or random-effects models. Furthermore, subgroup analyses were performed to assess the robustness of the associations. 27 studies with a total number of 3289 patients were eligible for this meta-analysis. Combined HRs suggested that MRD positivity was associated with inferior event-free survival (EFS) (HR = 2.00, 95% CI 1.77-2.26) and overall survival (OS) (HR = 2.34, 95% CI 1.86-2.95). The associations remained statistically significant in subgroup analyses including age group, MRD timing, disease status at MRD, MRD cutoff level, et al. Our findings suggested MRD as a potent clinical tool for assessing the prognosis of Ph+ ALL. Further studies using MRD-based risk stratification might help optimize individualized treatment strategies for Ph+ ALL patients.

PMID:34437635 | DOI:10.1371/journal.pone.0256801

PLoS One. 2021 Aug 26;16(8):e0256742. doi: 10.1371/journal.pone.0256742. eCollection 2021.

ABSTRACT

BACKGROUND: Women are underrepresented at higher levels of promotion or leadership despite the increasing number of women physicians. In surgery, this has been compounded by historical underrepresentation. With a nation-wide focus on the importance of diversity, our aim was to provide a current snapshot of gender representation in Canadian universities.

METHODS: This cross-sectional online website review assessed the current faculty listings for 17 university-affiliated academic surgical training departments across Canada in the 2019/2020 academic year. Gender diversity of academic surgical faculty was assessed across surgical disciplines. Additionally, gender diversity in career advancement, as described by published leadership roles, promotion and faculty appointment, was analyzed.

RESULTS: Women surgeons are underrepresented across Canadian surgical specialties (totals: 2,689 men versus 531 women). There are significant differences in the gender representation of surgeons between specialties and between universities, regardless of specialty. Women surgeons had a much lower likelihood of being at the highest levels of promotion (OR: 0.269, 95% CI: 0.179-0.405). Men surgeons were statistically more likely to hold academic leadership positions than women (p = 0.0002). Women surgeons had a much lower likelihood of being at the highest levels of leadership (OR: 0.372, 95% CI: 0.216-0.641).

DISCUSSION: This study demonstrates that women surgeons are significantly underrepresented at the highest levels of academic promotion and leadership in Canada. Our findings allow for a direct comparison between Canadian surgical subspecialties and universities. Individual institutions can use these data to critically appraise diversity policies already in place, assess their workforce and apply a metric from which change can be measured.

PMID:34437636 | DOI:10.1371/journal.pone.0256742

PLoS One. 2021 Aug 26;16(8):e0256685. doi: 10.1371/journal.pone.0256685. eCollection 2021.

ABSTRACT

Studies on the large-scale latitudinal patterns of gastropod drilling predation reveal that predation pressure may decrease or increase with increasing latitude, or even show no trend, questioning the generality of any large-scale latitudinal or biogeographic pattern. Here, we analyze the nature of spatio-environmental and latitudinal variation in gastropod drilling along the Indian eastern coast by using 76 samples collected from 39 locations, covering ~2500 km, incorporating several ecoregions, and ~15° latitudinal extents. We find no environmental or latitudinal gradient. In fact, drilling intensity varies highly within the same latitudinal bin, or oceanic sub-basins, or even the same ecoregions. Moreover, different ecoregions with their distinctive biotic and abiotic environmental variables show similar predation intensities. However, one pattern is prevalent: some small infaunal prey taxa, living in the sandy-muddy substrate-which are preferred by the naticid gastropods-are always attacked more frequently over others, indicating taxon and size selectivity by the predators. The result suggests that the biotic and abiotic factors, known to influence drilling predation, determine only the local predation pattern. In the present case, the nature of substrate and prey composition determines the local predation intensity: soft substrate habitats host dominantly small, infaunal prey. Since the degree of spatial variability in drilling intensity within any time bin can be extremely high, sometimes greater than the variability across consecutive time bins, temporal patterns in drilling predation can never be interpreted without having detailed knowledge of the nature of this spatial variability within a time bin.

PMID:34437602 | DOI:10.1371/journal.pone.0256685

PLoS One. 2021 Aug 26;16(8):e0256747. doi: 10.1371/journal.pone.0256747. eCollection 2021.

ABSTRACT

OBJECTIVE: Mass gathering events (MGEs) are associated with the transmission of COVID-19. Between 6 and 10 March 2020, several MGEs related to the Falles festival took place in Borriana, a municipality in the province of Castellon (Spain). The aim of this study was to estimate the incidence of COVID-19 and its association with these MGEs, and to quantify the potential risk factors of its occurrence.

METHODS: During May and June 2020, a population-based retrospective cohort study was carried out by the Public Health Center of Castelló and the Hospital de la Plana in Vila-real. Participants were obtained from a representative sample of 1663 people with potential exposure at six MGEs. A questionnaire survey was carried out to obtain information about attendance at MGEs and COVID-19 disease. In addition, a serologic survey of antibodies against SARS-Cov-2 was implemented. Inverse probability weighted regression was used in the statistical analysis.

RESULTS: A total of 1338 subjects participated in the questionnaire survey (80.5%), 997 of whom undertook the serologic survey. Five hundred and seventy cases were observed with an attack rate (AR) of 42.6%; average age was 36 years, 62.3% were female, 536 cases were confirmed by laboratory tests, and 514 cases were found with SARS-CoV-2 total antibodies. Considering MGE exposure, AR was 39.2% (496/1264). A dose-response relationship was found between MGE attendance and the disease, (adjusted relative risk [aRR] = 4.11 95% confidence interval [CI]3.25-5.19). Two MGEs with a dinner and dance in the same building had higher risks. Associated risk factors with the incidence were older age, obesity, and upper and middle class versus lower class; current smoking was protective.

CONCLUSIONS: The study suggests the significance of MGEs in the COVID-19 transmission that could explain the subsequent outbreak in Borriana.

PMID:34437628 | DOI:10.1371/journal.pone.0256747

PLoS One. 2021 Aug 26;16(8):e0256195. doi: 10.1371/journal.pone.0256195. eCollection 2021.

ABSTRACT

BACKGROUND: Psychiatric patients are at increased risk of being overweight or obese, and subsequently develop metabolic syndrome. Nevertheless, data regarding associated factors for weight gain are limited and inconsistent.

OBJECTIVE: The present study aimed to determine the risk of metabolic syndrome and its associated factors among psychiatric patients.

METHOD: A cross-sectional quantitative study was conducted among all psychiatric patients at the Psychiatric Unit of the University of Gondar Comprehensive Specialized Hospital from March 1- April 1, 2018. All eligible psychiatric patients were interviewed about their socio-demographic status,and clinical characteristics and useful parameters for the study were recorded from the medical records of the patients and by measuring waist to height ratio. Descriptive statistics were used to summarize baseline information.Binary logistic regression was used to determine the associated factors and P-value <0.05 and confidence interval (CI) of 95% were used as cut off points for determining statistical significance.

RESULT: From 300 patients included in the study, 168(56%) patients were females,and around 50.3% of the study participants had low literacy levels. As per waist to a height ratio scale, 58% (174) of the patients had a risk of metabolic syndrome. The Binary logistic regression analysis indicated that sex (p-<0.0001), occupation (p -0.032), marital status (p-0.006), and distance from the hospital (p<0.0001) were statistically significant determinants of metabolic syndrome risk in the psychiatric patient in our setting.

CONCLUSION: The majority of the psychiatric patients in the study setting had a risk of metabolic syndrome. Sex, marital status, employment status, and distance to the hospital were significantly associated with metabolic syndrome. Routine physical and laboratory investigations to detect metabolic syndrome are indispensable in psychiatric patients to prevent cardiovascular complications.

PMID:34437577 | DOI:10.1371/journal.pone.0256195

PLoS One. 2021 Aug 26;16(8):e0256423. doi: 10.1371/journal.pone.0256423. eCollection 2021.

ABSTRACT

BACKGROUND: Point-of-care (PoC) testing of platelet count (PLT) provides real-time data for rapid decision making. The goal of this study is to evaluate the accuracy and precision of platelet counting using a new microvolume (8 μL), absolute counting, 1.5 kg cytometry-based blood analyzer, the rHEALTH ONE (rHEALTH) in comparison with the International Society of Laboratory Hematology (ISLH) platelet method, which uses a cytometer and an impedance analyzer.

METHODS: Inclusion eligibility were healthy adults (M/F) ages 18-80 for donation of fingerprick and venous blood samples. Samples were from a random N = 31 volunteers from a single U.S. site. Samples were serially diluted to test thrombocytopenic ranges. Interfering substances and conditions were tested, including RBC fragments, platelet fragments, cholesterol, triglycerides, lipids, anti-platelet antibodies, and temperature.

RESULTS: The concordance between the rHEALTH and ISLH methods had a slope = 1.030 and R2 = 0.9684. The rHEALTH method showed a correlation between capillary and venous blood samples (slope = 0.9514 and R2 = 0.9684). Certain interferents changed platelet recovery: RBC fragments and anti-platelet antibodies with the ISLH method; platelet fragments and anti-platelet antibodies on the rHEALTH; and RBC fragments, platelets fragments, triglycerides and LDL on the clinical impedance analyzer. The rHEALTH’s precision ranged from 3.1-8.0%, and the ISLH from 1.0-10.5%.

CONCLUSIONS: The rHEALTH method provides similar results with the reference method and good correlation between adult capillary and venous blood samples. This demonstrates the ability of the rHEALTH to provide point-of-care assessment of normal and thrombocytopenic platelet counts from fingerprick blood with high precision and limited interferences.

PMID:34437590 | DOI:10.1371/journal.pone.0256423