Tag: statistics

Diagnosis (Berl). 2022 Jan 27. doi: 10.1515/dx-2021-0136. Online ahead of print.

ABSTRACT

OBJECTIVES: Podcasts have emerged as an efficient method for widespread delivery of educational clinical reasoning (CR) content. However, the impact of such podcasts on CR skills has not been established. We set out to determine whether exposure to expert reasoning in a podcast format leads to enhanced CR skills.

METHODS: This is a pseudo-randomized study of third-year medical students (MS3) to either a control group (n=22) of pre-established online CR modules, or intervention group (n=26) with both the online modules and novel CR podcasts. The podcasts were developed from four “clinical unknown” cases presented to expert clinician educators. After completing these assignments in weeks 1-2, weekly history and physical (H&P) notes were collected and graded according to the validated IDEA rubric between weeks 3-7. A longitudinal regression model was used to compare the H&P IDEA scores over time. Usage and perception of the podcasts was also assessed via survey data.

RESULTS: Ninety control and 128 intervention H&Ps were scored. There was no statistical difference in the change of average IDEA scores between intervention (0.92, p=0.35) and control groups (-0.33, p=0.83). Intervention participants positively received the podcasts and noted increased discussion of CR principles from both their ward (3.1 vs. 2.4, p=0.08) and teaching (3.2 vs. 2.5, p=0.05) attendings.

CONCLUSIONS: This is the first objective, pseudo-randomized assessment of CR podcasts in undergraduate medical education. While we did not demonstrate significant improvement in IDEA scores, our data show that podcasts are a well-received tool that can prime learners to recognize CR principles.

PMID:35086184 | DOI:10.1515/dx-2021-0136

Oncology. 2022 Jan 27. doi: 10.1159/000522204. Online ahead of print.

ABSTRACT

BACKGROUND: With an estimated 1.8 million deaths, lung cancer is one of the widely reported malignancies, with substantial morbidity and mortality rates. Thymidylate synthase (TS) is an important drug target for platinum-based doublet chemotherapy as it is the only de novo source of thymidylate production in the cell. TS polymorphisms in the 5’UTR of Thymidylate synthase enhancer region (TSER) 2R/3R and 3′- UTR 1494del6 are investigated in this study.

METHODS: A total of 700 lung cancer patients with platinum-based doublet chemotherapy were recruited in this study. TSER (2R/3R) and TS 1494del6 polymorphisms in North Indian lung cancer patients were examined, and statistical analysis was performed.

RESULTS: According to our findings, patients with the wild genotype (2R/2R) for the TSER polymorphism had a longer median survival time as compared to patients harboring the mutant type genotype (3R/3R) [MST=9.77 vs. 7.57 months; p=0.04]. On the contrary, patients with the mutant 14946del6 polymorphism (-6/-6) had a longer survival time than patients with the wild-type genotype (+6/+6) [MST=7.23 vs. 9 months]. Further, our findings elucidated that the patients with heterozygous genotype (2R3R) for TSER polymorphism had a 2.30-fold increased risk of developing leukopenia (AOR=2.30, 95% CI=0.96-5.52; p=0.05). A substantial risk of 5.14-fold constipation was found in heterozygous genotype (2R3R) when intermediate grade 2 toxicity was compared with low toxicity (grade 1) (p=0.007).An increased risk of nausea/vomiting was observed in patients with mutant genotype (-6/-6bp) for 1494 ins/del6 polymorphism compared to patients with wild-type genotype (+6/+6bp) (AOR= 2.77; 95%CI=1.10-6.96, p=0.03).

CONCLUSION: According to our findings, TSER and the 1494del6 polymorphism may operate as a prognostic marker in lung cancer patients receiving platinum-based chemotherapy. Furthermore, TS polymorphisms may influence the onset of platinum-related toxicity, such as hematological and gastrointestinal toxicity. These findings might facilitate therapeutic decisions for individualized therapy in lung cancer patients.

PMID:35086099 | DOI:10.1159/000522204

Acad Med. 2022 Jan 25. doi: 10.1097/ACM.0000000000004607. Online ahead of print.

ABSTRACT

PURPOSE: Using electrocardiogram (ECG) interpretation as an example of a widely taught diagnostic skill, the authors conducted a systematic review and meta-analysis to demonstrate how research evidence on instruction in diagnosis can be synthesized to facilitate improvement of educational activities (instructional modalities, instructional methods, and interpretation approaches), guide the content and specificity of such activities, and provide direction for research.

METHOD: The authors searched PubMed/MEDLINE, EMBASE, Cochrane CENTRAL, PsycInfo, CINAHL, ERIC, and Web of Science databases through February 21, 2020, for empirical investigations of ECG interpretation training enrolling medical students, residents, or practicing physicians. They appraised study quality with the Medical Education Research Study Quality Instrument and pooled standardized mean differences (SMDs) using random effects meta-analysis.

RESULTS: Of 1,002 articles identified, 59 were included (enrolling 17,251 participants). Among 10 studies comparing instructional modalities, 8 compared computer-assisted and face-to-face instruction, with pooled SMD 0.23 (95% CI, 0.09, 0.36) indicating a small, statistically significant difference favoring computer-assisted instruction. Among 19 studies comparing instructional methods, 5 evaluated individual versus group training (pooled SMD 0.35 favoring group study [95% CI, 0.06, 0.63]); 4 evaluated peer-led versus faculty-led instruction (pooled SMD 0.38 favoring peer instruction [95% CI, 0.01, 0.74]); and 4 evaluated contrasting ECG features (e.g., QRS width) from 2 or more diagnostic categories versus routine examination of features within a single ECG or diagnosis (pooled SMD 0.23 not significantly favoring contrasting features [95% CI, -0.30, 0.76]). Eight studies compared ECG interpretation approaches, with pooled SMD 0.92 (95% CI, 0.48, 1.37) indicating a large, statistically significant effect favoring more systematic interpretation approaches.

CONCLUSIONS: Some instructional interventions appear to improve learning in ECG interpretation; however, many evidence-based instructional strategies are insufficiently investigated. The findings may have implications for future research and design of training to improve skills in ECG interpretation and other types of visual diagnosis.

PMID:35086115 | DOI:10.1097/ACM.0000000000004607

J Phys Condens Matter. 2022 Jan 27. doi: 10.1088/1361-648X/ac4f7e. Online ahead of print.

ABSTRACT

We demonstrate theoretically the possibility of spinodal de-wetting in heterostructures made of light-atom liquids (hydrogen, helium, and nitrogen) deposited on suspended graphene. Extending our theory of film growth on two-dimensional materials to include analysis of surface instabilities via the hydrodynamic Cahn-Hilliard-type equation, we characterize in detail the spatial and temporal scales of the resulting spinodal de-wetting patterns. Both linear stability analysis and direct numerical simulations of the surface hydrodynamics show micron-sized (generally material dependent) patterns of “dry” regions. The physical reason for the development of such instabilities on graphene can be traced back to the inherently weak van der Waals interactions between atomically thin materials and atoms in the liquid. Thus two-dimensional materials could represent a new theoretical and technological platform for studies of spinodal de-wetting.

PMID:35086067 | DOI:10.1088/1361-648X/ac4f7e

J Neural Eng. 2022 Jan 27. doi: 10.1088/1741-2552/ac4f9b. Online ahead of print.

ABSTRACT

Introduction The human orbitofrontal cortex (OFC) is involved in automatic response inhibition and conflict processing, but the mechanism of frequency-specific power changes that control these functions is unknown. Theta and gamma activity have been independently observed in the OFC during conflict processing, while theta-gamma interactions in other brain areas have been noted primarily in studies of memory. Within the OFC, it is possible that theta-gamma phase amplitude coupling (PAC) drives conflict processing. Objective This study aims to characterize the coupled relationship between theta and gamma frequency bands in the OFC during conflict processing using a modified Stroop task. Methods Eight epilepsy patients implanted with OFC stereotactic electroencephalography (SEEG) electrodes participated in a color-word modified Stroop task. PAC between theta phase and gamma amplitude was assessed to determine the timing and magnitude of neural oscillatory changes. Group analysis was conducted using a non-parametric cluster-permutation t-test on coherence values. Results Theta-low gamma (LG) PAC significantly increased in five out of eight patients during successful trials of the incongruent condition compared with the congruent condition. Significant increases in theta-LG PAC were most prominent during cue processing 200-800ms after cue presentation. On group analysis, trial-averaged mean theta-LG PAC was statistically significantly greater in the incongruent condition compared to the congruent condition (p < 0.001, Cohen’s d=0.51). Conclusion For the first time, we report that OFC theta phase and LG amplitude coupling increases during conflict resolution. Given the delayed onset after cue presentation, OFC theta-LG PAC may contribute to conflict processing after conflict detection and before motor response. This explanation follows the hypothesis that global theta waves modulate local gamma signals. Understanding this relationship within the OFC will help further elucidate the neural mechanisms of human conflict resolution.

PMID:35086075 | DOI:10.1088/1741-2552/ac4f9b

Food Chem. 2022 Jan 20;380:132195. doi: 10.1016/j.foodchem.2022.132195. Online ahead of print.

ABSTRACT

An important problem in the olive sector is the occasional mismatch of results obtained by different tasting panels when the same olive oil sample is analysed. These discrepancies could be minimised by using reference materials (RM) for taster training. A comprehensive protocol based on the combined use of sensory and instrumental analysis for the certification of olive oil batches as RMs, developed within the framework of the project ‘Operational Group INTERPANEL’, is proposed. Similarity indices (R², cosθ and NEAR) applied on GC-MS fingerprints, allow a successful homogeneity and stability assessment of produced batches. Furthermore, the use of robust statistics combined with a set of instructions developed to remove outliers were applied with excellent results on sensory data set provided by supra-panel composed by more than 100 qualified tasters. This work is the first to provide a comprehensive protocol for certification of real olive oil samples as RM for sensory analysis.

PMID:35086013 | DOI:10.1016/j.foodchem.2022.132195

Schizophr Res. 2022 Jan 24;241:52-58. doi: 10.1016/j.schres.2021.12.025. Online ahead of print.

ABSTRACT

Aberrant salience (AS) is considered as a predisposing factor in early psychosis. Although it has been frequently examined in the general population as a measure of vulnerability to psychotic disorder, empirical evidence on AS in prodromal phases of psychosis is still relatively scarce. Thus, the aims of this research were (1) to investigate any significant association of AS with functioning, psychopathology and treatment components of an “early intervention in psychosis” program in a sample of young community help-seekers at Ultra-High Risk (UHR) of psychosis along a 1-year follow-up period, and (2) to longitudinally monitor the stability of AS across the 1 year of follow-up. Participants (87 UHR), aged 13-35 years, completed the Aberrant Salience Inventory (ASI), the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the brief version of the Schizotypal Personality Questionnaire (SPQ-B) at baseline and after the 1 year of follow-up. Spearman correlation analyses among psychopathological parameters and specialized treatment components were performed. A multiple linear regression analysis was also carried out. After a 1-year follow-up period, UHR subjects had a statistically relevant decrease in ASI total scores. This was significantly related to the number of individual cognitive-behavioral therapy (CBT) sessions and the number of family psychoeducational sessions offered to UHR participants and their family members during the same 12-month period. In conclusion, AS is clinically relevant in UHR individuals. However, it seems to improve over time along with the delivery of tailored, specialized psychosocial interventions for early psychosis.

PMID:35086058 | DOI:10.1016/j.schres.2021.12.025

J Environ Manage. 2022 Jan 24;307:114571. doi: 10.1016/j.jenvman.2022.114571. Online ahead of print.

ABSTRACT

The enormous biodiversity of tropical freshwater combined with a considerable increase in the construction of reservoirs urges to understand the ecological effects caused by damming. Using rarely available data obtained before (one year) and after (four years) the filling of a hydroelectric plant on the Teles Pires River (Amazon River basin), the effects on abundance, biomass, and diversity of the fish assemblage were evaluated using two complementary approaches: a BACI (before-after-control-impact) design with mixed models and analyses of covariance. Significant Before-After × Control-Impact interactions in abundance, biomass, and species richness were observed, with decreases of abundance and species richness and more stable biomass after filling. Some abundant species, such as Jupiaba polylepis, Jupiaba acanthogaster, Knodus cf. heteresthes, and Moenkhausia lepidura among others, declined in abundance or disappeared from the impact sites. However, temporal and particularly spatial variation independent of damming explained more variation in all the response variables analyzed, including species composition, and analyses of covariance demonstrated general negative trends irrespective of damming. This study illustrates the usefulness of BACI designs to assess the effects of damming but also that other statistical approaches are complementary, given the difficulty of identifying control sites and the short length of most ecological time series. The results also suggest that preserving tributaries upstream of reservoirs and natural regimes of spatial and temporal environmental variation might help to mitigate the impacts of damming in tropical ecosystems.

PMID:35085970 | DOI:10.1016/j.jenvman.2022.114571

J Surg Res. 2022 Jan 24;273:172-180. doi: 10.1016/j.jss.2021.12.029. Online ahead of print.

ABSTRACT

INTRODUCTION: Roux-en-Y Gastric Bypass (RYGB) has been associated with increased weight loss but more complications when compared with sleeve gastrectomy (SG). However, a direct comparison between RYGB and SG has never been performed in patients with a history of solid organ transplantation. The aim of this study was to determine the association between procedure type and surgical outcomes.

MATERIALS AND METHODS: Patients with a history of solid organ transplantation were identified in the Metabolic and Bariatric Surgery Accreditation Quality Improvement Project Participant Use File database from 2017 to 2018. Procedure type (SG versus RYGB) was used to stratify patients. Propensity score matching and multivariable logistic regressions were used, and outcomes were compared.

RESULTS: Of 678 cases identified, 80% (n = 542) underwent an SG and 20% (n = 136) had an RYGB. Patients differed significantly (P < 0.05) by multiple demographic variables. Multivariable regression revealed RYGB to be associated with higher overall morbidity (odds ratio [OR] 1.98; P = 0.012), morbidity related to surgery (OR 2.47; P = 0.002), unplanned readmissions (OR 2.48; P = 0.002), and readmissions related to surgery (OR 2.32; P = 0.016). After propensity score matching, RYGB, compared with SG, was also associated with higher morbidity (14% versus 7.4%; P = 0.077) and readmissions (13% versus 6.6%; P = 0.099) related to surgery, although this did not reach statistical significance.

CONCLUSIONS: In patients with a history of solid organ transplant, RYGB was associated with increased morbidity and readmissions compared with SG.

PMID:35085944 | DOI:10.1016/j.jss.2021.12.029

J Environ Manage. 2022 Jan 24;307:114560. doi: 10.1016/j.jenvman.2022.114560. Online ahead of print.

ABSTRACT

Air quality profoundly impacts public health and environmental equity. Efficient and inexpensive air quality monitoring instruments could be greatly beneficial for human health and air pollution control. This study proposes an image-based deep learning model (CNN-RC) that integrates a convolutional neural network (CNN) and a regression classifier (RC) to estimate air quality at areas of interest through feature extraction from photos and feature classification into air quality levels. The models were trained and tested on datasets with different combinations of the current image, the baseline image, and HSV (hue, saturation, value) statistics for increasing model reliability and estimation accuracy. A total of 3549 hourly air quality datasets (including photos, PM2.5, PM10, and the air quality index (AQI)) collected at the Linyuan air quality monitoring station of Kaohsiung City in Taiwan constituted the case study. The main breakthrough of this study is to timely produce an accurate image-based estimation of several pollutants simultaneously by using only one single deep learning model. The test results show that estimation accuracy in terms of R² for PM_2.5, PM_10, and AQI based on daytime (nighttime) images reaches 76% (83%), 84% (84%), and 76% (74%), respectively, which demonstrates the great capability of our method. The proposed model offers a promising solution for rapid and reliable multi-pollutant estimation and classification based solely on captured images. This readily scalable measurement approach could address major gaps between air quality data acquired from expensive instruments worldwide.

PMID:35085968 | DOI:10.1016/j.jenvman.2022.114560