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Asian Pacific Journal of Cancer... Jun 2024With earlier prostate cancer (PCa) diagnosis and increased survivorship, post-treatment quality of life (QoL) has become increasingly important. The Expanded Prostate...
BACKGROUND
With earlier prostate cancer (PCa) diagnosis and increased survivorship, post-treatment quality of life (QoL) has become increasingly important. The Expanded Prostate Cancer Index Composite (EPIC) is a widely adopted QoL instrument for PCa. We aimed to create a Punjabi version of EPIC to further research in the Punjabi-speaking population.
METHODS
A prototype of the Punjabi version of EPIC was created by forward-backward translations and revision. After concluding the cultural adaptation phase by interviewing 15 participants, a pilot version was created. Validation of the pilot version was performed by having 72 participants complete the Punjabi EPIC and another commonly used QoL instrument, the EORTC QLQ-c30, twice within a 4-week period. Test retest reliability (Pearson's correlations and difference distribution) and internal consistency (Cronbach's alpha) were measured using SAS version 9.4.
RESULTS
Modifications were needed for the prototype Punjabi version after forward-backward translations. Cultural adaptation has highlighted a few issues including syntax and terminology. Test-retest reliability of the Urinary, Bowel, Sexual and Hormone domains were 0.88, 0.91, 0.91, and 0.95, respectively, and subscale correlations ranged from 0.75 to 0.93. Internal consistency for domains and subscales was good except for Sexual Domain. Performance of EPIC is comparable, and in some cases, slightly better than validated Punjabi version of EORTC QLQ-C30.
CONCLUSIONS
The EPIC questionnaire was successfully translated into Punjabi and was culturally adapted. The resultant Punjabi version has high reliability and validity and will be an important tool for QoL research in the Punjabi population. EPIC was successfully translated, culturally adapted, and validated with high reliability and validity into Punjabi. It will be a valuable QoL tool for physicians in clinical and research settings, and for patients in decision-making.
Topics: Humans; Male; Quality of Life; Surveys and Questionnaires; Prostatic Neoplasms; Reproducibility of Results; Middle Aged; Aged; Psychometrics; Prognosis; Translations; Follow-Up Studies; Pilot Projects; India
PubMed: 38918655
DOI: 10.31557/APJCP.2024.25.6.1945 -
ENeuro Jun 2024Typical statistical practices in the biological sciences have been increasingly called into question due to difficulties in the replication of an increasing number of...
Typical statistical practices in the biological sciences have been increasingly called into question due to difficulties in the replication of an increasing number of studies, many of which are confounded by the relative difficulty of null significance hypothesis testing designs and interpretation of p-values. Bayesian inference, representing a fundamentally different approach to hypothesis testing, is receiving renewed interest as a potential alternative or complement to traditional null significance hypothesis testing due to its ease of interpretation and explicit declarations of prior assumptions. Bayesian models are more mathematically complex than equivalent frequentist approaches, which have historically limited applications to simplified analysis cases. However, the advent of probability distribution sampling tools with exponential increases in computational power now allows for quick and robust inference under any distribution of data. Here we present a practical tutorial on the use of Bayesian inference in the context of neuroscientific studies in both rat electrophysiological and computational modeling data. We first start with an intuitive discussion of Bayes' rule and inference followed by the formulation of Bayesian-based regression and ANOVA models using data from a variety of neuroscientific studies. We show how Bayesian inference leads to easily interpretable analysis of data while providing an open-source toolbox to facilitate the use of Bayesian tools. Bayesian inference has received renewed interest as an alternative to null-significance hypothesis testing for its interpretability, ability to incorporate prior knowledge into current inference, and robust model comparison paradigms. Despite this renewed interest, discussions of Bayesian inference are often obfuscated by undue mathematical complexity and misunderstandings underlying the Bayesian inference process. In this article, we aim to empower neuroscientists to adopt Bayesian statistical inference by providing a practical methodological walkthrough using single and multi-unit recordings from the rodent auditory circuit accompanied by a well-documented and user-friendly toolkit containing regression and ANOVA statistical models commonly encountered in neuroscience.
PubMed: 38918054
DOI: 10.1523/ENEURO.0484-23.2024 -
Journal of Medical Internet Research Jun 2024Cancer has emerged as a considerable global health concern, contributing substantially to both morbidity and mortality. Recognizing the urgent need to enhance the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cancer has emerged as a considerable global health concern, contributing substantially to both morbidity and mortality. Recognizing the urgent need to enhance the overall well-being and quality of life (QOL) of cancer patients, a growing number of researchers have started using online mindfulness-based interventions (MBIs) in oncology. However, the effectiveness and optimal implementation methods of these interventions remain unknown.
OBJECTIVE
This study evaluates the effectiveness of online MBIs, encompassing both app- and website-based MBIs, for patients with cancer and provides insights into the potential implementation and sustainability of these interventions in real-world settings.
METHODS
Searches were conducted across 8 electronic databases, including the Cochrane Library, Web of Science, PubMed, Embase, SinoMed, CINAHL Complete, Scopus, and PsycINFO, until December 30, 2022. Randomized controlled trials involving cancer patients aged ≥18 years and using app- and website-based MBIs compared to standard care were included. Nonrandomized studies, interventions targeting health professionals or caregivers, and studies lacking sufficient data were excluded. Two independent authors screened articles, extracted data using standardized forms, and assessed the risk of bias in the studies using the Cochrane Bias Risk Assessment Tool. Meta-analyses were performed using Review Manager (version 5.4; The Cochrane Collaboration) and the meta package in R (R Foundation for Statistical Computing). Standardized mean differences (SMDs) were used to determine the effects of interventions. The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework was used to assess the potential implementation and sustainability of these interventions in real-world settings.
RESULTS
Among 4349 articles screened, 15 (0.34%) were included. The total population comprised 1613 participants, of which 870 (53.9%) were in the experimental conditions and 743 (46.1%) were in the control conditions. The results of the meta-analysis showed that compared with the control group, the QOL (SMD 0.37, 95% CI 0.18-0.57; P<.001), sleep (SMD -0.36, 95% CI -0.71 to -0.01; P=.04), anxiety (SMD -0.48, 95% CI -0.75 to -0.20; P<.001), depression (SMD -0.36, 95% CI -0.61 to -0.11; P=.005), distress (SMD -0.50, 95% CI -0.75 to -0.26; P<.001), and perceived stress (SMD -0.89, 95% CI -1.33 to -0.45; P=.003) of the app- and website-based MBIs group in patients with cancer was significantly alleviated after the intervention. However, no significant differences were found in the fear of cancer recurrence (SMD -0.30, 95% CI -1.04 to 0.44; P=.39) and posttraumatic growth (SMD 0.08, 95% CI -0.26 to 0.42; P=.66). Most interventions were multicomponent, website-based health self-management programs, widely used by international and multilingual patients with cancer.
CONCLUSIONS
App- and website-based MBIs show promise for improving mental health and QOL outcomes in patients with cancer, and further research is needed to optimize and customize these interventions for individual physical and mental symptoms.
TRIAL REGISTRATION
PROSPERO CRD42022382219; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=382219.
Topics: Adult; Female; Humans; Male; Internet; Internet-Based Intervention; Mindfulness; Neoplasms; Quality of Life
PubMed: 38917445
DOI: 10.2196/47704 -
PloS One 2024This study aims to enhance the post-training evaluation of the annual performance agreement (APA) training organized by the Bangladesh Public Administration Training...
This study aims to enhance the post-training evaluation of the annual performance agreement (APA) training organized by the Bangladesh Public Administration Training Centre (BPATC), the apex training institute for civil servants. Utilizing fuzzy-set qualitative comparative analysis (fsQCA) and artificial neural network (ANN) techniques within Kirkpatrick's four-stage model framework, data were collected from a self-administered questionnaire survey of 71 in-service civil servants who participated in the APA training program. This study employs an asymmetric, non-linear model analyzed through a configurational approach and ANN to explore interrelationships among the four Kirkpatrick levels namely, reaction, learning, behavior, and results. Findings indicate that trainees were satisfied across all levels, identifying a non-linear relationship among these levels in post-training evaluation process. The research highlights that "learning skills" are most significant in the APA post-training evaluation, followed by behavior, results, and reaction. Theoretically, this research advances Kirkpatrick's model and adds to the literature on public service post-training evaluation. Practically, it recommends prioritizing strategies that address cognitive barriers to enhance training effectiveness. This study's innovative approach lies in its concurrent use of fsQCA and ANN methods to analyze the success or failure of APA-related trainees, offering alternative pathways to desired outcomes and contrasting traditional quantitative methods that provide a single solution. The findings have practical implications for public service training institutions and bureaucratic policymakers involved in capacity development, guiding the creation of more effective in-service training courses for public officials. The methodology and analysis can be applied in other contexts, allowing bureaucratic policymakers to replicate these findings in their learning institutes to identify unique configurations that lead to successful or unsuccessful training outcomes, adopt effective strategies, and avoid detrimental ones.
Topics: Humans; Neural Networks, Computer; Bangladesh; Surveys and Questionnaires; Male; Female; Adult; Learning
PubMed: 38917194
DOI: 10.1371/journal.pone.0305916 -
PloS One 2024The implementation of AI assisted cancer detection systems in clinical environments has faced numerous hurdles, mainly because of the restricted explainability of their...
The implementation of AI assisted cancer detection systems in clinical environments has faced numerous hurdles, mainly because of the restricted explainability of their elemental mechanisms, even though such detection systems have proven to be highly effective. Medical practitioners are skeptical about adopting AI assisted diagnoses as due to the latter's inability to be transparent about decision making processes. In this respect, explainable artificial intelligence (XAI) has emerged to provide explanations for model predictions, thereby overcoming the computational black box problem associated with AI systems. In this particular research, the focal point has been the exploration of the Shapley additive explanations (SHAP) and local interpretable model-agnostic explanations (LIME) approaches which enable model prediction explanations. This study used an ensemble model consisting of three convolutional neural networks(CNN): InceptionV3, InceptionResNetV2 and VGG16, which was based on averaging techniques and by combining their respective predictions. These models were trained on the Kvasir dataset, which consists of pathological findings related to gastrointestinal cancer. An accuracy of 96.89% and F1-scores of 96.877% were attained by our ensemble model. Following the training of the ensemble model, we employed SHAP and LIME to analyze images from the three classes, aiming to provide explanations regarding the deterministic features influencing the model's predictions. The results obtained from this analysis demonstrated a positive and encouraging advancement in the exploration of XAI approaches, specifically in the context of gastrointestinal cancer detection within the healthcare domain.
Topics: Humans; Gastrointestinal Neoplasms; Neural Networks, Computer; Artificial Intelligence; Diagnosis, Computer-Assisted
PubMed: 38917159
DOI: 10.1371/journal.pone.0305628 -
PloS One 2024The relationship between plant-based diets and gallstone disease has been debated. This study aimed to shed light on the association between plant-based dietary index...
BACKGROUND
The relationship between plant-based diets and gallstone disease has been debated. This study aimed to shed light on the association between plant-based dietary index and the risk of developing gallstone disease.
METHODS
Eligible participants were selected from National Health and Nutrition Examination Survey (NHANES) 2017-2020. Three plant-based diet indexes (PDI, healthy PDI, unhealthy PDI) were calculated using data from two NHANES 24-h dietary recall interviews. Restricted Cubic Spline and multivariate logistic regression were used to analyze the associations. Subgroup analysis was adopted to make the results more robust.
RESULTS
A total of 5673 eligible participants were analyzed. After adjusting for various confounding variables, uPDI was positively associated with gallstone disease (OR = 1.53, 95%CI: 1.02-2.29). No association was found between PDI/hPDI and gallstone disease (p > 0.05). The results of subgroup analysis did not show any positive association between uPDI and gallstones in specific groups.
CONCLUSION
Our study shows that the elevated uPDI are linked to a higher risk of gallstone disease.
Topics: Humans; Gallstones; Female; Male; Cross-Sectional Studies; Middle Aged; Nutrition Surveys; Adult; Diet, Vegetarian; Risk Factors; Aged
PubMed: 38917153
DOI: 10.1371/journal.pone.0305822 -
PloS One 2024This study aimed to understand the health of workers exposed to occupational noise and explore the influencing factors related to workers' health, especially the impact...
OBJECTIVE
This study aimed to understand the health of workers exposed to occupational noise and explore the influencing factors related to workers' health, especially the impact of noise on workers' hearing. This work can provide a basis for formulating relevant measures for occupational noise prevention and control in the future.
METHODS
On the basis of the key occupational disease monitoring project in Chongqing, China, in 2021, the data of 1125 workers exposed to occupational noise were analyzed. Data included demographic information, occupational history, clinical physical examination information, and noise detection information of the working environment. Chi-square test and multifactorial logistic regression were used for statistical analysis.
RESULTS
The prevalence rates of abnormal electrocardiogram (ECG), blood pressure (BP), and pure tone audiometry (PTA) were 21.9% (246/1125), 27.8% (313/1125), and 18.0% (202/1125), respectively. Male workers accounted for 78.8%. Compared with male workers, female workers had a lower prevalence of abnormal PTA (OR = 0.28, 95% CI = 0.16-0.50). Workers working in medium enterprises had a lower prevalence of abnormal BP than workers in micro enterprises (OR = 0.36, 95% CI = 0.19-0.66). The prevalence of abnormal BP and PTA of workers increased with age. After adjusting for age, sex, and body mass index, the prevalence of abnormal ECG of mining workers was higher than that of manufacturing workers (OR = 1.54, 95% CI = 1.07-2.24), and the prevalence of abnormal PTA had a rising trend with the increase in noise exposure value.
CONCLUSION
Noise-exposed workers have a high prevalence of abnormal ECG, BP, and PTA, and factors such as age, enterprise size, and workplace noise exposure are correlated with the aberrant health of workers. Governments, enterprises, and individuals need to attach great importance to the possible adverse effects of noise. They must also actively adopt various effective measures to protect the occupational safety and health of workers.
Topics: Humans; Noise, Occupational; Male; China; Female; Cross-Sectional Studies; Adult; Middle Aged; Occupational Exposure; Prevalence; Hearing Loss, Noise-Induced; Blood Pressure; Occupational Diseases; Electrocardiography; Audiometry, Pure-Tone; Young Adult
PubMed: 38917109
DOI: 10.1371/journal.pone.0305576 -
PloS One 2024Non-adherence to immunosuppressive medication after kidney transplant is an important cause of graft rejection and loss. Approaches to minimization of non-adherence have...
Study protocol for the development and validation of a questionnaire evaluating predisposition to immunosuppressant medication non-adherence of kidney pre-transplant patients. The KATITA project.
Non-adherence to immunosuppressive medication after kidney transplant is an important cause of graft rejection and loss. Approaches to minimization of non-adherence have focused on the identification of episodes of medication non-adherence, but by then irreparable harm to the graft may already have occurred, and a more effective approach would be to adopt preventive measures in patients who may have difficulty in adhering to medication. The aim of this study protocol is to develop and validate a clinical questionnaire for assessing, in kidney transplant candidate patients in the pre-transplant setting, the predisposition to non-adherence to immunosuppressive medication. In this multicenter, prospective study, a pilot questionnaire in Brazilian Portuguese language, composed of Likert-scaled statements expressing patients' beliefs, behaviors and barriers regarding medication taking will be assembled from a literature review, from focus groups, and an expert panel. The pilot questionnaire will be administered to a minimum of 300 patients in kidney transplant waiting lists and exploratory factor analysis will be used for development of the definitive questionnaire. A random subsample of a minimum of 60 patients will have the scale re-administered after one month for evaluation of test-retest reliability. A multicenter, external validation study will include 364 kidney transplant candidates who will be evaluated immediately before surgery and at months 3, 6 and 12 post-transplant for assessment of concurrent validity, by comparison with two scales that assess medication non-adherence, and for determination of predictive validity using a triangulation method for assessment of medication non-adherence. Structural validity will be assessed with confirmatory factor analysis using structural equation modeling. Cross-cultural generalizability and validity will be assessed by a multicenter study, in which a translation of the scale to another language will be administered to kidney transplant candidate patients from a different culture, with a subsample being selected for test-retest. This study will be conducted in Spain with a Spanish translation of the scale.
Topics: Humans; Kidney Transplantation; Immunosuppressive Agents; Surveys and Questionnaires; Medication Adherence; Prospective Studies; Reproducibility of Results; Graft Rejection; Pilot Projects; Female; Male
PubMed: 38917103
DOI: 10.1371/journal.pone.0305953 -
PloS One 2024Over 65s are frequent attenders to the Emergency Department (ED) and more than half are admitted for overnight stays. Early assessment and intervention by a dedicated... (Randomized Controlled Trial)
Randomized Controlled Trial
The cost effectiveness of early assessment and intervention by a dedicated health and social care professional team for older adults in the emergency department compared to treatment-as-usual: Economic evaluation of the OPTI-MEND trial.
BACKGROUND
Over 65s are frequent attenders to the Emergency Department (ED) and more than half are admitted for overnight stays. Early assessment and intervention by a dedicated ED-based Health and Social Care Professionals (HSCP) team reduces ED length of stay and the risk of hospital admissions among older adults while improving patient health-related quality-of-life and satisfaction with care. This study aims to evaluate whether augmenting the treatment as usual for older adults admitted to ED is cost-effective.
METHODS AND FINDINGS
Cost-effectiveness analysis (CEA), conducted alongside the OPTI-MEND randomised controlled trial of 353 patients aged ≥65 with lower urgency complaints compared the effectiveness of early assessment and intervention by a dedicated HSCP team in the ED to treatment as usual (TAU). An economic analysis estimated the average cost per older adults randomised to the HSCP team, and compared to TAU, how contact with HSCP team changed health care use, and associated total costs, and estimated the effect of HSCP on Quality-Adjusted Life Years (QALYs). Within the OPTI-MEND trial, the average cost of a contact with the HSCP team during ED attendance is estimated to be €801 per patient. Compared to TAU, the incremental QALY of intervention is 0.053 (95% CI: 0.023 to 0.0826, p<0.0001). Accounting for cost savings because of contact with HSCP team, the average incremental saving in the total cost, compared to TAU, is -€6,128 (95% CI: -€9,217 to -€3,038, p<0.0001). Given the incremental health gains and significant cost savings, bootstrapped cost CEA suggests that dedicated HSCP care dominates over TAU for low urgency older adults attending the ED.
CONCLUSIONS
A dedicated HSCP team in the ED significantly improves overall health for lower acuity older adults and, by reducing inpatient length of stay, results in staggering cost savings. This economic evaluation conducted on the OPTI-MEND trial provides convincing evidence that HSCP should be adopted as part of treatment as usual in Irish EDs.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT03739515; registered on 12th November 2018. https://classic.clinicaltrials.gov/ct2/show/NCT03739515.
Topics: Humans; Aged; Cost-Benefit Analysis; Emergency Service, Hospital; Female; Male; Aged, 80 and over; Quality-Adjusted Life Years; Length of Stay; Quality of Life; Patient Care Team; Hospitalization; Cost-Effectiveness Analysis
PubMed: 38917081
DOI: 10.1371/journal.pone.0298162 -
PloS One 2024Diversity, equity, and inclusion (DEI) mission statements continue to be adopted by academic institutions in general, and by dental schools around the globe in...
Diversity, equity, and inclusion (DEI) mission statements continue to be adopted by academic institutions in general, and by dental schools around the globe in particular. But DEI content seems to be under-developed in dental education. The objectives of this study were two-fold: to extract information from all the PBL cases at University of British Columbia's Faculty of Dentistry curriculum in terms of the diversity, equitable representation, and inclusion of patient and provider characteristics, context, and treatment outcomes; and; to compare these findings with the composition of the British Columbia census population, dental practice contextual factors, and the evidence on treatment outcomes within patient care. Information from all the 58 PBL cases was extracted between January and March 2023, focusing on patient and provider characteristics (e.g., age, gender, ethnicity), context (e.g., type of insurance), and treatment outcomes (e.g., successful/unsuccessful). This information was compared with the available literature. From all the 58 PBL cases, 0.4% included non-straight patients, while at least 4% of BC residents self-identify as non-straight; there were no cases involving First Nations patients although they make up 6% of the British Columbia population. Less than 10% of the cases involved older adults who make up almost 20% of the population. Only Treatments involving patients without a disability were 5.74 times more likely to be successful compared to those involving patients with a disability (p<0.05). The characteristics of the patients, practice context, and treatment outcomes portrayed in the existing PBL cases seem to differ from what is known about the composition of the British Columbia population, treatment outcome success, and practice context; a curriculum disconnect seems to exist. The PBL cases should be revised to better represent the population within which most students will practice.
Topics: Humans; Curriculum; Problem-Based Learning; British Columbia; Male; Female; Cultural Diversity; Education, Dental; Adult
PubMed: 38917078
DOI: 10.1371/journal.pone.0298843