A survey of statistics in three UK general practice journal

Background Many medical specialities have reviewed the statistical content of their journals. To our knowledge this has not been done in general practice. Given the main role of a general practitioner as a diagnostician we thought it would be of interest to see whether the statistical methods reported reflect the diagnostic process. Methods Hand search of three UK journals of general practice namely the British Medical Journal (general practice section), British Journal of General Practice and Family Practice over a one-year period (1 January to 31 December 2000). Results A wide variety of statistical techniques were used. The most common methods included t-tests and Chi-squared tests. There were few articles reporting likelihood ratios and other useful diagnostic methods. There was evidence that the journals with the more thorough statistical review process reported a more complex and wider variety of statistical techniques. Conclusions The BMJ had a wider range and greater diversity of statistical methods than the other two journals. However, in all three journals there was a dearth of papers reflecting the diagnostic process. Across all three journals there were relatively few papers describing randomised controlled trials thus recognising the difficulty of implementing this design in general practice

Efficacy of green infrastructure in reducing exposure to local, traffic-related sources of airborne particulate matter (PM)

One aim of roadside green infrastructure (GI) is to mitigate exposure to local, traffic-generated pollutants. Here, we determine the efficacy of roadside GI in improving local air quality through the deposition and/or dispersion of airborne particulate matter (PM). PM was collected on both pumped air filters and on the leaves of a recently installed ‘tredge’ (trees managed as a head-high hedge) at an open road environment next to a primary school in Manchester, U.K. The magnetic properties of PM deposited on leaves and filters (size fractions PM10 and PM2.5) were deduced from hysteresis loops, first-order reversal curves (FORCs), and low-temperature remanence measurements. These were complemented with electron microscopy to identify changes in magnetic PM concentration downwind of the tredge/GI. We show that the tredge is permeable to airflow using a simple CO2 tracer experiment; hence, it allows interception and subsequent deposition of PM on its leaves. Magnetic loadings per m3 of air from filters (PM10 saturation magnetisation, Ms, at 5 K) were reduced by 40 % behind the tredge and a further 63 % in the playground; a total reduction of 78 % compared to roadside air. For the PM2.5 fraction, the reduction in magnetic loading behind the tredge was remarkable (82 %), reflecting efficient diffusional capture of sub-5 nm Fe-oxide particles by the tredge. Some direct mixing of roadside and playground air occurs at the back of the playground, caused by air flow over, and/or through gaps in, the slowly-permeable tredge. The magnetic loading on tredge leaves increased over successive days, capturing ~23 % of local, traffic-derived PM10. Using a heuristic two-dimensional turbulent mixing model, we assess the limited dispersion of PM < 22.5 μm induced by eddies in the tredge wake. This study demonstrates that PM deposition on leaves reduces exposure significantly in this school playground setting; hence, providing a cost-effective mitigation strategy

Biomagnetic characterization of air pollution particulates in Lahore, Pakistan

We report the characterization of anthropogenic magnetic particulate matter (MPM) collected on leaves from roadside Callistemon (bottlebrush) trees from Lahore, Pakistan, and on known sources of traffic-related particulates to assess the potential of first-order reversal curve (FORC) diagrams to discriminate between different sources of anthropogenic magnetic particles. Magnetic measurements on leaves indicate the presence of surface-oxidized magnetite spanning the superparamagnetic (<30 nm) to single domain (∼30–70 nm) to vortex size range (∼70–700 nm). Fe-bearing particles are present both as discrete particles on the surface of larger mineral dust or carbonaceous particles and embedded within them, such that their aerodynamic sizes may be decoupled from their magnetic grain sizes. FORC diagrams of brake-pad residue specimens show a distinct combination of narrow central ridge, extending from 0 to 200 mT, and a low-coercivity, vertically spread signal, attributed to vortex and multi-vortex behavior of metallic Fe. This is in agreement with scanning electron microscopy results that show the presence of metallic as well as oxidized Fe. Exhaust-pipe residue samples display a more conventional “magnetite-like” signal comprising a lower coercivity central ridge (0–80 mT) and a tri-lobate signal attributed to vortex state and/or magnetostatic interactions. The FORC signatures of leaf samples combine aspects of both exhaust residue and brake-pad endmembers, suggesting that FORC fingerprints have the potential to identify and quantify the relative contributions from exhaust and non-exhaust (brake-wear) emissions. Such measurements may provide a cost-effective way to monitor the changing contribution; of future particulate emissions as the vehicle fleet is electrified over the coming years

Application of Response Surface Method in Reverse Osmosis Membrane to Optimize BOD, COD and Colour Removal from Palm Oil Mill Effluent

Palm oil mill effluent (POME) is typically non-biodegradable and has high concentration of organic matter that represented as COD, BOD and Colour values. The correlation of concentration and pH of POME, and Trans membrane pressure (TMP) of Reverse Osmosis (RO) membrane was optimized by response surface method using a second order polynomial model with central composite design (CCD) which is a part model of response surface method (RSM) in Design-Expert® software. The main limits that influenced the parameters removal i.e. concentration of POME, pH of solution and transmembrane pressure were empirically determined at laboratory level and successfully optimized using RSM. The best conditions were determined from 3D response surface and 2D contour graphs i.e. 10.05% of POME concentration at pH 3.0 and TMP 0.50 kPa to yield the last values of COD, BOD and Colour i.e. 24.1372 mg/L,  24.33 mg/L and 11.76 PtCo, respectively.  The results show that the response surface method effective to reduce the number of experiment

Accelerated apoptotic death and <i>in vivo</i> turnover of erythrocytes in mice lacking functional mitogen- and stress-activated kinase MSK1/2

The mitogen- and stress-activated kinase MSK1/2 plays a decisive role in apoptosis. In analogy to apoptosis of nucleated cells, suicidal erythrocyte death called eryptosis is characterized by cell shrinkage and cell membrane scrambling leading to phosphatidylserine (PS) externalization. Here, we explored whether MSK1/2 participates in the regulation of eryptosis. To this end, erythrocytes were isolated from mice lacking functional MSK1/2 (msk−/−) and corresponding wild-type mice (msk+/+). Blood count, hematocrit, hemoglobin concentration and mean erythrocyte volume were similar in both msk−/− and msk+/+ mice, but reticulocyte count was significantly increased in msk−/− mice. Cell membrane PS exposure was similar in untreated msk−/− and msk+/+ erythrocytes, but was enhanced by pathophysiological cell stressors ex vivo such as hyperosmotic shock or energy depletion to significantly higher levels in msk−/− erythrocytes than in msk+/+ erythrocytes. Cell shrinkage following hyperosmotic shock and energy depletion, as well as hemolysis following decrease of extracellular osmolarity was more pronounced in msk−/− erythrocytes. The in vivo clearance of autologously-infused CFSE-labeled erythrocytes from circulating blood was faster in msk−/− mice. The spleens from msk−/− mice contained a significantly greater number of PS-exposing erythrocytes than spleens from msk+/+ mice. The present observations point to accelerated eryptosis and subsequent clearance of erythrocytes leading to enhanced erythrocyte turnover in MSK1/2-deficient mice

Study of Radioclinical and Risk Factors of Cerebral Venous Thrombosis: A Retrospective Analysis of Patients Presenting to a Tertiary Hospital in Mogadishu, Somalia

Bakar Ali Adam,1,2 Ahmed Adam Osman,3 Mohamed Sheikh Hassan,1,2 Nor Osman Sidow,1 Mohamed Farah Osman Hidig,1 Abdulkadir Ahmed Mohamed,1 Abdiwahid Ahmed Ibrahim,1 Said Abdi Mohamed,1 Yahye Garad Mohamed,3 Said Abdirahman Ahmed,4 Mohamed Osman Omar Jeele,5 Mohamed Omar Hassan4 1Department of Neurology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia; 2Faculty of Medicine and Surgery, Mogadishu University, Mogadishu, Somalia; 3Department of Radiology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia; 4Department of Cardiology, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, Somalia; 5Department of Internal Medicine, Mogadishu Somali Turkish Training and Research Hospital, Mogadishu, SomaliaCorrespondence: Bakar Ali Adam, Email [email protected]: Cerebral venous thrombosis (CVT) is a rare but potentially life-threatening condition characterized by the formation of a blood clot in the dural venous sinuses or cerebral veins. CVT presents a diverse array of clinical symptoms, making its diagnosis challenging. Understanding regional variations and specific risk factors associated with CVT is crucial, especially in low-resource settings like Somalia, where epidemiological data is limited and healthcare resources are scarce.Objective: This study aims to investigate the clinical and risk factors associated with CVT in patients presenting to Mogadishu Somali-Turkey Recep Tayyip Erdogan Research and Training Hospital, a tertiary hospital in Mogadishu, Somalia.Methods: We conducted a retrospective observational study involving 68 patients diagnosed with CVT between January 2019 and December 2023. Data included demographic information, clinical presentations, risk factors, and anatomical thrombosis locations. Descriptive statistics and chi-square tests were used for analysis.Results: The majority of patients were female (86.76%) and aged 20– 40 years (86.76%). Significant risk factors included the postpartum period (77.94%) and pregnancy, with statistical analysis showing strong associations between CVT and the postpartum period (χ² = 62.96, p < 0.0001) and pregnancy (χ² = 5.21, p = 0.022). Postpartum CVT was linked to thrombosis location (p = 0.025). Headache was the predominant symptom (98.53%), followed by altered mental status (83.82%), focal motor deficits (80.88%), and seizures (70.59%). The superior sagittal sinus was the most commonly involved site (57.35%).Conclusion: This study emphasizes the postpartum period as a significant risk factor for CVT in Somalia and highlights the need for clinical vigilance and early intervention strategies. Larger, multicenter studies are needed to validate these findings.Keywords: cerebral venous thrombosis, CVT, postpartum, pregnancy, risk factors, Somalia, regional stud

Bedside Sublingual Video Imaging of Microcirculation in Assessing Bacterial Infection in Cirrhosis

Bacterial infections are common in cirrhosis and can lead to life-threatening complications. Sidestream dark-field (SDF) imaging has recently emerged as a noninvasive tool for capturing real-time video images of sublingual microcirculation in critically ill patients with sepsis. The objective of this study was to assess the utility of SDF in determining underlying infection in patients with cirrhosis. Sublingual microcirculation was compared among patients with compensated cirrhosis (Group A, n = 13), cirrhosis without sepsis (Group B, n = 18), cirrhosis with sepsis (Group C, n = 14), and sepsis only (Group D, n = 10). The blood flow was semi-quantitatively evaluated in four equal quadrants in small (10–25 mm); medium (26–50 mm); and large (51–100 mm) sublingual capillaries. The blood flow was described as no flow (0), intermittent flow (1), sluggish flow (2), and continuous flow (3). The overall flow score or microvascular flow index (MFI) was measured for quantitative assessment of microcirculation and predicting power for concurrent infection in cirrhosis. Marked impairment was observed at all levels of microvasculature in Groups B and C when compared with Group A. This effect was restricted to small vessels only when Group B was compared with Group C. MFI < 1.5 was found to have highest sensitivity (100%) and specificity (100%) for infection in decompensated cirrhosis. SDF imaging of sublingual microcirculation can be a useful bedside diagnostic tool to assess bacterial infection in cirrhosis

The Home-Based Older People's Exercise (HOPE) trial: study protocol for a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>Frailty is common in older age, and is associated with important adverse health outcomes including increased risk of disability and admission to hospital or long-term care. Exercise interventions for frail older people have the potential to reduce the risk of these adverse outcomes by increasing muscle strength and improving mobility.</p> <p>Methods/Design</p> <p>The Home-Based Older People's Exercise (HOPE) trial is a two arm, assessor blind pilot randomised controlled trial (RCT) to assess the effectiveness of a 12 week exercise intervention (the HOPE programme) designed to improve the mobility and functional abilities of frail older people living at home, compared with usual care. The primary outcome is the timed-up-and-go test (TUGT), measured at baseline and 14 weeks post-randomisation. Secondary outcomes include the Barthel Index of activities of daily living (ADL), EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D) quality of life measure and the geriatric depression scale (GDS), measured at baseline and 14 weeks post-randomisation. We will record baseline frailty using the Edmonton Frail Scale (EFS), record falls and document muscle/joint pain. We will test the feasibility of collection of data to identify therapy resources required for delivery of the intervention.</p> <p>Discussion</p> <p>The HOPE trial will explore and evaluate a home-based exercise intervention for frail older people. Although previous RCTs have used operationalised, non-validated methods of measuring frailty, the HOPE trial is, to our knowledge, the first RCT of an exercise intervention for frail older people that includes a validated method of frailty assessment at baseline.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN57066881">ISRCTN57066881</a></p

Frecuencia y variables asociadas a estigma-discriminación percibido en víctimas del conflicto armado colombiano

Resumen: Se desconoce la frecuencia de complejo estigma-discriminación percibido en víctimas del conflicto armado colombiano. El objetivo del estudio fue establecer la frecuencia y variables asociadas al estigma-discriminación percibido en víctimas del conflicto armado, en municipios del Departamento del Magdalena, Colombia. Se realizó un estudio transversal con víctimas registradas en el Programa de Atención Psicosocial y Salud Integral a Víctimas. Los síntomas depresivos se cuantificaron con cuatro ítems dicotómicos (tres o más se clasificaron como alto nivel de síntomas depresivos) y el estigma-discriminación percibido se cuantificó con seis incisos dicotómicos (dos o más afirmaciones se categorizó como alto estigma-discriminación percibido). Participaron 943 adultos (M = 47,9; DE = 14,2); 67,4%, mujeres; 109 (11,6%) informaron alto nivel de síntomas depresivos y 217 (23%) presentaron alto estigma-discriminación percibido. El alto estigma-discriminación percibido se asoció a alto nivel de síntomas depresivos (OR = 6,47; IC95%: 4,23-9,88). Se concluye que un cuarto de las víctimas del conflicto armado en Magdalena informa alto estigma-discriminación percibido; éste se asocia significativamente a alto nivel de síntomas depresivos

Controlled variations in stimulus similarity during learning determine visual discrimination capacity in freely moving mice

The mouse is receiving growing interest as a model organism for studying visual perception. However, little is known about how discrimination and learning interact to produce visual conditioned responses. Here, we adapted a two-alternative forced-choice visual discrimination task for mice and examined how training with equiprobable stimuli of varying similarity influenced conditioned response and discrimination performance as a function of learning. Our results indicate that the slope of the gradients in similarity during training determined the learning rate, the maximum performance and the threshold for successful discrimination. Moreover, the learning process obeyed an inverse relationship between discrimination performance and discriminative resolution, implying that sensitivity within a similarity range cannot be improved without sacrificing performance in another. Our study demonstrates how the interplay between discrimination and learning controls visual discrimination capacity and introduces a new training protocol with quantitative measures to study perceptual learning and visually-guided behavior in freely moving mice