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Parameters of subpopulations can be more relevant than those of superpopulations. For example, a healthcare provider may be interested in the effect of a treatment plan for a specific subset of their patients; policymakers may be concerned with the impact of a policy in a particular state within a given population. In these cases, the focus is on a specific finite population, as opposed to an infinite superpopulation. Such a population can be characterized by fixing some attributes that are intrinsic to them, leaving unexplained variations like measurement error as random. Inference for a population with fixed attributes can then be modelled as inferring parameters of a conditional distribution. Accordingly, it is desirable that confidence intervals are conditionally valid for the realized population, instead of marginalizing over many possible draws of populations. We provide a statistical inference framework for parameters of finite populations with known attributes. Leveraging the attribute information, our estimators and confidence intervals closely target a specific finite population. When the data are from the population of interest, our confidence intervals attain asymptotic conditional validity, given the attributes, and are shorter than those for superpopulation inference. In addition, we develop procedures to infer parameters of new populations with differing covariate distributions; the confidence intervals are also conditionally valid for the new populations under mild conditions. Our methods extend to situations where the fixed information has a weaker structure or is only partially observed. We demonstrate the validity and applicability of our methods using simulated data and a real-word dataset for predicting car prices. [ABSTRACT FROM AUTHOR]

We have previously reported that flavonoid extract from propolis (FP) can improve cardiac function in rats following myocardial infarction (MI). However, the mechanisms responsible for the cardioprotective effects of FP have not been fully elucidated. In the current study, we explored whether FP can reduce inflammatory cytokines and attenuate sympathetic nerve system activity and antiendoplasmic reticulum (ER) stress and whether the cardioprotective effects are related to peroxisome proliferator-activated receptor gamma (PPAR-γ) activation. Sprague Dawley rats were randomly divided into six groups: Sham group received the surgical procedure but no artery was ligated; MI group received ligation of the left anterior descending (LAD) branch of the coronary artery; MI + FP group received FP (12.5 mg/kg/d, intragastrically) seven days prior to LAD ligation; FP group (Sham group + 12.5 mg/kg/d, intragastrically); MI + FP + GW9662 group received FP prior to LAD ligation with the addition of a specific PPAR-γ inhibitor (GW9662), 1 mg/kg/d, orally); and MI + GW9662 group received the PPAR-γ inhibitor and LAD ligation. The results demonstrated that the following inflammatory markers were significantly elevated following MI as compared with expression in sham animals: IL-1β, TNF-α, CRP; markers of sympathetic activation: plasma norepinephrine, epinephrine and GAP43, nerve growth factor, thyroid hormone; and ER stress response markers GRP78 and CHOP. Notably, the above changes were attenuated by FP, and GW9662 was able to alleviate the effect of FP. In conclusion, FP induces a cardioprotective effect following myocardial infarction by activating PPAR-γ, leading to less inflammation, cardiac sympathetic activity, and ER stress. [ABSTRACT FROM AUTHOR]

Objectives: To investigate public awareness of colorectal cancer (three components: total knowledge, confidence and anticipated delay) in the Chinese population, to explore factors associated with total knowledge and to elucidate relationships among three components of public awareness of colorectal cancer. Methods: We recruited 562 adult Chinese participants with no history of colorectal cancer between March and May 2020 by convenience sampling method. Data were collected online using a self‐designed demographic questionnaire and a simplified Chinese version of the Bowel Cancer Awareness Measure. Univariate analysis and multivariate linear regression were applied. Results: The mean score for total knowledge was 10.56 (SD: 5.89). Over half of the participants (58.2%) lacked confidence about detecting warning signs. For 42.7% of participants, the anticipated delay was not within the acceptable range (2 weeks). Totally eight demographic variables were identified as significant predictors of total knowledge, accounting for 36.2% of the variance. Total knowledge was positively correlated with confidence (r = 0.126, p < 0.01) and negatively associated with anticipated delay (F = 8.891, p < 0.01). Conclusion: Public awareness of colorectal cancer was low in the Chinese population. Hence, educational interventions targeted for improving knowledge, enhancing individuals' confidence in detecting symptoms and reducing barriers to seeking medical help may be urgently required. [ABSTRACT FROM AUTHOR]

Aim: To investigate the safety and feasibility of taking low‐concentration carbohydrate solution at 2 h before induction of anesthesia for gestational diabetes mellitus (GDM) patients. Methods: GDM patients undergoing cesarean section were randomly assigned to experimental group (n = 43) and control group (n = 42). Two hours before induction of anesthesia, participants in experimental group orally received 300 mL low‐concentration carbohydrate solution, while those in control group received equivalent warm water. Blood glucose and serum insulin were measured at 2 h before induction of anesthesia, right before induction of anesthesia, and the morning of postoperative day 1. Neonatal blood glucose level was monitored at birth. Maternal gastrointestinal function and well‐being were assessed perioperatively. Results: The levels of blood glucose and serum insulin right before induction of anesthesia in the experimental group were significantly higher than those in the control group. There were four cases with hypoglycemia in the experimental group and 19 cases in the control group right before induction of anesthesia (9.3% vs 45.2%, p < 0.001). The incidence of neonatal hypoglycemia was 2.3% in the experimental group and 7.1% in the control group with no significance. Hunger score of the participants between the two groups right before induction of anesthesia was significantly different. No aspiration, nausea, and vomiting occurred in both groups before, during, and after surgery. No significant difference was found in the time to the first flatus and abdominal distension between the two groups. Conclusion: Taking low‐concentration carbohydrate solution is safe and feasible for patients with GDM undergoing elective cesarean section. [ABSTRACT FROM AUTHOR]

Aims and objectives: To compare the differences in psychosocial behaviour reactions, psychosocial needs, anxiety and depression before and after colostomy surgery and to explore the predictors of psychosocial behaviour reactions. Background: Colorectal cancer is increasing worldwide. Abdominoperineal resection accompanied by permanent colostomy can cause complicated psychosocial reactions and needs. However, colostomy patients' trajectories of psychosocial adjustment at different time points must be discussed. Design: A longitudinal study. Methods: Using a convenience sampling method, 67 patients planning to undergo colostomy surgery were recruited from a tertiary cancer centre in southern China from January 2013–January 2014. Data collection consisted of two phases, conducted 1–2 days before surgery and 1–2 days prior to discharge. The Ostomy Psychosocial Behaviour Reaction Questionnaire, the Ostomy Psychosocial Needs Questionnaire, the Hospital Anxiety and Depression Scale and a self‐designed demographic questionnaire were used to collect data. STROBE guidelines were followed. Results: The participants had a moderate level of psychosocial behaviour reactions, a deep and wide range of psychosocial needs and a high incidence of anxiety and depression before and after surgery. Anxiety before surgery was significantly higher than that after surgery. Psychosocial needs and anxiety were significant predictors of psychosocial behaviour reactions. Conclusions: Patients' anxiety was alleviated after surgery. The combination of ascertaining and meeting various psychosocial needs and managing negative emotions was helpful in alleviating patients' stress responses before and after surgery. Relevance to clinical practice: An increased focus on the relationships among psychosocial behaviour reactions, psychosocial needs, anxiety and depression at different time points in colostomy patients is necessary for future research and practice. [ABSTRACT FROM AUTHOR]

Background: The current study compared four differential item functioning (DIF) methods to examine their performances in terms of accounting for dual dependency (i.e., person and item clustering effects) simultaneously by a simulation study, which is not sufficiently studied under the current DIF literature. The four methods compared are logistic regression accounting neither person nor item clustering effect, hierarchical logistic regression accounting for person clustering effect, the testlet model accounting for the item clustering effect, and the multilevel testlet model accounting for both person and item clustering effects. The secondary goal of the current study was to evaluate the trade-off between simple models and complex models for the accuracy of DIF detection. An empirical example analyzing the 2011 TIMSS Mathematics data was also included to demonstrate the differential performances of the four DIF methods. A number of DIF analyses have been done on the TIMSS data, and rarely had these analyses accounted for the dual dependence of the data. Results: Results indicated the complex models did not outperform simple models under certain conditions, especially when DIF parameters were considered in addition to significance tests. Conclusions: Results of the current study could provide supporting evidence for applied researchers in selecting the appropriate DIF methods under various conditions. [ABSTRACT FROM AUTHOR]

Gestational diabetes mellitus affects millions of pregnant women. Lifestyle intervention is recommended as the first-line treatment, in which exercise plays an important role. Effective and safe exercise is required to facilitate glycaemic control and improve delivery outcomes. To investigate the efficacy and safety of the original Gymnastics for Pregnant Women program for glycaemic control and delivery outcomes improvement in gestational diabetes mellitus women. The study was a two-arm parallel randomized controlled clinical trial. The study was conducted in a tertiary specialized maternity hospital in Hangzhou, China. Totally 131 eligible pregnant women were enrolled from June to December 2020. Participants were randomly allocated to the control group (conventional intervention) or experimental group that engaged in the original Gymnastics for Pregnant Women program. The primary outcomes included glycaemic control during pregnancy and postpartum. Secondary outcomes included adverse events, maternal and neonatal outcomes. Participants showed a significant improvement in glycaemic control after engaging in the intervention for 2 weeks; the improvement was most significant in terms of the 2-h postprandial plasma glucose (P < 0.05). The fasting blood glucose and 2-h postprandial plasma glucose data indicated a higher glycaemic control rate in the experimental than control group (86.16% vs. 66.67%, P = 0.008; and 84.62% vs. 36.36% [6.09 ± 0.79 vs. 6.96 ± 1.06 mmol/L], P < 0.001, respectively). After delivery, the 2-h oral glucose tolerance test results indicated better glycaemic control in the experimental than control group (75.44% vs. 57.41% [6.93 ± 1.44 vs. 7.79 ± 2.03 mmol/L], P = 0.047). Additionally, the 2-h oral glucose tolerance test in the experimental group with reasonable exercise frequency (≥ 10 times per week) had the best glucose level (6.81 ± 1.30 mmol/L), followed by the experimental group with a lower exercise frequency (< 10 times per week) (7.35 ± 1.83 mmol/L) and the control group (7.79 ± 2.03 mmol/L). No statistical differences in maternal or neonatal outcomes were observed between the control and experimental groups (P > 0.05). In addition, there were no adverse events in the experimental group; however, in the control group, two cases experienced at least one hypoglycaemic episode and two cases received insulin during the study period. The original Gymnastics for Pregnant Women was associated with greater improvements in blood glucose levels during pregnancy and postpartum compared with a conventional intervention for women with gestational diabetes mellitus. ChiCTR2000033963 (2020-06-22). The original Gymnastics for Pregnant Women program improves glycaemic control in GDM women but does not affect delivery outcomes. [ABSTRACT FROM AUTHOR]