Categories
Nevin Manimala Statistics

The association between body mass index and health-related quality of life in the 2017 and 2018 health survey of England data: A cross-sectional observational analysis

Diabetes Obes Metab. 2024 Mar 18. doi: 10.1111/dom.15546. Online ahead of print.

ABSTRACT

AIM: To provide an updated estimate of the association between body mass index (BMI) and health-related quality of life (HRQoL) among the general population in England and to identify population subgroups with the highest potential utility gains from obesity interventions.

MATERIALS AND METHODS: The sample included 12 158 adults with valid HRQoL and BMI data from the 2017 and 2018 Health Survey for England. Robust standard error linear regression, controlling for demographic and socioeconomic characteristics, lifestyle behaviours and obesity-related comorbidities, was used for the baseline analysis. Robustness checks assessed the impact of (a) estimator selection; (b) model specifications; (c) statistical outliers at high BMI; (d) potential BMI measurement error; and (e) data pooling.

RESULTS: The study found a significant association between HRQoL and BMI, which exhibited an inverted U-shaped relationship. The mean HRQoL peaked at 25.7 kg/m2 in men and 22.6 kg/m2 in women and was reduced in the underweight, overweight and obesity BMI ranges. Sensitivity analyses reported similar coefficients, suggesting a robust model specification.

CONCLUSIONS: Reduced HRQoL beyond optimal BMI underlines the importance of maintaining a normal BMI range for overall health. The rising prevalence of class III obesity is a major public health concern given its disproportionate impact on health, health care utilization and costs. Obesity management is key to preventing the reduction in HRQoL associated with obesity-related comorbidities, and this analysis supports the development of targeted policies and population health initiatives for people with class III obesity.

PMID:38499493 | DOI:10.1111/dom.15546

Categories
Nevin Manimala Statistics

Exhaustive identification of genome-wide binding events of transcriptional regulators

Nucleic Acids Res. 2024 Mar 18:gkae180. doi: 10.1093/nar/gkae180. Online ahead of print.

ABSTRACT

Genome-wide binding assays aspire to map the complete binding pattern of gene regulators. Common practice relies on replication-duplicates or triplicates-and high stringency statistics to favor false negatives over false positives. Here we show that duplicates and triplicates of CUT&RUN are not sufficient to discover the entire activity of transcriptional regulators. We introduce ICEBERG (Increased Capture of Enrichment By Exhaustive Replicate aGgregation), a pipeline that harnesses large numbers of CUT&RUN replicates to discover the full set of binding events and chart the line between false positives and false negatives. We employed ICEBERG to map the full set of H3K4me3-marked regions, the targets of the co-factor β-catenin, and those of the transcription factor TBX3, in human colorectal cancer cells. The ICEBERG datasets allow benchmarking of individual replicates, comparing the performance of peak calling and replication approaches, and expose the arbitrary nature of strategies to identify reproducible peaks. Instead of a static view of genomic targets, ICEBERG establishes a spectrum of detection probabilities across the genome for a given factor, underlying the intrinsic dynamicity of its mechanism of action, and permitting to distinguish frequent from rare regulation events. Finally, ICEBERG discovered instances, undetectable with other approaches, that underlie novel mechanisms of colorectal cancer progression.

PMID:38499482 | DOI:10.1093/nar/gkae180

Categories
Nevin Manimala Statistics

Mortality of children and adolescents co-infected with tuberculosis and HIV: a systematic review and meta-analysis

AIDS. 2024 Mar 18. doi: 10.1097/QAD.0000000000003886. Online ahead of print.

ABSTRACT

OBJECTIVE: Children and adolescents with HIV infection are well-known to face a heightened risk of tuberculosis. However, the exact mortality rates and temporal trends of those with HIV-TB co-infection remain unclear. We aimed to identify the overall mortality and temporal trends within this population.

METHODS: PubMed, Web of Science, and Embase were employed to search for publications reporting on the mortality rates of children and adolescents with HIV-TB co-infection from inception to March 2, 2024. The outcome is the mortality rate for children and adolescents with HIV-TB co-infection during the follow-up period. In addition, we evaluate the temporal trends of mortality.

RESULTS: During the follow-up period, the pooled mortality was 16% (95% CI 13-20). Single infection of either HIV or TB exhibit lower mortality rates (6% and 4%, respectively). We observed elevated mortality risks among individuals aged less than 12 months, those with EPTB, poor adherence to ART, and severe immunosuppression. In addition, we observed a decreasing trend in mortality before 2008 and an increasing trend after 2008, although the trends were not statistically significant (P = 0.08 and 0.2 respectively).

CONCLUSIONS: Children and adolescents with HIV-TB co-infection bear a significant burden of mortality. Timely screening, effective treatment, and a comprehensive follow-up system contribute to reducing the mortality burden in this population.

PMID:38499478 | DOI:10.1097/QAD.0000000000003886

Categories
Nevin Manimala Statistics

Evaluation of adherence to antipsychotics: A real-world data study using four different dosing assumptions

Br J Clin Pharmacol. 2024 Mar 18. doi: 10.1111/bcp.16042. Online ahead of print.

ABSTRACT

AIMS: This study aimed to assess the frequency of dosing inconsistencies in prescription data and the effect of four dosing assumption strategies on adherence estimates for antipsychotic treatment.

METHODS: A retrospective cohort, which linked prescription and dispensing data of adult patients with ≥1 antipsychotic prescription between 2015-2016 and followed up until 2019, in Catalonia (Spain). Four strategies were proposed for selecting the recommended dosing in overlapping prescription periods for the same patient and antipsychotic drug: (i) the minimum dosing prescribed; (ii) the dose corresponding to the latest prescription issued; (iii) the highest dosing prescribed; and (iv) all doses included in the overlapped period. For each strategy, one treatment episode per patient was selected, and the Continuous Medication Availability measure was used to assess adherence. Descriptive statistics were used to describe results by strategy.

RESULTS: Of the 277 324 prescriptions included, 76% overlapped with other prescriptions (40% with different recommended dosing instructions). The number and characteristics of patients and treatment episodes (18 292, 18 303, 18 339 and 18 536, respectively per strategy) were similar across strategies. Mean adherence was similar between strategies, ranging from 57 to 60%. However, the proportion of patients with adherence ≥90% was lower when selecting all doses (28%) compared with the other strategies (35%).

CONCLUSION: Despite the high prevalence of overlapping prescriptions, the strategies proposed did not show a major effect on the adherence estimates for antipsychotic treatment. Taking into consideration the particularities of antipsychotic prescription practices, selecting the highest dose in the overlapped period seemed to provide a more accurate adherence estimate.

PMID:38499460 | DOI:10.1111/bcp.16042

Categories
Nevin Manimala Statistics

2023 Diabetic Kidney Disease Fact Sheet in Korea

Diabetes Metab J. 2024 Mar 19. doi: 10.4093/dmj.2023.0310. Online ahead of print.

ABSTRACT

BACKGROUND: To investigate the prevalence, incidence, comorbidities, and management status of diabetic kidney disease (DKD) and diabetes-related end-stage kidney disease (ESKD) in South Korea.

METHODS: We used the Korea National Health and Nutrition Examination Survey data (2019 to 2021, n=2,665) for the evaluation of prevalence, comorbidities, control rate of glycemia and comorbidities in DKD, and the Korean Health Insurance Service-customized database (2008 to 2019, n=3,950,857) for the evaluation of trends in the incidence and prevalence rate of diabetes-related ESKD, renin-angiotensin system (RAS) blockers and sodium glucose cotransporter 2 (SGLT2) inhibitors use for DKD, and the risk of atherosclerotic cardiovascular disease (ASCVD) and mortality according to DKD stages. DKD was defined as albuminuria or low estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 in patients with diabetes mellitus.

RESULTS: The prevalence of DKD was 25.4% (albuminuria, 22.0%; low eGFR, 6.73%) in patients with diabetes mellitus aged ≥30 years. Patients with DKD had a higher rate of comorbidities, including hypertension, dyslipidemia, and central obesity; however, their control rates were lower than those without DKD. Prescription rate of SGLT2 inhibitors with reduced eGFR increased steadily, reaching 5.94% in 2019. Approximately 70% of DKD patients were treated with RAS blockers. The prevalence rate of diabetesrelated ESKD has been steadily increasing, with a higher rate in older adults. ASCVD and mortality were significantly associated with an in increase in DKD stage.

CONCLUSION: DKD is prevalent among Korean patients with diabetes and is an independent risk factor for cardiovascular morbidity and mortality, which requiring intensive management of diabetes and comorbidities. The prevalence of diabetes-related ESKD has been increasing, especially in the older adults, during past decade.

PMID:38499437 | DOI:10.4093/dmj.2023.0310

Categories
Nevin Manimala Statistics

Level of Contamination of Positive Airway Pressure Devices Used in Obstructive Sleep Apnea

Clin Exp Otorhinolaryngol. 2024 Mar 19. doi: 10.21053/ceo.2024.00025. Online ahead of print.

ABSTRACT

OBJECTIVES: No study has evaluated the degree of contamination after the total disassembly of continuous positive-airway pressure (CPAP) devices. We assessed the extent of contamination of the CPAP device by disassembling the system and identifying the factors that influence the degree of CPAP contamination, which is applied daily in patients with obstructive sleep apnea (OSA).

METHODS: Chart review of the medical records of patients with OSA who underwent disassembly and cleaning of the CPAP device was performed by two skilled technicians who photographed the levels of contamination of each component and scored them using a visual analog scale. Clinical characteristics and records of CPAP device usage were statistically analyzed to determine the characteristics that were significantly associated with the degree of CPAP device contamination.

RESULTS: Among the 55 participants, not only the external components, including the mask and tube, but also the internal components, such as the humidifier and the interior of the main body, showed a substantial degree of contamination. The total and average daily duration of usage of the CPAP device were not significantly associated with the degree of contamination. Age was most frequently associated with the degree of contamination, such as in masks, humidifiers, and interior and exterior main parts. The degree of contamination of the internal components of the device was significantly correlated with the degree of contamination of the external components.

CONCLUSION: Age-specific guidelines for hygiene management of the external and internal CPAP components should be prepared.

PMID:38499436 | DOI:10.21053/ceo.2024.00025

Categories
Nevin Manimala Statistics

Educational neuromyths and instructional practices: The case of inclusive education teachers in Hong Kong

Trends Neurosci Educ. 2024 Mar;34:100221. doi: 10.1016/j.tine.2024.100221. Epub 2024 Feb 1.

ABSTRACT

BACKGROUND: Educational neuromyths are known to exist amongst teachers in Western countries, and some researchers argue that neuromyths may affect classroom teaching.

METHOD: An online survey was designed and distributed to sixty-four Hong Kong inclusive education teachers. Descriptive statistics, Pearson’s correlation, Hierarchical Multiple Regression, and Thematic analysis were used to analyzed the collected data.

RESULTS: First, there is a relatively low prevalence of neuromyths among Hong Kong teachers. Second, neuromyths were not significantly correlated with inclusive teachers’ instructional practices. Third, teachers’ general knowledge of the brain was significantly correlated with neuromyths and is a significant predictor of neuromyths. Fourth, the work-related stress of teachers was the main barrier to learning about neuroscience and adopting evidence-based practices in classroom teaching in Hong Kong.

CONCLUSION: Our findings raise awareness of environmental and cultural factors that need to be considered and might affect the prevalence of neuromyths studies in non-WEIRD contexts.

PMID:38499408 | DOI:10.1016/j.tine.2024.100221

Categories
Nevin Manimala Statistics

Multidimensional penalized splines for survival models: illustration for net survival trend analyses

Int J Epidemiol. 2024 Feb 14;53(2):dyae033. doi: 10.1093/ije/dyae033.

ABSTRACT

BACKGROUND: In descriptive epidemiology, there are strong similarities between incidence and survival analyses. Because of the success of multidimensional penalized splines (MPSs) in incidence analysis, we propose in this pedagogical paper to show that MPSs are also very suitable for survival or net survival studies.

METHODS: The use of MPSs is illustrated in cancer epidemiology in the context of survival trends studies that require specific statistical modelling. We focus on two examples (cervical and colon cancers) using survival data from the French cancer registries (cases 1990-2015). The dynamic of the excess mortality hazard according to time since diagnosis was modelled using an MPS of time since diagnosis, age at diagnosis and year of diagnosis. Multidimensional splines bring the flexibility necessary to capture any trend patterns while penalization ensures selecting only the complexities necessary to describe the data.

RESULTS: For cervical cancer, the dynamic of the excess mortality hazard changed with the year of diagnosis in opposite ways according to age: this led to a net survival that improved in young women and worsened in older women. For colon cancer, regardless of age, excess mortality decreases with the year of diagnosis but this only concerns mortality at the start of follow-up.

CONCLUSIONS: MPSs make it possible to describe the dynamic of the mortality hazard and how this dynamic changes with the year of diagnosis, or more generally with any covariates of interest: this gives essential epidemiological insights for interpreting results. We use the R package survPen to do this type of analysis.

PMID:38499394 | DOI:10.1093/ije/dyae033

Categories
Nevin Manimala Statistics

Mentally healthy living after pandemic social distancing: a study of older Canadians reveals helpful anxiety reduction strategies

Psychogeriatrics. 2024 Mar 18. doi: 10.1111/psyg.13103. Online ahead of print.

ABSTRACT

BACKGROUND: Throughout the COVID-19 pandemic, older Canadians were the most at risk of severe physical harm, including death, and their return to post-COVID life was expected to be especially anxiety-provoking. A study was conducted to obtain nationally representative evidence of older Canadians’ self-perceived anxiety levels and their strategies to manage or mitigate it as public health restrictions were lifting.

MATERIALS AND METHODS: This study had a cross-sectional descriptive design. An e-survey was used to collect data from 1327 Canadians aged 60+ stratified by age, sex, and education to resemble the larger general population. Participants completed the Geriatric Anxiety Scale (GAS-10) and indicated which of the 16 Centre for Addictions and Mental Health’s (2022) Coping with Stress and Anxiety strategies they were using to manage or mitigate their anxiety when social distancing was lifting. Descriptive statistics, Pearson correlation, and multiple regression analysis were used to explore the data.

RESULTS: While, on average, older Canadians were mildly anxious, nearly one-quarter of responders rated their anxiety as severe. Age, sex, perceived health, were statistically significant correlates of anxiety. Six coping strategies were associated with significantly lower anxiety scores. Moreover, accepting some fear and anxiety as normal, challenging worries and anxious thoughts, and practising relaxation/meditation appeared to increase anxiety.

CONCLUSION: Older Canadians used multiple strategies to manage or mitigate their anxiety, and seemingly, with more successful than detrimental tries. Practitioners have much to learn and understand about older people’s mental health promotion efforts after social distancing, now and for future pandemics.

PMID:38499385 | DOI:10.1111/psyg.13103

Categories
Nevin Manimala Statistics

Preventive interventions to improve older people’s health outcomes: systematic review and meta-analysis

Br J Gen Pract. 2024 Mar 18:BJGP.2023.0180. doi: 10.3399/BJGP.2023.0180. Online ahead of print.

ABSTRACT

BACKGROUND: Systematic reviews of preventive, non-disease-specific primary care trials for older people often report effects according to what is thought to be the intervention’s active ingredient.

AIM: To examine the effectiveness of preventive primary care interventions for older people and to identify common components that contribute to intervention success.

DESIGN AND SETTING: A systematic review and meta-analysis of 18 randomised controlled trials (RCTs) published in 22 publications from 2009 to 2019.

METHOD: A search was conducted in PubMed, MEDLINE, Embase, Web of Science, CENTRAL, CINAHL, and the Cochrane Library. Inclusion criteria were: sample mainly aged ≥65 years; delivered in primary care; and non-disease-specific interventions. Exclusion criteria were: non-RCTs; primarily pharmacological or psychological interventions; and where outcomes of interest were not reported. Risk of bias was assessed using the original Cochrane tool. Outcomes examined were healthcare use including admissions to hospital and aged residential care (ARC), and patient-reported outcomes including activities of daily living (ADLs) and self-rated health (SRH).

RESULTS: Many studies had a mix of patient-, provider-, and practice-focused intervention components (13 of 18 studies). Studies included in the review had low-to-moderate risk of bias. Interventions had no overall benefit to healthcare use (including admissions to hospital and ARC) but higher basic ADL scores were observed (standardised mean difference [SMD] 0.21, 95% confidence interval [CI] = 0.01 to 0.40) and higher odds of reporting positive SRH (odds ratio [OR] 1.17, 95% CI = 1.01 to 1.37). When intervention effects were examined by components, better patient-reported outcomes were observed in studies that changed the care setting (SMD for basic ADLs 0.21, 95% CI = 0.01 to 0.40; OR for positive SRH 1.17, 95% CI = 1.01 to 1.37), included educational components for health professionals (SMD for basic ADLs 0.21, 95% CI = 0.01 to 0.40; OR for positive SRH 1.27, 95% CI = 1.05 to 1.55), and provided patient education (SMD for basic ADLs 0.28, 95% CI = 0.09 to 0.48). Additionally, admissions to hospital in intervention participants were fewer by 23% in studies that changed the care setting (incidence rate ratio [IRR] 0.77, 95% CI = 0.63 to 0.95) and by 26% in studies that provided patient education (IRR 0.74, 95% CI = 0.56 to 0.97).

CONCLUSION: Preventive primary care interventions are beneficial to older people’s functional ability and SRH but not other outcomes. To improve primary care for older people, future programmes should consider delivering care in alternative settings, for example, home visits and phone contacts, and providing education to patients and health professionals as these may contribute to positive outcomes.

PMID:38499364 | DOI:10.3399/BJGP.2023.0180