Category: Nevin Manimala

Eur J Health Econ. 2025 Feb 21. doi: 10.1007/s10198-024-01755-2. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The aims of this study were to provide population norms for EQ-5D-5L in Hungary and investigate the differences in EQ-5D-5L normative data by survey mode, i.e. online surveys and computer assisted personal interviews (CAPI).

METHODS: A pooled database was built comprising six online (N = 7,034) and two CAPI (N = 3,020) population-based studies with the EQ-5D-5L. Descriptive statistics were performed. Multinominal logistic and linear regression analyses were applied to compare the online and CAPI samples. Traditional and machine learning regression tools were used to investigate the determinants of EQ-5D-5L index values.

RESULTS: ‘No problems’ in any of the five EQ-5D-5L domains were reported by 33.9% (online) and 58.9% (CAPI) of the participants. Most problems were reported on the pain/discomfort domain in both study types (51.9% and 33.6%, respectively). Men and more educated respondents had significantly higher average EQ-5D-5L index values. EQ-5D-5L index values and EQ VAS scores were significantly higher in the CAPI sample, except in age groups 65-74 (no difference) and 75+ (online scores were significantly higher). Only 7-10% of variance in the EQ-5D-5L index values was explained by the variables survey mode, education, sex and age, with age having the largest and sex the smallest effect.

CONCLUSIONS: EQ-5D-5L population norms derived from online and CAPI studies may differ significantly from each other. It is recommended to consider the survey mode, sampling and sociodemographic characteristics of the participants when choosing population norms as reference set. Further comparative studies investigating EQ-5D-5L population norms by different study designs and administration modes are encouraged.

PMID:39982665 | DOI:10.1007/s10198-024-01755-2

Hormones (Athens). 2025 Feb 21. doi: 10.1007/s42000-025-00636-4. Online ahead of print.

ABSTRACT

PURPOSE: Neoangiogenesis is necessary for adhesion and invasion of endometriotic lesions. We hypothesize that by blocking angiogenetic pathways we can suppress endometriosis. Oral contraceptive pills (OCs) are routinely used in endometriosis to suppress symptoms of the disease. In the current study, we attempt to evaluate the effects of OCs on various angiogenetic factors in women with endometriosis.

METHODS: Sixty women with endometriosis were randomly divided into two groups. Group A consisted of 30 women who received OCs in a cyclical manner for 3 months before surgery and group B of 30 women who did not. Biopsy specimens of ovarian endometrioma were collected. We used qRT-PCR to study the mRNA expression levels of VEGF, TF, PAR-2, SP1, and FGF1.

RESULTS: The levels of mRNA of all angiogenic factors were found to be elevated in women who received OCs compared with women who did not. This difference was statistically significant for VEGF, TF, FGF1, SP1 (p < 0.001), and PAR-2 (p = 0.046).

CONCLUSION: OC administration does not inhibit neoangiogenesis in endometriotic lesions; on the contrary, angiogenetic pathways might be upregulated.

PMID:39982662 | DOI:10.1007/s42000-025-00636-4

Anat Sci Educ. 2025 Feb 21. doi: 10.1002/ase.70003. Online ahead of print.

ABSTRACT

The aim of this study was to investigate the effects of narrative anatomy education and traditional anatomy education on academic achievement. The study included 64 students who were randomly divided into two groups. The two groups were (n = 32) control (Group 1) and (n = 32) experimental (Group 2). The pretest scores of the two groups were 36.40 ± 12.58 and 35.46 ± 9.18, respectively, and the difference between them was not significant. On this basis, the groups were randomly divided into experimental and control groups. The control group received traditional anatomy instruction, while the experimental group received narrative anatomy instruction in addition to traditional instruction. The posttest scores of the control group were 43.12 ± 10.37, while those of the experimental group were 57.03 ± 14.01, and there was a statistically significant difference (p < 0.001). It is predicted that providing narrative anatomy education in addition to traditional anatomy education will have a positive effect on academic success. The qualitative findings of the study revealed several key findings. Participants in the experimental group reported that narrative education facilitated a deeper understanding and retention of anatomical concepts. They highlighted the use of metaphors and storytelling as helpful in making complex material more relatable and memorable. In addition, students expressed that the narrative approach increased their engagement and motivation, contributing to a more enjoyable learning experience. These qualitative findings highlight the potential of narrative education to complement traditional teaching methods and provide a more holistic and interactive learning experience.

PMID:39981659 | DOI:10.1002/ase.70003

Cartilage. 2025 Feb 21:19476035251320747. doi: 10.1177/19476035251320747. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this research was to investigate the relationship between quantitative texture parameters and degenerative cartilage damage in knee osteoarthritis (KOA) by conducting a full-volume texture analysis of infrapatellar fat pad (IFP). In addition, this study also explored if the quantitative texture parameter models outperform semi-quantitative model in cartilage damage classification tasks.

MATERIALS AND METHODS: This retrospective study involved 202 patients who were diagnosed with KOA using imaging and clinical examinations. Texture parameters of the IFP were extracted from sagittal FSE PDWI fat-suppressed sequence images, and least absolute shrinkage and selection operator regression was used for feature selection. Spearman correlation analysis was conducted to assess the relationship between semi-quantitative parameter (Hoffa-synovitis score), quantitative parameters, and cartilage damage. Five multi-classification logistic regression models were developed to predict cartilage damage grade by using Hoffa-synovitis score, texture parameters, and clinical characteristics as independent variables. Subsequently, the performance of these models was compared.

RESULTS: Eight texture features were screened out in this study. Correlation analysis showed that Hoffa synovitis score, texture parameters, and cartilage damage grade were significantly correlated (all P < 0.05). The strongest correlation was found between Hoffa-synovitis score and cartilage damage, demonstrating a moderate positive relationship (r = 0.62). In terms of texture features, the Correlation parameter exhibited a moderate positive correlation with cartilage damage (r = 0.49), while other texture parameters had a slight positive correlation degree of positive or negative correlation. In the task of classifying cartilage damage, the model’s macro-average area under the curve (AUC) only using the Hoffa-synovitis score was 0.73 (95% confidence interval (CI): 0.64, 0.83), while the model using only selected texture parameters achieved a macro-average AUC of 0.84 (95% CI: 0.68, 0.94). Furthermore, the model that combined texture parameters and clinical features also achieved a macro-average AUC of 0.84 (95% CI: 0.72, 0.94). By integrating the Hoffa-synovitis score, texture parameters, and clinical features, the model’s macro-average AUC experienced a slight improvement to 0.85 (95% CI: 0.74, 0.93). Notably, the model combining only Hoffa-synovitis score and texture parameters had the best classification performance, with a macro-average AUC of 0.88 (95% CI: 77, 0.97). The performance of the 4 models incorporating texture parameters outperformed that of the Hoffa-synovitis score alone (all P < 0.05), however with no significant statistical difference observed among the 4 models (all P > 0.05).

CONCLUSIONS: There existed a correlation between the texture parameters of the infrapatellar fat IFP and cartilage damage in KOA. The models using texture parameters demonstrated better performance in classifying cartilage damage compared to the models using only semi-quantitative parameter. Thus, we can infer that texture parameters had the potential to be valuable imaging biomarkers for evaluating cartilage damage.

PMID:39981646 | DOI:10.1177/19476035251320747

J Glob Health. 2025 Feb 21;15:04010. doi: 10.7189/jogh.15.04010.

ABSTRACT

BACKGROUND: Sex and gender are important determinants of health. Gender-based health inequities in the paediatric population have been reported in various countries, but data remain limited. In Mozambique, research on this topic is very scarce. Here we aimed to explore whether boys and girls in Manhiça district, southern Mozambique, differ in access to and provision of healthcare.

METHODS: This retrospective analysis includes data on all paediatric (<15 years old) visits to six outpatient clinics and admissions to one hospital in Manhiça district from 2004 to 2020, collected through the morbidity surveillance system of the Manhiça Health and Demographic Surveillance System (HDSS). We compared characteristics and outcomes between boys and girls using descriptive statistics, standardised mean differences, and logistic regression. Post-discharge events were analysed using Cox proportional hazards regression and Fine-Gray competing risk regression. Minimum community-based incidence rates of outpatient clinic visits and hospitalisations were calculated using demographic surveillance data from the Manhiça HDSS and analysed with negative binomial regression.

RESULTS: Girls represented 49.2% (560 630 out of 1 139 962) of paediatric visits to outpatient clinics and 45.1% (18 625 out of 41 278) of hospitalisations. The girls-to-boys incidence rate ratio (IRR) for hospitalisations was 0.81 (95% confidence interval (CI) = 0.79-0.84). Both boys and girls experienced symptoms for a median duration of one day (interquartile range (IQR) = 1-2) before seeking care. Severe manifestations at presentation to an outpatient clinic or upon hospitalisation tended to be less frequent in girls (girls-to-boys odds ratios (ORs) = 0.71-1.11). Girls were less frequently referred or admitted to hospital after an outpatient clinic visit (OR = 0.82; 95% CI = 0.79-0.86 and OR = 0.85; 95% CI = 0.84-0.87, respectively). The hospital case fatality ratio was 4.1% in boys and 4.2% in girls. The median duration of hospitalisation was three days (IQR = 2-5) and did not differ between boys and girls. Revisits to outpatient clinics, hospital readmissions, and hospital post-discharge mortality were similar in both groups.

CONCLUSIONS: Girls had fewer referrals and admissions to hospital in Manhiça district, but they were also less likely to present with severe manifestations. Other studied indicators of healthcare access and provision were overall similar for boys and girls. Further research is needed to continue assessing potential gender biases and sex differences in paediatric healthcare in Mozambique.

PMID:39981643 | DOI:10.7189/jogh.15.04010

J Glob Health. 2025 Feb 21;15:04058. doi: 10.7189/jogh.15.04058.

ABSTRACT

BACKGROUND: Fee exemption policies are key strategies for reducing the barriers to accessing maternal health services and improving maternal and child health outcomes. This study used pooled national data to determine the impact of Ghana’s user fee exemption policy on maternal health service utilisation since it was implemented in 2008.

METHODS: Using four rounds of cross-sectional data from national surveys on women with live births, we conducted an inverse probability of treatment weighting analysis to evaluate the causal effects of Ghana’s user fee exemption policy intervention on the timing of first antenatal care (ANC) visit, completion of four or more ANC visits and facility-based delivery as indicators of maternal health service utilisation.

RESULTS: The average treatment effect of the fee exemption policy was an increase of 8, 9, and 21% in the utilisation of timely first ANC visit, completion of the recommended number of ANC visits, and facility-based delivery, respectively. Wealth index categorisation showed a clear stepwise increase in the likelihood of facility-based delivery. Compared to the poorest group, the odds were 1.48 times higher for the poorer group adjusted odds ratio (aOR) = 1.48 (95% confidence interval (CI) = 1.33-1.66), 2.27 times higher for the middle group aOR = 2.27 (95% CI = 1.95-2.64), 3.84 times higher for the rich group aOR = 3.84 (95% CI = 3.13-4.69), and 5.96 times higher for the richest group aOR = 5.96 (95% CI = 4.43-8.02). Women who reside in the Upper East region were more likely to utilise maternal health services.

CONCLUSIONS: Ghana’s fee exemption policy positively impacts maternal health service utilisation among pregnant women. However, there still exist disparities across geographical regions and wealth indexes.

PMID:39981639 | DOI:10.7189/jogh.15.04058

J Intensive Care Med. 2025 Feb 21:8850666251318692. doi: 10.1177/08850666251318692. Online ahead of print.

ABSTRACT

INTRODUCTION: Biostatistics is an increasing focus in both the United States Medical Licensing exams (USMLE) and medical school curricula. Nonetheless, literature has documented that it is poorly understood among both practicing physicians and physician trainees. Our purpose is to narrow this knowledge gap by offering readers a “how-to” guide that both supplements essential biostatistics knowledge and assists in constructing research projects.

METHODS: In Part II of our tandem manuscripts, we expand our Part I biostatistics analysis of research articles in the Journal of Intensive Care Medicine (JICM) with explanations and practical use of biostatistics, addressing the most common statistical terms and tests used in the JICM.

RESULTS: Understanding biostatistics requires interpreting the type of study, type of data collected, statistical tests available for all types of data, and results of the statistical tests.

CONCLUSION: Gaining proficiency in biostatistics will improve the precision of evidence-based medical outcomes, helping close the current knowledge gap among practicing physicians and trainees.

PMID:39981632 | DOI:10.1177/08850666251318692

Eur J Ophthalmol. 2025 Feb 21:11206721251314541. doi: 10.1177/11206721251314541. Online ahead of print.

ABSTRACT

INTRODUCTION: Myopia is a refractive error where distant objects are not clearly seen and appear blurred. Goal of this study was to evaluate long-term effectiveness of Repeated Low-Level Red Light (RLRL) therapy for children with myopia, which primarily focused on Axial length (AL) and Spherical Equivalent Refraction (SER) as primary endpoints.

METHODS: The research compared outcomes between RLRL treatment with Single Vision Spectacles (SVS) for childhood myopia management. We performed a systematic literature search in the PubMed, Embase and Cochrane databases using “Myopia” and ” Repeated Low-Level Red Light “. Mean differences (MD) were estimated and the effects of therapies measured. Publication bias and heterogeneity analysis were carried out by Inverted Precision Effect Test-Precision Effect Estimate Standard Error (PET-PEESE) (and subsequent Search Sequential Analysis) and Tau test. Bayesian meta-analysis was performed using Jaffrey Amazing Statistical Package (JASP).

RESULTS: This meta-analysis comprised 1,714 participants: 824 in RLRL and 890 in SVS group. Pooled effect size for AL reduction was 0.953 ± 0.294, (95% credible interval (CI) 0.775 to 0.980). Pooled effect size for SER reduction was 1.521 ± 0.662 (95% CI 0.102 to 2.736). PET-PEESE analysis revealed no significant publication bias (p-value 0.407). Random effects models were employed for presence of significant heterogeneity (3.9 and 5.7 for AL; 5.7 for SER), alongside degree of variation (0.828 & 1.665) for Tau (τ), which estimates the between-study variance.

CONCLUSION: Long-term observations indicate that RLRL treatment significantly influences myopia management, leading to considerable reductions in both AL and SER. Additional research is essential to investigate potential long-term rebound effects.

PMID:39981627 | DOI:10.1177/11206721251314541

Radiat Prot Dosimetry. 2025 Feb 21:ncaf012. doi: 10.1093/rpd/ncaf012. Online ahead of print.

ABSTRACT

The UKHSA radon detectors with polyallyldiglycol carbonate sensing material produced from 2010 onward were used to confirm that they are purely radon detectors only with negligible interference from thoron presence. The statistical analysis of results, after following standard detector processing procedures, showed that such devices can only detect 2.4% ± 0.3% of the total thoron activity concentration compared to the calibrated reference device. It was also demonstrated that thoron, unlike radon, can only travel a very short distance from the source to be effectively measured. Based on the above, it has been concluded that interference of thoron in radon measurement is negligible (within the statistical measurement error), and hence can be ignored in standard indoor and outdoor measurements.

PMID:39981623 | DOI:10.1093/rpd/ncaf012

Cancer Med. 2025 Feb;14(4):e70651. doi: 10.1002/cam4.70651.

ABSTRACT

OBJECTIVE: This study aimed to analyze disease cost levels among colorectal cancer (CRC) patients, examining differences in disease costs between those with type 2 diabetes mellitus (T2DM) and those without T2DM while considering various demographic characteristics.

METHODS: The study included respondents from colorectal cancer patients diagnosed and managed within the population-based cancer registry system of the Shanghai Municipal Center for Disease Control and Prevention from 2020 to 2022. Diabetic colorectal cancer cases were matched with nondiabetic colorectal cancer controls using propensity scores, maintaining a 1:1 ratio between cases and controls; bias for the majority of the matched variables is below 10%. Direct, indirect, and intangible costs were estimated for study subjects.

RESULTS: After propensity score matching, the analysis encompassed 376 cases of T2DM-related CRC and 376 non-T2DM CRC cases. The T2DM group exhibited higher direct medical costs (¥57,059.65 vs. ¥48,933.93, p < 0.05), direct nonmedical costs (¥9292.45 vs. ¥7969.35), indirect costs (¥300.13 vs. ¥241.11), intangible costs (¥3601.70 vs. ¥2631.96), and total disease costs (¥70,253.93 vs. ¥59,776.36, p < 0.05) compared to the non-T2DM group. In Stage II CRC, direct medical costs were ¥74,008.39 for the T2DM group versus ¥57,368.84 for the non-T2DM group. Among surgical patients, direct medical costs were ¥57,658.81 for the T2DM group versus ¥1337.00 for the non-T2DM group, and ¥49,061.52 for the non-T2DM surgical group versus ¥1089.00 for the non-T2DM nonsurgical group.

CONCLUSION: Colorectal cancer imposes a substantial economic burden. Patients with CRC and concurrent T2DM experience a higher economic burden compared to nondiabetic patients. Notably, individuals with both T2DM and Stage II cancer face a significantly higher economic burden, whereas surgical patients exhibit a significantly greater disease burden than nonsurgical patients. Efforts should concentrate on primary prevention and secondary prevention to alleviate the economic burden associated with colorectal cancer.

PMID:39981614 | DOI:10.1002/cam4.70651