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Nevin Manimala Statistics

Spatial analysis of measles vaccination coverage in the State of São Paulo

BMC Public Health. 2023 Jan 5;23(1):29. doi: 10.1186/s12889-022-14797-z.

ABSTRACT

BACKGROUND: Measles is a contagious viral disease that seriously affects children. The measles vaccine is widely recommended in Brazil and in the world; however, the disease remains relevant for the health authorities. The aim of the present study was to evaluate first and second dose of measles vaccine coverage (VC) in the cities of São Paulo and its spatial dynamics between 2015 and 2020.

METHOD: In this mixed-type ecological study, we used secondary, public domain data from 2015 to 2020, extracted from the Digital Information System of the National Immunization Program, Mortality Information System and the National Live Birth Information System. After calculating the VC, the following four categories were created: very low, low, adequate, and high, and the spatial autocorrelation of VC was analyzed using the Global and Local Moran’s statistics.

RESULTS: A steady decline in adherence to the vaccination was observed, which dynamically worsened until 2020, with a high number of cities fitting the classification of ineffective coverage and being potentially harmful to the effectiveness of the immunization activities of their neighbors.

CONCLUSION: A direct neighborhood pattern was observed between the units with low vaccination coverage, which implied that the reduction in measles VC was somehow related to and negatively influenced by the geographic location and social culture of these areas.

PMID:36604709 | DOI:10.1186/s12889-022-14797-z

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Nevin Manimala Statistics

Gut microbiome and stages of diabetes in middle-aged adults: CARDIA microbiome study

Nutr Metab (Lond). 2023 Jan 5;20(1):3. doi: 10.1186/s12986-022-00721-0.

ABSTRACT

BACKGROUND: Animal and human studies suggest the gut microbiome is linked to diabetes but additional data are needed on the associations of the gut microbiome to specific diabetes characteristics. The aim of this study was to examine the associations of gut microbiome composition to insulin resistance [Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)], duration of diabetes, and 4 stages of diabetes [normoglycemia, pre-diabetes, and diabetes with (+) and without (-) medication for diabetes].

METHODS: Data are from a sub-sample (n = 605) of Black and White participants from the 30-year follow-up exam of the prospectively followed community-based Coronary Artery Risk Development in Young Adults cohort (2015-2016; aged 48-60 years). Stool samples were collected and sequenced using the 16S ribosomal RNA method. Microbial measures included: α diversity (within-person), β diversity (between-person), and taxonomies. All analyses were adjusted for demographic, clinical, lifestyle factors, and use of relevant medications (full adjustment). Multivariate linear regression models were used to assess the association of diabetes characteristics with α diversity and genera abundance, while the association with β diversity was analyzed using permutational multivariate analysis of variance. Statistical significance was set to p-value < 0.05 for α and β diversity analyses and to q-value < 0.1 for genera abundance analyses.

RESULTS: There were 16.7% of participants with pre-diabetes, and 14.4% with diabetes (9% diabetes+) with median (interquartile range) diabetes duration of 5 (5-10) years. In the fully adjusted models, compared to those with no diabetes, longer diabetes duration and the diabetes + group had a lower α diversity. There were significant differences in β diversity across diabetes-related characteristics. A significantly reduced abundance of butyrate-producing genera was associated with higher HOMA-IR (ex., Anaerostipes and Lachnospiraceae_UCG.004), longer diabetes duration (ex., Agathobacter and Ruminococcus), and diabetes + (ex., Faecalibacterium and Romboutsia).

CONCLUSIONS: Our results suggest that an adverse alteration of gut microbiome composition is related to higher insulin resistance, longer diabetes duration, and is present in those persons with diabetes using medications. These diabetes-related characteristics were also associated with lower levels of certain butyrate-producing bacteria that produce health-promoting short-chain fatty acids. Understanding the role of gut microbiota in glucose regulation may provide new strategies to reduce the burden of diabetes.

PMID:36604708 | DOI:10.1186/s12986-022-00721-0

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Nevin Manimala Statistics

Tools for assessing health research partnership outcomes and impacts: a systematic review

Health Res Policy Syst. 2023 Jan 5;21(1):3. doi: 10.1186/s12961-022-00937-9.

ABSTRACT

OBJECTIVE: To identify and assess the globally available valid, reliable and acceptable tools for assessing health research partnership outcomes and impacts.

METHODS: We searched Ovid MEDLINE, Embase, CINAHL Plus and PsycINFO from origin to 2 June 2021, without limits, using an a priori strategy and registered protocol. We screened citations independently and in duplicate, resolving discrepancies by consensus and retaining studies involving health research partnerships, the development, use and/or assessment of tools to evaluate partnership outcomes and impacts, and reporting empirical psychometric evidence. Study, tool, psychometric and pragmatic characteristics were abstracted using a hybrid approach, then synthesized using descriptive statistics and thematic analysis. Study quality was assessed using the quality of survey studies in psychology (Q-SSP) checklist.

RESULTS: From 56 123 total citations, we screened 36 027 citations, assessed 2784 full-text papers, abstracted data from 48 studies and one companion report, and identified 58 tools. Most tools comprised surveys, questionnaires and scales. Studies used cross-sectional or mixed-method/embedded survey designs and employed quantitative and mixed methods. Both studies and tools were conceptually well grounded, focusing mainly on outcomes, then process, and less frequently on impact measurement. Multiple forms of empirical validity and reliability evidence was present for most tools; however, psychometric characteristics were inconsistently assessed and reported. We identified a subset of studies (22) and accompanying tools distinguished by their empirical psychometric, pragmatic and study quality characteristics. While our review demonstrated psychometric and pragmatic improvements over previous reviews, challenges related to health research partnership assessment and the nascency of partnership science persist.

CONCLUSION: This systematic review identified multiple tools demonstrating empirical psychometric evidence, pragmatic strength and moderate study quality. Increased attention to psychometric and pragmatic requirements in tool development, testing and reporting is key to advancing health research partnership assessment and partnership science. PROSPERO CRD42021137932.

PMID:36604697 | DOI:10.1186/s12961-022-00937-9

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Nevin Manimala Statistics

On-farm diversity, use pattern, and conservation of enset (Ensete ventricosum) genetic resources in southern Ethiopia

J Ethnobiol Ethnomed. 2023 Jan 5;19(1):2. doi: 10.1186/s13002-022-00569-x.

ABSTRACT

BACKGROUND: Enset is an important source of food and is consumed by about 25 million people as a staple or co-staple food crop mainly in southern parts of Ethiopia. Large numbers of enset landraces exist in different administrative zones of Ethiopia with a wide range of altitudes and agroclimatic zones. However, limited information is available on the diversity, distribution, and utilization pattern corresponding to the diverse ethnolinguistic as well as sociocultural communities of the country. Hence, this study was devised to explore and document the richness of farmers’ tradition and practice on the diversity and distribution of enset landraces on the farm level and selection pattern for different purposes regarding the production, utilization, and conservation of enset genetic resources.

METHODS: The study was conducted in four major enset-growing administrative zones of Ethiopia, namely Hadiya, Kembata-Tembaro, Gurage, and Silte. A total of 240 farm households were surveyed using individual interviews, 18 key informant interviews, 36 focus group discussions with 5 participants, and direct on-farm field observations for data collection. Considering that enset has a rich cultural background and indigenous knowledge, ethnobotanical research approach was applied to data collection and analysis. The Shannon-Weaver, Simpson, Pielou, and Jaccard’s similarity indices were used to evaluate the diversity and similarity of the landraces as well as using descriptive statistics in SPSS Ver. 24. Preference in direct matrix ranking was also used to compute and rank the enset landraces most preferred by the people in the context of specific use value in the study area.

RESULTS: A total of 282 farmer-named enset landraces have been identified, with a range from 2 to 32 on individual homegardens. The largest number of landraces was found in the Hadiya Zone (86), while the lowest was scored in the Silte Zone (57). The Shannon diversity index (H’) ranged from 3.73 (Silte) to 3.96 (Hadiya). Similarly, landraces revealed a very narrow range of variances in Simpson’s 1-D diversity index, and it ranged from 0.963 (Silte) to 0.978 (Hadiya). Likewise, the similarity index ranged from 0.24 to 0.73 sharing 16-47 landraces in common. Of the 282 landraces, 210 (74.5%) were recorded in more than one zones, whereas 72 (25.5%) had narrow distribution being restricted to a single zone.

CONCLUSIONS: Farmers have established long-term practices and experiences in cultivation, utilization, and conservation of a diverse group of enset landraces to fill their domestic and market purposes in each zone. The variation is likely to be related to agroclimatic differences, ethnicity factors, food cultures, and historical backgrounds. Therefore, to facilitate on-farm conservation as well as sustainable utilization of the enset genetic resources, farmers need to be supported by different stakeholders for all their worth and also in crop improvement programs.

PMID:36604690 | DOI:10.1186/s13002-022-00569-x

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Nevin Manimala Statistics

A delta-radiomic lymph node model using dynamic contrast enhanced MRI for the early prediction of axillary response after neoadjuvant chemotherapy in breast cancer patients

BMC Cancer. 2023 Jan 5;23(1):15. doi: 10.1186/s12885-022-10496-5.

ABSTRACT

BACKGROUND: The objective of this paper is to explore the value of a delta-radiomic model of the axillary lymph node (ALN) using dynamic contrast-enhanced (DCE) MRI for early prediction of the axillary pathological complete response (pCR) of breast cancer patients after neoadjuvant chemotherapy (NAC).

METHODS: A total of 120 patients with ALN-positive breast cancer who underwent breast MRI before and after the first cycle of NAC between October 2018 and May 2021 were prospectively included in this study. Patients were divided into a training (n = 84) and validation (n = 36) cohort based on the temporal order of their treatments. Radiomic features were extracted from the largest slice of targeted ALN on DCE-MRI at pretreatment and after one cycle of NAC, and their changes (delta-) were calculated and recorded. Logistic regression was then applied to build radiomic models using the pretreatment (pre-), first-cycle(1st-), and changes (delta-) radiomic features separately. A clinical model was also built and combined with the radiomic models. The models were evaluated by discrimination, calibration, and clinical application and compared using DeLong test.

RESULTS: Among the three radiomic models, the ALN delta-radiomic model performed the best with AUCs of 0.851 (95% CI: 0.770-0.932) and 0.822 (95% CI: 0.685-0.958) in the training and validation cohorts, respectively. The clinical model yielded moderate AUCs of 0.742 (95% CI: 0.637-0.846) and 0.723 (95% CI: 0.550-0.896), respectively. After combining clinical features to the delta-radiomics model, the efficacy of the combined model (AUC = 0.932) in the training cohort was significantly higher than that of both the delta-radiomic model (Delong p = 0.017) and the clinical model (Delong p < 0.001) individually. Additionally, in the validation cohort, the combined model had the highest AUC (0.859) of any of the models we tested although this was not statistically different from any other individual model’s validation AUC. Calibration and decision curves showed a good agreement and a high clinical benefit for the combined model.

CONCLUSION: This preliminary study indicates that ALN-based delta-radiomic model combined with clinical features is a promising strategy for the early prediction of downstaging ALN status after NAC. Future axillary MRI applications need to be further explored.

PMID:36604679 | DOI:10.1186/s12885-022-10496-5

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Nevin Manimala Statistics

High porosity 3D printed titanium mesh allows better bone regeneration

BMC Oral Health. 2023 Jan 6;23(1):6. doi: 10.1186/s12903-023-02717-5.

ABSTRACT

BACKGROUND: Most patients with insufficient bone mass suffer from severe horizontal or vertical bone defects in oral implant surgery. The purpose of this study was to compare the bone regeneration effects of titanium meshes with different porosity in the treatment of bone defects.

METHODS: Nine beagle dogs were equally divided into three groups based on execution time. Three months after the extraction of the first to fourth premolars of the mandible, three bone defects were randomly made in the mandible. Bone particles and three kinds of three-dimensional (3D) printed titanium nets with different porosities (low porosity group (LP), 55%; medium porosity group (MP), 62%; and high porosity group (HP), 68%) were replanted in situ. The beagles were killed 4, 8, and 12 weeks after surgery. Formalin-fixed specimens were embedded in acrylic resin. The specimens were stained with micro-CT, basic fuchsin staining, and toluidine blue staining.

RESULTS: Micro-CT analysis showed that the trabecular thickness, trabecular number, and bone volume fraction of the HP group were higher than those of the other two groups. Moreover, the trabecular separation of the HP group decreased slightly and was lower than that of the MP and LP groups. Histological staining analysis showed that the trabecular number in the HP group was higher than in the other two groups at 8 and 12 weeks, and the bone volume fraction of the HP was higher than that in the other two groups at 12 weeks. Moreover, the trabecular thickness of the MP was higher than that of the LP group at 12 weeks and the trabecular separation was lower in the HP group at 4 and 8 weeks. The differences were statistically significant (p < 0.05).

CONCLUSION: A 3D printed titanium mesh with HP in a certain range may have more advantages than a titanium mesh with LP in repairing large bone defects.

PMID:36604677 | DOI:10.1186/s12903-023-02717-5

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Nevin Manimala Statistics

“Assessing exposure of printing factory workers in thailand to selected heavy metals using urine and hair as non-invasive matrices”

BMC Public Health. 2023 Jan 5;23(1):31. doi: 10.1186/s12889-022-14807-0.

ABSTRACT

BACKGROUND: There are few thorough studies on the extent and inter-element relationships of heavy metal contamination in printing factory workers, especially in developing countries. The objective of this study was to determine the levels of eight heavy metals, including arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni), cobalt (Co), lead (Pb), mercury (Hg), and manganese (Mn), in urine and scalp hair of printing industry workers, and assess inter-element correlations.

METHODS: We examined a total of 85 urine samples and 85 scalp hair samples (3 cm hair segments taken from near the scalp) in 85 printing workers from a printing house in Bangkok, Thailand. We used an interviewer-administered questionnaire about participants’ printing techniques, work characteristics, and work environment. Urine and scalp hair samples were analyzed for levels of each element using the inductively coupled plasma optical emission spectrometry (ICP-OES) technique.

RESULTS: As, Cd, Cr, Ni, Pb were detected in urine with the geometric mean concentration range of 0.0028-0.0209 mg/L, and Hg, Pb, Ni, Cd, Co, Mn, Cr were detected in hair samples (0.4453-7.165 mg/kg dry weight) of printing workers. The geometric mean Ni level was significantly higher in the urine of production line workers than back-office personnel (0.0218 mg/L vs. 0.0132 mg/L; p = 0.0124). The other elements did not differ significantly between production line and back-office workers in either urine or hair. There was also a strong, statistically significant positive correlation between Ni and Co levels in hair samples of workers (r = 0.944, p < 0.0001).

CONCLUSIONS: Average concentrations of most of the metals in urine and hair of printing workers were found to be above the upper reference values. The significantly higher concentrations of Ni in production line workers might be due to more exposure to printed materials. A strong inter-element correlation between Ni and Co in hair samples can increase stronger health effects and should be further investigated. This study reveals possible dependencies and impact interactions of heavy metal exposure in printing factory workers.

PMID:36604667 | DOI:10.1186/s12889-022-14807-0

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Nevin Manimala Statistics

Efficacy and safety of tranexamic acid in posterior lumbar interbody fusion: a meta-analysis of randomized controlled trials

J Orthop Surg Res. 2023 Jan 5;18(1):14. doi: 10.1186/s13018-022-03493-8.

ABSTRACT

OBJECTIVE: To evaluate the efficacy and safety of tranexamic acid (TXA) in hemostasis in patients undergoing posterior lumbar interbody fusion (PLIF) by meta-analysis.

METHODS: This study was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42022354812). The databases PubMed, Cochrane Library, Web of Science, and Embase were searched for randomized controlled trial (RCT) papers on the use of TXA in patients with PLIF from database establishment to August 2022. Two researchers screened the literature, extracted data, evaluated the risk of bias of the included studies, recorded the authors, sample size, type of study design, and TXA dose of each study, and extracted the intraoperative blood loss, number of blood transfusions, total blood loss, drainage volume, operation time, and incidence of deep venous thrombosis in each study. Meta-analysis was performed using RevMan 5.4 software provided by Cochrane Library.

RESULTS: A total of 14 RCTs with a total of 1681 patients were included in this study, including 836 patients in the TXA group and 845 patients in the control group. The intraoperative blood loss [mean difference (MD) = – 125.97, 95% confidence interval (CI) (- 138.56, – 113.37), P < 0.0001] and less total blood loss [MD = – 204.28, 95% CI (- 227.38, – 181.18), P < 0.00001] in TXA group were lower than the control group. Statistical significance was also observed in postoperative drainage volume [MD = – 115.03, 95% CI (- 123.89, – 106.17), P < 0.00001], operation time [MD = – 8.10, 95% CI (- 14.49, – 1.71), P = 0.01], and blood transfusion rate [odds ratio (OR) = 0.30, 95% CI (0.23, 0.39), P < 0.00001]. However, there was no statistical difference observed in the incidence of deep venous thrombosis [OR = 0.83, 95% CI (0.56, 1.21), P = 0.33].

CONCLUSION: The application of TXA in PLIF can reduce intraoperative blood loss, total blood loss, drainage volume, the incidence of transfusion events, and operation time without increasing the risk of deep venous thrombosis.

PMID:36604661 | DOI:10.1186/s13018-022-03493-8

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Nevin Manimala Statistics

Determinants of depression and anxiety among type 2 diabetes patients in governments’ hospitals at Harari regional state, Eastern Ethiopia: A multi-center cross-sectional study

BMC Psychiatry. 2023 Jan 5;23(1):13. doi: 10.1186/s12888-022-04494-x.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus is the most common health problem globally. Depression and anxiety can exacerbate disease complications, make patients suffer more, and increase healthcare costs. Even though, depression and anxiety are common among type 2 diabetes mellitus patients, there have been limited studies conducted about the determinants of depression and anxiety in Ethiopia. Therefore, the purpose of this study was to assess the magnitude and determinants of depression and anxiety symptoms among Type 2 diabetes mellitus patients, attending out-patient treatment at Harari regional state government hospitals, Eastern Ethiopia.

METHOD: An institutional based cross-sectional study was conducted from March to April at Harari regional state government hospitals in eastern Ethiopia. A total of 421 participants were recruited using the systematic sampling technique. Data was collected by using Afan Oromo version of interviewer-administered structured and semi-structured questionnaires. Depression and Anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale. Bivariate and multivariate logistic regression analysis was done to identify variables related to both depression and anxiety symptoms. The association was described using an adjusted odds ratio and a 95% confidence interval (CI), with P-values of 0.05 used as a cutoff for a significant association in the adjusted analysis.

RESULT: Out of the 416 participants included in this study, 42.3%, 40.4% had depression and anxiety symptoms, respectively. Being female (Adjusted Odds Ratio = 1.85(1.09-3.15)), no formal education (Adjusted Odds Ratio = 2.65, (1.04-6.73)), age ≥ 70 (Adjusted Odds Ratio = 2.88 (1.28-6.48)), family history of mental illness (Adjusted Odds Ratio = 1.71 (1.35-3.82)) and poor social support (Adjusted Odds Ratio = 2.35(1.12-6.03)) were statistically associated with depression. While having a family history of mental illness (AOR 1.74(1.03-2.95)), being widowed (AOR = 3.45(1.49-8.01)), and having poor social support (AOR = 2.15(1.12, 4.89)) were statistically significant associated with anxiety at a p-value < 0.05.

CONCLUSION: Current study results showed that the magnitude of depression and anxiety were relatively high among type 2 diabetes mellitus patients.Having a family history of mental illness and poor social support were statistically associated with both depression and anxiety symptoms. Screening, early detection, and appropriate treatment of depression and anxiety symptoms in type 2 diabetes mellitus patients should be prioritized by health care providers.

PMID:36604654 | DOI:10.1186/s12888-022-04494-x

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Nevin Manimala Statistics

Activity-to-sedentary ratio provides novel insight into mortality reduction among male survivors of cardiovascular disease in the United States: national health and nutrition examination survey, 2007-2014

BMC Public Health. 2023 Jan 6;23(1):35. doi: 10.1186/s12889-023-14978-4.

ABSTRACT

BACKGROUND: Lower physical activity and sedentary behavior have been identified as modifiable risk factors for cardiovascular disease (CVD). However, the quantitative, dose-response association between activity-to-sedentary ratio (ASR) and mortality is unknown.

METHODS: Prospective cohort studies with participants 50 to 80 years that reported the association between recreational physical activity, sedentary behavior, and all-cause mortality were included from the 2007 to 2014 United States National Health and Nutrition Examination Survey (NHANES) and followed through December 31, 2015. Cox or Weibull regression models and restricted cubic splines were used to determine the association between ASR and all-cause mortality.

RESULTS: Sixty deaths occurred among 498 CVD survivors, with a median of 56 months of follow-up. After accounting for all covariates, CVD survivors with an ASR between 0.21 and 0.57 (hazard ratio [HR], 0.47; 95% confidence interval [CI], 0.25-0.87) and those with an ASR more than 0.57 (HR, 0.40; 95% CI, 0.20-0.81) were at significantly lower risk for mortality than participants with an ASR < 0.21. Moreover, a nonlinear negative association and an L-shaped association were observed for the level of ASR with risk of mortality among CVD survivors (P for nonlinearity = 0.004). What’s more, adjusting for covariates, a statistically significant interaction (P for interaction = 0.016) between sex and ASR, an increase of ASR more than and equal to 0.18 was associated with a lower risk of mortality among males (HR, 0.23; 95% CI, 0.12-0.46).

CONCLUSIONS: An negative correlation between ASR and mortality in CVD survivors, especially in males when ASR is more than 0.18. Our novel findings provide further insights into easing the global burden of deaths.

PMID:36604643 | DOI:10.1186/s12889-023-14978-4