Category: Statistics

BMC Public Health. 2024 Nov 2;24(1):3040. doi: 10.1186/s12889-024-20402-2.

ABSTRACT

BACKGROUND: While there is growing evidence highlighting the prevalence of mental health concerns among university faculty, few studies have examined mental health interventions in this population. The objective of this systematic review and meta-analysis was to collect and critically appraise the available evidence about the effectiveness of interventions designed to improve the mental health of faculty.

METHODS: A systematic search was conducted by searching PubMed, EMBASE, Scopus, Web of Science, and CINAHL to identify relevant studies published in English language from January 1st, 2000 until October 1st, 2023. The search focused on studies done on academic faculty to describe interventions or support programs aimed at improving mental health outcomes, with comparison of mental health data before and after the intervention and an improvement in mental health as study outcome. A random effect meta-analysis method was used to estimate the effectiveness of interventions on faculty mental health.

RESULTS: Ten publications with 891 participants from 2,217 retrieved records were included. The random effect model showed substantial heterogeneity (I² = 84.8%, 95% CI: 73.8 – 91.2%, p < 0.001). The pooled SMD was – 1.41 (95% CI: -2.81-0.004) showing a large effect, and it significantly favors the use of intervention for reducing mental health issues among faculty members. The effect size estimates for all included studies ranged from small to large, showing the positive effect of intervention on faculty mental health. Multimodal inference analysis showed that, of the many studied factors for faculty mental health, the region was the most important predictor of intervention effectiveness. However, when the significance of quantitative moderators was tested using meta-regression, age (p = 0.9491) and duration of intervention (p = 0.1284) were not statistically significant.

CONCLUSION: Interventions aimed at enhancing the mental health of university faculty were overall significant; however, individual studies showed heterogeneous results. Making efforts to enhance the mental health of faculty is crucial and has been proven effective; nevertheless, the existing evidence necessitates further research in this area. For interventions to be effective, it is imperative to tailor them to the specific environment and to the unique characteristics of faculty members.

PROSPERO REGISTRATION NUMBER: CRD42023490388.

PMID:39488684 | DOI:10.1186/s12889-024-20402-2

Cardiovasc Diabetol. 2024 Nov 2;23(1):393. doi: 10.1186/s12933-024-02470-1.

ABSTRACT

BACKGROUND: Dysglycemia and insulin resistance increase type 2 diabetes (T2D) and cardiovascular disease (CVD) risk, yet associations with specific glucose-insulin homeostatic biomarkers have been inconsistent. Vitamin D and marine omega-3 fatty acids (n-3 FA) may improve insulin resistance. We sought to examine the association between baseline levels of insulin, C-peptide, HbA1c, and a novel insulin resistance score (IRS) with incident cardiometabolic diseases, and whether randomized vitamin D or n-3 FA modify these associations.

METHODS: VITamin D and OmegA-3 TriaL (NCT01169259) was a randomized clinical trial testing vitamin D and n-3 FA for the prevention of CVD and cancer over a median of 5.3 years. Incident cases of T2D and CVD (including cardiovascular death, myocardial infarction, stroke, and coronary revascularization) were matched 1:1 on age, sex, and fasting status to controls. Conditional logistic regressions adjusted for demographic, clinical, and adiposity-related factors were used to assess the adjusted odds ratio (aOR) per-standard deviation (SD) and 95%CI of baseline insulin, C-peptide, HbA1c, and IRS (Insulin×0.0295 + C-peptide×0.00372) with risk of T2D, CVD, and coronary heart disease (CHD).

RESULTS: We identified 218 T2D case-control pairs and 715 CVD case-control pairs including 423 with incident CHD. Each of the four biomarkers at baseline was separately associated with incident T2D, aOR (95%CI) per SD increment: insulin 1.46 (1.03, 2.06), C-peptide 2.04 (1.35, 3.09), IRS 1.72 (1.28, 2.31) and HbA1c 7.00 (3.76, 13.02), though only HbA1c remained statistically significant with mutual adjustments. For cardiovascular diseases, we only observed significant associations of HbA1c with CVD (1.19 [1.02, 1.39]), and IRS with CHD (1.25 [1.04, 1.50]), which persisted after mutual adjustment. Randomization to vitamin D and/or n-3 FA did not modify the association of these biomarkers with the endpoints.

CONCLUSIONS: Each of insulin, C-peptide, IRS, and HbA1c were associated with incident T2D with the strongest association noted for HbA1c. While HbA1c was significantly associated with CVD risk, a novel IRS appears to be associated with CHD risk. Neither vitamin D nor n-3 FA modified the associations between these biomarkers and cardiometabolic outcomes.

PMID:39488682 | DOI:10.1186/s12933-024-02470-1

BMC Sports Sci Med Rehabil. 2024 Nov 2;16(1):224. doi: 10.1186/s13102-024-01010-4.

ABSTRACT

OBJECTIVE: The influence of the menstrual cycle on practical power performance such as barbell back squats and jumping performance in women has not yet been fully investigated. In addition, the performance level of athletes has not been considered in previous studies. This study aimed to investigate the influence of different cycle phases on acute back squat performance, jumping ability and psychological state concerning the performance level.

METHODS: 24 female strength athletes (age: 25.2 ± 3.3 years; height: 169.5 ± 3.4 cm; body weight: 67.7 ± 7.3 kg) were recruited for the study. Level of performance was classified according to Santos et al. (intermittent (n = 13), advanced (n = 6), highly advanced (n = 5)). Participants were tested for 1RM barbell back squat and jumping performance (countermovement and squat jump) as well as two questionnaires assessing their psychological states in the menses (M), late follicular phase (FP) and mid-luteal phase (LP) in three MC. Saliva estradiol and progesterone concentrations with a menstrual cycle diary were used to confirm a normal MC. A principal components analysis for power performance, well-being, relaxation and alertness was carried out and a linear mixed model was used for statistical evaluation.

RESULTS: No significant differences were found between the MC phases in performance scores (p > 0.05), readiness (p > 0.05) and alertness (p > 0.05). However, a high correlation between MC phases, performance level and back squat performance was detected. Correlation analyses indicate that a higher performance level results in a higher variation depending on the MC of the squat performance. For well-being, a significantly lower score was detected in M than in FP and LP.

CONCLUSION: In general the performance score of the lower body is not influenced by the MC. If strength performance and jumping ability are considered separately, there are indications that strength capability is influenced at a higher performance level. In addition, individual variance was also observed, so this should also be considered. However, further studies are needed to confirm this assumption due to the small sample sizes of the individual performance levels.

TRIAL REGISTRATION: German registry for clinical studies (DRKS00034816, Date: 08/01/2024).

PMID:39488680 | DOI:10.1186/s13102-024-01010-4

Biochem Genet. 2024 Nov 3. doi: 10.1007/s10528-024-10950-y. Online ahead of print.

ABSTRACT

Successful embryo implantation relies on a receptive endometrium and a maternofetal dialogue. Abnormal receptivity is a common cause of implantation failure in assisted reproductive techniques. This study aimed to develop a novel transcriptomic-based diagnostic assay, Adhesio, for assessing endometrial receptivity and guiding personalized embryo transfer. Adhesio was developed based on an initial dataset of 74 endometrial biopsies. Two types of biopsy samples were involved: 45 endometrial biopsies collected during the optimal theoretical window of implantation (WOI) and 29 endometrial biopsies which cells have been cultured with or without an autologous embryo. Microarray analysis was performed to identify differentially expressed genes associated with endometrial receptivity and selected candidate genes were assessed using quantitative real-time polymerase chain reaction (RT-qPCR) on biopsy samples. Statistical analyses were conducted to assess the performance and accuracy of Adhesio. The microarray analysis identified three distinct clusters of endometrial samples with differential gene expression patterns. Cluster 1 exhibited 1717 differentially expressed genes involved in biological processes associated with endometrial receptivity. A specific transcriptomic signature of 60 genes associated with endometrial co-culture was obtained using class prediction approach. Thereafter, an original panel of 10 genes was selected as potential biomarkers for endometrial receptivity based on their expression profiles in both endometrial biopsies and co-cultured cells. This article outlines the methodology employed to develop Adhesio, a test that assesses endometrial receptivity using an original panel of 10 genes. These genes are not only involved during the WOI but are also influenced by the maternal-fetal dialogue.

PMID:39488671 | DOI:10.1007/s10528-024-10950-y

Pediatr Surg Int. 2024 Nov 2;40(1):287. doi: 10.1007/s00383-024-05869-9.

ABSTRACT

PURPOSE: Practice patterns of same-day discharge for pediatric laparoscopic appendectomy for non-perforated appendicitis are not well-analyzed. Our aim is to evaluate current practice patterns and outcomes of same-day discharge for these patients.

METHODS: NSQIP-P retrospective registry identified patients (2017-2021) who underwent laparoscopic appendectomy for non-perforated appendicitis. Annual same-day discharge (SDD) rate was determined. SDD patients were compared to those discharged postoperative days 1-2 (non-SDD). Sub-group analysis was performed on ICD-10 code K35.30. Regression was performed.

RESULTS: Overall, 67,214 patients were identified. The SDD rate increased from 33.3% (2017) to 52.5% (2021) with decreased 30-day readmissions between SDD and non-SDD (1.3% vs 2.1%, p < 0.001). Sub-group analysis identified 7,330 patients with SDD rates from 50.7% (2019) to 60.4% (2021) with decreased 30-day readmissions (1.3% vs 2.1%, p < 0.001) for SDD versus non-SDD. No increase in adverse events for SDD occurred in either analysis. Regression identified esophageal/gastric/intestinal diseases increased odds of early readmission or reoperation (OR 1.85, p = 0.042).

CONCLUSION: Same-day discharge after pediatric laparoscopic appendectomy for non-perforated acute appendicitis continues to increase in frequency without a significant increase in adverse outcomes. SDD rates are 20-30% lower than previously published single-center studies, indicating there is a likely a larger percentage of patients that could discharge same-day.

LEVEL OF EVIDENCE (I-V): Level III.

PMID:39488659 | DOI:10.1007/s00383-024-05869-9

Clin Ther. 2024 Nov 1:S0149-2918(24)00287-X. doi: 10.1016/j.clinthera.2024.09.024. Online ahead of print.

ABSTRACT

PURPOSE: Patients with transfusion-dependent β-thalassemia (TDT) have reduced levels of β-globin, leading to ineffective erythropoiesis and iron overload. Patients with TDT depend on regular red blood cell transfusions (RBCTs) and iron chelation therapy for survival and management of disease- and treatment-related clinical complications. This study describes the clinical and economic burden in patients with TDT in England.

METHODS: This longitudinal, retrospective study linked the Clinical Practice Research Datalink (CPRD) database with secondary care data from the Hospital Episode Statistics database to identify patients with a diagnosis of β-thalassemia between July 1, 2008, and June 30, 2018. Included patients had a diagnosis of β-thalassemia prior to the index date, ≥8 RBCTs per year for ≥2 consecutive years, and ≥1 year of follow-up data available from the index date. Each eligible patient was exact matched with up to 5 controls in the CPRD. Proportions of deaths and rates of mortality, acute and chronic complications, and healthcare resource utilization (HCRU) were calculated during the follow-up period.

FINDINGS: Of 11,359 identified patients with β-thalassemia, 237 patients with TDT met the eligibility criteria and were matched with 1184 controls. The mean age at the index date was approximately 25 years in the patient and control groups. The proportion of deaths (7.17% vs 1.18%; P < 0.05) and mortality rate (1.19 deaths per 100 person-years vs 0.20 deaths per 100 person-years) were higher among patients with TDT compared to controls. Endocrine complications and bone disorders were the most prevalent complications among patients with TDT (58.23%) and included osteoporosis (29.11%), diabetes mellitus (28.27%), and hypopituitarism (28.27%). Patients with TDT had a mean of 13.62 RBCTs per patient per year (PPPY). HCRU was substantially higher among patients with TDT, wherein patients with TDT had higher rates of prescriptions recorded in primary care (24.09 vs 8.61 PPPY), outpatient visits (16.69 vs 1.31 PPPY), and inpatient hospitalizations (17.41 vs 0.24 PPPY) than controls. Inpatient hospitalizations were primarily <1 day, with 16.62 events PPPY lasting <1 day and 0.79 events PPPY lasting ≥1 day. Patients with TDT aged ≥18 years had increased rates of mortality, clinical complications, and HCRU than those aged <18 years.

IMPLICATIONS: Patients with TDT in England have higher mortality than matched controls, substantial disease-related clinical complications, and substantial HCRU. High mortality and clinical complications highlight the need for additional innovative therapies for TDT.

PMID:39488494 | DOI:10.1016/j.clinthera.2024.09.024

An Pediatr (Engl Ed). 2024 Nov 1:S2341-2879(24)00265-5. doi: 10.1016/j.anpede.2024.10.006. Online ahead of print.

ABSTRACT

INTRODUCTION: The management of congenital heart disease (CHD) has evolved, improving patient outcomes; however, challenges persist for patients, emphasizing the importance of assessing health-related quality of life (HRQoL). The widely used Pediatric Quality of Life Inventory underscores the relevance of HRQoL assessment, especially in children subject to medical procedures.

OBJECTIVE: To evaluate HRQoL in children with congenital heart disease undergoing cardiac catheterization, analysing its association with clinical and sociodemographic variables in a tertiary care hospital.

MATERIALS AND METHODS: We conducted a cross-sectional study in paediatric patients aged 2-18 years undergoing haemodynamic procedures for congenital heart diseases. We used the Pediatric Quality of Life Inventory (PedsQL) to assess HRQoL. The statistical analysis included descriptive statistics, χ² tests, Kruskal-Wallis tests and multivariate linear regression analysis with the aim of identifying factors associated with HRQoL.

RESULTS: The sample included 164 patients, among whom pulmonary atresia and patent ductus arteriosus were frequent diagnoses. Physical functioning and school functioning were significantly impaired, with median scores of 32.14 (IQR, 17.14-62.87) and 56 (IQR, 28-88), respectively. The results were more favourable for emotional functioning and social functioning, with median scores of 62 (IQR, 32-74) and 68 (IQR, 44-100), respectively. Single ventricle defects and pulmonary atresia were associated with lower quality of life scores in emotional functioning (P = .035) and physical functioning (P = .048), respectively.

CONCLUSION: This study highlights the current challenges in evaluating HRQoL for children with CHD. It identified significant associations between specific diagnoses and decreased HRQoL scores, emphasizing the need for comprehensive care strategies.

PMID:39488488 | DOI:10.1016/j.anpede.2024.10.006

Cardiovasc Revasc Med. 2024 Oct 28:S1553-8389(24)00705-X. doi: 10.1016/j.carrev.2024.10.007. Online ahead of print.

ABSTRACT

BACKGROUND: The J-CTO investigators recently developed angiographic difficulty scores for each of the three major coronary arteries in patients undergoing first-attempt chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in de novo occlusions.

METHODS: We examined the performance of the individual J-CTO scores in a large multicenter registry.

RESULTS: The CTO lesion location was as follows: right coronary artery (RCA) 3,805 (54%), left anterior descending artery (LAD) 2,303 (33%), and left circumflex (LCX) 935 (13%). Patients in the PROGRESS-CTO registry were younger, more likely to be female, and had higher J-CTO scores compared with the J-CTO registry. Increasing difficulty scores were associated with lower technical success in the PROGRESS-CTO registry (score 0: 94.4 % – score ≥3: 82.6% for the RCA difficulty score; score 0: 96.4% – score ≥3: 86.1 for the LAD difficulty score; and score 0: 95.4% – score ≥3: 81.2% for the LCX difficulty score). The C-statistic of the coronary artery specific J-CTO scores in the PROGRESS-CTO registry were: LAD 0.69 (95% confidence intervals [CI], 0.64-0.73), LCX 0.63 (95% CI, 0.57-0.69), and RCA 0.61 (95-% CI, 0.58-0.64) with good calibration (Hosmer-Lemeshow p-value >0.05 for all). The AUC of the classic J-CTO score for LAD lesions was similar with the LAD J-CTO score (p-for-difference = 0.26), but worse for LCX (p-for-difference = 0.04) and RCA lesions (p-for-difference = 0.04).

CONCLUSION: In the PROGRESS-CTO registry, the coronary artery specific J-CTO scores did not improve prediction of the technical success of CTO-PCI compared with the classic J-CTO score.

PMID:39488482 | DOI:10.1016/j.carrev.2024.10.007

J Pediatr Surg. 2024 Oct 20:162020. doi: 10.1016/j.jpedsurg.2024.162020. Online ahead of print.

ABSTRACT

AIM: To evaluate factors associated with excellent correction in pectus excavatum patients undergoing vacuum bell therapy (VBT).

METHODS: A single-institution retrospective chart review was performed November 2012-April 2023 to assess corrections of patients who underwent VBT. Patient demographics, presentation, and results were collected. Excellent correction was defined as complete correction or >100 % improved from an average standard chest depth of 0.51 cm. Data are reported using odds ratio & confidence intervals; and paired t-test comparison. A p-value of <0.05 was regarded as significant.

RESULTS: VBT was utilized in 431 patients with 278 patients included and 153 excluded due to loss of follow-up or incomplete data. Of those included, 89 % were male. There were 31 patients with excellent corrections (11 %) and 247 non-excellent corrections. Initial chest depth < 1.5 cm and chest wall flexibility remain important predictors of positive outcome (p=0.008 and < 0.001, respectively). Excellent correction was statistically more likely in patients aged 8 to 12.9 (OR = 2.2, p = 0.039). Surgical correction following VBT was performed in only 15.5 % (42 of 278) of our patients, none of which were in the group with an excellent correction.

CONCLUSION: Excellent correction for pectus excavatum via VBT was achieved in a small proportion of patients, with improved outcomes in those initiating therapy at a younger age, with a mild defect, and with increased chest wall flexibility. These data may be used to help determine those more likely to achieve complete correction from a nonsurgical approach and guide decisions towards treatment methods.

PMID:39488480 | DOI:10.1016/j.jpedsurg.2024.162020

Dent Mater. 2024 Nov 1:S0109-5641(24)00309-9. doi: 10.1016/j.dental.2024.10.019. Online ahead of print.

ABSTRACT

OBJECTIVES: To proof the feasibility of direct colour printing on 3Y-TZP using 222 nm UV-C through investigating the degree and durability of the colour changes, and testifying whether surface, mechanical and biological properties are influenced by the treatment.

METHODS: 222 nm UV-C light (Irradiance: 1.870 mW/cm²) was used to treat 3Y-TZP for durations from 15 min to 24 h. ΔE*, TP, crystalline structure, surface morphology, S_a, BFS and biological activities were investigated before and after irradiation. SPSS 28.0 was used for statistical analysis (α = 0.05).

RESULTS: 222 nm UV-C irradiation was capable to shade white 3Y-TZP into tooth colours. With the increase of ΔE*, TP decreased, such that the longer the irradiation time, the higher the ΔE* (logarithmic relationship) and lower the TP. Despite the induced optical changes being prone to fade, the process can be predicted by inversely proportional relationships between ΔE*, TP and the testing points. The treated surface exhibited enhanced hydrophilicity, while the recovery phenomenon was observed. Other properties were not altered by the treatment.

SIGNIFICANCE: This is the seminal study demonstrating the feasibility of direct colour printing on 3Y-TZP using 222 nm UV-C. The new relationship between the colour centre and E_g of 3Y-TZP was established, whereas the induced optical changes were stabilised after a certain period and were highly predictable by controlling the irradiation periods. The irradiation was only correlated to the electron excitation and oxygen vacancies, and would not lead to any changes of other properties. A simple, safe and promising approach to achieve satisfactory colours on 3Y-TZP in clinical practice can be developed.

PMID:39488475 | DOI:10.1016/j.dental.2024.10.019