Category: Statistics

J Biosoc Sci. 2024 Apr 15:1-10. doi: 10.1017/S0021932024000142. Online ahead of print.

ABSTRACT

An increase in the prevalence of obesity due to lockdown and confinement linked to COVID-19 is observed. Variations in the nutritional status of schoolchildren from Jujuy are analyzed in relation to confinement due to COVID-19 (2019-2021) and its relationship with socio-demographic variables and the school environment. This is an observational, descriptive study. Data from 56,695 schoolchildren aged 6-18 years old is analyzed based on two temporary cuts (2019 pre-confinement and 2021 post-confinement). The nutritional status of schoolchildren (underweight, overweight, and obese) was established using the IOTF (International Obesity Task Force) criterion. The prevalence of each nutritional phenotype was estimated by sex and age group, considering the following independent variables: setting (rural/urban), school management system (public/private), geographic altitude, and percentage of households with unmet basic needs (UBN) in the place where they attend school. Multiple proportions contrast was performed using Fisher’s test, a transition matrix ws produced and a statistical model of proportional odds was fitted. It was observed that between 2019 and 2021, the prevalence of underweight decreased and the prevalence of overweight and obesity increased significantly. In 2021, 67% of schoolchildren maintained the same nutritional category that they had in 2019, 21% gained weight and 12% lost weight. The model explains about 52% of the total variability observed. The factors that are significantly correlated in the model are school cycle, age, geographic altitude, school setting, and % of households with UBN. The results indicate that during the COVID-19 pandemic, there was a shift to the right in the distribution of the nutritional status categories of the schoolchildren population in Jujuy, with a decrease in the prevalence of underweight and an increase in the prevalence of overweight and obesity with variations related to age, school location, geographic altitude, and socioeconomic characteristics of the households in the place where the children attended school.

PMID:38618941 | DOI:10.1017/S0021932024000142

Clin Trials. 2024 Apr 15:17407745241238443. doi: 10.1177/17407745241238443. Online ahead of print.

ABSTRACT

BACKGROUND: The current endpoints for therapeutic trials of hospitalized COVID-19 patients capture only part of the clinical course of a patient and have limited statistical power and robustness.

METHODS: We specify proportional odds models for repeated measures of clinical status, with a common odds ratio of lower severity over time. We also specify the proportional hazards model for time to each level of improvement or deterioration of clinical status, with a common hazard ratio for overall treatment benefit. We apply these methods to Adaptive COVID-19 Treatment Trials.

RESULTS: For remdesivir versus placebo, the common odds ratio was 1.48 (95% confidence interval (CI) = 1.23-1.79; p < 0.001), and the common hazard ratio was 1.27 (95% CI = 1.09-1.47; p = 0.002). For baricitinib plus remdesivir versus remdesivir alone, the common odds ratio was 1.32 (95% CI = 1.10-1.57; p = 0.002), and the common hazard ratio was 1.30 (95% CI = 1.13-1.49; p < 0.001). For interferon beta-1a plus remdesivir versus remdesivir alone, the common odds ratio was 0.95 (95% CI = 0.79-1.14; p = 0.56), and the common hazard ratio was 0.98 (95% CI = 0.85-1.12; p = 0.74).

CONCLUSIONS: The proposed methods comprehensively characterize the treatment effects on the entire clinical course of a hospitalized COVID-19 patient.

PMID:38618926 | DOI:10.1177/17407745241238443

Phys Chem Chem Phys. 2024 Apr 15. doi: 10.1039/d3cp06100k. Online ahead of print.

ABSTRACT

Most QM-cluster models of enzymes are constructed based on X-ray crystal structures, which limits comparison to in vivo structure and mechanism. The active site of chorismate mutase from Bacillus subtilis and the enzymatic transformation of chorismate to prephenate is used as a case study to guide construction of QM-cluster models built first from the X-ray crystal structure, then from molecular dynamics (MD) simulation snapshots. The Residue Interaction Network ResidUe Selector (RINRUS) software toolkit, developed by our group to simplify and automate the construction of QM-cluster models, is expanded to handle MD to QM-cluster model workflows. Several options, some employing novel topological clustering from residue interaction network (RIN) information, are evaluated for generating conformational clustering from MD simulation. RINRUS then generates a statistical thermodynamic framework for QM-cluster modeling of the chorismate mutase mechanism via refining 250 MD frames with density functional theory (DFT). The 250 QM-cluster models sampled provide a mean ΔG^‡ of 10.3 ± 2.6 kcal mol^-1 compared to the experimental value of 15.4 kcal mol^-1 at 25 °C. While the difference between theory and experiment is consequential, the level of theory used is modest and therefore “chemical” accuracy is unexpected. More important are the comparisons made between QM-cluster models designed from the X-ray crystal structure versus those from MD frames. The large variations in kinetic and thermodynamic properties arise from geometric changes in the ensemble of QM-cluster models, rather from the composition of the QM-cluster models or from the active site-solvent interface. The findings open the way for further quantitative and reproducible calibration in the field of computational enzymology using the model construction framework afforded with the RINRUS software toolkit.

PMID:38618904 | DOI:10.1039/d3cp06100k

Disaster Med Public Health Prep. 2024 Apr 15;18:e67. doi: 10.1017/dmp.2024.66.

ABSTRACT

AIM AND BACKGROUND: In contemporary healthcare, the crucial importance of disaster preparedness and response within the nursing profession has gained recognition. Considering the elevated probability of encountering numerous disasters in Türkiye, it is noteworthy that limited research has been conducted in this domain. This study, therefore, aims to investigate the related factors to nurses’ disaster preparedness Türkiye through a meta-analysis method.

METHODS: The study was conducted based on PRISMA guidelines. We searched the national databases in Türkiye and Web of Science Core Collection. Descriptive studies published in Turkish or English between 01.01.2000-31.12.2021 in Türkiye were included in the study to derive the pooled outputs.

RESULTS: A total of nine studies, encompassing a sample size of 3222 nurses, met the inclusion criteria. The meta-analysis’ results revealed that gender and prior experience with disasters did not exhibit a statistically significant impact on nurses’ disaster preparedness (p>0.05). Conversely, engaging in disaster education programs, familiarizing oneself with disaster plans, and actively participating in disaster drills were found to have a significant positive effect on nurses’ preparedness for disasters (p<0.05). However, it is worth noting that the analysis of disaster experience exhibited substantial heterogeneity (I²=85.6%), indicating variations among the included studies. Similarly, the analysis related to reading disaster plans also demonstrated high heterogeneity (I²=77.7%).

CONCLUSION: Based on the available evidence from the meta-analysis, it can be concluded that receiving disaster education, reading disaster plans, and participating in disaster drills have a positive and significant impact on nurses’ perception of disaster preparedness.

PMID:38618888 | DOI:10.1017/dmp.2024.66

Eur J Gen Pract. 2024 Dec;30(1):2340672. doi: 10.1080/13814788.2024.2340672. Epub 2024 Apr 15.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) screening uptake in many countries has been low and further impacted by the COVID-19 pandemic. General Practitioners (GPs) are key facilitators, however research on their impact on organised CRC screening is still limited.

OBJECTIVES: To evaluate the effectiveness of tailored talks with GPs to increase population uptake of the long-established CRC screening programme in Ancona province, Italy.

METHODS: In this prospective cohort study, one-to-one tailored talks were organised in January 2020 between the GPs of one county of the province (with GPs from other counties as controls) and the screening programme physician-in-chief to discuss the deployment and effectiveness of organised screening. Data was extracted from the National Healthcare System datasets and linear regression was used to assess the potential predictors of CRC screening uptake.

RESULTS: The mean CRC screening uptake remained stable from 39.9% in 2018-19 to 40.8% in 2020-21 in the 22 GPs of the intervention county, whereas it statistically significantly decreased from 38.7% to 34.7% in the 232 control GPs. In multivariate analyses, belonging to the intervention county was associated with an improved uptake compared to the control counties (+5.1%; 95% Confidence Intervals – CI: 2.0%; 8.1%).

CONCLUSION: Persons cared for by GPs who received a tailored talk with a cancer screening specialist avoided a drop in CRC screening adherence, which characterised all other Italian screening programmes during the COVID-19 emergency. If future randomised trials confirm the impact of tailored talks, they may be incorporated into existing strategies to improve population CRC screening uptake.

PMID:38618885 | DOI:10.1080/13814788.2024.2340672

Anat Rec (Hoboken). 2024 Apr 15. doi: 10.1002/ar.25453. Online ahead of print.

ABSTRACT

Recent studies have suggested a connection between disturbances of the apelin system and various cardiac pathologies, including hypertension, heart failure, and atherosclerosis. Vascular endothelial growth factor is crucial for cardiac homeostasis as a critical molecule in cardiac angiogenesis. Neuronal nitric oxide synthase is an essential enzyme producing nitric oxide, a key regulator of vascular tone. The present study aims to shed light upon the complex interactions between these three vital signaling molecules and examine their changes with the progression of hypertensive heart disease. We used two groups of spontaneously hypertensive rats and age-matched Wistar rats as controls. The expression of the apelin receptor, vascular endothelial growth factor, and neuronal nitric oxide synthase were assessed immunohistochemically. We used capillary density and cross-sectional area of the cardiomyocytes as quantitative parameters of cardiac hypertrophy. Immunoreactivity of the molecules was more potent in both ventricles of spontaneously hypertensive rats compared with age-matched controls. However, capillary density was lower in both ventricles of the two age groups of spontaneously hypertensive rats compared with controls, and the difference was statistically significant. In addition, the cross-sectional area of the cardiomyocytes was higher in both ventricles of the two age groups of spontaneously hypertensive rats compared with controls, and the difference was statistically significant. Our study suggests a potential link between the apelin receptor, vascular endothelial growth factor, and neuronal nitric oxide synthase in cardiac homeostasis and the hypertensive myocardium. Nevertheless, further research is required to better comprehend these interactions and their potential therapeutic implications.

PMID:38618880 | DOI:10.1002/ar.25453

Disaster Med Public Health Prep. 2024 Apr 15;18:e70. doi: 10.1017/dmp.2024.40.

ABSTRACT

OBJECTIVE: To evaluate the effect of the Disaster Medical Assistance Team (DMAT) in an inner-city emergency department during the coronavirus disease (COVID-19) pandemic.

METHODS: Data were abstracted from individual emergency department encounters over 6 weeks. The study compared left without being seen (LWBS) percentage, door-to-provider, and door-to-disposition times for 2 weeks before, during, and after the DMAT.

RESULTS: The LWBS percentages for the 2 weeks before and after the DMAT were 16.2% and 11.6%, respectively. The LWBS percentage during the DMAT was 8.1%. Door-to-disposition times for the 2 weeks before and after the DMAT were 7.36 hours and 8.53 hours, respectively. The door-to-disposition during the DMAT was 7.33 hours. Door-to-disposition was statistically significant during the 2 weeks of the DMAT compared to the 2 weeks after the DMAT (7.33 vs 8.53, P < 0.05) but not statistically significant when compared to the period before the DMAT (7.36 vs 7.33, P = 1.00). Door-to-provider time was the longest during the DMAT (122.5 minutes [2.04 hours]) when compared to the time frame before the DMAT (114.54 minutes [1.91 hours]) and after the DMAT (102.84 minutes [1.71 hours]).

CONCLUSION: The DMAT had the most positive impact on LWBS percentages. The DMAT showed no improvement in door-to-provider times in the study and only in door-to-disposition times when comparing the time the DMAT was present to after the DMAT departed.

PMID:38618877 | DOI:10.1017/dmp.2024.40

Nurs Open. 2024 Apr;11(4):e2147. doi: 10.1002/nop2.2147.

ABSTRACT

AIM: This study focuses on the fathers of children with chronic illnesses in an effort to clarify how the stressor and the father’s sense of coherence (SOC) influence their mental health and how the father’s SOC is associated with the social support.

DESIGN: Cross-sectional study.

METHODS: We conducted a self-reported questionnaire survey of 137 respondents (51 fathers of children with chronic illnesses, 86 fathers of healthy children) were statistically using ANOVA.

RESULTS: The fathers’ stressor was significantly related to their SOC. Furthermore, the SOC of the fathers majorly influenced their mental health, while having a buffering effect on the stressor with respect to depression. And their SOC was significantly positively associated with the social support. Our findings underscore that father’s SOC has a buffering effect on self-mental health and is important for maintaining mental health and enhancing SOC to reduce the stressors of these fathers with respect to depression.

PMID:38618873 | DOI:10.1002/nop2.2147

Int J Health Policy Manag. 2024 Feb 17. doi: 10.34172/ijhpm.2024.7919. Online ahead of print.

ABSTRACT

BACKGROUND: The health system performance assessment is a challenging process for decision-makers. In case of Kazakhstan’s healthcare system, the calculation of avoidable mortality, which has been underutilized to date, could serve as an additional tool to prioritize areas for improvement. Therefore, the aim of the study is to analyse avoidable mortality in Kazakhstan.

METHODS: The data was retrieved from the Bureau of National Statistics, Kazakhstan. It covers population data by age, mortality rates from disease groups based on the Joint OECD/Eurostat classification of preventable and treatable causes of mortality. The data spans from 2015 to 2021, categorized by gender and 5-year age groups (0, 1-4, 5-9, …, 70-74). Standardization was performed using the 2015 OECD standard population. We used joinpoint regression analysis to calculate the average annual percentage change.

RESULTS: From 2015 to 2019, the annual percentage change in avoidable mortality per 100000 population was -3.8 (-5.7 to -1.8), and from 2019 to 2021 it increased by 17.6 (11.3 to 24.3). Males exhibited higher avoidable mortality rates compared to females. The preventable mortality rate was consistently higher than the treatable mortality. Both preventable and treatable mortality decreased from 2015 to 2019, with preventable mortality reaching 272.17 before rising to 379.23 per 100000 population in 2021. Between 2015 and 2021, treatable mortality rates increased from 179.3 (176.93- 181.67) to 205.45 (203.08-207.81) per 100000 population.

CONCLUSION: In Kazakhstan, the leading causes of avoidable mortality were circulatory diseases, respiratory diseases, and cancer. To achieve the goals of Universal Health Coverage and improve the overall population health, there is an urgent need to amend the healthcare system and reduce avoidable mortality. While it is important to acknowledge the influence of COVID-19 on these trends, our study’s focus on avoidable mortality provides valuable insights that complement the understanding of pandemic-related effects.

PMID:38618853 | DOI:10.34172/ijhpm.2024.7919

Int J Health Policy Manag. 2024 Mar 13. doi: 10.34172/ijhpm.2024.8032. Online ahead of print.

ABSTRACT

BACKGROUND: Mortality rate in rural areas is a useful measure of the health of the population and the function of the health system, which varies over space and time. The objective of this research is to explore the spatial and temporal variations in the rural mortality rate in Iran at the county level in 2006, 2011 and 2016.

METHODS: data were gathered from the rural population and mortality statistics published by the Statistical Centre of Iran and the National Organization for Civil Registration. Global spatial patterns were assessed using the Global Moran’s I and local clusters through the Local Moran’ I.

RESULTS: Spatial distribution of rural mortality rate shows that during the years under study the number of counties with a lower rate has increased. The counties with rate of less form continuous areas in the southwest, central and east regions. The excess risk map reveals significant variations in both value and extent. Also, the values of Moran’s index increased from 0.1848 in 2006 to 0.4041 in 2016, which indicates the strengthening of the cluster spatial pattern of the overall rural mortality rate. Local patterns have undergone substantial changes over space and time.

CONCLUSION: The findings indicate significant spatial and temporal variations in rural mortality rates in Iran. Policymakers can use this information to plan and enhance healthcare infrastructure in specific counties. The findings serve for evaluating the effectiveness of health policies, enabling policymakers to make informed decisions, allocate resources efficiently and design targeted interventions for improved public health outcomes.

PMID:38618838 | DOI:10.34172/ijhpm.2024.8032