Category: Statistics

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Mar 6;59(3):336-343. doi: 10.3760/cma.j.cn112150-20240911-00731.

ABSTRACT

To investigate the epidemiological characteristics of co-infection involving macrolide-resistant Mycoplasma pneumoniae (MRMP) and non-bacterial pathogens in hospitalized children at Women and Children’s Hospital of Ningbo University from 2021 to 2024, a retrospective cross-sectional study was conducted. Throat swabs were collected from children admitted for respiratory tract infections between January 2021 and December 2024. A total of 22 311 children aged 0-18 years old were included, including 12 021 males and 10 290 females. The median age was 5.00 years and the mean age was (5.02±3.25) years. Real-time fluorescence quantitative polymerase chain reaction (PCR) and multiplex PCR were employed to determine the MP infection rate, the prevalence of MRMP, and the co-infection rates with non-bacterial pathogens across different years. Patients with MRMP were categorized into two groups based on the presence or absence of co-infections: simple infection group and mixed infection group. The differences in age, gender, and onset time between these groups were analyzed, along with the distribution of pathogens in the mixed infection group. Chi-square tests were used for intergroup comparisons. The results showed that the overall positive rate of MP among the 22 311 children was 39.42% (8 794/22 311), with a detection rate of MP drug resistance gene mutations at 70.42% (6 193/8 794). The co-infection rate of MRMP was 24.29% (1 504/6 193). Statistically significant differences were observed in the MP positive rate and the detection rate of drug resistance gene mutations from 2021 to 2024 (χ²=1 674.420, P<0.05; χ²=67.733, P<0.05), with peak values in 2023 (50.87% and 73.83%, respectively). Among the annual co-infections, the highest rate was in 2024 (28.72%), while the lowest was in 2022 (7.30%). In the age distribution, the rate of mixed infections decreased with increasing age (χ²=84.742, P<0.05). Seasonally, the infection rates in winter 2023 and the spring, summer, and autumn of 2024 were significantly higher than those in 2022 (χ²=24.243, 13.101, 26.181, and 10.687, respectively; all P<0.05), with the lowest mixed infection rate observed in winter 2022 over the four-year period. Over the four years, the highest positive rate for rhinovirus was consistently observed in MRMP co-infections each year, particularly in the 3-to 6-year-old age group. The positive rate for mixed infections involving respiratory syncytial virus, human bocavirus, and parainfluenza virus was notably higher in the 0- to 3-year-old age group. Following the removal of non-pharmaceutical interventions (NPIs) in December 2022, the co-infection rate of other respiratory viruses and MRMP increased in Ningbo City. In conclusion, the positive rate of MRMP has shown an upward trend from 2021 to 2023. Post-NPI removal, MRMP mixed infections have become more prevalent in 2023 and 2024, predominantly affecting children aged 0-6 years, with rhinovirus being the most common co-pathogen.

PMID:40107784 | DOI:10.3760/cma.j.cn112150-20240911-00731

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Mar 6;59(3):328-335. doi: 10.3760/cma.j.cn112150-20241024-00845.

ABSTRACT

This study utilized data from the non-communicable diseases (NCDs) Progress Monitor Reports (2015, 2017, 2020, 2022) released by World Health Organization (WHO) to analyze the implementation of NCDs prevention and control policies in China from 2014 to 2021 through descriptive statistical method, aiming to provide evidence for strengthening national NCDs strategies. The analysis focuses on WHO-recommended ‘best buys’ policies for NCDs prevention and control, covering 10 categories (18 interventions): national NCDs targets, mortality data, risk factor surveys, national integrated NCDs policies/strategies/action plans, tobacco demand-reduction measures, harmful use of alcohol reduction measures, unhealthy diet reduction policies, physical activity campaigns, national clinical guidelines for cancer/CVD/diabetes/CRD management, and drug therapy/counselling for cardiovascular diseases. In accordance with the WHO’s NCDs progress monitor scoring methodology, policies are assigned 1.0 point for full implementation, 0.5 points for partial implementation, and 0 points for non-implementation or missing data, with a maximum total score of 18.0 points. The analytical metrics encompass the policy implementation score, implementation rate, and period-on-period implementation growth rate. The results showed that China’s total policy implementation scores for NCDs prevention and control in 2014, 2016, 2019, and 2021 were consistently higher than the global average (8.5, 10.5, 9.5, 9.5 vs 6.7, 8.3, 8.6, 8.6). From 2014 to 2021, the total score increased by 1.0 point, and the implementation rate improved by 8.9%. From 2014 to 2016, China’s total policy implementation score rose from 8.5 to 10.5, primarily driven by improvements in tobacco tax increases and unhealthy diet reduction measures (salt reduction, restrictions on high-fat foods, and regulation of breast-milk substitute sales). However, this progress was partially offset by a decline in scores for physical activity campaigns. From 2016 to 2019, the total score decreased to 9.5, largely due to lower scores in harmful use of alcohol reduction measures (alcohol taxation and advertising bans). From 2019 to 2021, the total score remained stable, with increases in marketing to children restrictions balanced by declines in scores for drug therapy/counselling for cardiovascular diseases. In 2021, China’s total policy implementation score (9.5) exceeded the global average (8.6) but fell below the G20 average (11.2). Significant gaps remained compared to top-performing G20 countries such as Turkey (16.5), particularly in tobacco control and restrictions on harmful alcohol use. In conclusion, from 2014 to 2021, China’s total policy implementation score for NCDs prevention and control consistently exceeded the global average, demonstrating an upward trend, and various NCDs prevention and control policies have been continuously improved.

PMID:40107783 | DOI:10.3760/cma.j.cn112150-20241024-00845

Zhonghua Yu Fang Yi Xue Za Zhi. 2025 Mar 6;59(3):277-285. doi: 10.3760/cma.j.cn112150-20240802-00618.

ABSTRACT

Objective: To investigate the multimorbidity of myopia and obesity, as well as myopia and malnutrition, among children and adolescents aged 7-18 in Guangdong Province and analyze their epidemiological characteristics and related factors. Methods: A stratified random cluster sampling method was used to select 274 939 children and adolescents aged 7-18 from 21 cities in Guangdong Province in 2023. Physical examination information such as height, weight, distance vision, and diopter, as well as questionnaire survey information on dietary behavior, physical activity, screen behavior, sleep time, etc., were collected to analyze the current status and trends of multimorbidity between myopia and obesity, myopia and malnutrition. The multivariate logistic regression model was used to analyze the related factors of multimorbidity. Results: The multimorbidity rates of myopia and obesity, myopia and malnutrition in children and adolescents aged 7-18 in Guangdong Province in 2023 were 4.43% and 6.40%, respectively. The multimorbidity rates for males were 5.44% and 6.88%, respectively, which were higher than those for females, about 3.31% and 5.88% (both P<0.001). The multimorbidity rates of urban students were 5.03% and 6.73%, respectively, which were higher than those of county students at 4.03% and 6.18% (both P<0.001). The multimorbidity rates of myopia and obesity, myopia and malnutrition increased with the increase of academic stage (all P<0.001). The multimorbidity rates of myopia and obesity, as well as myopia and malnutrition, fluctuated with age, with the first decrease occurring at the age of 12. The multivariate logistic regression analysis showed that compared to children and adolescents aged 7-18 who had daily after-school tutoring <2 hours, daily screen time <2 hours, did not consume sugary drinks every day, sleep time that could meet health requirements daily, and exercised≥60 minutes of moderate-to vigorous-physical activity ≥60 minutes for at least 3 days per week, those who had daily after-school tutoring ≥2 hours (OR=1.18, 95%CI: 1.11-1.26), daily screen time ≥2 hours (OR=1.09, 95%CI: 1.02-1.16), consumed sugary drinks every day (OR=1.20, 95%CI: 1.11-1.30), daily sleep time that could not meet the health requirements (OR=1.16, 95%CI: 1.09-1.23), and no exercise per week (OR=1.09, 95%CI: 1.01-1.18) had a higher risk of multimorbidity of myopia and obesity. Compared to children and adolescents who exercised≥60 minutes of moderate-to vigorous-physical activity ≥60 minutes for at least 3 days per week, those who exercised <3 days per week (OR=1.20, 95%CI: 1.17-1.34) had a higher risk of multimorbidity of myopia and malnutrition. Conclusion: The multimorbidity rates of myopia and obesity, as well as myopia and malnutrition, in children and adolescents aged 7-18 in Guangdong Province are relatively low and fluctuate with age. Physical activity, screen time, consumption of sugary drinks, and sleep time may be associated with these multimorbidities.

PMID:40107777 | DOI:10.3760/cma.j.cn112150-20240802-00618

Korean J Pain. 2025 Mar 20. doi: 10.3344/kjp.24343. Online ahead of print.

ABSTRACT

BACKGROUND: This study compared the quality and duration of analgesia between the superior trunk (ST) and the clavipectoral fascial plane (CFP) blocks in conjunction with a selective supraclavicular nerve (SCN) block for clavicular surgeries.

METHODS: Fifty patients undergoing mid-third clavicular procedures were randomly assigned to the ST group (received an SCN block followed by blockage of the ST of the brachial plexus) and the CFP group (received an SCN block followed by the CFP block). The primary outcome was the time until the first rescue analgesia. Secondary outcomes included total nalbuphine dosage and numerical rating scale (NRS) scores within the first 24 hours, the onset of sensory block, as well as deltoid and biceps muscle function using the modified Bromage score (MBS), diaphragmatic excursion, along with satisfaction levels.

RESULTS: The ST group exhibited a more prolonged duration until the first request for rescue analgesia compared to the CFP group (18.76 ± 0.89 hours vs. 15.34 ± 1.38 hours), with a mean difference of 3.42 hours (95% confidence interval: 2.76 to 4.08, P < 0.001). The ST group consumed less nalbuphine and reported lower NRS scores at 6, 8, 12, 16, and 24 hours than the CFP group. Additionally, the ST group exhibited a lower MBS and diaphragmatic excursion than the CFP group. However, the differences in the onset of sensory block and satisfaction levels were not statistically significant.

CONCLUSIONS: The ST group demonstrated superior outcomes in pain control with less favorable outcomes concerning diaphragmatic excursion and upper limb motor function.

PMID:40107773 | DOI:10.3344/kjp.24343

Genome Res. 2025 Mar 19. doi: 10.1101/gr.279281.124. Online ahead of print.

ABSTRACT

In cancer, genetic and transcriptomic variations generate clonal heterogeneity, leading to treatment resistance. Long-read single-cell RNA sequencing (LR scRNA-seq) has the potential to detect genetic and transcriptomic variations simultaneously. Here, we present LongSom, a computational workflow leveraging high-quality LR scRNA-seq data to call de novo somatic single-nucleotide variants (SNVs), including in mitochondria (mtSNVs), copy number alterations (CNAs), and gene fusions, to reconstruct the tumor clonal heterogeneity. Before somatic variant calling, LongSom reannotates marker gene-based cell types using cell mutational profiles. LongSom distinguishes somatic SNVs from noise and germline polymorphisms by applying an extensive set of hard filters and statistical tests. Applying LongSom to human ovarian cancer samples, we detected clinically relevant somatic SNVs that were validated against matched DNA samples. Leveraging somatic SNVs and fusions, LongSom found subclones with different predicted treatment outcomes. In summary, LongSom enables de novo variant detection without the need for normal samples, facilitating the study of cancer evolution, clonal heterogeneity, and treatment resistance.

PMID:40107722 | DOI:10.1101/gr.279281.124

Can J Surg. 2025 Mar 19;68(2):E108-E116. doi: 10.1503/cjs.015923. Print 2025 Mar-Apr.

ABSTRACT

BACKGROUND: Strategies to address inequities, bias, and discrimination that disadvantage Canadian physicians from marginalized groups are urgently needed. We describe a multilevel needs assessment of equity, diversity, and inclusion (EDI) in 2 departments of surgery that focused on identifying evidence-based interventions.

METHODS: We invited members of the departments of surgery at the University of Calgary and the University of Saskatchewan to complete the Diversity Engagement Survey (DES), a 22-item instrument designed to understand workplace engagement and inclusion among physicians, with higher scores indicating greater engagement and inclusion. Leaders completed a Leadership EDI Readiness Assessment to understand their own barriers to EDI work and an Organizational EDI Readiness Assessment to understand structures for EDI in their division. Leaders were provided resources and interventions to address the identified gaps in these assessments.

RESULTS: The most common organizational gaps in structures for EDI work in surgical divisions and training programs (n = 34, 37.4%) were in community outreach and measurement and reporting. Surgeons who identified as cisgender men (n = 101) felt more engaged and included than those who identified as cisgender women (n = 43; 3.81 [standard deviation (SD) 0.73] v. 3.51 [SD 0.78]; p = 0.04). White cisgender men (n = 66) had the highest feelings of engagement and inclusion (mean 3.95 [SD 0.62]). Participating surgical sections and training programs were directed to evidence-informed initiatives to improve community outreach and measurement and reporting to address EDI in their settings.

CONCLUSION: Our findings support that gender and racial or ethnic identities influence the workplace experiences of surgeons in Canada. A multilevel approach to EDI work in surgical departments can direct leaders to areas for intervention.

PMID:40107712 | DOI:10.1503/cjs.015923

Can J Surg. 2025 Mar 19;68(2):E97-E107. doi: 10.1503/cjs.014923. Print 2025 Mar-Apr.

ABSTRACT

BACKGROUND: Trauma educational opportunities for general surgery residents in Canada are uncharacterized. We aimed to characterize these opportunities for and identify factors associated with such opportunities.

METHODS: We performed a prospective cross-sectional study characterizing trauma educational opportunities within Canadian trauma programs. Data were collected during 1 summer week and 1 winter week. We summarized educational opportunities by trauma site and season and used multivariable modelling to evaluate factors associated with increased likelihood of procedure opportunities.

RESULTS: Nine academic trauma centres participated. Most consults (93.9%) and trauma team activations (TTAs) (72.3%) were for blunt injuries, and most presentations were during the summer (67.2% TTAs + consults, 69.3% TTAs). Trauma services cared for a median of 14 (interquartile range [IQR] 10-20) inpatients, 4 (IQR 1-6) patients in the intensive care unit, and 0 (IQR 0-2) patients admitted to another service but subsequently followed by a trauma physician (i.e., consulting patients), which varied across hospitals (p < 0.001). Consult, TTA, nonoperative, and operative procedure volumes varied across sites. The most common operative procedures were laparotomies (36.4%), with 1.33 laparotomies per week per site. For nonlaparotomy operations, the maximum volume was 6 over 2 weeks. More operations occurred during summer (74.2%) than winter. Multivariable modelling determined that penetrating mechanisms (odds ratio [OR] 1.87, 95% confidence interval [CI] 1.11-3.15) and TTAs with a trauma surgeon present (OR 2.37, 95% CI 1.59-3.54) were associated with increased likelihood of procedures.

CONCLUSION: Trauma educational opportunities remain heterogeneous across Canada. Higher volumes of patients with trauma were seen during the summer. Penetrating mechanism and TTAs with a trauma surgeon present appear to increase opportunities to perform procedures. Our results can inform general surgery training programs to optimize resident trauma training in Canada.

PMID:40107711 | DOI:10.1503/cjs.014923

Nurs Health Sci. 2025 Mar;27(1):e70081. doi: 10.1111/nhs.70081.

ABSTRACT

The study explored the challenges and needs in diabetes care for people with diabetes and comorbid cognitive impairment from the triangular perspectives of diabetes educators, patients, and family caregivers. The study employed a phenomenological research design with qualitative data collection, involving semi-structured interviews with 8 diabetes educators, 7 patients, and 6 caregivers. The data were gathered from a health education center in a hospital in Taiwan. Thematic analysis was utilized to analyze the qualitative data. Three categories with eight themes emerged. Challenges included “care challenges in compliance”, “limited family involvement”, and “caregiver distress”. Needs were identified as “training for educators on cognitive impairments”, “caregiver education”, and “standard care procedures”. Clinical realities showed “inconsistent awareness” and “lack of consensus on resource referrals among professionals”. Diabetes care for people with cognitive impairment faces challenges including poor compliance and limited family cooperation, requiring better comorbidity training for educators and caregivers, and standardized care procedures for healthcare professionals. Findings can guide future training programs and serve as a resource for caregivers.

PMID:40107710 | DOI:10.1111/nhs.70081

BMJ Open. 2025 Mar 18;15(3):e086150. doi: 10.1136/bmjopen-2024-086150.

ABSTRACT

OBJECTIVES: The aim of this study was to compare the cost-effectiveness of total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) and explore variation by age and gender.

DESIGN: Cost-effectiveness analysis using a lifetime cohort Markov model.

SETTING: National population registry data.

PARTICIPANTS: Model parameters were informed by propensity score-matched comparisons of TSA and HA in patients with osteoarthritis and an intact rotator cuff using data from the National Joint Registry.

INTERVENTIONS: TSA and HA.

PRIMARY OUTCOME MEASURES: Quality-adjusted life years (QALYs) and healthcare costs for age and gender subgroups. A probabilistic sensitivity analysis was performed.

RESULTS: In all subgroups, TSA was more cost-effective, with the probability of being cost-effective about 70% for TSA versus 30% for HA at any willingness-to-pay threshold above £1100 per QALY. TSA was dominant in young patients (≤60 years) with a mean cost saving of £463 in men and £658 in women, and a mean QALY gain of 2 in both men and women. In patients aged 61-75 years, there was a mean cost saving following HA of £395 in men and £181 in women, while QALYs remained superior following TSA with a 1.3 gain in men and 1.4 in women. In the older cohort (> 75 years), the cost difference was highest and the QALY difference was lowest; there was a cost-saving following HA of £905 in men and £966 in women. The mean QALY gain remained larger after TSA: 0.7 in men and 0.9 in women.

CONCLUSION: TSA was more cost-effective than HA in patients with osteoarthritis. QALYs were superior following TSA in all patient groups. Cost differences varied by age and TSA was dominant in young patients.

PMID:40107707 | DOI:10.1136/bmjopen-2024-086150

BMJ Open. 2025 Mar 18;15(3):e082952. doi: 10.1136/bmjopen-2023-082952.

ABSTRACT

OBJECTIVE: This study examines the risk factors associated with non-communicable diseases (NCDs), specifically diabetes mellitus (DM) and hypertension (HTN), among adults in Bangladesh, a lower-middle-income country. Given the rising prevalence of DM and HTN and their significant public health burden, this research aims to identify key socioeconomic, demographic and lifestyle-related determinants to inform targeted interventions.

DESIGN: The study used nationally representative cross-sectional data extracted from the Bangladesh Demographic and Health Survey conducted in 2017-2018.

SETTING: Bangladesh.

PARTICIPANTS: The study included 8013 women and 6691 men aged 18 and older who were eligible for blood pressure and blood glucose measurements.

PRIMARY OUTCOMES: Type 2 DM, HTN.

RESULTS: HTN was significantly associated with higher odds of diabetes (adjusted OR (AOR)=1.28, 95% CI: 1.14 to 1.43), while diabetes was associated with increased odds of HTN (AOR=1.24, 95% CI: 1.11 to 1.39). Individuals aged 40 years and older had 74.8% higher odds of diabetes (AOR=1.748, 95% CI: 1.58 to 1.993) and were 3.21 times more likely to have HTN (AOR=4.208, 95% CI: 3.781 to 4.685). Overweight individuals had 2.15 times higher odds of HTN compared with those with normal weight (AOR=2.154, 95% CI: 1.98 to 2.34). Wealthier individuals also showed significantly higher odds of both DM and HTN.

CONCLUSIONS: This study highlights the strong association between DM and HTN and identifies age, overweight status and higher socioeconomic class as key risk factors. These findings underscore the need for integrated public health strategies targeting NCD prevention and management in Bangladesh. Further research should explore longitudinal trends and the impact of targeted interventions on reducing the burden of NCDs.

PMID:40107706 | DOI:10.1136/bmjopen-2023-082952