Category: Statistics

PLoS Negl Trop Dis. 2024 Dec 4;18(12):e0011835. doi: 10.1371/journal.pntd.0011835. Online ahead of print.

ABSTRACT

BACKGROUND/METHODOLOGY: Despite progress using mass drug administration (MDA), lymphatic filariasis (LF) remains a major public health issue in India. Vector control could potentially augment MDA towards LF elimination. We conducted a cost-effectiveness analysis of MDA alone and MDA together with vector control single (VCS) modality or vector control integrated (VCI) modalities. Data came from historical controls and a three-arm cluster randomized trial of 36 villages at risk of LF transmission in Tamil Nadu, India. The arms were: MDA alone (the standard of care); MDA plus VCS (expanded polystyrene beads covering the water surface in wells and cesspits to suppress the filariasis vector mosquito Culex quinquefasciatus); and MDA plus VCI (VCS plus insecticidal pyrethroid-impregnated curtains [over windows, doors, and eaves). Economic costs in 2010 US$ combined government and community inputs from household to state levels. Outcomes were controlled microfilaria prevalence (MfP) and antigen prevalence (AgP) to conventional elimination targets (MfP<1% or AgP<2%) from 2010 to 2013, and modeled disability adjusted life years (DALYs) averted.

PRINCIPAL FINDINGS: The estimated annual economic cost per resident was US$0.53 for MDA alone, US$1.02 for VCS, and US$1.83 for VCI. With MDA offered in all arms, all arms reduced LF prevalence substantially from 2010 to 2013. MDA proved highly cost effective at $112 per DALY averted, a very small (8%) share of India’s then per capita Gross Domestic Product. Progress towards elimination was comparable across all three study arms.

CONCLUSIONS: The well-functioning MDA program proved effective and very cost-effective for eliminating LF, leaving little scope for further improvement. Supplementary vector control demonstrated no statistically significant additional benefit on MfP or AgP in this trial.

PMID:39630851 | DOI:10.1371/journal.pntd.0011835

PLoS One. 2024 Dec 4;19(12):e0312271. doi: 10.1371/journal.pone.0312271. eCollection 2024.

ABSTRACT

BACKGROUND: The COVID-19 pandemic impacted the world in every aspect. Higher institutions were greatly affected because the outbreak disrupted the teaching and learning structure. Vaccines decrease the rate of infection and transmission of the virus, but the presence of some myths has led to hesitancy towards the vaccine.

OBJECTIVE: The purpose of the survey was to assess the knowledge, perception, and acceptance of the COVID-19 vaccine among undergraduate students in Enugu State, Nigeria.

METHODS: This was a cross-sectional study carried out among undergraduate students at the University of Nigeria Nsukka (UNN), the Institute of Management and Technology (IMT), and Enugu State University of Technology Enugu state (ESUT), Nigeria between March and November 2023. These institutions were chosen based on their large student populations, diverse academic offerings, and significant geographical coverage within the state. Data collection was done using a 26-item validated self-administered questionnaire. Statistical Product and Service Solutions (SPSS) version 25 with appropriate descriptive (frequency and percentage) and inferential statistics (Chi-square) were used to analyze the data.

RESULTS: 1,143 completed questionnaires were obtained. The modal age range was 18-24 years accounting for 814 (71.2%) of the participants. A total of 577 (50.5%) participants demonstrated a good level of knowledge while 685 (59.9%) showed a positive perception of the COVID-19 vaccine. Gender (p = 0.010) and institution (p < 0.001) were associated with their perception of the COVID-19 vaccine. In addition, knowledge and perception of the COVID-19 vaccine were significantly associated with its acceptance at p = 0.038 and < 0.001, respectively.

CONCLUSION: This study reveals that COVID-19 vaccine acceptance among university students in Enugu State, Nigeria, remains low despite moderate knowledge and generally positive attitudes, with perceptions playing a more significant role than knowledge. The findings highlight the need for educational interventions that not only provide accurate information but also actively address misconceptions. To improve vaccine uptake, public health campaigns should focus on shifting perceptions through culturally sensitive, institution-specific strategies.

PMID:39630847 | DOI:10.1371/journal.pone.0312271

Rev Bras Enferm. 2024 Nov 29;77Suppl 3(Suppl 3):e20230283. doi: 10.1590/0034-7167-2023-0283. eCollection 2024.

ABSTRACT

OBJECTIVE: To identify factors associated with poor sleep quality in elderly dependent individuals in social vulnerability.

METHOD: Cross-sectional study with 59 elderly dependent individuals assisted by Family Health Units in São Carlos/SP. The following tools were used: Katz Index, Lawton and Brody Scale, Pittsburgh Sleep Quality Index, Addenbrooke’s Cognitive Examination Revised, Fried’s Frailty Phenotype, Geriatric Depression Scale (15 items), Perceived Stress Scale, Family APGAR, Social Support Scale from the Medical Outcomes Study, and World Health Organization Quality of Life, abbreviated and “old” versions.

RESULTS: The majority of participants were women (52.5%), aged 60-74 years (71.1%), and had poor sleep quality (76.2%). Stress (OR=1.12; 95%CI=1.02-1.22) and polypharmacy (OR=7.39; 95%CI=1.22-44.73) increased the chances of poor sleep quality, while physical activity decreased these chances (OR=0.15; 95%CI=0.02-0.79).

CONCLUSION: Stress and polypharmacy are associated with poor sleep quality in elderly dependent individuals.

PMID:39630845 | DOI:10.1590/0034-7167-2023-0283

J Am Assoc Nurse Pract. 2024 Dec 1;36(12):674-676. doi: 10.1097/JXX.0000000000001076.

ABSTRACT

The document statistics tool, which authors use to review their work before submission, is explained. The tool yields readability statistics, which assess the document’s ease of reading. Authors are encouraged to take advantage of its features, which are described in full.

PMID:39630489 | DOI:10.1097/JXX.0000000000001076

JAMA Netw Open. 2024 Dec 2;7(12):e2447797. doi: 10.1001/jamanetworkopen.2024.47797.

ABSTRACT

IMPORTANCE: Use of secure messaging for clinician-to-clinician communication has increased exponentially over the past decade, but its association with clinician work is poorly understood.

OBJECTIVE: To investigate the association between secure messaging use and wrong-patient ordering errors.

DESIGN, SETTING, AND PARTICIPANTS: This cohort study included inpatient attending physicians, trainee physicians, and advanced practice practitioners (APPs) from 14 academic and community hospitals. Secure messaging volume was assessed over a 3-month period (February 1 to April 30, 2023).

EXPOSURE: Secure messaging volume per clinician-day, measured as the count of secure messages sent and received by a clinician on a given clinician-day.

MAIN OUTCOMES AND MEASURES: Retract-and-reorder events were used to identify wrong-patient ordering errors, and the presence of any retract-and-reorder event on a clinician-day was the primary outcome. Multilevel logistic regression was used to examine the association between secure messaging volume and wrong-patient ordering errors after adjusting for clinician age, sex, patient load, order volume, and clinical service.

RESULTS: A total of 3239 clinicians (median [IQR] age, 37 [32-46] years; 1791 female [55.3%]; 1680 attending physicians [51.2%], 560 trainee physicians [17.3%], and 999 APPs [30.8%]) with 75 546 clinician-days were included. Median secure messaging volume was 16 (IQR, 0-61) messages per day. Retract-and-reorder events were identified on 295 clinician-days (0.4%). Clinicians with secure messaging volume at the 75th percentile had a 10% higher odds of wrong-patient ordering errors compared with those at the 25th percentile (odds ratio [OR], 1.10; 95% CI, 1.01-1.20). After stratifying by clinician role, the association between secure messaging and wrong-patient ordering errors was observed only for attending physicians (OR, 1.20; 95% CI, 1.02-1.42) and APPs (OR, 1.18; 95% CI, 1.00-1.40).

CONCLUSIONS AND RELEVANCE: In this cohort study of inpatient clinicians, higher daily secure messaging was associated with increased odds of wrong-patient ordering errors. Although messaging may increase cognitive load and risk for wrong-patient ordering errors, these results do not provide conclusive evidence regarding the direct impact of secure messaging on errors, as increased messaging may also reflect greater care coordination, increased patient complexity, or communication of the presence of a wrong-patient ordering error.

PMID:39630450 | DOI:10.1001/jamanetworkopen.2024.47797

JAMA Netw Open. 2024 Dec 2;7(12):e2449005. doi: 10.1001/jamanetworkopen.2024.49005.

ABSTRACT

IMPORTANCE: Understanding exposure to air pollution is important to public health, and disparities in the spatial distribution of regulatory air quality monitors could lead to exposure misclassification bias.

OBJECTIVE: To determine whether racial and ethnic disparities exist in Environmental Protection Agency (EPA) regulatory air quality monitor locations in the US.

DESIGN, SETTING, AND PARTICIPANTS: This national cross-sectional study included air quality monitors in the EPA Air Quality System regulatory monitoring repository, as well as 2022 American Community Survey Census block group estimates for racial and ethnic composition and population size. Bayesian mixed-effects models of the count of criteria pollutant monitors measuring an area were used, adjusting for population size and accounting for spatial autocorrelation. Data were analyzed from March to June 2024.

EXPOSURE: Census block group-level racial and ethnic composition.

MAIN OUTCOME AND MEASURES: Number of regulatory monitors measuring a census block group by criteria pollutant (particulate matter [PM], ozone [O3], nitrogen dioxide [NO2], sulfur dioxide [SO2], lead [Pb], and carbon monoxide [CO]).

RESULTS: This analysis included 329 725 481 individuals living in 237 631 block groups in the US (1 936 842 [0.6%] American Indian and Alaska Native, 18 554 697 [5.6%] Asian, 40 196 302 [12.2%] Black, 60 806 969 [18.4%] Hispanic, 555 712 [0.2%] Native Hawaiian and Other Pacific Islander, 196 010 370 [59.4%] White, 1 208 267 [0.3%] some other race, and 10 456 322 [0.4%] 2 or more races). Adjusting for population size, monitoring disparities were identified for each criteria pollutant. Relative to the White non-Latino population, all groups were associated with fewer NO2, O3, Pb, and PM monitors. Disparities were consistently largest for Native Hawaiian and Other Pacific Islander populations, followed by American Indian and Alaska Native populations and those of 2 or more races. An increase in percentage of Native Hawaiian and Other Pacific Islander race was associated with fewer monitors for SO2 (adjusted odds ratio [aOR], 0.91; 95% BCI, 0.90-0.91), CO (aOR, 0.95; 95% BCI, 0.94-0.95), O3 (aOR, 0.95; 95% BCI, 0.94-0.95), NO2 (aOR, 0.97; 95% BCI, 0.91-0.94), and PM (aOR, 0.96; 95% BCI, 0.95-0.96). An increase in the percentage of those of Asian race was associated with slightly more SO2 (aOR, 1.04; 95% BCI, 1.03-1.04) monitors.

CONCLUSIONS AND RELEVANCE: This cross-sectional study of racial and ethnic disparities in the location of EPA regulatory monitors determined that data may not be equitably representative of air quality, particularly for areas with predominantly Native Hawaiian and Other Pacific Islander or American Indian or Alaska Native populations. Integration of multiple data sources may aid in filling monitoring gaps across race and ethnicity. Where possible, researchers should quantify uncertainty in exposure estimates.

PMID:39630448 | DOI:10.1001/jamanetworkopen.2024.49005

Matern Child Health J. 2024 Dec 4. doi: 10.1007/s10995-024-04023-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Almost all parents seek online child-related information. This study focuses on parents’ experience of using information from an easy-to-read parenting website, Naître et Grandir (N&G), specifically parents with low socioeconomic status (SES). SES is correlated with health literacy, a major determinant of child education and health. In January 2019, the Information Assessment Method (IAM) questionnaire was improved and implemented in a smartphone application (IAM + N&Gsmart) to reach more low SES parents.

OBJECTIVES: We measured the influence of IAM + N&Gsmart on the frequency with which low SES parents responded to the IAM survey of N&G webpages and the relative proportions of anticipated benefits of the N&G content. We also compared these benefits among fathers and mothers.

METHODS: This was a 4-year prospective time series. For each N&G webpage, parents were invited to complete an IAM questionnaire and report anticipated outcomes. IAM data were collected before (2017-2018) and after (2019-2020) the intervention (IAM + N&Gsmart launch) from Quebec parents of 0-8-year-old children who completed at least one IAM questionnaire. Descriptive and inferential statistical analyses were applied.

RESULTS: Participants completed 10,362 IAM questionnaires. Low SES participants anticipated more benefits than other participants, and particularly low SES fathers more than low SES mothers. The proportion of responses and reported benefits from low SES participants increased post-intervention.

CONCLUSIONS FOR PRACTICE: Results suggest that increasing literacy-oriented web content can lead to greater benefits among low SES parents, and that increasing father awareness and father-inclusive content can lead to even greater benefits among low SES fathers.

PMID:39630399 | DOI:10.1007/s10995-024-04023-0

J Neurooncol. 2024 Dec 4. doi: 10.1007/s11060-024-04885-y. Online ahead of print.

ABSTRACT

BACKGROUND: Thyroid Transcription Factor-1 (TTF-1) expression in lung adenocarcinoma (LUAD) has been studied for its prognostic value in early-stage and metastatic disease. Its role in brain metastasis remains unexplored. This study investigates the predictive value and association of TTF-1 status with clinicopathological variables in patients with synchronous LUAD brain metastases.

MATERIAL AND METHODS: In this bicentric retrospective study, 245 patients with newly diagnosed, treatment-naïve brain metastasis undergoing resection were included. Patient data were retrieved from electronic records. Outcomes included overall and progression-free survival. Statistical analysis included Kaplan-Meier estimates and Cox proportional hazards regression.

RESULTS: Mean Ki67 index in TTF-1 negative patients was 43% [95% CI 38-48%] compared to 32% [95% CI 29-35%] in TTF-1 positive (TTF-1 +) patients (p < 0.001). Tumor volume was significantly larger in TTF-1 negative (TTF-1-) patients (mean volume 24 mL [95% CI 18-31 mL]) vs. 15 mL [95% CI 12-17 mL] in TTF-1 + patients (padjust = 0.003). Perifocal edema was smaller in TTF-1- patients (mean volume: 58 mL [95% CI 45-70 mL]) vs. 84 mL [95% CI 73-94 mL] in TTF-1 + patients (padjust = 0.077). Tumor and edema volume did not correlate. TTF-1- patients showed worse overall, intracranial, and extracranial progression-free survival. In a multivariable Cox model, positive TTF-1 status was independently associated with improved outcomes. Negative TTF-1 status was associated with increased hazard for intracranial disease progression compared to extracranial progression.

CONCLUSION: In synchronous LUAD brain metastases, TTF-1 negativity reflects an aggressive phenotype with larger proliferation capacity and tumor volume. Future research should explore the underlying cellular and molecular alterations of this phenotype.

PMID:39630375 | DOI:10.1007/s11060-024-04885-y

Atten Percept Psychophys. 2024 Dec 4. doi: 10.3758/s13414-024-02976-6. Online ahead of print.

ABSTRACT

Studies suggest that mid-level features could underlie object animacy perception. In the current research, we tested whether ensemble animacy perception is based on high- or mid-level features. We used five types of images of animals and inanimate objects: color, grayscale, silhouettes, texforms – unrecognizable images that preserve mid-level texture and shape information – and scrambled images. In the series of Experiments 1, we asked participants to evaluate the animacy of single images and sets of eight images using a 10-point scale. In the series of Experiments 2, participants were shown two sets of eight images and had to choose a more animate one in the two-alternative forced-choice (2AFC) task. We found that in both paradigms, observers could report the mean animacy of the set of texform images without direct access to information about high-level features. Thus, ensemble animacy could be extracted only based on mid-level features such as shape and texture without access to more high-level information.

PMID:39630351 | DOI:10.3758/s13414-024-02976-6

Biol Trace Elem Res. 2024 Dec 4. doi: 10.1007/s12011-024-04456-2. Online ahead of print.

ABSTRACT

We aimed to explore the role of Indium (In), Terbium (Tb), Yttrium (Y), and Lanthanum (La) in the serum of women with recurrent pregnancy loss (RPL) and compare them to controls. Additionally, the study aimed to examine the relationship between REE levels and oxidative DNA damage, to identify potential risk factors contributing to RPL. This case-control study included 30 RPL cases and 30 controls with uncomplicated pregnancy. Inductively Coupled Plasma Mass Spectrometer was used to evaluate levels of In, Tb, Y, and La in the serum samples in both groups. The relationship between REE levels, Total Antioxidant Capacity (TAC), and DNA damage was studied by correlation analysis. There was a significant increase in levels of In, Tb, Y, and La in the serum of the RPL group in contrast to the control group (P < 0.001). Furthermore, a negative correlation was observed between increased Y, Tb, La, and TAC in RPL cases (significant at P < 0.05), indicative of weakened antioxidant defenses. Moreover, increased levels of Y, Tb, and La exhibited a positive correlation with the DNA damage marker, statistically significant at P < 0.05. These findings highlight the potential role of oxidative stress-induced DNA damage and metal intoxication in the development of RPL, underscoring the importance of further research to clarify underlying mechanisms and develop preventive strategies.

PMID:39630330 | DOI:10.1007/s12011-024-04456-2