Category: Statistics

BMC Public Health. 2024 Nov 26;24(1):3283. doi: 10.1186/s12889-024-20838-6.

ABSTRACT

OBJECTIVES: In the context of musculoskeletal health, the emergence of pre-sarcopenia as a precursor to sarcopenia has garnered attention for its potential insights into early muscle loss. We explored the association between different metabolic phenotypes of obesity, and the incidence of pre-sarcopenia over a 3-year follow-up in a cohort from the Tehran Lipid and Glucose Study (TLGS).

METHODS: In this 3-year longitudinal study, 2257 participants were categorized into four groups based on their BMI and metabolic status: metabolically healthy normal weight (MHNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obese (MUO). The participants were assessed for various anthropometric and body composition indices including muscle mass determined by bioelectrical impedance analysis (BIA). Blood samples were collected for metabolic indices, and participants underwent measurements for blood pressure. Pre-sarcopenia was defined based on low muscle mass. Statistical analyses included logistic regression and chi-squared tests.

RESULTS: The MUNW group exhibited the highest prevalence of pre-sarcopenia (33.5%), while the MHO group had the lowest (2.8%). Adjusted models revealed that the odds ratio for pre-sarcopenia was higher in the MUNW group (OR = 2.23, P < 0.001), whereas the MHO and MUO groups showed lower odds (OR = 0.11 and 0.13, both P < 0.001). Notably, the association was gender-dependent, with MUNW females having a higher risk even after adjustments (OR = 2.37, P = 0.042).

CONCLUSION: Our findings suggest that metabolic health may play a pivotal role in pre-sarcopenia, emphasizing the need for targeted interventions based on both metabolic and obesity phenotypes.

PMID:39592987 | DOI:10.1186/s12889-024-20838-6

BMC Infect Dis. 2024 Nov 27;24(1):1352. doi: 10.1186/s12879-024-10225-2.

ABSTRACT

BACKGROUND: Human Immune Deficiency Virus (HIV) remains the leading cause of morbidity and mortality globally. It can lead to Acquired Immunodeficiency Syndrome (AIDS), which results in gradual deterioration and failure of the immune system. As the immune system becomes compromised, the patient becomes highly susceptible to life-threatening infection which ends with early death. Even though Antiretroviral Therapy (ART) significantly decreases mortality as a whole, the rate of death is still the highest, especially in the first and second years of ART initiation. The study aims to assess the survival and predictors of mortality among HIV-infected adults after initiation of antiretroviral therapy in Jigjiga City Governmental Hospitals, Eastern Ethiopia.

METHOD: Institution-based Retrospective follow-up study was employed among ART patients from January 1, 2015, to December 31, 2021. Data were cleaned and entered in Epi-data version 3.1 and exported to STATA 14 for further analysis. Kaplan-Meier and Log-Rank tests were applied to compare survival differences among categories of different variables. In bi-variable analysis, P-values < 0.20 were included in a multivariable analysis. A multivariable Cox regression model was used to measure the risk of death identify the and significant predictors of death. Variables that a P-value < 0.05 were considered statistically significant predictors of mortality.

RESULT: In this study 466(53.34%) participants were male and 552(65.56%) were urban residents about 91(10.81%) have died with an overall incidence rate of 3.92 (95% CI (2.43-5.41)) per 100-person year of observation. The overall survival probability of the study group was 83.97%. In the multivariable Cox regression analysis, baseline World Health Organization (WHO) stage III/IV (AHR = 2.42(1.43-4.09)) have no caregiver (AHR = 2.23; 95% CI (1.16-4.29)), being bedridden functional status (AHR = 2.18; 95% CI (1.01-4.72)), and poor last known adherence level (AHR = 4.23; 95%CI (2.39-7.47)) were found to be significant predictors of mortality.

CONCLUSION: The incidence of death was relatively high, especially in the second year of ART. Baseline clinical WHO stage III/IV, bedridden functional status at enrolment, and absence of caregiver, poor level of recent adherence were found to be independent predictors of mortality. Patients with these risk factors need special attention and are crucial to reducing the rate of mortality.

PMID:39592986 | DOI:10.1186/s12879-024-10225-2

BMC Public Health. 2024 Nov 26;24(1):3275. doi: 10.1186/s12889-024-20770-9.

ABSTRACT

BACKGROUND: Consumption of sugary drinks (SD) among children and adolescents is a prevalent public health issue both within Canada and worldwide. This problem is exacerbated by the powerful marketing of such beverages to youth, which is known to influence a wide range of dietary behaviours.

METHODS: A cross-sectional, secondary analysis of the International Food Policy Survey Youth Wave 2019 was conducted to assess the relationship between self-reported exposure to SD marketing within the past 30 days or SD brand advertisements and brand preference and brand recall among youth aged 10-17 from Australia, Canada, Chile, Mexico, the United Kingdom, and the United States. Ordinal, multinomial, and binary logistic regression were used as appropriate to examine these associations.

RESULTS: Youth brand preference and recall was positively associated with self-reported exposure to general and brand-specific SD marketing across all countries. No statistical interaction was observed between youth age and SD marketing overall or within countries. Soft drinks, sports drinks, and fruit juice brands were most commonly recalled by all youth.

CONCLUSION: Similar results were observed among children and adolescents within all countries. Global marketing policies should consider older children and adolescents to adequately protect and support child health.

PMID:39592972 | DOI:10.1186/s12889-024-20770-9

Comput Biol Med. 2024 Nov 25;184:109466. doi: 10.1016/j.compbiomed.2024.109466. Online ahead of print.

ABSTRACT

Convolutional neural networks are continually evolving; with some efforts aimed at improving accuracy, others at increasing speed, and some at enhancing accessibility. Improving accessibility broadens the application of neural networks across a wider range of tasks, including the detection of eye diseases. Early diagnosis of eye diseases and consulting an ophthalmologist can prevent many vision disorders. Given the importance of this issue, various datasets have been collected from the cornea to facilitate the process of making neural network models. However, most of the methods introduced in the past are computationally complex. In this study, we tried to increase the accessibility of deep neural network models. We did this at the most fundamental level-specifically, by redesigning and optimizing the convolutional layers. By doing so, we created a new general model that incorporates our novel convolutional layer named ArConv layers. Thanks to the efficient performance of this new layer, the model has suitable complexity for use in mobile phones and perform the task of diagnosing the presence of disease with high accuracy. The final model we present contains only 1.3 million parameters. In comparison to the MobileNetV2 model, which has 2.2 million parameters, our model demonstrated better accuracy when trained and evaluated on the RfMiD dataset under identical conditions, achieving an accuracy of 0.9328 versus 0.9266 on the RfMiD test set.

PMID:39591671 | DOI:10.1016/j.compbiomed.2024.109466

Comput Biol Med. 2024 Nov 25;184:109368. doi: 10.1016/j.compbiomed.2024.109368. Online ahead of print.

ABSTRACT

This study addresses the characterization of normal gait and pathological deviations caused by neurological diseases. We focus on the angular knee kinematics in the sagittal plane and we propose to exploit Hidden Markov Models to build a statistical model of normal gait. Such model provides a log-likelihood score that quantifies gait quality. Hence allowing to assess deviations of pathological cycles from normal gait. Our approach allows a refined characterization of motor impairments of three different patients’ groups. In particular, it detects the affected lower limb in Hemiparetic patients. Comparatively to the Gait Variable Score and a Dynamic Time Warping-based metric, our results show that our statistical method is more effective for finely quantifying pathological deviations. Finally, we show the potential use of our methodology to assess therapeutic impacts during gait rehabilitation, which represents a promising avenue for improving patient care.

PMID:39591667 | DOI:10.1016/j.compbiomed.2024.109368

Rep Prog Phys. 2024 Nov 26. doi: 10.1088/1361-6633/ad9756. Online ahead of print.

ABSTRACT

Statistical mechanics provides a framework for describing the physics of large, complex many-body systems using only a few macroscopic parameters to determine the state of the system. For isolated quantum many-body systems, such a description is achieved via the eigenstate thermalization hypothesis (ETH), which links thermalization, ergodicity and quantum chaotic behavior. However, tendency towards thermalization is not observed at finite system sizes and evolution times in a robust many-body localization (MBL) regime found numerically and experimentally in the dynamics of interacting many-body systems at strong disorder. Although the phenomenology of the MBL regime is well-established, the central question remains unanswered: under what conditions does the MBL regime give rise to an MBL phase in which the thermalization does not occur even in the asymptotic limit of infinite system size and evolution time?&#xD;&#xD;This review focuses on recent numerical investigations aiming to clarify the status of the MBL phase, and it establishes the critical open questions about the dynamics of disordered many-body systems. Persistent finite size drifts towards ergodicity consistently emerge in spectral properties of disordered many-body systems, excluding naive single-parameter scaling hypothesis and preventing comprehension of the status of the MBL phase. The drifts are related to tendencies towards thermalization and non-vanishing transport observed in the dynamics of many-body systems, even at strong disorder. These phenomena impede understanding of microscopic processes at the ETH-MBL crossover. Nevertheless, the abrupt slowdown of dynamics with increasing disorder strength suggests the proximity of the MBL phase. This review concludes that the questions about thermalization and its failure in disordered many-body systems remain a captivating area open for further explorations.

PMID:39591655 | DOI:10.1088/1361-6633/ad9756

J Interpers Violence. 2024 Nov 26:8862605241299445. doi: 10.1177/08862605241299445. Online ahead of print.

ABSTRACT

This study aimed to extend limited extant knowledge of female-perpetrated sexual offenses, including child sexual abuse material (CSAM) offenses, that enter the criminal justice system. Sexual offenses actioned by the police in one jurisdiction of Australia between 1 January 2012 and 30 June 2021 (N = 37,864) were analyzed to explore the prevalence of sexual offenses and types of sexual offenses perpetrated; the relationship between perpetrator gender, age, and offense type; and the relationship between perpetrator gender, age, offense type, and likelihood of law enforcement action (N = 34,835). Consistent with previous research, (predominantly adult) males were responsible for most sexual offenses before police. Females were responsible for 12.2% of all offenses over this period, with juvenile females (10-17 years) implicated in a significant proportion (10.2%) of all offenses. In fact, juvenile females were responsible for the majority of assaultive CSAM offenses, whereas juvenile males mostly perpetrated offline child sexual abuse offenses. Regarding adults, there was a minimal, statistically significant difference between gender and offense type. Odds of perpetrating an online assaultive CSAM offense were 20 times higher for juvenile females compared to both adult males and adult females, and 7.69 times higher for juvenile females compared to juvenile males. Finally, for the same offense type, gender and age differentially impacted law enforcement action. For all offense types, enforcement and gravity (e.g., arrest and referral to court) of further action, were significantly lower among all females and juvenile males compared to adult males. Juvenile females were least likely to have any serious action taken. These findings provide a seminal platform from which to expand much-needed research on female-perpetrated offending to inform policy and practice.

PMID:39591641 | DOI:10.1177/08862605241299445

Am J Trop Med Hyg. 2024 Nov 26:tpmd230732. doi: 10.4269/ajtmh.23-0732. Online ahead of print.

ABSTRACT

The rapid diagnosis of coronavirus disease 2019 (COVID-19) is critical for comprehensive public health response strategies, and self-testing with antigen rapid diagnostic tests (Ag-RDTs) presents opportunities to test in hard-to-reach communities. Therefore, we evaluated the acceptability, feasibility, and uptake of Ag-RDT self-testing at the community level in Tanzania. From June to October 2022, symptomatic individuals or those with recent contact with a known or suspected COVID-19 patient were offered assisted testing and self-testing within mining communities and at transport hubs. This study included a cross-sectional survey before and after implementation. Participants were assessed for their acceptability and uptake of the nasal Ag-RDT self-test and their preference for nasal Ag-RDT self-testing. The survey data were collected in Open Data Kit, whereas the Ag-RDT results in the community were recorded by using the COVISUSPECT Mobile Application. Data analysis was performed by using STATA and R Statistical Software. A total of 538 individuals were screened, and 454 (84.4%) consented to be tested. The preference for self-testing was relatively low (33%), and the majority of participants (67%) opted to be assisted by a healthcare professional. Of the participants who opted for testing, 149 (32.8%) were able to self-test. Generally, there was no major difference in the various assessed parameters between the baseline and end-line surveys. The results from fitting multiple logistic regression indicated that after controlling for age, participants living in Dodoma were significantly less likely to opt for self-testing (odds ratio = 0.54; P-value = 0.023) compared with those living in Dar es Salaam. There was no significant difference in self-testing between participants living in Mara and those living in Dar es Salaam (odds ratio = 0.7; P-value = 0.179). After controlling for region, older (≥40 years) participants were significantly less likely to self-test compared with participants aged 18 to <40 years (odds ratio = 0.47; P-value = 0.002). The intervention was well-accepted in all areas in which Ag-RDTs were deployed. Our findings can therefore support the Ministry of Health by increasing accessibility to severe acute respiratory syndrome coronavirus 2 testing in the hard-to-reach communities in response to the next COVID-19 wave.

PMID:39591640 | DOI:10.4269/ajtmh.23-0732

Adv Emerg Nurs J. 2024 Nov 26. doi: 10.1097/TME.0000000000000552. Online ahead of print.

ABSTRACT

Mass gathering events can greatly impact overburdened emergency medical service systems and emergency departments, which frequently experience staffing shortages and overcrowding. Nurse practitioners (NPs) were introduced into an event medicine team at mass gatherings to reduce emergency transports to local emergency departments as well as offering a “treat and release” disposition for patients presenting to medical tents. This study aimed to examine the impact of NPs at mass gathering events; 147 chart reviews were performed from 05/01/2023 to 09/30/2023 for all patients assessed by an NP at events staffed by an event medicine team; 60% of patients assessed by an NP were treated and released from the event, potentially reducing the number of patient transports and emergency department visits considerably. NPs can provide higher levels of care at events, treating common complaints such as heat-related illness, nausea, vomiting, minor trauma, and laceration repairs. Although this study did not compare data from events where NPs were not present versus when they were utilized to grasp the statistical impact their presence has had since their introduction to the team model, the study clearly shows the benefits NPs bring to mass gathering medical care. This is significant for emergency NPs as this research validates the need to include these providers in this new setting and role in which they can practice. More research is needed to compare patient outcomes with and without NPs present.

PMID:39591635 | DOI:10.1097/TME.0000000000000552

Ophthalmic Surg Lasers Imaging Retina. 2024 Nov 1:1-6. doi: 10.3928/23258160-20241114-01. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: This study compares the ability of resident ophthalmologists to identify neovascularization (NV) in patients with proliferative diabetic retinopathy (PDR) using widefield swept-source optical coherence tomography angiography (SS-OCTA) and fluorescein angiography (FA).

PATIENTS AND METHODS: Fluorescein angiography and SS-OCTA images were scrambled to create a grading set consisting of 1) early and late phase FA images, 2) B-scan videos, and 3) vitreoretinal interface (VRI) slab. Participants were asked to identify NV.

RESULTS: Twelve resident physicians participated in the study. Resident physicians correctly identified 75.6% of NV using FA, 65.3% of NV using SS-OCTA B-scans, and 90.7% of NV using the SSOCTA VRI slab. There was no statistically significant difference in participants’ ability to detect NV across imaging modalities (P = 0.08).

CONCLUSION: Detection rates of NV using SS-OCTA were comparable to that of using FA. Results suggest that SS-OCTA may be an appropriate imaging modality for detection of NV in PDR patients. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].

PMID:39591626 | DOI:10.3928/23258160-20241114-01