Category: Statistics

BMC Oral Health. 2024 Nov 20;24(1):1417. doi: 10.1186/s12903-024-05184-8.

ABSTRACT

BACKGROUND: Oral diseases are a significant global public health challenge. Current evidence indicates that several chronic conditions are individually associated with tooth loss. People are living with more than one chronic condition, known as multimorbidity (MM). Considering the common risk factors for oral and chronic diseases, this study aimed to evaluate the association between MM and tooth loss in the Chilean population.

METHODS: Cross-sectional study with secondary data from the latest Chilean National Health Survey (ENS 2016-17). The number of remaining teeth was classified into four groups: functional dentition (≥ 20 remaining teeth), moderate tooth loss (10 to 19), severe tooth loss (1 to 9), and edentulism (0). MM was defined based on the number of chronic conditions as a binary variable (MM_{≥ 2}) and as a 4-level categorical variable (MM_G0-G3), G0: none, G1: 1, G2: 2-4, and G3: ≥5 conditions. Stratified analysis by age group (< 65, ≥ 65 years) was performed. Mean and SD were calculated for crude and adjusted remaining teeth. Significance level was set to 0.05. Prevalence ratios were estimated with Poisson regression models with robust variance, crude and adjusted for sex, age, geographic area, and educational level. Logistic regressions models were fitted to calculate odds ratios as a sensitivity analysis.

RESULTS: Of 4,151 adults aged 17-98, 54.9% had MM and the prevalence of moderate, severe tooth loss and edentulism was 25.4%, 6.9% and 4.8% respectively. Adults aged ≥ 65 years with MM_{≥ 2} were 1.66 [1.04-2.66] times more likely to have severe tooth loss than those without MM. Adults aged < 65 years with MM_G3 were 1.76 [1.12-2.77] times more likely to have moderate tooth loss and 2.55 [1.02-6.36] times more likely to have severe tooth loss than those without MM.

CONCLUSIONS: In this study, we found statistically significant associations between the number of chronic conditions and moderate/severe tooth loss in both analyzed age groups. These findings highlight the need to provide oral health care for adults with multimorbidity using a person-centred model and to seek strategies to prioritize health care.

PMID:39567956 | DOI:10.1186/s12903-024-05184-8

BMC Womens Health. 2024 Nov 20;24(1):617. doi: 10.1186/s12905-024-03458-5.

ABSTRACT

BACKGROUND: The use of immediate postpartum intrauterine contraceptive devices during the postpartum period supports women’s need for spacing births and prevents them from unplanned pregnancies. However, in developing countries, utilization of immediate postpartum contraceptives is low. This increases the risk of maternal morbidity, maternal mortality, preterm birth, child mortality, low birth weight, and small gestational age in subsequent pregnancy with interpregnancy interval.

OBJECTIVE: To assess immediate postpartum intrauterine contraceptive device utilization and the associated factors among women who gave birth in Hospitals in West Wolegga Zone in 2020.

METHODS AND MATERIALS: An institutional-based cross-sectional study was conducted in public hospitals in the West Wolegga Zone from 1 April 2020 to 30 April 2020 among 290 postpartum women. The sample size was proportionally allocated to six hospitals by considering their monthly delivery. Study subjects were taken by systematic sampling technique (Kth=N/n =1025/290=3.53), thus every 4th woman who gave birth in the hospital was recruited in each hospital until the total sample size for this study was obtained. Bivariable and multivariable logistic regression was used to assess the association of independent variables with immediate postpartum intrauterine device utilization. A significance level of 0.05 was used to assess the statistical significance of the study’s associations.

RESULTS: In this study, the magnitude of the Immediate postpartum intrauterine contraceptive device utilization was 19.3%.factors like Early initiation of antenatal care [AOR=4.46 95% CI:1.84-10.78], Planning of future pregnancy [AOR=3.7(95% CI: 1.43-9.54)], Ever heard of the immediate postpartum intrauterine contraceptive device [AOR=2.67(95% CI: 1.08-6.58)] and Counseling about postpartum intrauterine contraceptive device [AOR=5.15(95% interval: 2.00-13.28] were associated with immediate postpartum intrauterine device utilizations.

CONCLUSION: The use of immediate postpartum intrauterine contraceptive devices is low compared to other studies conducted in Ethiopia. Age, early antenatal care initiation, pregnancy planning, hearing of the immediate postpartum intrauterine device immediately inserted after delivery, and counselling on the immediate postpartum intrauterine device were significantly associated with mothers’ use of immediate postpartum intrauterine devices. Health Program directors should develop strategies to increase the use of immediate postpartum intrauterine contraceptive devices.

PMID:39567955 | DOI:10.1186/s12905-024-03458-5

J Orthop Surg Res. 2024 Nov 21;19(1):778. doi: 10.1186/s13018-024-05274-x.

ABSTRACT

BACKGROUND: Hidden blood loss (HBL) is a notable complication in spinal endoscopic procedures. This study aims to compare tissue damage and hidden blood loss between two minimally invasive spinal techniques: unilateral biportal endoscopic lumbar discectomy (UBE) and percutaneous endoscopic interlaminar discectomy (PEID). Furthermore, the study examines the risk factors contributing to hidden blood loss in each procedure.

PATIENTS AND METHODS: A single-center retrospective cohort study was conducted on 86 patients who underwent unilateral biportal endoscopic lumbar discectomy (UBE) and 73 patients who received percutaneous endoscopic interlaminar discectomy (PEID) between January 2021 and December 2023.Demographic data, blood loss parameters, and serum levels of creatine kinase (CK) and C-reactive protein (CRP) were recorded. Pearson or Spearman correlation analyses were conducted to evaluate associations between patient characteristics and HBL. Additionally, multiple linear regression analysis was used to identify independent risk factors for HBL.

RESULTS: A total of 159 consecutive patients were included in this study, consisting of 83 females and 76 males. The average hidden blood loss (HBL) was 431.00 ± 160.52 ml in the UBE group and 328.40 ± 87.71 ml in the PEID group, showing a statistically significant difference (P < 0.05). Pearson or Spearman correlation analysis indicated that in the UBE group, HBL was associated with operation time, preoperative hematocrit (Hct), ASA classification, and paraspinal muscle thickness. In the PEID group, HBL was correlated with operation time, preoperative activated partial thromboplastin time (APTT), paraspinal muscle thickness, and the presence of diabetes (P < 0.05). Multiple linear regression analysis demonstrated a positive correlation between HBL and operation time in both groups (P < 0.05), identifying operation time as an independent risk factor for HBL. Furthermore, CRP and CK levels were generally lower in the PEID group compared to the UBE group, particularly on postoperative day 3 for CRP and postoperative day 1 for CK. Both total blood loss and hidden blood loss were significantly lower in the PEID group than in the UBE group.

CONCLUSION: Compared to UBE, PEID shows superior results regarding surgical trauma, total blood loss, hidden blood loss (HBL), and postoperative hematocrit (Hct) reduction. Consequently, PEID is recommended as the treatment of choice for younger patients or those with compromised baseline perioperative conditions.Additionally, Hidden blood loss remains a critical factor, and surgical duration presents a shared risk in both procedures.

PMID:39567947 | DOI:10.1186/s13018-024-05274-x

Mar Pollut Bull. 2024 Nov 19;209(Pt B):117266. doi: 10.1016/j.marpolbul.2024.117266. Online ahead of print.

ABSTRACT

The Baltic Sea highly susceptible to the proliferation of Phytoplankton blooms. Present work examines the long-term trend and spatio-temporal variability of satellite derived chlorophyll concentration (Chl a) in the Baltic Sea during the period 2004-2021. Furthermore, the influence of water quality and meteorological parameters on Baltic Sea primary productivity has been analyzed using robust Generalized Additive Models (GAM) and Granger Causality statistical test. Statistically significant increasing trend in chlorophyll a concentration is observed in the Baltic Sea at the 95 % confidence interval. GAM model reveals that the most significant controlling factor is sea surface temperature (p < 0.0001), followed by nitrate and phosphate. Both GAM and Granger Causality tests confirm that water quality parameters are the major drivers in limiting the growth of Phytoplankton blooms in the Baltic Sea. Summer bloom shows in-phase relationship with Sea surface temperature and out of phase relationship with the phosphate nutrient.

PMID:39566147 | DOI:10.1016/j.marpolbul.2024.117266

Spectrochim Acta A Mol Biomol Spectrosc. 2024 Nov 16;328:125446. doi: 10.1016/j.saa.2024.125446. Online ahead of print.

ABSTRACT

Precise determination of veterinary pharmaceutical concentrations represents a critical foundation for delivering safe and efficacious animal healthcare interventions. Two synthetic glucocorticoids – dexamethasone sodium phosphate (DXM) and prednisolone acetate (PRD) – are extensively employed in veterinary medicine due to their potent anti-inflammatory capabilities. Our research presents a novel, cost-effective, and environmentally sustainable analytical methodology that enables simultaneous quantification of DXM and PRD within binary veterinary formulations. The method synergistically combines UV spectroscopy with dimension reduction algorithms (DRAs), representing a significant advancement in pharmaceutical analysis. A comprehensive evaluation of seventeen DRAs was conducted using four distinct performance metrics: mean squared error (MSE), mean absolute error (MAE), median absolute error (MedAE), and coefficient of determination (R²). Among the assessed algorithms, mini-batch sparse principal component analysis demonstrated superior predictive accuracy for this specific analytical challenge. The developed method was validated using the accuracy profile approach, yielding results that confirm its satisfactory accuracy. An ecological impact assessment was conducted using five greenness evaluation tools: the Green Solvent Selection Tool (GSST), National Environmental Methods Index (NEMI), Green Certificate modified Eco-Scale, carbon footprint analysis, and the Modified GAPI (MoGAPI). In addition, whiteness was evaluated with Red-Green-Blue 12 (RGB 12) algorithms. The proposed method showed elevated GSST scores and a greener profile according to NEMI. The calculated carbon footprint was 0.0006 kg CO₂ equivalent per sample, with a Green Certificate modified Eco-Scale score of 84, a MoGAPI score of 81, and a whiteness assessment of 90.1 by the RGB12 algorithm. Statistical comparison between the proposed spectrophotometric method and a previously reported HPLC method for pharmaceutical dosage form analysis revealed no statistically significant differences at the 95 % confidence level. This study underscores the innovative combination of UV spectroscopy with dimension reduction algorithms, presenting substantial improvements over traditional UV techniques for drug analysis. This method enhances both the efficiency and accuracy of active ingredient determination in pharmaceutical dosage forms while also supporting environmental sustainability.

PMID:39566135 | DOI:10.1016/j.saa.2024.125446

Cortex. 2024 Nov 8;181:233-257. doi: 10.1016/j.cortex.2024.08.011. Online ahead of print.

ABSTRACT

Despite the need for successful navigation, humans vary greatly in their ability to navigate, and these individual differences may relate to variation in brain structure. While prior research provides support for a correlation between hippocampal volume and navigation ability in both navigation experts and in older individuals, this relationship is under scrutiny for healthy, young adults. We assessed 99 healthy young adults’ ability to navigate in a virtual, desktop maze and correlated their performance with total hippocampal gray matter volume. For a subset of these individuals, we further segmented the medial temporal lobe-including regions of the hippocampus-into anatomically-distinct subregions to uniquely examine the association between volumes of hippocampal subfields and navigation. Given the need to distinguish between similar-looking maze hallways and partially overlapping routes, young adults with stronger pattern separation ability may perform better in this task. Thus, we theorized that successful navigation would positively correlate with hippocampal CA3 and dentate gyrus (DG) subfield volumes due to these regions’ role in pattern separation. CA1 and entorhinal cortex (ERC) are both associated with rodent spatial memory, too, suggesting a possible relationship between their volumes and navigation performance. Consistent with our hypotheses, we observed a positive relationship between volumes of hippocampal subfields and wayfinding accuracy, while ERC and parahippocampal cortex volumes correlated with navigation efficiency. However, when analyzing total hippocampal volume, a nuanced interpretation is warranted. We found evidence of Simpson’s Paradox, where total hippocampal volume and navigation accuracy displayed no correlation in males, a negative correlation in females, yet a positive correlation when considering the full sample of males and females combined. Furthermore, no significant relationship was observed between total hippocampal volume and path efficiency. Given these findings, we urge caution in interpreting the results because these associations differ by analysis techniques (including voxel-based morphometry), after sex stratification, and with anterior and posterior hippocampal subdivisions. Overall, this study enhances our understanding of the relationship between brain volume and navigation ability for young adults but also emphasizes the need for methodological consistency across studies with respect to boundary definitions, neuroimaging techniques, statistical methods, and factors that give rise to individual differences.

PMID:39566126 | DOI:10.1016/j.cortex.2024.08.011

Cir Cir. 2024 Nov 20. doi: 10.24875/CIRU.23000090. Online ahead of print.

ABSTRACT

OBJECTIVE: We aimed to predict the risk of hypotension due to spinal anesthesia (HSA) by measuring the diameter and area of the inferior vena cava (IVC-D, IVC-A) through ultrasound and pleth variability index (PVI) in patients who underwent endovenous radiofrequency ablation under spinal anesthesia (SA).

METHODS: This cross-sectional, observational, and prospective study was completed with 64 patients. Before SA, PVI IVC-D, and IVC-A were measured. Patients were divided into two groups as hypotension group (Group 1) and patients who did not developed hypotension after SA (Group 2). Shapiro-Wilk normality test and student’s t-test were used for statistical analysis.

RESULTS: The mean PVI of Group 1 was higher than Group 2, whereas the mean IVC-D and IVC-A in Group 2 was significantly higher than Group 1 (p = 0.000, p = 0.000, p = 0.001). Cutoff values for hypotension PVI > 15% and IVC-A ≤ 2.98 mm2 (p = 0.001, p < 0.05).

CONCLUSION: PVI and IVC-D and IVC-A measurements are effective and reliable methods that should be used to predict the risk of developing HSA in patients who will undergo surgery under SA.

PMID:39566108 | DOI:10.24875/CIRU.23000090

J Clin Endocrinol Metab. 2024 Nov 20:dgae812. doi: 10.1210/clinem/dgae812. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate serum metabolomic biomarkers associated with incident type 2 diabetes mellitus (T2DM) and evaluate their performance in improving T2DM risk prediction.

METHODS: Untargeted proton nuclear magnetic resonance (1H NMR) spectroscopy-based metabolomics analyses were conducted in the Multi-Ethnic Study of Atherosclerosis (MESA; n=3460; discovery cohort) and Rotterdam Study (RS; n=1556; replication cohort). Multivariable cause-specific hazards models were used to analyze the associations between 23,571 serum metabolomic spectral variables and incident T2DM. Replicated metabolites required an FDR-adjusted P<0.01 in MESA, P<0.05 in RS, and consistent direction of association. Pathway and network analyses were conducted to elucidate biological mechanisms underlying T2DM development. Utility of the replicated metabolites in improving T2DM risk prediction was assessed based on the Framingham Diabetes Risk Score. A 2-sample Mendelian randomization was conducted to assess causal associations.

RESULTS: Nineteen metabolites were significantly associated with incident T2DM. Pathway analyses revealed disturbances in aminoacyl-tRNA biosynthesis, metabolism of branched-chain amino acids (BCAAs), glycolysis/gluconeogenesis, and glycerolipid metabolism. Network analyses identified interactions with upstream regulators including p38 MAPK, c-JNK, and mTOR signaling pathways. Adding replicated metabolites to the Framingham Diabetes Risk Score showed modest to moderate improvements in prediction performance in MESA and RS, with Δ c-statistic of 0.05 (95% CI, 0.04-0.07) in MESA and 0.03 (95% CI, 0.01-0.05) in RS. Genetically increased BCAAs and mannose were associated with T2DM.

CONCLUSIONS: 1H NMR measured metabolites involved in aminoacyl-tRNA biosynthesis, BCAA metabolism, glycolysis/gluconeogenesis, and glycerolipid metabolism were significantly associated with incident T2DM and provided modest to moderate predictive utility beyond traditional risk factors.

PMID:39566105 | DOI:10.1210/clinem/dgae812

Eur J Public Health. 2024 Nov 20:ckae185. doi: 10.1093/eurpub/ckae185. Online ahead of print.

ABSTRACT

This study aims to provide an investigation of the containment and mitigation strategies encompassing the entirety of the pandemic in Taiwan. This descriptive, observational study used COVID-19 data from Taiwan, Japan, and South Korea, and analysed news releases from the Taiwanese health authority. Statistics provided evidence of outbreak severity through infection and mortality rates, while qualitative results from the document review offered insights on the actions taken by the government chronologically from 2 February 2020 to 31 December 2022. All three countries experienced significant infection peaks in 2022. Taiwan had two distinct peaks, one in late May and another in October. South Korea had a single, high peak in late March, while Japan experienced multiple smaller waves, the biggest wave in August. Similarly, weekly mortality rates peaked in 2022 for all three countries after a surge in their infected cases, with Taiwan (5.15/100 000) and South Korea (4.69/100 000) having higher rates than Japan (1.65/100 000). Results from qualitative analysis showed that Taiwan’s early containment measures might have delayed the epidemic curve, allowing time for better preparation and proactive responses. However, the lack of a clear transition plan and the vulnerability of the elderly population contributed to higher mortality and infection rates. Despite ongoing challenges, Taiwan avoided nationwide lockdowns and relied on targeted restrictions to control transmission of the virus. Results of this article offer the narratives, reflections, and experiences from the case of Taiwan which may potentially present promising opportunities for impact in other settings and for future pandemics.

PMID:39566089 | DOI:10.1093/eurpub/ckae185

J Bone Miner Res. 2024 Nov 20:zjae190. doi: 10.1093/jbmr/zjae190. Online ahead of print.

ABSTRACT

Vitamin D dysregulation can occur in people living with HIV, disrupting calcium homeostasis and bone turnover. We aimed to investigate the potential mechanisms by which vitamin D regulates bone turnover in adolescents living with perinatally-acquired HIV (ALWH) in southern Africa. A pre-planned secondary analysis was performed of baseline data from the VITALITY trial [PACTR20200989766029] which enrolled ALWH (11-19 years) taking antiretroviral therapy for ≥6 months, and recorded socio-demographic, clinical and dietary data. After over-night fasting, vitamin D metabolites [25(OH)D, 1,25(OH)2D, 24,25(OH)2D], intact parathyroid hormone (PTH) and bone turnover markers (BTMs) [CTX and P1NP] were measured. Tandem Mass Spectrometry measured vitamin D metabolites, whilst intact PTH and BTMs were analysed by electrochemiluminescence immunoassay. Stratified by 25(OH)D [<75 vs ≥75 nmol/L], associations between standardized concentrations (β = standard deviations) of vitamin D metabolites, intact PTH and BTMs were assessed using structural equations modelling (SEM) adjusted for age, sex and country (Zimbabwe/Zambia). Among the 842 ALWH enrolled, the median dietary calcium intake was 100 mg [IQR:55-145]. The SEM showed PTH was positively associated [β 0.21, 95%CI: 0.1,0.32] with 1,25(OH)2D, only when 25(OH)D was <75 nmol/L vs ≥75 nmol/L [β 0.23, 95%CI: -0.13,0.59], with evidence of an interaction [β -0.11, 95%CI: -0.20,-0.02]. A positive relationship between 25(OH)D and 24,25(OH)2D was seen irrespective of 25(OH)D concentration. 24,25(OH)2D was inversely related to BTMs, particularly when 25(OH)D was <75 nmol/L [CTX: β -0.15, 95%CI: -0.24,-0.06, and P1NP: β -0.14, 95%CI: -0.22,-0.06]. There was interaction between dietary calcium and 25(OH)D on PTH [β -0.15, 95% CI: -0.22,-0.07] suggesting an interaction between low 25(OH)D and low dietary calcium which increases PTH. In conclusion, associations between 25(OH)D, PTH, 1,25(OH)2D and BTMs in ALWH appear dependent upon 25(OH)D concentrations <75 nmol/L and calcium intake. A novel, potentially causal pathway between 25(OH)D, 24,25(OH)2D and BTMs was seen. Findings enhance understanding of vitamin D metabolism in people living with HIV.

PMID:39566074 | DOI:10.1093/jbmr/zjae190