Category: Statistics

BMC Musculoskelet Disord. 2024 Nov 13;25(1):908. doi: 10.1186/s12891-024-08030-8.

ABSTRACT

BACKGROUND: Studies have shown that the clinical efficacy of TBS (Trabecular Bone Score) of DXA in hip fracture patients. This study aimed to investigate the difference of TBS in trochanteric fractures and femoral neck fractures in hip fracture patients.

METHODS: Data were derived from the University affiliated hospital, the participants included 249 patients aged 60 years or older who were available of TBS prescribe by DXA. 89 femoral neck fracture patients and 160 trochanteric fractures were enrolled. Spine T- score, hip T- score (neck), hip T- score (total), lowest T- score in hip, L1-L4 TBS. TBS Z-score, L1-L4 BMD(g/cm²), L1-L4 BMD T-score, L1 TBS, L1 BMD(g/cm2), L1 BMD T-score, L2 TBS, L2 BMD(g/cm2), L2 BMD T-score, L3 TBS, L3 BMD(g/cm2), L3 BMD T-score, L4 TBS, L4 BMD(g/cm2), L4 BMD T-score, lowest TBS score, highest TBS score were analyzed.

RESULTS: Demographic data (age, sex, height, weight, BMI) and T-score of hip and spine in two groups showed no significant difference. TBS in spine in two groups revealed higher TBS in femoral neck fracture groups.

CONCLUSION: There is no difference of age, sex, and BMI in two groups. The T-score was not statistically significant in comparison of bone quality in hip fracture groups. The TBS in femoral neck fracture group is higher than trochanteric fractures. The TBS in spine can be more valuable than T-score of DXA for the proper evaluation of bone quality in the hip fracture patients.

PMID:39538232 | DOI:10.1186/s12891-024-08030-8

BMC Public Health. 2024 Nov 13;24(1):3145. doi: 10.1186/s12889-024-20593-8.

ABSTRACT

BACKGROUND: The global prevalence of obesity is increasing not only in adults but also in children and adolescents. In addition to the role of genetic and biological factors, policies such as the need for quarantine during the coronavirus epidemic and the family’s behavioral and socioeconomic status in causing obesity cannot be ignored. The current research aimed to investigate the effect of virtual education programs on the health responsibility of overweight students during the outbreak of the Coronavirus.

METHODS: This was a semi-experimental study with a pre-test-post-test design and a randomized control group, which was conducted in three stages)pre-intervention, intervention, and post-intervention) during 2021-22 in Tehran Province, Iran. The samples were 60 adolescent girls aged 12-18 with a body mass index higher than 25 and placed in two test and control groups through random cluster sampling. Data was collected using the demographic information profile and the 12-item health responsibility questionnaire from HPLPII. The intervention was implemented as 6 virtual training sessions of 1.5 h for the test group. After 1.5 months, BMI was measured and a post-test was done. SPSS version 22 software was used for data analysis.

RESULTS: There was no significant change in the BMI of students after the intervention in the control group (p = 0.476), but it decreased significantly in the test group (p < 0.001). Before the intervention, there was no statistically significant difference between the average score of health responsibility in the test group (54.63 $\pm 6.93$ ) and the control group (53.03 $\pm$ 6.79) (P = 0.370). After the intervention, the mean difference between the test group (62.56) and the control group (55.10) was statistically significant (P < 0.001). Before the intervention, about 70% of the students in both the test and control groups were at a relatively favorable health responsibility level. After the study, the number of students in the test group who were placed at a completely favorable level was almost twice as before, and a statistically significant difference was observed between the two groups(P = 0.035).

CONCLUSIONS: The results of the present study showed that virtual education during the outbreak of COVID-19 has led to an increase in the responsibility for the health of overweight and obese students (in terms of improving health behaviors, increasing the hours of physical activity, and modifying the eating pattern) and reducing the body mass index of students.

PMID:39538224 | DOI:10.1186/s12889-024-20593-8

BMC Public Health. 2024 Nov 13;24(1):3154. doi: 10.1186/s12889-024-20654-y.

ABSTRACT

BACKGROUND: Safe motherhood programs must include both readiness for complications and childbirth. Birth preparedness and complication readiness (BPCR) is a comprehensive approach that helps resolve delays in deciding to seek care for obstetric problems.

OBJECTIVES: To identify the determinants of BPCR practice among reproductive age group women in Africa.

DESIGN: Systematic Review and Meta-Analysis.

DATA SOURCES AND METHODS: Preferred Reporting Items for Systematic Reviews and meta-analysis (PRISMA) were followed and databases such as MEDLINE, PubMed, Scopus, Hinari, Google Scholar, and Web of Science were used to find the available studies. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to identify associated factors. I2 statistics, funnel plot, and Egger test were used to assess the studies’ heterogeneity and publication bias.

RESULTS: In this review, a total of 32 studies with 17,787 sample sizes were included. Knowledge of BPCR (AOR = 2.12, 95% CI: 1.44, 3.13), knowledge of danger signs during pregnancy (AOR = 1.60; 95% CI: 1.37, 1.88), Knowledge of labor and delivery danger signs (AOR = 1.44; 95% CI: 1.28, 1.62), Knowledge of postpartum danger signs (AOR = 1.40; 95% CI: 1.21, 1.63), urban residency (AOR = 1.32; 95% CI: 1.03, 1.70), Antenatal Care follow-up (AOR = AOR = 1.52;95% CI:1.42, 1.63), history of stillbirth (AOR = 1.59; 95% CI: 1.36, 1.86), parity (AOR = 1.76; 95% CI: 1.16, 2.66) and secondary or higher educational status (AOR = 1.51: 95% CI: 1.35, 1.68) were the determinants of BPCR practice.

CONCLUSION: BPCR practice among African women of reproductive age has been greatly affected by antenatal care visits, urban residency, knowledge of danger during pregnancy, labor, and postpartum, history of stillbirth, primiparity, and secondary or higher education. Focused interventions that address the identified factors may enhance BPCR practices and maternal health outcomes in Africa.

PMID:39538222 | DOI:10.1186/s12889-024-20654-y

Health Qual Life Outcomes. 2024 Nov 14;22(1):98. doi: 10.1186/s12955-024-02305-3.

ABSTRACT

BACKGROUND: Despite being a widely used generic measure of health-related quality of life worldwide, there is limited evidence on the psychometric properties of the EuroQoL Five-dimensions five level (EQ-5D) among cervical cancer patients in Ethiopia.

OBJECTIVE: To evaluate psychometric properties of the Amharic version of EQ-5D among Ethiopian cervical cancer patients.

METHODS: A longitudinal survey of cervical cancer patients receiving treatment at two Ethiopian tertiary care facilities was conducted from March 2022 to July 2023. Participants completed the EQ-5D and the European Organization for Research and Therapy of Cancer (EORTC QLQ-C30) at baseline and after three months on treatment. Effect size and standardized response mean were used to assess responsiveness. Anchor-based and distribution-based methods were used to calculate the minimal clinically important difference (MCID). Minimal detectable change (MDC) ratios were computed at the individual and group levels. Statistical significance was determined at p < 0.05.

RESULTS: Three hundred seventy-one patients completed the survey at baseline and follow-up with a mean age of 49.72 (10.80) years. The majority (268,73%) of the patients had early-stage cancer. The EQ-5D index and EQ VAS scores respectively improved by 0.04 and 7.0 post-treatment.The physical domains of EORTC QLQ-C30 had showed high correlation with physical dimensions of EQ-5D (r > 0.6) and the instrument showed good discriminate validity between patients with different health states. The effect size ranged between – 0.12 and 0.60 for the EQ-5D index value and – 0.12 to 1.16 for the EQ VAS, indicating small to large responsiveness. The average (range) MCID value of the EQ-5D index was 0.10-0.15. The findings showed that MCID to MDC ratios at the group level were more clinically meaningful than the individual level.

CONCLUSION: The EQ-5D effectively detected changes and discriminate patients with different levels of health. While group-level MCIDs were established in this study, further studies are recommended to prove its usefulness at the individual-level.

PMID:39538221 | DOI:10.1186/s12955-024-02305-3

BMC Pulm Med. 2024 Nov 13;24(1):565. doi: 10.1186/s12890-024-03335-9.

ABSTRACT

BACKGROUND: The association of lipoprotein-associated phospholipase A2 (Lp-PLA2) with various cardiovascular events has been well-established. However, the exploration of its potential involvement in Chronic obstructive pulmonary disease (COPD) is currently limited. Therefore, our study aims to examine the relationship between Lp-PLA2 and pulmonary conditions, including emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction, to provide further evidence of a possible association with COPD development.

METHODS: Using data from the Southwest Hospital Health Management Center, spanning January 2013 to July 2024, we analyze relationship of serum Lp-PLA2 levels with diffuse pulmonary emphysema and pulmonary functions. In univariate analysis, group differences were assessed with t-tests for numerical variables and Chi-square tests for categorical data. Variables found to be statistically significant (two-sided P < 0.05) in univariate analysis were subsequently included as covariates in multivariate analysis, performed using a binary logistic regression model. Odds ratios and 95% confidence intervals were calculated to assess the differences.

RESULTS: We established 2 case-control populations: the Imaging population (1056 subjects, mean age 57.666 ± 8.700 years old, 89.9% male) selected from 24,670 initial records, and the Pulmonary Function population (279 subjects, mean age 52.082 ± 11.473 years old, 71.4% male) selected from 1868 initial records. Univariate analysis revealed that serum Lp-PLA2 levels were significantly higher in patients with diffuse pulmonary emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction compared to those without (454.682 ± 141.382U/L vs. 423.330 ± 140.658U/L, P < 0.001; 475.059 ± 157.181U/L vs. 420.824 ± 142.119U/L, P = 0.006; 475.31 ± 148.980U/L vs. 439.036 ± 157.977U/L, P = 0.049, respectively). Multivariate analysis further showed higher Lp-PLA2 levels were associated with increased risks of diffuse pulmonary emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction. Using Lp-PLA2 ≤ 300 U/L as reference, odds ratios for the aforementioned conditions showed a gradually increasing trend with every 100U/L increase in Lp-PLA2 levels.

CONCLUSIONS: Our preliminary study suggests that Lp-PLA2 is independently associated with diffuse pulmonary emphysema, obstructive ventilatory dysfunction as well as small airway dysfunction, which are commonly seen in COPD development. These findings indicated a possible association between Lp-PLA2 and COPD, though further validation is needed in a large cohort of COPD patients.

PMID:39538218 | DOI:10.1186/s12890-024-03335-9

BMC Psychiatry. 2024 Nov 13;24(1):796. doi: 10.1186/s12888-024-06146-8.

ABSTRACT

BACKGROUND: Cognitive impairment is common in chronic schizophrenia patients. The purpose of this study was to explore the efficacy of Shen-based Qigong Exercise (SBQE) in improving the cognitive impairment of stable schizophrenia patients in rehabilitation wards.

METHODS: SBQE is derived from the theory of “body-spirit syncretism (xin shen he yi)” in traditional Chinese medicine (TCM) and is extracted from the four traditional Qigong techniques. In this 12-week, randomized, single-blind, controlled study, a total of 40 schizophrenia patients were randomly assigned to either the SBQE group or the control group. The scores for the Scale for the Assessment of Negative Symptoms (SANS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were recorded at baseline and week 12, respectively.

RESULTS: At week 12, the mean RBANS total score was 84.5 points in the SBQE group and 72.8 points in the control group. The estimated mean difference was – 11.60 points (2-sided 95% CI, -22.41 to -0.79; P = 0.04). This difference was statistically significant (time-by-group interaction effect estimates, F_(1,38) = 5.07; P = 0.03).

CONCLUSIONS: Our preliminary findings indicated that SBQE led to an improvement in cognitive impairment in stable schizophrenia patients in rehabilitation wards. Further research with robust design and larger sample sizes is necessary to validate the effects of SBQE on cognitive function and psychiatric symptoms in schizophrenia, thus providing more substantial evidence for the clinical application of SBQE.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05310955 on 22/02/2022; http://www.chictr.org.cn/ Identifier: ChiCTR2200057373 on 10/03/2022.

PMID:39538216 | DOI:10.1186/s12888-024-06146-8

BMC Oral Health. 2024 Nov 13;24(1):1368. doi: 10.1186/s12903-024-05156-y.

ABSTRACT

INTRODUCTION: The alveolar bone defect often was hardly healed naturally by the body’s repair mechanism. Implant placement was the most favored option for replacing a missing tooth in the current times, and the preservation of alveolar bone was vital. Tooth components, especially dentin, were very similar to alveolar bone components and could be used for promoting the alveolar bone regeneration process in reconstructive dentistry.

METHODS: We exhaustively scoured multiple literature databases, such as PubMed and Embase, from inception to September 2024. The protocol for this meta-analysis was officially registered with PROSPERO (CRD42023400591). Randomized clinical trials (RCTs) that reported alveolar bone preservation through demineralized dentin grafts were chosen from the studies. We extracted both qualitative and quantitative data and evaluated statistical heterogeneity using the I² test. The potential for publication bias was evaluated using both qualitative and quantitative methods. A visual evaluation of the funnel plot was used for the qualitative assessment, with the Begg’s test and the Egger’s test were used for quantitative analysis.

RESULTS: Ultimately, 7 studies met the inclusion criteria, comprising 230 participants who were adults without systemic diseases and free from caries or peri-apical infections. Compared with the control group, the demineralized dentin matrix (DDM) group was not statistically significant for improving radiographic ridge width change (SMD – 0.09, 95% CI -0.39 to 0.22) and ISQ values (SMD 0.06, 95% CI -2.39 to 2.51). These results indicate that DDM performs comparably to the control, suggesting that it can be considered an effective alternative in achieving similar outcomes in these specific measures.

CONCLUSIONS: The DDM grafts appear to be a feasible alternative to other biomaterials used for alveolar bone preservation.

CLINICAL TRIAL NUMBER: Not applicable. This study is a meta-analysis and does not involve a clinical trial. Therefore, no clinical trial number has been assigned.

PMID:39538212 | DOI:10.1186/s12903-024-05156-y

BMC Med Educ. 2024 Nov 13;24(1):1301. doi: 10.1186/s12909-024-06040-7.

ABSTRACT

There is a paucity of rigorous longitudinal data regarding the relationship between humanities and their effect on multiple psychometrics. Using an observational art course, we assessed pre- and post-course metrics and longitudinal impacts with 120 preclinical medical students taking the “Art of Observation” between 2016 and 2019. Jefferson Scale of Empathy (JSE) and Jeffreys Transcultural Self-Efficacy Tool (TSET) were assessed annually for four years. Budner Tolerance of Ambiguity (TOA) Scale was administered before and after the course. The JSE showed no drop in empathy as students progressed from first to fourth year (p = 0.374). The TSET showed statistically significant increases in cultural self-efficacy (p < 0.001) in the cognitive and practical components but no change in the affective component of the scale. After the art course, TOA significantly improved on two [solubility (p = 0.009) and complexity (p = 0.21)] of the three subscales, but not novelty (p = 0.62). Empathy and cultural self-efficacy remained consistently high throughout medical school and did not decrease during the clinical years in an institution prioritizing the humanities and community engagement. Comfort with cultural competency generally improved throughout training. After taking an art course that emphasizes cognitive flexibility and a multiple perspectival approach, students demonstrated greater tolerance for ambiguity.

PMID:39538208 | DOI:10.1186/s12909-024-06040-7

BMC Pregnancy Childbirth. 2024 Nov 13;24(1):747. doi: 10.1186/s12884-024-06971-5.

ABSTRACT

BACKGROUND: Education during pregnancy is important for the development of the pregnant woman’s ability to adapt to change and for a healthy birth. In this study, we aimed to examine the effects of education through a diabetes education program on maternal and newborn health in women diagnosed with gestational diabetes.

MATERIALS AND METHODS: In our study, we compared the maternal and neonatal health outcomes of pregnant women who participated in the diabetes education program and were diagnosed with gestational diabetes with the outcomes of pregnant women who did not participate in the diabetes education program and were diagnosed with gestational diabetes. The study included patients who were diagnosed with diabetes between 24and 26 weeks gestation at a tertiary education and research hospital and who underwent a 75-gram OGTT test. Age, BMI, parity, method of delivery, weight gain during pregnancy, newborn birth weight, gestational age and Apgar scores were compared.

RESULTS: The study included 119 patients and analyzed maternal-neonatal outcomes. There were no statistically significant differences in age (33 ± 5.7 versus 31 ± 5.2), body mass index (BMI) (32.2 vs. 31.2), gravidity, parity, number of miscarriages, mode of delivery, family history of diabetes, smoking, prenatal corticosteroid use, and gestational age at delivery. The HbA1c value (p: 0.013), the total weight gain during pregnancy (p: 0.015), the need for insulin treatment (p: 0.002), and the birth weight (0.005) were significantly higher in the group without diabetes education.

CONCLUSION: In our study, diabetic school education was associated with lower HbA1c levels, less weight gain and less need for insulin therapy. When the results were categorized by insulin use, it was found that in patients using insulin, those who received diabetic school education had fewer macrosomic fetuses, whereas in patients not using insulin, those who received diabetic school education had lower maternal weight gain during pregnancy.

PMID:39538195 | DOI:10.1186/s12884-024-06971-5

BMC Med Educ. 2024 Nov 13;24(1):1298. doi: 10.1186/s12909-024-06306-0.

ABSTRACT

BACKGROUND: Procrastination is characterized by the deliberate postponement of assigned educational tasks and is correlated with low academic achievement and depression. Concern about procrastination is particularly high among medical students, as it has a strong association with aspects such as low self-efficacy, lack of organization, low intrinsic motivation, inefficient effort regulation and time management problems. On the other hand, it was found that students’ use of study strategies is significantly related to better academic results. The relationship between students’ tendency to procrastinate and the adoption of effective study strategies remains little explored, leaving a critical space for investigation. This study aims to fill this gap by exploring how procrastination affects the selection and effectiveness of study strategies adopted by students.

METHODS: This cross-sectional study was conducted in Brazil and included medical students from the first to the seventh semester of the Unichrsitus Medical School. The validated procrastination scale and the Learning and Study Strategies Inventory were used. Generalized linear regression multivariate models with robust errors were used to verify the association between the study variables.

RESULTS: 447 students participated, 70.2% of whom were female, with an average age of 23 years. The domain of “study aids” scored higher among younger students, who self-referred as black and who studied in private schools prior to the Medical School. Higher procrastination scores were statistically associated with higher main idea selection, concentration, time organization and anxiety scores and with lower study aids and study preoccupation scores (p values < 0.05). In addition, active methodology was associated with higher scores in the domains of study aids and time organization.

CONCLUSIONS: Procrastination is associated with the study strategies used by medical students, which can be modified through training and ultimately improve their performance. Students in traditional models, who are older, white and from public schools may especially benefit from this training.

PMID:39538189 | DOI:10.1186/s12909-024-06306-0