Category: Statistics

Front Nutr. 2024 Oct 21;11:1302260. doi: 10.3389/fnut.2024.1302260. eCollection 2024.

ABSTRACT

Vitamin D deficiency has emerged as a significant concern in public health due to its potential association with various metabolic disorders. This study aimed to investigate the relationship between serum vitamin D levels and the susceptibility to hyperlipidemia among adults. Using a multi-stage sampling approach, we recruited a cohort of 2072 eligible individuals aged over 18 years. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured alongside glucolipid metabolic markers, and comprehensive demographic and physical data were collected. The cohort exhibited a hyperlipidemia prevalence of 42.18%, with 19.88% demonstrating vitamin D deficiency. Notably, 23.68% of individuals with vitamin D deficiency also presented hyperlipidemia. Statistical analysis revealed a significantly higher prevalence of hyperlipidemia among those with vitamin D deficiency compared to those with sufficient levels (23.68% vs. 17.11%, P < 0.05). After adjusting for various factors including age, geographical region, exercise status, BMI, fasting glucose level, and blood pressure, lower serum 25(OH)D concentrations were found to significantly increase the risk of hyperlipidemia (Odds Ratio [OR] = 1.41; 95% CI: 1.057, 1.885; P < 0.05). Further stratification of the hyperlipidemic cohort revealed that vitamin D deficiency was associated with 1.459- and 1.578-times higher risks for total cholesterol and triglyceride abnormalities, respectively, compared to those with sufficient vitamin D levels. Moreover, each 10 ng/mL decrease in serum vitamin D level corresponded to an increased risk of total cholesterol (OR = 0.82; 95% CI: 0.728, 0.974; P < 0.05) and triglyceride abnormalities (OR = 0.79; 95% CI: 0.678, 0.927; P < 0.05). However, there were no significant differences observed between vitamin D-sufficient and-deficient groups regarding Low-Density Lipoprotein (LDL) and High-Density Lipoprotein (HDL) abnormalities. These findings underscore the potential role of serum vitamin D deficiency as an independent risk factor contributing to the elevated prevalence of hyperlipidemia in the adult population.

PMID:39498411 | PMC:PMC11532166 | DOI:10.3389/fnut.2024.1302260

Health Data Sci. 2024 Nov 4;4:0199. doi: 10.34133/hds.0199. eCollection 2024.

ABSTRACT

Background: Previous studies suggested that smoking behavior (e.g., smoking status) was associated with an elevated risk of chronic kidney disease (CKD), yet whether this association is causal remains uncertain. Methods: We used data for half million participants aged 40 to 69 years from the UK Biobank cohort. In the traditional observational study, we used Cox proportional hazards models to calculate the associations between 2 smoking indices-smoking status and lifetime smoking index and incident CKD stages 3 to 5. Mendelian randomization (MR) approaches were used to estimate a potential causal effect. In one-sample MR, genetic variants associated with lifetime smoking index were used as instrument variables to examine the causal associations with CKD stages 3 to 5, among 344,255 UK Biobank participants with white British ancestry. We further validated our findings by a two-sample MR analysis using information from the Chronic Kidney Disease Genetics Consortium genome-wide association study. Results: In the traditional observational study, both smoking status [hazard ratio (HR): 1.26, 95% confidence interval (CI): 1.22 to 1.30] and lifetime smoking index (HR: 1.22, 95% CI: 1.20 to 1.24) were positively associated with a higher risk of incident CKD. However, both our one-sample and two-sample MR analyses showed no causal association between lifetime smoking index and CKD (all P > 0.05). The genetic instruments were validated by several statistical tests, and all sensitivity analyses showed similar results with the main model. Conclusion: Evidence from our analyses does not suggest a causal effect of smoking behavior on CKD risk. The positive association presented in the traditional observational study is possibly a result of confounding.

PMID:39498379 | PMC:PMC11532587 | DOI:10.34133/hds.0199

Br J Clin Psychol. 2024 Nov 4. doi: 10.1111/bjc.12512. Online ahead of print.

ABSTRACT

OBJECTIVES: The ability to interpret facial expressions accurately is important to adaptive social functioning. Social anxiety disorder is associated with a biased interpretation of facial emotions. This study aimed to demonstrate the effects of feedback training on modifying interpretation bias in individuals with high social anxiety.

METHODS: A total of 451 university students were screened, and 69 participants with high social anxiety were randomly assigned to either a training (n = 37) or a control (n = 32) group. Participants completed pre-questionnaires on social anxiety and depression symptoms, then performed a single session of experiment, followed by post-questionnaires on social anxiety symptoms. In the experiment, participants viewed an ambiguous facial expression and rated the intensity on a continuous scale. The training group received feedback that presented their ratings alongside the actual intensity, allowing them to accurately assess their emotional perception bias through trial-by-trial feedback. The control group received no feedback.

RESULTS: The training group showed a significant reduction in interpretation bias for happy and angry faces after the experiment, while the control group did not. However, although the training group’s social anxiety symptoms decreased post-experiment, the difference was not statistically significant compared to the control group.

CONCLUSIONS: These findings provide preliminary evidence that the feedback training targeting dimensional ratings of emotions may be a promising option for correcting interpretation bias in individuals with high social anxiety. Future research could implement multiple sessions of training to potentially reduce both interpretation bias and social anxiety symptoms and verify the long-term effects.

PMID:39497245 | DOI:10.1111/bjc.12512

J Sports Sci. 2024 Nov 4:1-7. doi: 10.1080/02640414.2024.2423138. Online ahead of print.

ABSTRACT

Males typically outperform females in Olympic-style weightlifting, as judged by total weight lifted, and similarly heavier athletes outperform lighter athletes. Current methods can standardise weightlifting performances across body mass to compare different body mass classes, but they do not address the sex gap. This study introduces a novel approach that puts male and female performances on a single unified scale, across the range of body mass, allowing mixed sex teams to be compared. The method uses standardised residuals or “z-scores” derived from models of performance regressed on sex and body mass fitted by GAMLSS (generalised additive models for location, scale and shape). Reference data come from the International Weightlifting Federation (IWF) world championships and Olympics 2017-2023. To ensure the validity of the model for ranking team performances in the future, results from 2000 to 2023 were compared and shown to be stable over time. A web application is available to aid athletes, coaches and health professionals to compare performances and monitor progress over time.

PMID:39497237 | DOI:10.1080/02640414.2024.2423138

Inj Epidemiol. 2024 Nov 4;11(1):61. doi: 10.1186/s40621-024-00544-y.

ABSTRACT

BACKGROUND: The U.S.-Mexico “border wall” between El Paso, Texas and Ciudad Juárez, Mexico was raised and extended beginning in 2018 in accordance with Presidential Executive Order 13,767. We hypothesized that these changes resulted in increased incidence and severity of injuries of individuals attempting to cross the border wall in the El Paso region.

METHODS: A retrospective cohort review was conducted of University Medical Center of El Paso Trauma Registry charts from 2001 to 2022. Year of injury, gender, age, Injury Severity Score, hospital length-of-stay, ICU length-of-stay, ventilator days, and survival were analyzed by Chi-square analysis with Fisher’s exact test for categorical variables and Independent Samples T-test for continuous variables. An independent samples Mann Whitney U Test was used to compare border wall fall injuries before and after 2018.

RESULTS: Of the 842 patients reviewed, 69 patients presented before 2018 and 773 presented from 2018 to 2022. Statistically significant differences were identified in the mean Injury Severity Score which increased from 6.3 (SD ± 3.8) to 8.3 (SD ± 5.5, p < .001) and the mean hospital length-of-stay which increased from 6.7 days (SD ± 5.5) to 9.5 days (SD ± 8.0, p < .005).

CONCLUSION: The incidence, severity, and hospital length-of-stay related to injuries crossing the U.S.-Mexico border have increased with changes in height of the border wall since 2018. Additional resources should be allocated to Emergency Departments and Trauma Centers along the Southwest Border to serve this unique patient population. Additional consideration should be given to the cost of the border wall.

PMID:39497229 | DOI:10.1186/s40621-024-00544-y

Eur J Med Res. 2024 Nov 5;29(1):529. doi: 10.1186/s40001-024-02121-x.

ABSTRACT

BACKGROUND: The triglyceride-glucose (TyG) index has garnered recognition as a surrogate marker for insulin resistance, a pivotal factor in the pathogenesis of various metabolic disorders. Despite its emerging role, the empirical evidence delineating its association with prediabetes mellitus (Pre-DM) remains scant. This research aims to clarify the link between the TyG index and the likelihood of Pre-DM development within a Chinese demographic.

METHODS: This investigation was structured as a retrospective cohort analysis, encompassing a sample of 179,177 Chinese adults. These individuals underwent medical examinations at the Rich Healthcare Group over a period spanning from 2010 to 2016. To ascertain the relationship between the TyG index and the incidence of Pre-DM, this study employed Cox regression analysis complemented by sensitivity and subgroup assessments. Furthermore, Cox proportional hazards regression with cubic spline functions and smooth curve fitting was incorporated to explore the existence of any non-linear connection within this association.

RESULTS: Upon adjusting for a comprehensive array of confounding variables, a statistically significant positive correlation between the TyG index and the risk of Pre-DM was identified (HR: 1.60, 95%CI 1.56-1.65, P < 0.001). The analysis illuminated a non-linear relationship, with an inflection point at a TyG index value of 8.78. For TyG index values below and above this inflection point, the HR was calculated to be 1.94 (95%CI 1.86-2.03) and 1.26 (95%CI 1.20-1.33), respectively. Sensitivity analyses further fortified the reliability of these findings.

CONCLUSIONS: This comprehensive examination delineated a significantly positive, non-linear correlation between the TyG index and the risk of Pre-DM within a Chinese population. Individuals with TyG index values below 8.78 have a significantly increased risk of developing prediabetes. These findings underscore the TyG index’s potential efficacy as a predictive tool for assessing Pre-DM risk in clinical practice.

PMID:39497216 | DOI:10.1186/s40001-024-02121-x

Diabetol Metab Syndr. 2024 Nov 5;16(1):263. doi: 10.1186/s13098-024-01500-y.

ABSTRACT

OBJECTIVE: To explore the association between the Oxidative Balance Score (OBS), which represents the balance of multiple oxidative stress-related dietary and lifestyle exposures, and the risk of metabolic syndrome (MetS).

METHODS: A population-based cross-sectional study design was adopted and 16,850 participants in NHANES database were included in the statistics analysis stage. The OBS was constructed by combining information from 20 a priori selected pro- and antioxidant factors. Weighted logistic regression and restricted cubic splines (RCS) were used to estimate the association between OBS and MetS.

RESULTS: Participants in the highest OBS quartile, indicating low oxidative stress (OS) levels, exhibited a significantly lower risk of MetS (odds Ratio [OR] = 0.55, 95% confidence Interval [CI]: 0.47-0.64) compared to the lowest quartile. Specifically, higher OBS was inversely associated with abdominal obesity (OR = 0.61, 95% CI: 0.54-0.69), hypertension (OR = 0.69, 95% CI: 0.58-0.83), elevated triglycerides (OR = 0.68, 95% CI: 0.57-0.82), low high-density lipoprotein cholesterol (HDL-C) levels (OR = 0.60, 95% CI: 0.50-0.70) and fasting blood glucose (FBG) levels (OR = 0.74, 95% CI: 0.62-0.88). The observed inverse association between OBS and hypertension or FBG levels appeared to primarily influenced by BMI. The association between dietary OBS intervals and elevated FBG levels was not statistically significant in men, whereas the risk was lower by 25% in women.

CONCLUSIONS: A higher OBS, representing a balance of multiple oxidative stress-related dietary and lifestyle exposures, is associated with a lower risk of MetS. Therefore, adhering to an antioxidant diet and lifestyle may help prevent the occurrence of metabolic disorders.

PMID:39497207 | DOI:10.1186/s13098-024-01500-y

Eur J Med Res. 2024 Nov 5;29(1):533. doi: 10.1186/s40001-024-02080-3.

ABSTRACT

BACKGROUND: Stereotactic body radiation therapy (SBRT) has been widely used for pancreatic cancer. However, there is still a lack of studies comparing the latest SBRT techniques in terms of clinical efficacy and safety.

OBJECTIVES: This study aims to evaluate three latest SBRT delivery platforms: CyberKnife (CK), Tomography Radixact (TOMO), and Halcyon volume rotation intensity modulation therapy (VMAT) for the treatment of pancreatic cancer.

METHODS: Sixteen patients with pancreatic cancer treated with CK were retrospectively analyzed. SBRT plans were designed using Precision and Eclipse software. CK plans were optimized in two forms: fixed collimator (CK-Fixed) and multi-leaf grating collimator (CK-MLC). TOMO plans were designed with 2.5 cm Fixed Jaw, pitch 0.123-0.43 and 4.0 modulation factors in precision system. In Eclipse 15.6 system, photon optimizer (OP) algorithm was used to design the coplanar two-arc Halcyon VMAT. The median radiation dose was 40 Gy (35-45 Gy) in 5 fractions. The effectiveness of clinical treatment was evaluated by comparing the homogeneity index (HI), conformity index (CI), coverage of the planning target volume (PTV) and dose distribution parameters of organs at risk (OAR).

RESULTS: All plans met the limits of clinical target dose and OAR. CK-MLC plans had the lowest maximum dose of 2 cm normal tissue from PTV margin (D_2cm), indicating a low risk of peripheral radiation damage. Additionally, the CK-MLC plans had the lowest dose parameters and provided the best protection for the kidney, spinal cord, small intestine, and duodenum, with a paired t-test p < 0.05, indicating a statistical difference.

CONCLUSION: High conformity and adjustability of CK-MLC allowed for precise complex target localization and conformal dose distribution, benefiting tumor treatment while maximally reducing damage to OAR. This study provides valuable dosimetric evidence for SBRT technique selection for pancreatic cancer.

PMID:39497204 | DOI:10.1186/s40001-024-02080-3

J Neuroeng Rehabil. 2024 Nov 5;21(1):197. doi: 10.1186/s12984-024-01480-0.

ABSTRACT

BACKGROUND: Restriction of movement at a joint due to disease or dysfunction can alter the range of motion (ROM) at other joints due to joint interactions. In this paper, we quantify the extent to which joint restrictions impact upper limb joint movements by conducting a disability simulation study that used wearable inertial sensors for three-dimensional (3D) motion capture.

METHODS: We employed the Wearable Inertial Sensors for Exergames (WISE) system for assessing the ROM at the shoulder (flexion-extension, abduction-adduction, and internal-external rotation), elbow (flexion-extension), and forearm (pronation-supination). We recruited 20 healthy individuals to first perform instructed shoulder, elbow, and forearm movements without any external restrictions, and then perform the same movements with restriction braces placed to limit movement at the shoulder, elbow, and forearm, separately, to simulate disability. To quantify the extent to which a restriction at a non-instructed joint affected movement at an instructed joint, we computed average percentage reduction in ROM in the restricted versus unrestricted conditions. Moreover, we performed analysis of variance and post hoc Tukey tests (q statistic) to determine the statistical significance (p < 0.05 denoted using ^*) of the differences in ROM of an instructed joint in the unrestricted versus restricted conditions.

RESULTS: Restricting movement at the shoulder led to a large reduction in the average ROM for elbow flexion-extension (21.93%, q = 9.34^*) and restricting elbow movement significantly reduced the average ROM for shoulder flexion-extension (17.77%, q = 8.05^*), shoulder abduction-adduction (19.80%, q = 7.60^*), and forearm pronation-supination (14.04%, q = 4.96^*). Finally, restricting the forearm significantly reduced the average ROM for shoulder internal-external rotation (16.71%, q = 3.81^*) and elbow flexion-extension (10.01%, q = 4.27^*).

CONCLUSIONS: Joint interactions across non-instructed joints can reduce the ROM of instructed movements. Assessment of ROM in the real-world using 3D motion capture, for example using the WISE system, can aid in understanding movement limitations, informing interventions, and monitoring progress with rehabilitation.

PMID:39497195 | DOI:10.1186/s12984-024-01480-0

Influenza Other Respir Viruses. 2024 Nov;18(11):e70039. doi: 10.1111/irv.70039.

ABSTRACT

BACKGROUND: Respiratory syncytial virus (RSV) is an important cause of acute lower respiratory infections worldwide, including Thailand. This study aimed to assess clinical and economic burdens of RSV infections across different age groups in Thailand.

METHOD: A retrospective cohort study was conducted using data from a tertiary care hospital from 2014 to 2021. Patients who tested at least one positive RSV were included and stratified into five age groups (< 2, 2-5, 5-18, 18-65, and > 65 years). Healthcare resource utilization, direct medical costs, and clinical outcomes were analyzed with descriptive statistics. Generalized linear models with gamma distributions and log link were used to model cost outcomes. Costs were reported in 2021 US dollars (USD), with 1 USD = 31.98 Thai Baht.

RESULTS: A total of 2122 RSV-positive patients were identified, half of which (1097) were hospitalized. The median (interquartile range [IQR]) total hospitalization costs ranged from USD780 (IQR: USD488-USD1185) in those < 2 years to USD2231 (IQR: USD1250-USD4989) in those aged 65+ years. Case fatality rates among hospitalized patients also varied from 2.5% to 28.4% depending on age. Increased age, presence of comorbidities, and need for critical care were associated with higher hospitalization costs.

CONCLUSION: Among RSV-positive patients, younger children experienced the greatest burden, but poorer outcomes were observed in older adults. Higher costs were associated with older age, comorbidities and critical care needs. Understanding RSV economic burdens is crucial for assessing the cost-effectiveness and public health value of vaccination programs that prioritize at-risk groups to mitigate the public health impact.

PMID:39497189 | DOI:10.1111/irv.70039