Category: Statistics

Front Med (Lausanne). 2024 Oct 3;11:1436866. doi: 10.3389/fmed.2024.1436866. eCollection 2024.

ABSTRACT

INTRODUCTION: Colorectal cancer (CRC) is the third most incident and the second most lethal malignant tumor. Despite the recognized association between obesity and CRC, further clarification is necessary regarding the lipids that are overexpressed during the development of CRC. In this scenario, the combination of metabolomics and a three-dimensional (3D) co-culture model involving CRC tumor cells and lipids can enhance the knowledge of energy metabolism modifications at the cross-talk between colorectal cancer and adipocytes. This study aimed to screen potential metabolites in the three dimensional (3D) co-culture of CRC and adipocytes by investigating the metabolome composition of this co-culture released into the extracellular space, which is known as the secretome.

METHODS: Pre-adipocyte cells (3T3-L1), human colon carcinoma (HT-29), and the 3D co-culture (3T3-L1 + HT-29) were cultured for the secretome obtention. Then, ultra-high-performance liquid chromatography coupled with high-resolution mass spectrometry (LC-HRMS) was employed to analyze the metabolomics of each secretome.

RESULTS: Overall, 3.731 molecules were detected independent of the cell culture. When comparing the three cultures, 105 molecules presented a statistically significant difference in abundance between groups. Among these molecules, 16 were identified, with a particular emphasis on six lipids (PG 20:0, octadecenal, 3-Hydroxytetracosanoyl-CoA, 9,10-dihydroxy-octadecenoic acid, palmitoleic acid, and PA 18:4) and one amino acid derivative (acetylglutamic acid), which presented significant scores during the partial least-squares discriminant analysis (PLS-DA).

DISCUSSION: Although it is too early to determine the possible impact of such molecules in a CRC microenvironment, these results open new avenues for further studies on the energy metabolism at the cross-talk of colorectal cancer adipocytes.

PMID:39421865 | PMC:PMC11484090 | DOI:10.3389/fmed.2024.1436866

Ann Appl Stat. 2024 Sep;18(3):1840-1857. doi: 10.1214/23-aoas1859. Epub 2024 Aug 5.

ABSTRACT

Understanding how genetic variation affects gene expression is essential for a complete picture of the functional pathways that give rise to complex traits. Although numerous studies have established that many genes are differentially expressed in distinct human tissues and cell types, no tools exist for identifying the genes whose expression is differentially regulated. Here we introduce DRAB (differential regulation analysis by bootstrapping), a gene-based method for testing whether patterns of genetic regulation are significantly different between tissues or other biological contexts. DRAB first leverages the elastic net to learn context-specific models of local genetic regulation and then applies a novel bootstrap-based model comparison test to check their equivalency. Unlike previous model comparison tests, our proposed approach can determine whether population-level models have equal predictive performance by accounting for the variability of feature selection and model training. We validated DRAB on mRNA expression data from a variety of human tissues in the Genotype-Tissue Expression (GTEx) Project. DRAB yielded biologically reasonable results and had sufficient power to detect genes with tissue-specific regulatory profiles while effectively controlling false positives. By providing a framework that facilitates the prioritization of differentially regulated genes, our study enables future discoveries on the genetic architecture of molecular phenotypes.

PMID:39421855 | PMC:PMC11484521 | DOI:10.1214/23-aoas1859

Front Psychol. 2024 Oct 3;15:1407433. doi: 10.3389/fpsyg.2024.1407433. eCollection 2024.

ABSTRACT

INTRODUCTION: The educational system in Costa Rica, as regulated by Law #7727, which governs Alternative Conflict Resolution and Promotion of Social Peace must consider the interplay of various factors influencing classroom conflicts and the management strategies employed by teachers. Consequently, it becomes imperative to identify the most effective conflict resolution practices applicable within this context. To achieve this, a thorough procedure based on mixed methods was employed to analyze and interpret both classroom conflict behaviors and teachers’ strategic responses.

METHOD: This study employed an indirect observational methodology, from a mixed methods approach. Data was collected through a focus group comprised of teachers. Following the connect framework, the procedure was conducted in three phases: QUAL-QUAN-QUAL. Two analytical techniques were implemented. A lag sequential analysis was used to explore potential behavioral patterns. The results of this analysis informed a polar coordinate analysis, which generated a visual representation of the relationships between codes.

RESULTS AND DISCUSSION: A focus group addressed four questions, yielding satisfactory data quality control results (kappa values: 0.80, 0.77, 0.76, 0.82). In polar coordinate analysis, the 37 observational instrument categories were designated as focal behaviors. Each of the 37 analyses treated all categories as conditioned behaviors. The analysis identified 342 activation/inhibition relationships between focal and conditioned behaviors. Of these, 195 were statistically highly significant, distributed across quadrants: Quadrant I (106), Quadrant II (36), Quadrant III (16), Quadrant IV (36). Significant gaps in understanding of conflict were identified, along with disparities in the resources and competencies necessary for successful conflict resolution among the observed educators. Specifically, teachers frequently employed techniques informed by intuition rather than deliberate strategy learned in their training. Consequently, the study advocates for enhancing teachers’ cognitive and emotional competencies to optimize conflict management within the classroom and bolster their adaptive coping mechanisms.

PMID:39421838 | PMC:PMC11483860 | DOI:10.3389/fpsyg.2024.1407433

Front Psychol. 2024 Oct 3;15:1420834. doi: 10.3389/fpsyg.2024.1420834. eCollection 2024.

ABSTRACT

INTRODUCTION: The mental health of populations is usually affected after a disaster event. However, it is not known what the level of mental health of Chinese population 1 year after COVID-19, nor what factors influence it.

AIM: This study aimed to examine the mental health status of general population in Chengdu 1 year after COVID-19, and then analyse influencing factors.

METHOD: This study is a cross-sectional survey based on the SCL-90 questionnaire. Continuous data were described as M and SD, and counting data were described as frequencies(n) and percentages (%). Chi-square test or Fisher’s exact test were used for statistical inference, and significance variables were included in the binary logistic regression equation for multivariate analysis.

RESULTS: There were 172 participants with positive screening results. Age, marital status, number of kids, self-perceived health and the presence of chronic disease had an effect on screening results. Logistic regression analysis showed that age and self-perceived health were the main influencing factors.

DISCUSSION: Young people aged 18-19 and those who consider themselves not very healthy were at higher risk of poor mental health 1 year after the COVID-19 outbreak.

IMPACT STATEMENT: Community institutions and community workers should focus on the mental health status of people 1 year after COVID-19, with a focus on people with poor self-perceived health and younger age groups, and take early preventive measures.

PMID:39421837 | PMC:PMC11484628 | DOI:10.3389/fpsyg.2024.1420834

Front Public Health. 2024 Oct 3;12:1425904. doi: 10.3389/fpubh.2024.1425904. eCollection 2024.

ABSTRACT

BACKGROUND: In the sanitation sector, occupational injuries among sanitary workers (SWs) are prevalent due to hazardous working conditions and poor environmental surroundings. Despite the significant risks faced by these workers, the issue has received limited attention, and no comprehensive global meta-analysis on occupational injuries among sanitary workers has been conducted to date.

OBJECTIVE: In this study, we aimed to conduct a systematic review and meta-analysis of occupational injuries among sanitary workers globally from 2000 to 2023.

METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed for the screening process, and the Population, Intervention, Comparison, Outcome and Study (PICOS) framework was to formulate search questions. Published articles from 2000 to 2023 were retrieved using various search engines. The keywords used were as follows: “Occupation Job Injuries” *OR “Work Injuries” *OR “Occupational Injuries” AND “Sanitary workers” (“Street sweepers” [SS] *OR “health facilities cleaners” [HCFC]) *OR “Solid waste collectors” [SWCs] *OR “Sewage workers” [STW] were used. Data analysis was performed using Stata Version 17MP. The overall effect size was calculated using the random-effects model combined with the restricted maximum likelihood (REML) approach, known as the Random-Effect REML Model. A 95% confidence interval (CI: 95%) was applied, and a p-value of less than 0.05 was considered statistically significant.

RESULTS: Studies were sourced from PubMed (n = 34), Medline (n = 39), Embase (n = 23), Global Health (n = 37), other databases (n = 54), and review studies (n = 10), resulting in a total of 197 studies. Of these, only 23 studies fully met the inclusion criteria. Among 8,138 sanitary workers (SWs), 4,469 (55%) were solid waste collectors (SWCs), 2,317 (28%) were street sweepers (SS), 1,144 (14%) were health facility cleaners (HCFC), and 208 (3%) were a combination of SS and SWCs. Globally, the pooled prevalence of occupational injuries among SWs was 36.49% (95%CI: 0.29-0.45). Specifically, 39.14% (95%CI: 0.24-0.53) prevalence was observed in high-income countries, while 35.22% (95%CI: 0.36-0.44) was reported in low-income countries. Year-by-year analysis showed a prevalence of 36.70% (95%CI:0.28-0.46) from 2001 to 2015 and 36.45% (95% CI:0.25-0.48) from 2016 to 2022. The overall heterogeneity of the studies was substantial, with an I-squared value of 90.03% and a heterogeneity index of 214.43 (p < 0.05), indicating statistically significant heterogeneity among the eligible studies.

CONCLUSION: This systematic review and meta-analysis revealed that sanitation and hygiene workers face an increased risk of occupational injuries, largely due to insufficient attention to occupational safety and health services in their work environments. To mitigate these risks, the review recommends policy amendments, national regulations, and international initiatives aimed at improving occupational health and safety (OHS) services for these workers. These measures are crucial for reducing the prevalence of work-related injuries in the sanitation sector.

PMID:39421826 | PMC:PMC11483865 | DOI:10.3389/fpubh.2024.1425904

Front Public Health. 2024 Oct 3;12:1436236. doi: 10.3389/fpubh.2024.1436236. eCollection 2024.

ABSTRACT

INTRODUCTION: We analyzed the changes in the top 10 non-communicable diseases (NCDs) over the past century across the World Health Organization (WHO) regions.

MATERIALS AND METHODS: The data were extracted from the Global Burden of Disease (GBD) studies. After we accessed this source, all NCDs were sorted according to their prevalence in 2019, and the 10 most common NCDs were selected. Then, the incidence, prevalence, and mortality rates of these 10 NCDs were compared to the rates in 2000.

RESULTS: Diabetes and kidney disease had the highest increase in incidence (49.4%) and prevalence (28%) in the Eastern Mediterranean region. Substance use disorders had a huge increase (138%) in the mortality rates among women in the Americas region. On the other hand, women in Southeast Asia experienced the greatest decrease in incidence (-19.8%), prevalence (-15.8%), and mortality rates (-66%).

CONCLUSION: In recent years, nearly all NCDs have shown an increase, yet mortality rates have declined across all regions. Lifestyle can be a major cause of this increase, but advancements in health and medical services, such as screening and treatment, have played a crucial role in improving survival rates.

PMID:39421825 | PMC:PMC11484412 | DOI:10.3389/fpubh.2024.1436236

J Med Internet Res. 2024 Oct 17;26:e56192. doi: 10.2196/56192.

ABSTRACT

BACKGROUND: Barcode information management systems (BIMS) have been implemented in operating rooms to improve the quality of medical care and administrative efficiency. Previous research has demonstrated that the Agile development model is extensively used in the development and management of information systems. However, the effect of information systems on staff acceptance has not been examined within the context of clinical medical information management systems.

OBJECTIVE: This study aimed to explore the effects and acceptance of implementing a BIMS in comparison to the original information system (OIS) among operating and supply room staff.

METHODS: This study was a comparative cohort design. A total of 80 staff members from the operating and supply rooms of a Northern Taiwan medical center were recruited. Data collection, conducted from January 2020 to August 2020 using a mobile-based structured questionnaire, included participant characteristics and the Information Management System Scale. SPSS (version 20.0, IBM Corp) for Windows (Microsoft Corporation) was used for data analysis. Descriptive statistics included mean, SD, frequency, and percentage. Differences between groups were analyzed using the Mann-Whitney U test and Kruskal-Wallis test, with a P value <.05 considered statistically significant.

RESULTS: The results indicated that the BIMS generally achieved higher scores in key elements of system success, system quality, information quality, perceived system use, perceived ease of use, perceived usefulness, and overall quality score; none of these differences were statistically significant (P>.05), with the system quality subscale being closest to significance (P=.06). Nurses showed significantly better perceived system use than technicians (1.58, SD 4.78 vs -1.19, SD 6.24; P=.02). Significant differences in perceived usefulness were found based on educational level (P=.04) and experience with OIS (P=.03), with junior college-educated nurses and those with over 6 years of OIS experience reporting the highest perceived usefulness.

CONCLUSIONS: The study demonstrates that using the Agile development model for BIMS is advantageous for clinical environments. The high acceptance among operating room staff underscores its practicality and broader adoption potential. It advocates for continued exploration of technology-driven solutions to enhance health care delivery and optimize clinical workflows.

PMID:39418645 | DOI:10.2196/56192

JMIR Form Res. 2024 Oct 15. doi: 10.2196/62742. Online ahead of print.

ABSTRACT

BACKGROUND: Telemedicine has revolutionized healthcare by significantly enhancing accessibility. However, the acceptability and uptake of tele-medicine is prone to various hindering factors. Studies have shown that both patients and healthcare providers appreciate the aspect of convenience. However, healthcare providers’ limited understanding of or inability to leverage the technology involved can be a barrier. With advancements in telemedicine technologies, understanding the viewpoints of patients and providers is crucial for an effective and acceptable telemedicine service. This study reports findings from a usability study of HelixVM™, a telemedicine platform that uses an Artificial Intelligence (AI)-powered triage for healthcare delivery. We discuss aspects of asynchronous medicine, healthcare accessibility, saving time, productivity, data exchange, security, privacy, AI-powered triage and quality of care.

OBJECTIVE: To assess the usability and effectiveness of the HelixVM marketplace platform.

METHODS: We recruited 102 patients and 12 providers in a mixed-methods study design involving surveys, and in-depth structured interviews with a subset of the providers only. The survey questionnaires are a modified version of the telehealth utility questionnaire. We analyzed the patient’s data using descriptive statistics and factor analysis to identify latent demographic patterns. For the providers data, we used a deductive thematic analysis approach to identify key themes from the interviews and interpreted overall sentiments of the providers for negative, neutral or positive. We also calculated percentages of different responses for the providers from the surveys and interviews, where applicable.

RESULTS: Patients: Overall, 86% of patients are satisfied with HelixVM and 89% will use the services again. More than 90% of patients agreed that HelixVM improves access to healthcare, saves time and that the platform is an acceptable way to receive healthcare. Chi-square tests demonstrate statistical significance for all the survey questions (p-value <.001). Results from factor analysis show a higher propensity of female gender in middle age groups whose encounter type is fast-track, self-report medium level of tech-savviness and residing in the South regions of US rate the platform more positively. Providers: Thematic analysis identified themes of asynchronous medicine in terms of accessibility and quality of care, time and productivity, integration within the workflow, data exchange and AI-triage. Certain challenges of incomplete data in patient chart and its impact on provider time are cited. Suggestions for improvements include options to ensure completeness of patient questionnaires and better screening to ensure that only asynchronous ‘qualified’ patients get through to the provider.

CONCLUSIONS: Overall, our study findings indicate a positive experience for patients and providers. The use of fast-track prescription is favorable as compared to traditional telemedicine. Some concerns on data completeness, gaps and accuracy exist. Suggestions are provided for improvement. This study adds to the knowledgebase of existing literature and provides for a detailed analysis into the real-world implementation of a telemedicine market-place platform.

PMID:39418632 | DOI:10.2196/62742

JCO Glob Oncol. 2024 Oct;10:e2400060. doi: 10.1200/GO.24.00060. Epub 2024 Oct 17.

ABSTRACT

PURPOSE: The incidence of GI cancers is increasing in sub-Saharan African countries. We described the oncological care pathway and assessed presentation, diagnosis, and treatment intervals and delays among patients with GI cancer who presented to the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife, Nigeria.

METHODS: We analyzed data from 545 patients with GI cancer in the African Research Group for Oncology (ARGO) database. We defined presentation interval as the interval between symptom onset and presentation to tertiary hospital, diagnostic interval as between presentation and diagnosis, and treatment interval as between diagnosis and initiation of treatment. We considered >3 months, >1 month, and >1 month to be presentation, diagnosis, and treatment delays, respectively. We compared lengths of intervals using Mann-Whitney U tests and logistic regression.

RESULTS: The most frequent cancer types were pancreatic (32%) and colorectal (28%). Most patients presented at stages III (38%) and IV (30%). The median presentation interval was 84 days (IQR, 56-191), and 49% presented after 3 months or longer. The median diagnosis and treatment intervals were 0 (IQR, 0-8) and 7 (IQR, 0-23) days, respectively. There was no relationship between age, sex, education, or distance to tertiary hospital and presentation delay, but patients with stage III to IV versus I to II had higher odds of presentation delay (odds ratio [OR], 1.68 [95% CI, 1.13 to 2.50]). Among patients with pancreatic cancer, older patients were less likely to have a diagnosis delay (OR, 0.50 [95% CI, 0.25 to 0.98]).

CONCLUSION: About half of patients with GI cancer in Ile-Ife, Nigeria, did not present to tertiary hospitals until more than 90 days after noticing symptoms. Efforts are warranted to improve public knowledge of GI cancer symptoms and to strengthen health systems for prompt diagnosis and referral to specialty care.

PMID:39418630 | DOI:10.1200/GO.24.00060

JCO Glob Oncol. 2024 Oct;10:e2400318. doi: 10.1200/GO-24-00318. Epub 2024 Oct 17.

ABSTRACT

PURPOSE: Paclitaxel is effective chemotherapy against various cancers but can cause hypersensitivity reaction (HSR). This study aimed to identify predictors associated with paclitaxel HSR and develop a clinical prediction model to guide clinical decisions.

METHODS: Data were collected from the medical records database of Rajavithi Hospital. Patients with cancer treated with paclitaxel from 2015 to 2022 were included, and a multivariable logistic regression analysis identified predictors associated with paclitaxel HSR. The scoring system was transformed and calibrated on the basis of diagnostic parameters. Discrimination and calibration performances were assessed. Internal validation was conducted using bootstrap resampling with 1,000 replications.

RESULTS: This study involved 3,708 patients with cancer, with an incidence of paclitaxel HSR of 10.11%. An 11-predictor-based Pac-HSR scoring system was developed, involving the following factors: younger age; poor Eastern Cooperative Oncology Group performance status; previous history of paclitaxel HSR; medication allergy history; chronic obstructive airway disease; lung and cervical cancers; high actual dose of paclitaxel; no diphenhydramine premedication; low hemoglobin level; high WBC count; and high absolute lymphocyte count. The C-statistics was 0.73 (95% CI, 0.70 to 0.76), indicating acceptable discrimination. The P value of the Hosmer-Lemeshow goodness-of-fit test was 0.751. The ratio of observed and expected values was 1.00, indicating good calibration. At a cutoff point of 8, specificity was 75.28% and sensitivity was 57.07%. Internal validation indicated good performance with minimal bias, and decision curve analysis demonstrated improved prediction with the use of this scoring system in clinical decision making.

CONCLUSION: This study developed the 11-predictor-based Pac-HSR scoring system for predicting paclitaxel HSR in patients with cancer. High-risk patients identified by this score should be prioritized for close monitoring and early treatment prophylaxis.

PMID:39418625 | DOI:10.1200/GO-24-00318