Category: Statistics

Respir Res. 2024 Jun 21;25(1):255. doi: 10.1186/s12931-024-02883-2.

ABSTRACT

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a devastating interstitial lung disease (ILD) with a high mortality rate. The antifibrotic medications pirfenidone and nintedanib have been in use since 2014 for this disorder and are associated with improved rate of lung function decline. Less is known about their long-term outcomes outside of the clinical trial context.

METHODS: The Pulmonary Fibrosis Foundation Patient Registry was used for this study. Patients with an IPF diagnosis made within a year of enrollment were included. The treated group was defined as patients receiving either pirfenidone or nintedanib for at least 180 days. The untreated group did not have any record of antifibrotic use. Demographic data, comorbidities, serial lung function, hospitalization, and vital status data were collected from the registry database. The primary outcomes were transplant-free survival, time to first respiratory hospitalization, and time to 10% absolute FVC decline. Time-to-event analyses were performed utilizing Cox proportional hazards models and the log-rank test. Model covariates included age, gender, smoking history, baseline lung function, comorbidities, and oxygen use.

RESULTS: The registry contained 1212 patients with IPF; ultimately 288 patients met inclusion criteria for the treated group, and 101 patients were designated as untreated. Patients treated with antifibrotics were significantly younger (69.8 vs. 72.6 years, p = 0.008) and less likely to have smoked (61.1% ever smokers vs. 72.3% never smokers, p = 0.04). No significant differences were seen in race, gender, comorbidities, or baseline pulmonary function between groups. The primary outcome of transplant-free survival was not significantly different between the two groups (adjusted HR 0.799, 95% CI 0.534-1.197, p = 0.28). Time to respiratory hospitalization was significantly shorter in the treated group (adjusted HR 2.12, 95% CI 1.05-4.30, p = 0.04). No significant difference in time to pulmonary function decline was seen between groups.

CONCLUSIONS: This multicenter study demonstrated 63% of newly diagnosed IPF patients had continuous antifibrotic usage. Antifibrotics were not associated with improved transplant-free survival or pulmonary function change but was associated with an increased hazard of respiratory hospitalization. Future studies should further investigate the role of antifibrotic therapy in clinically important outcomes in real-world patients with IPF and other progressive ILDs.

PMID:38907239 | DOI:10.1186/s12931-024-02883-2

BMC Med Ethics. 2024 Jun 21;25(1):73. doi: 10.1186/s12910-024-01073-5.

ABSTRACT

BACKGROUND: Studies from different countries report a stagnation or regression of moral competence in medical students between the first and the last year of their studies, and the value of various educational interventions remains uncertain.

METHODS: We used Moral Competence Test (MCT) to measure C-scores of moral competence to determine the change in the MCT C-scores between the first- and the fifth-year medical students from two medical schools in the Czech Republic in the academic year 2022/2023 and to analyze factors associated with the C-scores (observational study). In addition, for the first-year students, we compared the results of the MCT before and after an intervention in medical ethics curriculum (interventional study). We used a cross-sectional and descriptive design for the observational study. Students completed the MCT, consisting of two moral dilemmas (Worker´s Dilemma and Doctor´s Dilemma), the results measured by the C-score, which represents moral competence.

RESULTS: In total, 685 students participated in the observational study. Objective 1: based on the analysis of the C-score, we observed a decrease in moral competence between the first and the fifth-year medical students (p < .001). Objective 2: we did not observe a statistically significant effect of gender (p = .278), or self-rated religiosity (p = .163). Objective 3: in the interventional study, 440 students participated in the pretest and 422 students participated in the posttest. The test of statistical significance found no improvement in students’ moral competence after the intervention (p = .253).

CONCLUSION: Medical students show a regression in moral competence during medical education; it was lower in medical students in their fifth year, compared to the first-year medical students without the effect of gender, or self-rated religiosity. Although educational intervention consisting of multiple tools of medical ethics teaching (PBL, CBL, KMDD and StorED) did not lead to increase in moral competence, the longitudinal effect of such intervention remains to be seen.

PMID:38907238 | DOI:10.1186/s12910-024-01073-5

BMC Ophthalmol. 2024 Jun 21;24(1):265. doi: 10.1186/s12886-024-03528-0.

ABSTRACT

BACKGROUND: Retinopathy of prematurity (ROP) is a proliferative disorder of the developing retina. Intravitreal bevacizumab injection (IVB) is an emerging treatment for severe forms of ROP, which does not restrict the visual field in comparison to laser therapy. The present study aimed to determine and evaluate the risk factors for ROP recurrence following IVB injection.

MATERIALS AND METHODS: In this retrospective study, 98 eyes of 49 infants with ROP who had received IVB injections as the primary treatment for type 1 ROP are included.

RESULTS: Fifty-four eyes (55.1%) had aggressive retinopathy of prematurity (A-ROP), and forty-four (44.9%) had Stage III Plus ROP in Zone II. ROP recurred in 13 eyes (13.26%) of 8 infants. The mean period between IVB and the ROP recurrence was 8.08 (95% CI:5.32-10.83) weeks. The infants who had ROP recurrence had lower birth weight (P value = 0.002), lower postmenstrual age at IVB injection (P value = 0.001), lower IVB injection gap period from birth (P value = 0.044), higher oxygen therapy requirement rate after IVB injection (P value < 0.001, OR:19.0) and higher oxygen therapy duration (P value = 0.006). The ROP severity, gestational age at birth, and diet were not statistically different between the recurrence and complete regression groups. Out of 13 eyes treated with laser photocoagulation because of ROP relapse, macula dragging occurred in one eye, and all the cases met the complete regression.

CONCLUSION: Low birth weight and oxygen therapy are the most important risk factors for ROP relapse, which requires meticulous oxygen treatment guidelines for premature infants.

PMID:38907228 | DOI:10.1186/s12886-024-03528-0

BMC Womens Health. 2024 Jun 21;24(1):361. doi: 10.1186/s12905-024-03148-2.

ABSTRACT

BACKGROUND: Pregnancy; It is an important process that directly affects the mother and the fetus, where women benefit more from health services and the need for health-related decision-making and information increases. It is very important to determine and improve the health literacy level of these women. The study determined the relationship between vaccine hesitancy and health literacy in pregnant women.

METHODS: It is a cross-sectional type of research. The research was carried out in a state hospital. The online form was sent to 230 pregnant women. Ethics committee, institution and scale permissions were obtained for the study. The data of the study were collected online by using the questionnaire prepared by scanning the literature, the Anti-Vaccination Scale and the Health Literacy Scale. Statistical analyzes of the data were performed using the SPSS version 25 program.

RESULTS: The Vaccine Hesitancy Scale score of the pregnant women was 55.53 ± 10.15, whereas their Health Literacy Scale score was 98.57 ± 21.48. Health literacy was associated with the sociodemographic and obstetric characteristics of the pregnant women. Educational status, economic status, place of residence, and family structure were associated with vaccine hesitancy.

CONCLUSIONS: It was determined that there was a negative correlation between the anti-vaccination scale scores of the pregnant women and the health literacy scale scores. As a result, it was determined that the anti-vaccination level of the pregnant women was moderate and the health literacy level was sufficient. It can be recommended to provide appropriate trainings and counseling to target groups, which will increase the health literacy level of pregnant women.

PMID:38907226 | DOI:10.1186/s12905-024-03148-2

Nutr J. 2024 Jun 21;23(1):66. doi: 10.1186/s12937-024-00954-0.

ABSTRACT

BACKGROUND: Healthy eating habits at a young age are crucial to support growth and development and good general health. In this context, monitoring youth dietary intakes adequately with valid tools is important to develop efficient interventions and identify groups that are more at risk of inadequate intakes. This study aimed to assess the relative validity of the self-administered web-based 24-h dietary recall (R24W) for evaluating energy and nutrient intakes among active adolescents.

METHODS: Participants were invited to complete one interviewer-administered 24-h dietary dietary recall and the R24W on up to three occasions within one month. A total of 272 French-speaking active adolescents aged 12 to 17 years from the province of Québec were invited to complete three R24W and one interview-administered 24-h recall. Student’s t-test and correlations were conducted on sex-adjusted data. Percent differences, cross-classification (percentage of agreement), weighted Kappa and Bland-Altman plots were calculated.

RESULTS: Mean (SD) energy intake from the R24W was 8.8% higher than from the interview-administered 24-h dietary recall (2558 kcal ± 1128 vs. 2444 kcal ± 998, p < 0.05). Significant differences in mean nutrient intake between the R24W and the interview-administered 24-h dietary recall ranged from 6.5% for % E from fat (p < 0.05) to 25.2% for saturated fat (p < 0.001), i.e., higher values with R24W. Sex-adjusted correlations were significant for all nutrients except for % E from proteins and thiamin (range: 0.24 to 0.52, p < 0.01). Cross-classification demonstrated that 36.6% of the participants were classified in the same fourth with both methods, 39.6% in the adjacent fourth, and 5.7% misclassified. Bland-Atman plots revealed proportional bias between the two methods for 7/25 nutrients. Completing at least two recalls with the R24W increased the precision of intake estimates.

CONCLUSION: These data suggest that the R24W presents an acceptable relative validity compared to a standard interview-administered 24-h recall for estimating energy and most nutrients in a cohort of French-speaking adolescents from the province of Québec.

PMID:38907225 | DOI:10.1186/s12937-024-00954-0

BMC Public Health. 2024 Jun 21;24(1):1658. doi: 10.1186/s12889-024-19080-x.

ABSTRACT

BACKGROUND: Dietary changes are necessary to improve population health and meet environmental sustainability targets. Here we analyse the impact of promotional activities implemented in UK supermarkets on purchases of healthier and more sustainable foods.

METHODS: Three natural experiments examined the impact of promotional activities on sales of a) no-added-sugar (NAS) plant-based milk (in 199 stores), b) products promoted during ‘Veganuary’ (in 96 stores), and c) seasonal fruit (in 100 non-randomised intervention and 100 matched control stores). Data were provided on store-level product sales, in units sold and monetary value (£), aggregated weekly. Predominant socioeconomic position (SEP) of the store population was provided by the retailer. Analyses used interrupted time series and multivariable hierarchical mixed-effects models.

RESULTS: Sales of both promoted and total NAS plant-based milks increased significantly during the promotional period (Promoted:+126 units, 95%CI: 105-148; Overall:+307 units, 95%CI: 264-349). The increase was greater in stores with predominately low SEP shoppers. During Veganuary, sales increased significantly for plant-based foods on promotion (+60 units, 95%CI: 37-84), but not for sales of plant-based foods overall (dairy alternatives: -1131 units, 95%CI: -5821-3559; meat alternatives: 1403 units, 95%CI: -749-3554). There was no evidence of a change in weekly sales of promoted seasonal fruit products (assessed via ratio change in units sold: 0.01, 95%CI: 0.00-0.02), and overall fruit category sales slightly decreased in intervention stores relative to control (ratio change in units sold: -0.01, 95%CI: -0.01-0.00).

CONCLUSION: During promotional campaigns there was evidence that sales of plant-based products increased, but not seasonal fruits. There was no evidence for any sustained change beyond the intervention period.

PMID:38907224 | DOI:10.1186/s12889-024-19080-x

BMC Oral Health. 2024 Jun 21;24(1):714. doi: 10.1186/s12903-024-04503-3.

ABSTRACT

BACKGROUND: A pulp stone is a calcified mass that develops in the dental pulp of any tooth. Despite many studies examining the relationship between pulp stone formation and non-oral factors, the methods used in these studies have been unable to explain the exact role of these factors alone as distinct from probable effects within the oral cavity environment. Considering that totally unerupted (impacted or developing) teeth are unexposed to the oral cavity’s environmental and functional conditions, they provide a more suitable material for studying the effects of these non-oral factors on pulp stone formation. This research study aimed to investigate pulp stones in unerupted teeth and the associated factors in a Saudi subpopulation.

METHODS: The study included 644 cone-beam computed tomography images, with 496 (50.9%) maxillary and 479 (49.1%) mandibular teeth. Of the investigated patients, 293 (45.5%) were men, and 351 (54.5%) were women. The age range was 15-76 years. A chi-square test was used to investigate the associations between pulp stones and age, gender, and history of systemic disease and chronic medication use.

RESULTS: Pulp stones in unerupted teeth were present in 24.2% of the examined dental jaws and 18.6% of the examined teeth. There was no statistically significant relationship between pulp stones and gender (p > 0.05). A significantly greater percentage of pulp stones were found with increasing age (p = 0.000). Additionally, a significantly increased number of pulp stones was observed in patients with systemic diseases and chronic medications (p < 0.05).

CONCLUSIONS: The results support the idea that pulp stones can be present in any type of unerupted tooth. This study provides additional evidence of the increased incidence of pulp stones with age, systemic disease, and chronic medications.

PMID:38907221 | DOI:10.1186/s12903-024-04503-3

Mar Pollut Bull. 2024 Jun 20;205:116596. doi: 10.1016/j.marpolbul.2024.116596. Online ahead of print.

ABSTRACT

Since the 21st century, the Beibu Gulf area has been affected by increasing anthropogenic activities, which makes the coastal aquatic ecosystem extremely concerning. However, the comprehensive exploration and analysis of the long-term scale behavior change characteristics of various water quality environment factors is still limited. Through comprehensively detecting coastal surface water environmental behavior information from 33 locations in the Beibu Gulf from 2005 to 2015, we revealed and quantified mutual response characteristics and patterns of various environmental indicators. The main environmental pollution indicators (e.g., COD, NH₄⁺, NO₃^–, and DIP) showed a gradual decrease in concentration from the coast to the offshore sea area, and significantly increases during the wet season. The semi-enclosed Maowei Sea exhibited the most prominent performance with significant differences compared to other regions in Beibu Gulf. The average Chlorophyll-a (Chla) content in the coastal area of the Beibu Gulf during the wet season was more than twice that of the dry season, yet the interaction pattern between Chla and environmental factors in the two seasons was opposite to its concentration behavior, accompanied by a closely significant relationship with thermohaline structure and the input of nitrogen and phosphorous nutrients. The multivariate statistical analysis results of total nutrient dynamics suggested that the Beibu Gulf was clearly divided into different regions in both dry and wet season clusters. The present study can provide a comprehensive perspective for the spatial and temporal migration patterns and transformation laws of coastal water environmental factor, which should contribute to improve the prevention countermeasure of nutrient pollution in coastal environment.

PMID:38905738 | DOI:10.1016/j.marpolbul.2024.116596

J Neurosurg. 2024 Jun 21:1-12. doi: 10.3171/2024.4.JNS232968. Online ahead of print.

ABSTRACT

OBJECTIVE: The onco-functional balance represents the primary goal in neuro-oncology. The increasing use of navigated transcranial magnetic stimulation (nTMS) allows the noninvasive characterization of cortical functional anatomy, and its reliability for motor and language mapping has previously been validated. Calculation and arithmetic processing has not been studied with nTMS so far. In this study, the authors present their preliminary data concerning nTMS calculation.

METHODS: The authors designed a monocentric prospective study, adopting an internal protocol to use nTMS for preoperative planning, including arithmetic processing. When awake surgery was possible, according to the patients’ conditions, nTMS points were used to guide direct cortical stimulation (DCS), i.e., the gold standard for cortical mapping. Navigated TMS-based tractography was used for surgical planning. Statistical analyses on the nTMS and DCS points were performed.

RESULTS: From February 2021 to October 2023, 61 procedures for nTMS calculation mapping were performed. The clinical evaluation, including pre- and postoperative evaluations (3 months after surgery), demonstrated a good clinical outcome with preservation of arithmetic function and recovery (92.8% of patients). Between the awake and asleep surgery groups, the postoperative clinical results were comparable at the 3-month follow-up, with > 90% of the patients achieving improved calculation function. The surgical strategy adopted was aimed at sparing nTMS positive points in asleep procedures, whereas nTMS and DCS positive points were not removed in awake procedures. Overall, 62% of the positive points for calculation functions were exposed by craniotomy and 85% were spared during surgery. None of the patients developed nTMS-related seizures. Diffusion tensor imaging fiber tracking based on nTMS positive points for calculation was used. The white matter fiber tracts involved in calculation functions were the arcuate fasciculus (56%) and frontal aslant tract (22%). When nTMS and DCS points were compared in awake surgery (n = 10 patients), a sensitivity of 31.71%, specificity of 85.76%, positive predictive value of 22.41%, negative predictive value of 90.64%, and accuracy of approximately 69% were achieved.

CONCLUSIONS: Based on the authors’ preliminary data, nTMS can be an advantageous tool to study cognitive functions, aimed at minimizing neurological impairment. The postoperative clinical outcome for patients who underwent operation with nTMS was very good. Considering these results, nTMS has proved to be a feasible method to map cognitive areas including those for calculation functions. Further analyses are needed to validate these data. Finally, other cognitive functions (e.g., visuospatial) may be explored with nTMS.

PMID:38905716 | DOI:10.3171/2024.4.JNS232968

J Osteopath Med. 2024 Jun 24. doi: 10.1515/jom-2024-0001. Online ahead of print.

ABSTRACT

CONTEXT: Anxiety disorders have a far-reaching impact on society, with profound implications on both mental and physical health. In response, there is growing interest in manual therapy modalities, with emerging research suggesting their potential to alleviate related symptoms.

OBJECTIVES: To establish a consensus regarding manual therapy modalities for addressing anxiety symptoms, a systematic review of current literature was conducted.

METHODS: A literature search was conducted between May and August 2023, utilizing a systematic search on both PubMed and Google Scholar, adhering to the defined inclusion criteria. In addition, information was gathered utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Both authors (KLW and TH) conducted the literature review. The inclusion criteria include articles written in English, peer-reviewed, anxiety conditions documented, and manual therapy delivered by a respectfully qualified professional. Manual therapy modalities include massage therapy, osteopathic manipulative treatment (OMT), foot reflexology, acupressure, manual therapy, healing touch, therapeutic touch, and gentle touch. After initial data collection, both researchers independently screened articles utilizing two metrics: a level of evidence (LOE) table and a screening criterion incorporating unique elements from the search process. The quality of the included articles was assessed utilizing Strength of Recommendation Taxonomy (SORT). When reviewer discrepancies arose, authors reread full-text studies and discussed the inclusion and exclusion criteria to achieve consensus.

RESULTS: The data searches identified 8,979 articles, with 239 articles remaining after duplicates and nonapplicable articles were removed. A total of 42 articles met the inclusion criteria, with only 40 articles able to be obtained for full-article review. After full review and the exclusion of articles with invalid author conclusions, meta-analysis, or systematic reviews, 34 articles were included in the review. All articles received an LOE rating of 2 or better and aligned with our specific screening criteria. Based on SORT, each modality was assigned a “B” rating. Among the included articles, n=27 demonstrated statistical significance in favor of manual therapy modalities as an anxiety treatment. The positive results for the aforementioned manual therapies on anxiety symptom improvement are shown: 15/18 (83 %) massage therapy, 2/6 (33 %) OMT, 5/5 (100 %) foot reflexology, 1/1 (100 %) acupressure, 1/1 (100 %) manual therapy, 0/2 (0 %) healing touch, 1/1 (100 %) therapeutic touch, and 1/1 (100 %) gentle touch.

CONCLUSIONS: A pattern emerged, wherein individuals receiving manual therapy interventions displayed a statistically significant reduction in anxiety intensity. Considering the positive results, manual therapy should be considered an effective strategy for anxiety management.

PMID:38905700 | DOI:10.1515/jom-2024-0001