Category: Statistics

Games Health J. 2024 Jun 21. doi: 10.1089/g4h.2024.0092. Online ahead of print.

ABSTRACT

The “red potion,” inspired by video games, emulates the health point replenishment mechanism for injured game characters. Conversely, red ginger, known for its potential tonic properties in enhancing cardiovascular endurance, poses challenges in acquisition within specific regions. Several previous studies have highlighted the existence of an inseparable link when gamers are engaged in real-world activities, even without actively playing the game in the virtual world. This suggests the potential for the “red potion” concept to enhance the well-being of gamers in reality. A statistical ANOVA experiment involved 90 participants, all avid gamers, categorized into three groups: basic, placebo, and experimental. The basic group (BG) received a red-colored beverage without red ginger infusion or the ‘red potion’ concept. In contrast, the placebo group (PG) received a similar beverage described as a “red potion” but without red ginger. Lastly, the experimental group (EG) received a red ginger-infused beverage without the “red potion” concept. Despite receiving different treatments, all beverages were presented in the same red color. Participants underwent the “beep test” to assess their baseline stamina. The results revealed that both PG and EG exhibited comparable cardiovascular endurance, affirming the potential of the “red potion” concept to positively influence gamers.

PMID:38904083 | DOI:10.1089/g4h.2024.0092

Med Pr. 2024 Jun 20:187809. doi: 10.13075/mp.5893.01453. Online ahead of print.

ABSTRACT

BACKGROUND: Students of medical universities, future employees, will have an impact on the shaping healthcare system. It is important to know and understand their opinions on the factors affecting working conditions and, consequently, changes necessary to improve effectiveness of health care. Students’ expectations can contribute to the changing working conditions for graduates and bring added value to health system redefinition.

MATERIAL AND METHODS: The study used factor analysis to check whether its use was justified. Reliability analysis was performed and structure indicators were determined for each question. The anonymous survey was conducted from September 2017 until March 2018; 1205 students were randomly selected for the sample.

RESULTS: Eighty percent of the students declared interest in healthcare changes, >50% reported that the main factors influencing the work were competencies, financing, medical equipment and organization. Over 90% of the respondents indicated too long wait times for an appointment with a specialist and admission to hospital as the reason for the low efficiency of healthcare, whereas >80% of the survey participants considered insufficient funding to be a barrier. The need for changing the financing scheme was underlined by >90% of the students, and of health priorities by about 80%. Approximately 71% of the respondents were in favour of limiting the role of government in decision-making processes and introducing changes into the education system.

CONCLUSIONS: Students’ views on organizational and financial factors of working conditions can contribute to improvement in systemic solutions at both micro and macro levels. Limiting the role of politicians in planning and implementing reforms can motivate employees to be more creative and decisive. Analysis of opinions can bring added value to health policy and systemic changes and should be extended by further research results after the COVID-19 pandemic. Students’ interest in healthcare reform encourages reflection on enriching education with managerial skills. Med Pr Work Health Saf. 2024;75(4).

PMID:38904078 | DOI:10.13075/mp.5893.01453

Gut Liver. 2024 Jun 21. doi: 10.5009/gnl230143. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Liver transplantation is the most effective treatment for the sickest patients with acute-on-chronic liver failure (ACLF). However, the influence of donor age on liver transplantation, especially in ACLF patients, is still unclear.

METHODS: In this study, we used the data of the Scientific Registry of Transplant Recipients. We included patients with ACLF who received liver transplantation from January 1, 2007, to December 31, 2017, and the total number was 13,857. We allocated the ACLF recipients by age into group I (donor age ≤17 years, n=647); group II (donor age 18-59 years, n=11,423); and group III (donor age ≥60 years, n=1,787). Overall survival (OS), graft survival, and mortality were compared among the three age groups and the four ACLF grades. Cox regression was also analyzed.

RESULTS: The 1-, 3-, and 5-year OS rates were 89.6%, 85.5%, and 82.0% in group I; 89.4%, 83.4%, and 78.2% in group II; and 86.8%, 78.4%, and 71.4% in group III, respectively (p<0.001). When we analyzed the different effects of donor age on OS with different ACLF grades, in groups II and III, we observed statistical differences. Finally, the cubic spline curve told us that the relative death rate changed linearly with increasing donor age.

CONCLUSIONS: Donor age is related to OS and graft survival of ACLF patients after transplantation, and poorer results were associated with elderly donors. In addition, different donor ages have different effects on recipients with different ACLF grades.

PMID:38904075 | DOI:10.5009/gnl230143

iScience. 2024 May 27;27(6):110125. doi: 10.1016/j.isci.2024.110125. eCollection 2024 Jun 21.

ABSTRACT

The UN (United Nations) collects global data on the country-level Percentage of Population Residing in Urban Area (PPRUA). However, variations in urban definitions make these data incomparable across countries. This study assesses national defined PPRUA within UN statistics against estimates we derived using global comparable definitions. Refer to the UN’s Degree of Urbanization framework, we propose 90 global harmonized methods for estimating PPRUA by combining different configurations of three global population datasets, six urban total population thresholds, and five urban population density thresholds. This approach demonstrated significant variations in country-level PPRUA estimations, with wide 95% confidence intervals using the Z score method. Most national defined PPRUA fall between the upper 95% CI and the median of the estimations, underscoring the need for globally harmonious PPRUA estimates. This study advocates for a reassessment of datasets and thresholds in the future and for investigating urbanization on a scale beyond the country level.

PMID:38904069 | PMC:PMC11186970 | DOI:10.1016/j.isci.2024.110125

PCN Rep. 2024 Jun 18;3(2):e212. doi: 10.1002/pcn5.212. eCollection 2024 Jun.

ABSTRACT

AIM: Given the escalating prevalence of autism spectrum disorder (ASD), the persistent paucity of child psychiatrists in Japan, and the need to prepare for unforeseen situations, such as the COVID-19 pandemic, it is essential to establish a reliable screening tool. This study aims to validate the Infant Behavior Checklist (IBC) developed by Japanese experts and determine its appropriate cut-off score.

METHODS: A total of 354 clinic-referred children, along with their caregivers, participated in this research. Clinical records, including diagnoses established through the sub-structured diagnostic interviews, and the IBC assessments, were subjected to rigorous statistical analysis.

RESULTS: Among the 24 items, six failed to reach significance to differentiate ASD from non-ASD cases. The Cronbach’s alpha coefficient for the IBC was calculated at 0.77. The IBC total score for ASD cases was significantly higher than that of non-ASD cases. With the chosen cut-off score, the IBC demonstrated an area under the ROC curve of 0.803, along with sensitivity, specificity, positive predictive value, and negative predictive value of 8.03, 0.79, 0.69, 0.34, and 0.94, respectively.

CONCLUSION: The IBC exhibits satisfactory internal consistency and content and discriminant validity. The high sensitivity and other associated indices for the optimal cut-off score of the IBC affirm its validity as a screening instrument for ASD. Nevertheless, further investigations are warranted to ascertain the clinical utility of the IBC.

PMID:38904062 | PMC:PMC11187909 | DOI:10.1002/pcn5.212

Front Endocrinol (Lausanne). 2024 Jun 6;15:1322253. doi: 10.3389/fendo.2024.1322253. eCollection 2024.

ABSTRACT

OBJECTIVE: Evidence has been increasingly pointing towards a potential link between phenotypes related to obesity and the incidence of colorectal cancer. However, confirming this as a direct causal connection remains elusive. This investigation aims to elucidate the causative links between obesity-associated phenotypes and the incidence of colorectal cancer.

METHODS: Employing the Two Sample Mendelian Randomization (TwoSampleMR) R package, analyses were conducted using Mendelian randomization (MR) to discern potential causative links between obesity categories sourced from both the Institute for Education and University (IEU) Open GWAS Project and Zenodo, and colorectal tumors (data obtained from IEU Open GWAS and FinnGen). For primary evaluations, the study utilized the Wald ratio and the Inverse Variance Weighting (IVW) methods, while the MR-Egger approach was integrated for sensitivity assessment. Bidirectional Mendelian Randomization (Bidirectional MR), as well as Linkage Disequilibrium (LD) Score Regression with well-imputed HapMap3 single nucleotide polymorphisms (SNPs), were additionally executed. Sensitivity assessments entailed IVW, MR-Egger methodologies to assess heterogeneity and pleiotropy, along with a leave-one-out strategy. Instrumental variables were chosen judiciously based on predetermined P-value thresholds and F-statistics.

RESULTS: Results from MR evaluations did not identify a clear causative link between BMI and colorectal malignancy. Conversely, both measures of obesity, the Waist-Hip Ratio (WHR) and its adjusted form for BMI (WHRadjBMI), displayed a connection to increased risk of colorectal cancer, especially prominent among female subjects. Reverse MR analyses dismissed potential reverse causality between colorectal malignancies and obesity. A significant genetic interplay was observed between WHR, WHRadjBMI, and colorectal cancer instances. Ensuing MR probes spotlighted inflammatory bowel ailment as a protective factor, while salad intake was indicated as a potential risk concerning colorectal malignancies. Sensitivity reviews, which included tests for both pleiotropy and heterogeneity, validated the robustness of the MR findings.

CONCLUSION: Findings from this research indicate that specific obesity-related parameters, notably WHR and WHRadjBMI, carry a causal relationship with an elevated colorectal cancer risk. The impact is distinctly more evident among females. Such insights might be pivotal for public health deliberations, hinting that individuals boasting a high WHR might necessitate intensified colorectal cancer screenings.

PMID:38904048 | PMC:PMC11187001 | DOI:10.3389/fendo.2024.1322253

Front Endocrinol (Lausanne). 2024 Jun 5;15:1348310. doi: 10.3389/fendo.2024.1348310. eCollection 2024.

ABSTRACT

OBJECTIVES: The relationship between cathepsins and prostate cancer (PCa) has been reported. However, there is a lack of research on cathepsins and benign prostate diseases (BPDs). This study investigated the potential genetic link between cathepsins and BPDs through the utilization of Mendelian randomization (MR) analysis to determine if a causal relationship exists.

METHODS: Publicly accessible summary statistics on BPDs were obtained from FinnGen Biobank. The data comprised 149,363 individuals, with 30,066 cases and 119,297 controls for BPH, and 123,057 individuals, with 3,760 cases and 119,297 controls for prostatitis. The IEU OpenGWAS provided the Genome-wide association data on ten cathepsins. To evaluate the causal relationship between BPDs and cathepsins, five distinct MR analyses were employed, with the primary method being the inverse variance weighted (IVW) approach. Additionally, sensitivity analyses were conducted to examine the horizontal pleiotropy and heterogeneity of the findings.

RESULTS: The examination of IVW MR findings showed that cathepsin O had a beneficial effect on BPH (IVW OR=0.94, 95% CI 0.89-0.98, P=0.0055), while cathepsin X posed a threat to prostatitis (IVW OR=1.08, 95% CI 1.00-1.16, P=0.047). Through reverse MR analysis, it was revealed that prostatitis had an adverse impact on cathepsin V (IVW OR=0.89, 95% CI 0.80-0.99, P=0.035), while no favorable association was observed between BPH and cathepsins. The results obtained from MR-Egger, weighted median, simple mode, and weighted mode methods were consistent with the findings of the IVW approach. Based on sensitivity analyses, heterogeneity, and horizontal pleiotropy are unlikely to distort the results.

CONCLUSION: This study offers the initial evidence of a genetic causal link between cathepsins and BPDs. Our findings revealed that cathepsin O was beneficial in preventing BPH, whereas cathepsin X posed a potential threat to prostatitis. Additionally, prostatitis negatively affected cathepsin V level. These three cathepsins could be targets of diagnosis and treatment for BPDs, which need further research.

PMID:38904040 | PMC:PMC11188316 | DOI:10.3389/fendo.2024.1348310

Zhonghua Wei Chang Wai Ke Za Zhi. 2024 Jun 25;27(6):615-620. doi: 10.3760/cma.j.cn441530-20230724-00013.

ABSTRACT

Objective: To study the influence of neoadjuvant chemoradiotherapy on peritoneal wound recovery after abdominoperineal resection (APR). Methods: This was a retrospective cohort study of data of 219 patients who had been pathologically diagnosed with low rectal cancer and undergone APR in the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology between January 2018 and December 2021. Of these patients, 158 had undergone surgery without any pre-surgical treatment (surgery group), 35 had undergone surgery after neoadjuvant chemotherapy (neoadjuvant chemotherapy group), and 26 had undergone surgery after neoadjuvant chemoradiotherapy (neoadjuvant chemoradiotherapy group). The primary outcome was perineal wound complications occurring within 30 days. The status of wound healing was classified into the following three levels: Level A: abnormal wound seepage that improved after wound discharge; Level B: wound infection and dehiscence; and Level C: Level B plus fever. The patients’ general condition, tumor status, perianal wound healing level, and intra- and post-operative recovery were recorded. Results: None of the study patients had any complications during surgery. The duration of surgery was 240.0 (180.0-300.0) minutes, 240.0 (225.0-270.0) minutes and 270.0 (240.0-356.2) minutes in the surgery, neoadjuvant chemotherapy, and neoadjuvant chemoradiotherapy groups, respectively (H=6.508, P=0.039). The rates of perineal wound complications were 34.6% (9/26) and (22.9%, 8/35)in the neoadjuvant chemoradiotherapy group and the neoadjuvant chemotherapy group, being significantly higher than that in the surgery group (10.1%, 16/158). After adjusting for patient age and sex using a logistic regression model, the risk of complications was still higher in the neoadjuvant chemoradiotherapy than in the surgery group (OR=4.6, 95%CI: 1.7-12.7; OR=2.6, 95%CI: 1.0-6.8), these differences being statistically significant (both P<0.05). The duration of hospital stay was 9.5 (7.0-12.0) days, 10.0 (8.0-17.0) days and 11.5 (9.0-19.5) days for patients in the surgery, neoadjuvant chemotherapy, and neoadjuvant chemoradiotherapy groups, respectively (H=0.569, P=0.752). However, after adjusting for patient age and sex by using a generalized linear model, hospital stay was longer in the neoadjuvant chemoradiotherapy than in the surgery group (β [95% CI]: 4.4 [0.5-8.4], P=0.028). After surgery, 155 of 219 patients required further adjuvant chemotherapy. A higher proportion of patients with than without wound complications did not attend for follow-up (32.2% [10/31] vs. 16.1% [20/124]); this difference is statistically significant (χ²=4.133, P=0.023). Conclusions: In patients with low rectal cancer, neoadjuvant radiotherapy may be associated with an increased risk of perineal wound infection and non-healing.

PMID:38901995 | DOI:10.3760/cma.j.cn441530-20230724-00013

Zhonghua Wei Chang Wai Ke Za Zhi. 2024 Jun 25;27(6):591-599. doi: 10.3760/cma.j.cn441530-20231019-00140.

ABSTRACT

Objective: To analyze the differences in clinicopathological features of colon cancers and survival between patients with right- versus left-sided colon cancers. Methods: This was a retrospective cohort study. Information on patients with colon cancer from January 2016 to August 2020 was collected from the prospective registry database at Peking Union Medical College Hospital . Primary tumors located in the cecum, ascending colon, and proximal two-thirds of the transverse colon were defined as right-sided colon cancers (RCCs), whereas primary tumors located in the distal third of the transverse colon, descending colon, or sigmoid colon were defined as left-sided colon cancers (LCCs). Clinicopathological features were compared using the χ² test or Mann-Whitney U test. Survival was estimated by Kaplan-Meier curves and the log-rank test. Factors that differed significantly between the two groups were identified by multivariate survival analyses performed with the Cox proportional hazards function. One propensity score matching was performed to eliminate the effects of confounding factors. Results: The study cohort comprised 856 patients, with TNM Stage I disease, 391 (45.7%) with Stage II, and 336 (39.3%) with Stage III, including 442 (51.6%) with LCC and 414 (48.4%) with RCC and 129 (15.1%). Defective mismatch repair (dMMR) was identified in 139 patients (16.2%). Compared with RCC, the proportion of men (274/442 [62.0%] vs. 224/414 [54.1%], χ²=5.462, P=0.019), body mass index (24.2 [21.9, 26.6] kg/m² vs. 23.2 [21.3, 25.5] kg/m², U=78,789.0, P<0.001), and well/moderately differentiated cancer (412/442 [93.2%] vs. 344/414 [83.1%], χ²=22.266, P<0.001) were higher in the LCC than the RCC group. In contrast, the proportion of dMMR (40/442 [9.0%] vs. 99/414 [23.9%], χ²=34.721, P<0.001) and combined vascular invasion (106/442[24.0%] vs. 125/414[30.2%], χ²=4.186, P=0.041) were lower in the LCC than RCC group. The median follow-up time for all patients was 48 (range 33, 59) months. The log-rank test revealed no significant differences in disease-free survival (DFS) (P=0.668) or overall survival (OS) (P=0.828) between patients with LCC versus RCC. Cox proportional hazards model showed that dMMR was significantly associated with a longer DFS (HR=0.419, 95%CI: 0.204‒0.862, P=0.018), whereas a higher proportion of T3-4 (HR=2.178, 95%CI: 1.089‒4.359, P=0.028), N+ (HR=2.126, 95%CI: 1.443‒3.133, P<0.001), and perineural invasion (HR=1.835, 95%CI: 1.115‒3.020, P=0.017) were associated with poor DFS. Tumor location was not associated with DFS or OS (all P>0.05). Subsequent analysis showed that RCC patients with dMMR had longer DFS than did RCC patients with pMMR (HR=0.338, 95%CI: 0.146‒0.786, P=0.012). However, the difference in OS between the two groups was not statistically significant (HR=0.340, 95%CI:0.103‒1.119, P=0.076). After propensity score matching for independent risk factors for DFS, the log-rank test revealed no significant differences in DFS (P=0.343) or OS (P=0.658) between patients with LCC versus RCC, whereas patient with dMMR had better DFS (P=0.047) and OS (P=0.040) than did patients with pMMR. Conclusions: Tumor location is associated with differences in clinicopathological features; however, this has no impact on survival. dMMR status is significantly associated with longer survival: this association may be stronger in RCC patients.

PMID:38901992 | DOI:10.3760/cma.j.cn441530-20231019-00140

Zhonghua Yi Xue Za Zhi. 2024 Jun 25;104(24):2256-2259. doi: 10.3760/cma.j.cn112137-20240125-00192.

ABSTRACT

The clinical manifestations, biochemical and metabolic data, genetic variations and treatment data of children with MTHFR gene variant induced hyperhomocysteinemia admitted to Hangzhou Children’s Hospital and Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from November 2015 to September 2021 were analysed retrospectively. A total of 15 pediatric patients were included, including 10 males and 5 females, with onset ages ranging from 6 days to 18 years old and confirmed ages ranging from 40 days to 18 years old. One confirmed case was detected through neonatal screening, and the remaining 14 cases were all diagnosed through genetic diagnosis after onset. The main clinical manifestations were feeding difficulties, hypotonia, epilepsy, developmental delay. All patients had elevated levels of blood homocysteine, with blood homocysteine levels before and after treatment being (151.46±57.44) μmol/L and (69.96±32.88) μmol/L, significantly decreased after treatment compared with before treatment, with a statistically significant difference (P<0.001). The blood methionine level before the treatment was 9.40 (6.20, 11.96) μmol/L, normal or slightly decreased compared to the reference range. The methionine level returned to normal after treatment. A total of 19 MTHFR gene variants were detected, with 6 being unreported variants and 13 being known variants. c.1316C>T (p.L439P) was the most common variant(16.6%,5/30). All the patients had varied neurological damages, with 7 patients improved after metabolic therapy by carnitine and folinic acid, 8 patients experiencing developmental delay, and 1 patient experiencing frequent epilepsy. The clinical manifestations of MTHFR gene variation-related hyperhomocysteinemia are complex and variable. Early-onset and homozygous variants often have a poor prognosis. Blood homocysteine, blood amino acid analysis, serum total homocysteine assay and gene testing are helpful for early diagnosis.

PMID:38901983 | DOI:10.3760/cma.j.cn112137-20240125-00192