Category: Statistics

BMC Public Health. 2024 Dec 18;24(1):3468. doi: 10.1186/s12889-024-21054-y.

ABSTRACT

INTRODUCTION: Globally, there has been a decline in the age of menarche; the decline is higher in poorer countries than in richer ones. The measurement of the decline was based on the reported mean age at menarche (MAM) across the countries. There is a significant knowledge gap in investigating the generational decline in MAM in low- and median-income countries (LMC). In Nigeria, different studies have reported MAM, but none have attempted to investigate the generational shift in the reported MAM in girls residing in rural and urban areas. This review sought to understand if there is a rural-urban disparity in the MAM.

METHODS: Documents were searched in the relevant bibliometric database and Population intervention, comparison(s) and outcome (PICO) framework were used as eligibility criteria for extracting data from the documents based on some inclusion and exclusion criteria. The population are adolescent schoolgirls in rural and urban settlements in Nigeria. The comparator is the age of menarche of urban versus rural adolescent schoolgirls in Nigeria, while the mean age at menarche (MAM) is the outcome. Data quality assessment was done to critically appraise the included studies and enhance. Data were synthesized using narrative review, descriptive and inferential statistics.

RESULTS: Ten articles were included in the study, following the PRISMA framework. The overall mean evaluation of the risk of bias in the individual studies included in the review was computed to be 88%. Generally, there seems to be a decline in the age at menarche from 1976 to 2023. The rural MAM is higher than the urban MAM, and the gap between the two appears to be narrowing. The t-test showed no statistically significant mean differences between the rural and urban mean age at menarche (T = 2.1009, p value = 0.4679). The mean menarcheal age for girls in rural and urban areas is 13.44 and 13.04, respectively. There is a strong positive correlation between the rural and urban MAMs (Pearson = 0.93, p < 0.001). The Gaussian kernel estimated a bimodal distribution for rural girls, where they are most likely to experience menarche at 11 and 13 years, respectively, while urban girls are most likely to experience menarche at 13 years. In both locations, the incidence of menarche decreases just after the peak at 13 years.

CONCLUSION: Although rural girls have delayed menarche, there is no statistically significant mean difference between the age at menarche reported for rural and urban areas in Nigeria. Interventions in the form of counseling and reproductive education are recommended. The review provides a strong foundation for further research and policy development aimed at improving the health and well-being of adolescent girls in Nigeria and other similar settings.

PROSPERO REGISTRATION: CRD42024529497.

PMID:39695506 | DOI:10.1186/s12889-024-21054-y

BMC Ophthalmol. 2024 Dec 18;24(1):539. doi: 10.1186/s12886-024-03808-9.

ABSTRACT

BACKGROUND: Dry eye syndrome (DES) is common but lack of data in quality of life (QoL) of DES patients in Thailand. The primary outcome of this study was to determine QoL and health utility in patients of DES by EuroQol 5-domain (EQ-5D) of the 5-level version (5 L) instrument. The secondary outcome was comparison of the utility in the patients of DES classified by severity and causes including the autoimmune and non-autoimmune diseases.

METHOD: The study was a cross-sectional study at a hospital in the northern part of Thailand. The inclusions DES patients were followed by Tear Film and Ocular surface Society the Dry Eye WorkShop II definition. The EQ-5D-5 L (Thai version) descriptive system and the EQ visual analogue scale (VAS) was instrument for QoL evaluation.

RESULT: Total patients of DES were fifty-six. The most patients were female. The mean age was 57.7(± 13.9) years. The mean of EQ-5D-utility and EQ-VAS were 0.76 (± 0.18) and 72.56 (± 15.19), respectively. The mean of EQ-5D-utility in these patients who were classified by severity including mild, moderate and severe were 0.84 (± 0.16), 0.78 (± 0.14) and 0.71 (± 0.22), respectively. There is no statistic significant in the EQ-5D-utility and EQ-VAS among severity and the causes of these patients.

CONCLUSIONS: This study demonstrated the importance of assessing QoL in DES. The EQ-5D-utility was accorded with the severity of DES. However, no statistic significant was showed in the mean of EQ-5D-utility and EQ-VAS between the severity and between the causes including the autoimmune and non-autoimmune diseases of these patients.

PMID:39695504 | DOI:10.1186/s12886-024-03808-9

BMC Med Educ. 2024 Dec 18;24(1):1487. doi: 10.1186/s12909-024-06440-9.

ABSTRACT

BACKGROUND: A Bachelor’s degree in nursing is one of the most challenging programs in the field of medical sciences. As a result, maintaining students’ academic motivation at the desired level is a constant concern for policymakers and educational administrators. Furthermore, tackling complex ethical dilemmas is inherent in nursing, making the educational period an important moment to instill moral sensitivity and reinforce professional ethics in students. This study aimed to investigate the association between academic motivation and moral sensitivity among undergraduate nursing students.

METHODS: In this descriptive-correlational study, 265 undergraduate nursing students from the Abhar School of Nursing at Zanjan University of Medical Sciences in Iran were chosen using a census approach in 2024. The data collection tools included demographic surveys, the Academic Motivation Scale (AMS), and the Moral Sensitivity Questionnaire (MSQ), all completed online. The data were analyzed with SPSS version 16 software, which used descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, ANOVA, Pearson correlation, and multiple regression) with a significance level of 0.05.

RESULTS: Nursing students had average academic motivation and moral sensitivity ratings of 79.24 ± 14.05 and 121.12 ± 16.33, respectively. Furthermore, a significant relationship was found between the overall scores and all dimensions of academic motivation and moral sensitivity (p < 0.001). Additionally, 29.1% of the variance in moral sensitivity was explained by the dimensions of the student’s academic motivation.

CONCLUSION: This study’s findings revealed a link between academic motivation and moral sensitivity among nursing students. As a result, it is advised that levels of academic motivation be continually checked during the program. This will assist in identifying students at danger of losing motivation and allow for the development and execution of effective initiatives to improve their academic engagement.

PMID:39695501 | DOI:10.1186/s12909-024-06440-9

BMC Infect Dis. 2024 Dec 18;24(1):1424. doi: 10.1186/s12879-024-10312-4.

ABSTRACT

BACKGROUND: Bacteremia is prevalent in neonates, largely attributed to factors inherent in the neonatal period. However, the prevalence of proven bacteremia in Ethiopian neonates has not been previously synthesized. Accordingly, this systematic review and meta-analysis aimed to analyze the prevalence of bacteremia and pathogen profiles in neonates hospitalized for clinical sepsis in Ethiopia.

METHODS: This systematic review and meta-analysis followed the preferred reporting items for systematic review and meta-analysis (PRISMA) 2020. The literature search was conducted across five databases including PubMed, Google Scholar, Web of Science, Science Direct, and Research for Life spanning from January 2015 to July 2023. The search strategy used MeSH terms and involved screening titles and abstracts, reviewing full-text articles, and including only observational studies published in English within the specified timeframe. Data extraction and quality assessment were performed by three experienced reviewers using a validated data collection tool and the Joanna Briggs Institute quality assessment tool, respectively. The prevalence of neonatal bacteremia was determined through a random effects model, with heterogeneity among studies assessed using the Q statistic and the I² statistic. Publication bias was evaluated using a funnel plot and Egger’s regression test, and STATA version 16.0 was used for all analysis at 95% confidence level.

RESULTS: A meta-analysis of nine studies revealed a bacteremia prevalence of 40.0% (95% CI: 34.0-46.0%). Subgroup analysis indicated variations in prevalence based on regions and study designs, with Oromia at 44.0% (95% CI: 28.0, 61.0%) and Amhara at 39.0% (95% CI: 27.0, 51.0%). Longitudinal studies exhibited a higher prevalence (47.0%, 95% CI: 27.0-68.0%) compared to cross-sectional designs (38.0%, 95% CI: 32.0-44.0%). Gram-negative bacteria were identified as the predominant etiological agents, representing 59.5% (95% CI: 56.8-62.3%) of cases. Among the bacterial species, Staphylococcus aureus emerged as the most prevalent (20.0%, 95% CI: 18.0%, 22.0%), followed by coagulase-negative staphylococci and Klebsiella pneumoniae, each contributing to 17.0% (95% CI: 15.0%, 20.0%) of bacteremia cases.

CONCLUSION: The study revealed a significant high prevalence of bacteremia, with differences noted across regions and study designs. Key pathogens identified were Staphylococcus aureus, Klebsiella pneumoniae and coagulase-negative staphylococci. It is advisable to implement surveillance systems, targeted prevention strategies, diagnostic stewardship, and further research on regional variations and bacterial profiles to effectively enhance the ominous future.

PMID:39695487 | DOI:10.1186/s12879-024-10312-4

BMC Public Health. 2024 Dec 18;24(1):3451. doi: 10.1186/s12889-024-20988-7.

ABSTRACT

INTRODUCTION: Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Red blood cell indices (RBIs) are associated with CVD risk factors (CRFs) and easy to test, making them useful as a screening tool for early identification of individuals at high risk for CVDs.

METHODS: Data from 31,781 participants in the China National Health Survey conducted from 2012 to 2017 were analyzed. Linear and non-linear relationships between RBIs and CRFs (hyperuricemia, diabetes, dyslipidemia) were assessed using restricted cubic splines. Propensity score weighting was used to balance confounders between RBI groups in the multivariable logistic regression models.

RESULTS: Hemoglobin concentration, red blood cell count and hematocrit all showed a significant linear dose-response association with all CRFs (p values < 0.001). Higher RBIs levels were associated with increased risk of hyperuricemia, diabetes, high LDL, high triglycerides, and high total cholesterol, but decreased HDL. For example, compared to the lowest quantile of HGB, the highest quantile had a 26% (13-40%) higher risk for hyperuricemia, a 43% (25-63%) higher risk of diabetes, 87% (61%-1.18 fold) higher risk of high LDL, and 68% (52-85%) higher risk of high triglycerides. Non-linear relationships were revealed between RBIs and most CRFs except uric acid and glucose. Sex differences were observed, with stronger associations between RBIs and hyperuricemia in women but stronger links with high LDL in men.

CONCLUSIONS: Elevated RBIs indicated higher risk of multiple CRFs. These findings suggest incorporating RBIs into CVD screening strategies to facilitate early prevention efforts, with consideration of sex differences.

PMID:39695473 | DOI:10.1186/s12889-024-20988-7

BMC Geriatr. 2024 Dec 18;24(1):1001. doi: 10.1186/s12877-024-05607-9.

ABSTRACT

PURPOSE: This umbrella review aimed to summarise and synthesize the evidence on the outcomes reported and used to assess the value and or efficacy of geriatric assessments (GAs) for older adults with cancer.

METHODS: Six electronic databases, PsycINFO, MEDLINE, Embase, CINAHL, Cochrane Library and Web of Science databases, were searched to identify systematic reviews with or without meta-analyses that described the value or outcomes of GAs for older adults with cancer.

RESULTS: Twenty-six systematic reviews were included, of which six included a meta-analysis of the data. Thirteen associations and or outcomes were identified. Overall geriatric impairments predicted or were associated with majority of identified outcomes. However, the type of domains associated with outcomes differed within and across reviews. Only treatment toxicity was statistically significantly lower for patients allocated to the GA intervention group compared to standard care. Systematic reviews without meta-analyses demonstrated a positive impact of GA with management on treatment completion, communication and care planning and patient satisfaction with care.

CONCLUSION: There is evidence demonstrating the predictive value of GAs for older adults with cancer. GAs seems to be beneficial for older adults with cancer across some outcomes, with strong evidence demonstrating the impact of GA with management for treatment toxicity. However, there is mixed or limited evidence demonstrating the effect of GA in other treatment modalities, and on quality of life and economic outcomes.

PMID:39695448 | DOI:10.1186/s12877-024-05607-9

BMC Cancer. 2024 Dec 18;24(1):1519. doi: 10.1186/s12885-024-13279-2.

ABSTRACT

BACKGROUND: Every year, hundreds of thousands of patients receive an orthopaedic or dental implant containing metals such as cobalt, chromium and titanium. Since the European Chemicals Agency (2020) classified pure cobalt metal as a Category 1B carcinogen, manufacturers of products containing ≥ 0.1% of this metal must perform a risk assessment and justify that there are no viable alternatives. The up-classification of cobalt metal to a carcinogen without good evidence that its use in implants is carcinogenic may cause unnecessary concern to the many patients who have, or may require such implants. Although in vitro and animal studies have shown such metals to be carcinogenic, human epidemiological studies have not been definitive. In addition, although many advances have been made in the past few decades with regard to the materials used in implant metals, no recent review of their carcinogenic effects have been published.

METHODS: This scoping review aims to summarise epidemiological studies conducted in recent years (from 2010 to present) to outline the carcinogenic effects of orthopaedic metal implants that have been published. This encompasses implants of different materials and surfaces, including metal, polyethylene and ceramic orthopaedic implants, cemented and cementless joint replacement surgeries, and surgical techniques such as resurfacing and total joint replacements that are currently in use and the potential carcinogenicity related to their use. Research papers with various study designs published in the English language were included. Studies were excluded if participants had a prior history of cancer before receiving orthopaedic implants and if they focused solely on the carcinogenicity of metals or materials not related to orthopaedic implants.

RESULTS: A total of 16 studies, encompassing over 700,000 implant patients, were identified through PubMed and have been included in this review. In long term follow-up of up to 17.9 years, no increased risk of all-site cancer was seen in these patients. However, an increase in site-specific cancers, namely prostate, melanoma and haematological cancers have been identified. Specifically, an increase in prostate cancer was identified in three studies.

CONCLUSION: Based on the summarised evidence, there is no consistent evidence to show that patients with any type of orthopaedic implant has an increased risk of cancer, although slight (non-statistically significant) increases in prostate cancer was observed and this, in particular, deserves longer-term surveillance.

PMID:39695440 | DOI:10.1186/s12885-024-13279-2

BMC Gastroenterol. 2024 Dec 18;24(1):463. doi: 10.1186/s12876-024-03557-5.

ABSTRACT

BACKGROUND: Several studies have demonstrated that systemic immune inflammation index (SII) has a positive relationship with hepatic steatosis. However, it is lack of system evidence for the correlation between SII and hepatic fibrosis. The objective of this study was to evaluate the relationships between SII and hepatic steatosis or hepatic fibrosis.

METHODS: A cross-sectional analysis was performed from the National Health and Nutrition Examination Survey (NHANES). Fibrosis-4 index (FIB-4), NAFLD fibrosis score (NFS) and hepamet fibrosis score (HFS) were the indicators for hepatic fibrosis; fatty liver index (FLI), NAFLD liver fat score (LFS) and Framingham steatosis index (FSI) were the indicators for hepatic steatosis. Pearson’s test, generalized linear model (GLM) and restricted cubic splines (RCS) were used to analyze associations of SII with hepatic fibrosis and hepatic steatosis.

RESULTS: A total of 21,833 participants were enrolled in the study. Pearson’s test and GLM revealed that there were negative relationships between SII and hepatic fibrosis (FIB-4, NFS and HFS), while positive relationships between SII and hepatic steatosis (FLI, LFS and FSI). The corresponding β (95%CI) of SII and hepatic fibrosis were – 0.35(-0.46, -0.24), -0.67(-0.71, -0.63) and – 0.10(-0.12, -0.09), respectively. The corresponding β (95%CI) of SII and hepatic steatosis were 6.12(4.75, 7.50), 0.22(0.12, 0.31) and 0.27(0.20, 0.34), respectively. Statistically significant non-linear association were found in SII with hepatic fibrosis and hepatic steatosis in RCS model (all P < 0.001).

CONCLUSION: There was a negative significant association between SII and hepatic fibrosis, while a positive significant association between SII and hepatic steatosis.

PMID:39695411 | DOI:10.1186/s12876-024-03557-5

BMC Nephrol. 2024 Dec 18;25(1):461. doi: 10.1186/s12882-024-03914-2.

ABSTRACT

BACKGROUND: Heart failure often leads to hospitalization and can directly impact other organs, such as the kidneys. Acute kidney injury (AKI) is a common complication in patients hospitalized for acute decompensated heart failure (ADHF) and is associated with worse outcomes. However, there are limited data on the magnitude of AKI among hospitalized ADHF patients in resource-limited settings such as Ethiopia. This study sought to determine the prevalence of AKI and the factors associated with AKI in ADHF patients in Northwest Ethiopia.

METHOD: A hospital-based cross-sectional study was conducted at the University of Gondar Hospital in Northwest Ethiopia from June 1 to September 30, 2022. A total of 239 participants were included using consecutive sampling. Demographic information was collected through patient interviews, and relevant clinical and laboratory data were obtained from the patients’ medical records. The data were analyzed using STATA version 15.0. Bivariate and multivariate logistic regression analyses were carried out to identify independently associated factors of AKI among patients with ADHF. A P value < 0.05 was considered to indicate statistical significance.

RESULTS: The overall prevalence of AKI in ADHF patients was 25.1% (CI = 19.98-31.03). Older age ≥ 60 years(AOR = 2.95, 95%CI:1.34-6.21), diabetes mellitus (AOR = 9.55,95%CI:2.68-33.99),Hypertension (AOR = 2.34,95% CI:1.08-5.07), sepsis (AOR = 2.13,95%CI:1.09-4.8), use of loop diuretics (AOR = 4.03,95%CI:1.86-8.69) and previous history of AKI (AOR = 11.56,95%CI:4.02-33.26) were independently associated with the occurrence of AKI among ADHF patients.

CONCLUSION: A quarter of the patients admitted with ADHF developed AKI. Older age; comorbid diabetes mellitus, hypertension, or sepsis; a previous history of AKI; and the use of loop diuretics were associated with the occurrence of AKI. Such clinical characteristics available at hospital admission can be used to identify patients at increased risk for developing AKI.

PMID:39695409 | DOI:10.1186/s12882-024-03914-2

BMC Gastroenterol. 2024 Dec 18;24(1):459. doi: 10.1186/s12876-024-03515-1.

ABSTRACT

BACKGROUND: The worldwide incidence of constipation is exhibiting an increasing trend. The objective of this study was to assess the relationship between dietary components and the occurrence of constipation.

METHODS: Sociodemographic characteristics data of participants experiencing constipation and those without were sourced from the National Health and Nutrition Examination Survey (NHANES; 2000-2010; n = 1903; ≥20 years). Sociodemographic characteristics of participants experiencing constipation and those without were sourced from the National Health and Nutrition Examination Survey (NHANES). Data from two 24-hour dietary recalls (n = 1696; participants aged 20 years and older) were utilized to compare the dietary intake of various food components between constipated and non-constipated individuals, as well as to investigate the relationship between food component consumption and constipation. Odds ratios (OR) were calculated using an adjusted model. The distribution of the data was illustrated through a histogram. Based on this distribution, vegetable intake was categorized into five groups (0-0.733, 0.733-1.47, 1.47-2.2, 2.2-2.93, 2.93-8) for the purpose of subgroup analysis.

RESULTS: The median age of individuals experiencing constipation is 41.5 years, with women accounting for 65.3% and men accounting for 34.7%. The consumption of fruits (constipated people = 0.79 cups/d; non-constipated people = 0.93 cups/d), vegetables (1.21 cups/d; 1.59 cups/d), dairy (1.68 cups/d; 1.55 cups/d), and oils (15.31 g/d; 19.61 g/d) is below the recommended dietary intake for both groups. After multivariable adjustment, vegetable consumption (OR: 0.74, 95% CI: 0.59-0.92, p = 0.008) and female (OR: 2.12, 95% CI: 1.38-3.24, p < 0.001) were identified as significant predictors of constipation. The subgroup analysis concerning vegetable consumption indicated a statistically significant result within Group (2.93,8 ] [OR: 0.2, 95% CI: 0.069-0.57].

CONCLUSIONS: The findings of the research suggest that it is advisable for individuals to consume a minimum of 2.93 cups of vegetables daily. Furthermore, females exhibit a significantly elevated risk of experiencing constipation. However, no association has been identified between constipation and either age or educational level.

PMID:39695406 | DOI:10.1186/s12876-024-03515-1