Category: Statistics

Eat Weight Disord. 2024 Aug 16;29(1):52. doi: 10.1007/s40519-024-01676-2.

ABSTRACT

The study was conducted in order to study breakfast skipping (BKS) frequency, factors associated with, health consequence and undergraduate students academic performance during Covid-19 pandemic as earliest studies focusing on this area. A cross-sectional study was carried out among 2225 of undergraduate students. The study was carried between the period of 15/1/2020 to 3/4/2020 using an online self-report Breakfast Eating Habit Survey (BEHS). The BEHS survey was divided into two sections. The first sections included sociodemographic information (gender, BMI, age, smoking, residency, parental education, family income, studying system and stage (public or private), and studying institution (university or institute) academic performance. The second part included questions regarding breakfast eating habits including frequency of skipping meals, factors related to BKS health consequences and types of snacks. Logistic regression is a common technique used for modeling outcomes that fall into the range of 1 and 0. For this purpose, a logistic regression was performed to find adjusted odds ratio and crude odds ratio. The results showed that the majority of participants were female (1238, 55.7%). Out of 2,224 students, 2059 are aged between 18 to 24 years. Most of the participants were from first level (26.5%), second level (32.8%), third level (17.6%) or the fourth level (21.3%). Over 92% of participants were single and about 68% came from families of medium income families. The statistical analysis showed that the odds of BKS is reduced among students who live in accommodation by 54% (odds ratio = 54%, CI (41-71%), p value = 0.000). It seems that students with low income and normal or higher BMI are more likely to skip breakfast more regularly. The odds of skipping breakfast among students with BMI of 18-24.9 is reduced by 41% (odds ratio = 59%, CI (27%-93%), p value = 0.027) and the odds of BKS is reduced among students with BMI of 25-29.9 by 45% (odds ratio = 55%, CI (31-95%). Additionally, students with medium or high incomes are more likely to skip breakfast as much as twofold in comparison with students with low income (medium income (odds ratio = 1.85, CI (1.08-3.17), p-value = 0.024), high income (odds ratio = 1.98, CI (1.12-3.51), p-value = 0.019). The most common reasons for skipping breakfast included include time constraint, not hungry, breakfast is not ready, afraid to be overweight and lack of appetite. The consequences of skipping breakfast were feeling hungry throughout the day, feeling tired, and not paying attention in class and low academic performance. To concluded, BKS during Covid-19 is more common among students with higher BMI, higher income and living in accommodation. The main reason is time constraint and the most common health problems are being tired and luck of attention.

PMID:39150632 | DOI:10.1007/s40519-024-01676-2

Int Urol Nephrol. 2024 Aug 16. doi: 10.1007/s11255-024-04184-5. Online ahead of print.

ABSTRACT

PURPOSE: The use of topical corticosteroids (TCSs) has become an efficient, less-invasive treatment for phimosis. Whether any significant difference in efficacy exists between TCSs based on their potency is unclear.

METHODS: Electronic databases were searched up to March 2024 for randomised controlled trials (RCTs) comparing the use of any type or concentration of TCSs with placebo or no treatment in boys with any degree of physician diagnosed phimosis. A random-effects network meta-analysis (NMA) using a consistency model within a frequentist approach was employed. The primary outcome was partial or complete resolution of phimosis reported as a pooled risk ratio (RR) with 95% CI. Relative ranking was assessed with surface under the cumulative ranking curve (SUCRA) probabilities.

RESULTS: Seventeen RCTs, containing 2057 participants were identified. NMA suggested that, compared with control, the high (RR 3.19 (95% CI 1.42 to 7.16), moderate (RR 2.68 (95% CI 1.87 to 3.83) and low (RR 3.05 (95% CI 1.63 to 5.71) potency TCSs statistically significantly increased complete or partial clinical resolution of phimosis. The SUCRA plot revealed that high potency (SUCRA = 0.76) was ranked first followed by low and moderate TCSs. When we assessed comparative efficacy among TCSs based on potency, none of the classes were superior to others. The certainty of the evidence for an effect of moderate potent TCSs was that of moderate GRADE quality.

CONCLUSION: Moderate to low potency TCSs are of comparable therapeutic effect in the treatment of phimosis to that of highly potent formulations. More high-quality RCTs are warranted.

PMID:39150601 | DOI:10.1007/s11255-024-04184-5

Arch Dermatol Res. 2024 Aug 16;316(8):522. doi: 10.1007/s00403-024-03280-x.

NO ABSTRACT

PMID:39150584 | DOI:10.1007/s00403-024-03280-x

Acta Parasitol. 2024 Aug 16. doi: 10.1007/s11686-024-00856-5. Online ahead of print.

ABSTRACT

PURPOSE: Tick-transmitted parasites as Babesia gibsoni, Babesia vogeli, Ehrlichia canis, and Hepatozoon canis are major health concern for dogs. Owing to prevalence and infection severity, there is need of sensitive, specific, and affordable test for their simultaneous detection.

METHODS: Prevalence of B. gibsoni, B. vogeli, E. canis, and H. canis infections was assessed on 719 blood samples by microscopy and multiplex PCR assay targeting 18S rRNA (B. gibsoni & H. canis), ITS1 & 5.8S rRNA (B. vogeli) and VirB9 gene (E. canis). An internal control (canine-actin) was also included to increase the accuracy of assay and effect of associated risk factors with disease prevalence was also studied.

RESULTS: Microscopic prevalence of B. gibsoni, B. vogeli, E. canis and H. canis was 5.0%, 0.1%, 1.4% and 1.0%, respectively, whereas with multiplex PCR assay, the corresponding values were 8.9%, 1.1%, 2.6% and 5.1% besides concurrent infections of B. gibsoni & H. canis (0.4%), B. gibsoni & E. canis (0.4%), E. canis & H. canis (0.3%) and B. gibsoni & B. vogeli (0.1%). Analytical sensitivity of developed assay was 0.1pg (B. gibsoni & H. canis), 0.01pg (B. vogeli), and 1.0pg (E. canis). A ″fair″ (B. vogeli & H. canis) to ″substantial″ (B. gibsoni & E. canis) agreement between two tests was observed with data as statistically significant. Breed, sex and location were significantly associated with B. gibsoni infection.

CONCLUSION: The developed multiplex PCR assay offers a potential solution to detect these pathogens simultaneously, aiding in timely diagnosis and effective disease management in suspected dogs.

PMID:39150582 | DOI:10.1007/s11686-024-00856-5

Support Care Cancer. 2024 Aug 16;32(9):592. doi: 10.1007/s00520-024-08794-8.

ABSTRACT

BACKGROUND: The effectiveness of generalist palliative care interventions in hospitals is unknown.

AIM: This study aimed to explore the impact of a palliative care case management intervention for patients with gastrointestinal cancer (PalMaGiC) on hospital admissions, healthcare use, and place of death.

DESIGN: This was a register-based cohort study analyzing data from the Danish Register on Causes of Death, the Danish National Patient Register, and the Danish Palliative Database.

SETTING/PARTICIPANTS: Deceased patients with gastrointestinal cancer from 2010 to 2020 exposed to PalMaGiC were compared over three periods of time to patients receiving standard care.

RESULTS: A total of 43,969 patients with gastrointestinal cancers were included in the study, of whom 1518 were exposed to PalMaGiC. In the last 30 days of life, exposed patients were significantly more likely to be hospitalized (OR of 1.62 (95% CI 1.26-2.01)), spend more days at the hospital, estimate of 1.21 (95% CI 1.02-1.44), and have a higher number of hospital admissions (RR of 1.13 (95% CI 1.01-1.27)), and were more likely to die at the hospital (OR of 1.94 (95% CI 1.55-2.44)) with an increasing trend over time. No differences were found for hospital healthcare use.

CONCLUSION: Patients exposed to the PalMaGiC intervention had a greater likelihood of hospitalizations and death at the hospital compared to unexposed patients, despite the opposite intention. Sensitivity analyses show that regional differences may hold some of the explanation for this. Future development of generalist palliative care in hospitals should focus on integrating a home-based approach, community care, and PC physician involvement.

PMID:39150573 | DOI:10.1007/s00520-024-08794-8

Planta. 2024 Aug 16;260(3):73. doi: 10.1007/s00425-024-04503-1.

ABSTRACT

The ultrastructural design and biochemical organization of the significantly thickened outer tissues of the gametophytic stem of Hypnodendron menziesii optimizes load bearing of the stem. Hypnodendron menziesii is a bryoid umbrella moss growing in high humid conditions on the forest floors of New Zealand. The erect gametophyte bears up to eight whorls of branches in succession, spreading across the stem that bears the heavy weight of branches with highly hydrated leaves. Our investigation using a combination of light microscopy, transmission electron microscopy (TEM), scanning electron microscopy (SEM), and TEM-immunolabeling techniques provided novel information on the structural design and biochemical organization of greatly thickened cell walls of epidermal, hypodermal, and outermost cortical tissues, comparing underlying thin-walled cortical tissues in the gametophytic stem. Probing into the ultrastructure of the cell wall architecture of these target tissues by TEM and SEM revealed the cell walls to display a multilamellar organization, in addition to demonstrating the presence of an electron-dense substance in the cell wall, presumably flavonoids. The pattern of distribution and concentration of rhamnogalacturonan, homogalacturonan, and heteromannan, as determined by immunogold labeling, suggests that it is the combination of structural and molecular design of the cell wall that may optimize the mechanical function of the epidermal, hypodermal, and outer cortical tissues. Statistical relationships between the overall thickness of epidermal, hypodermal, and outer cortical cell walls, the lumen area of cells and the percentage area of cell wall occupied in these tissues at different heights of the stem, and thickness of secondary cell wall layers (L1-L4/5) were explored. The results of these analyses unequivocally support the contribution of outer tissues to the mechanical strength of the resilient stem.

PMID:39150569 | DOI:10.1007/s00425-024-04503-1

Omega (Westport). 2024 Aug 16:302228241274248. doi: 10.1177/00302228241274248. Online ahead of print.

ABSTRACT

This study provides a decadal analysis of national suicide data over 90 years, offering a comprehensive view of long-term trends and current levels in the United States. We analyzed mean decadal suicide numbers, rates, and confidence intervals from the 1930s to the early 2020s across demographic categories including sex, race, and age. Our findings reveal that suicide rates in the 2020s are the highest since the 1930s. The data indicate significant variations across groups; the 2020s show the highest suicide rates for both Whites and Nonwhites, and individuals under 44 years of age. Conversely, men’s suicide rates were slightly lower than those in the 1930s, whereas rates for women and older adults peaked during the 1930s. The results underscore the need for ongoing surveillance of suicide trends and proactive suicide prevention measures by governmental and other relevant organizations.

PMID:39149875 | DOI:10.1177/00302228241274248

JMIRx Med. 2024 Aug 14;5:e56405. doi: 10.2196/56405.

ABSTRACT

BACKGROUND: Sleeve gastrectomy is an effective surgical option for morbid obesity, and it improves glucose homeostasis. In patients with gastric cancer and type 2 diabetes mellitus (DM), gastrectomy, including total gastrectomy, is beneficial for glycemic control.

OBJECTIVE: This study aims to clarify the effects of gastrectomy and different reconstructive techniques on the incidence of postoperative DM in patients with gastric cancer.

METHODS: This retrospective, single-center, cohort study included 715 patients without DM who underwent total gastrectomy at the Tokyo Metropolitan Bokutoh Hospital between August 2005 and March 2019. Patients underwent reconstruction by Roux-en-Y (RY) gastric bypass or other surgical techniques (OT), with DM onset determined by hemoglobin A1c levels or medical records. Analyses included 2-sample, 2-tailed t tests; χ2 tests; and the Kaplan-Meier method with log-rank tests to compare the onset curves between the RY and OT groups, along with additional curves stratified by sex. A Swimmer plot for censoring and new-onset DM was implemented.

RESULTS: Stratified data analysis compared the RY and OT reconstruction methods. The hazard ratio was 1.52 (95% CI 1.06-2.18; P=.02), which indicated a statistically significant difference in the incidence of new-onset diabetes between the RY and OT groups in patients with gastric cancer. The hazard ratio after propensity score matching was 1.42 (95% CI 1.09-1.86; P=.009).

CONCLUSIONS: This first-of-its-kind study provides insight into how different methods of gastric reconstruction affect postoperative diabetes. The results suggest significant differences in new-onset DM after surgery based on the reconstruction method. This research highlights the need for careful surgical planning to consider potential postoperative DM, particularly in patients with a family history of DM. Future studies should investigate the role of gut microbiota and other reconstructive techniques, such as laparoscopic jejunal interposition, in developing postoperative DM.

PMID:39149857 | DOI:10.2196/56405

JMIR Public Health Surveill. 2024 Aug 15;10:e58942. doi: 10.2196/58942.

ABSTRACT

BACKGROUND: In 2022, the World Health Organization highlighted the alarming state of oral health (OH) worldwide and urged action to include OH in initiatives on noncommunicable diseases. The population needs improved OH skills and attitudes and an adequate level of OH literacy (OHL) and general health literacy (HL). The implementation of health promotion actions in the workplace, which is a part of most people’s lives, appears to be an opportunity. In France, civil servants have several socioprofessional levels and represent an excellent model with results transposable to the population.

OBJECTIVE: This study aimed at determining the OHL and HL level of civil servants in France in order to implement specific prevention actions in their workplaces.

METHODS: A cross-sectional study of French civil servants was conducted in France from October 2023 to February 2024. Participants completed three validated questionnaires in French: (1) a questionnaire on OH knowledge, (2) the Oral Health Literacy Instrument, French version (OHLI-F; this is composed of reading comprehension and numeracy sections) to assess the OHL level, and (3) the Short Test of Functional Health Literacy in Adults, French version (s-TOFHLA-F) to assess the HL level. The scores for OH knowledge, the OHLI-F, and the s-TOFHLA-F were reported as means (SD) and the 95% CI. These scores were classified into 3 categories: adequate (75-100), marginal (60-74) and inadequate (0-59). ANOVA and binary logistic regression were performed. The OHLI-F reading comprehension and OHLI-F numeracy scores were compared using the Welch 2-sample t test and a paired t test (both 2-tailed). For the correlation matrix, the Pearson correlation and related tests were computed.

RESULTS: A total of 1917 persons completed the 3 questionnaires, with adequate levels of OHL (n=1610, 84%), OH knowledge (n=1736, 90.6%), and HL (n=1915, 99.9%). The scores on the s-TOFHLA-F (mean 98.2, SD 2.8) were higher than the OHLI-F (mean 80.9, SD 7.9) and OH knowledge (mean 87.6, SD 10.5). The OHLI-F was highly correlated with OH knowledge (P<.001), but the OHLI-F and OH knowledge had a low correlation with s-TOFHLA-F (P=.43). The OHLI-F reading comprehension score was significantly higher than the OHLI-F numeracy score (P<.001). Age, education level, and professional category impacted the 3 scores (P<.001). The professional category was a determinant of adequate OHLI-F and OH knowledge scores.

CONCLUSIONS: Some French civil servants had inadequate or marginal levels of OH knowledge (n=181, 9.5%) and OHL (n=307, 16%) but none had an inadequate level of HL. Results highlighted the relevance of implementing OH promotion programs in the workplace. They should be nonstandardized, adapted to the literacy level of professional categories of workers, and focused on numeracy skills. Thus, appropriate preventive communication and improved literacy levels are the means to achieve greater disease equity and combat the burden of noncommunicable diseases.

PMID:39149854 | DOI:10.2196/58942

Biom J. 2024 Sep;66(6):e202200371. doi: 10.1002/bimj.202200371.

ABSTRACT

Analysis of the restricted mean survival time (RMST) has become increasingly common in biomedical studies during the last decade as a means of estimating treatment or covariate effects on survival. Advantages of RMST over the hazard ratio (HR) include increased interpretability and lack of reliance on the often tenuous proportional hazards assumption. Some authors have argued that RMST regression should generally be the frontline analysis as opposed to methods based on counting process increments. However, in order for the use of the RMST to be more mainstream, it is necessary to broaden the range of data structures to which pertinent methods can be applied. In this report, we address this issue from two angles. First, most of existing methodological development for directly modeling RMST has focused on multiplicative models. An additive model may be preferred due to goodness of fit and/or parameter interpretation. Second, many settings encountered nowadays feature high-dimensional categorical (nuisance) covariates, for which parameter estimation is best avoided. Motivated by these considerations, we propose stratified additive models for direct RMST analysis. The proposed methods feature additive covariate effects. Moreover, nuisance factors can be factored out of the estimation, akin to stratification in Cox regression, such that focus can be appropriately awarded to the parameters of chief interest. Large-sample properties of the proposed estimators are derived, and a simulation study is performed to assess finite-sample performance. In addition, we provide techniques for evaluating a fitted model with respect to risk discrimination and predictive accuracy. The proposed methods are then applied to liver transplant data to estimate the effects of donor characteristics on posttransplant survival time.

PMID:39149839 | DOI:10.1002/bimj.202200371