Category: Statistics

BMC Psychol. 2024 Nov 16;12(1):669. doi: 10.1186/s40359-024-02162-1.

ABSTRACT

BACKGROUND: Exposure to pesticides in the living environment can be associated with the prevalence of health symptoms. This study investigates associations between health symptoms among residents in areas with fruit crop fields where pesticides are applied, and psychological perceptions and attitudes about environmental aspects and exposures.

METHODS: A cross-sectional survey combined with routine primary care electronic health records (EHR) data was conducted in 2017 in rural areas of the Netherlands with high concentration of fruit crops (n = 3,321, aged ≥ 16 years). Individual exposure to pesticides was estimated using geocoded data on fruit crops around the home. Validated instruments were used to assess symptom report and psychological perceptions and attitudes. Annual prevalence of various health symptoms was derived from EHRs. Multilevel regression models were used to analyze associations between health symptoms (outcome), fruit crops, and multiple psychological perceptions and attitudes (confounders).

RESULTS: Living in the vicinity of fruit crop fields was generally not associated with self-reported symptom duration and general practitioner (GP) registered symptoms. For self-reported symptoms, symptom prevalence decreased when crop density within 250 m and 500 m from the home increased. No associations were found at other distances. Furthermore, higher levels of environmental worries, perceived exposure, and perceived sensitivity to pesticides and attribution of symptoms to environmental exposures were generally associated with a higher number of self-reported symptoms, and longer symptom duration. Symptoms reported to GPs were not associated with psychological perceptions and attitudes, except for perceived sensitivity to pesticides.

CONCLUSION: Psychological perceptions and attitudes appear to be related to self-reported symptoms, but not to GP-registered symptoms, independent of the actual levels of exposure as measured by the size of the area of crop fields. Perceptions about environmental factors should be taken into account in environmental health risk assessment research when studying health symptoms.

PMID:39550569 | DOI:10.1186/s40359-024-02162-1

BMC Gastroenterol. 2024 Nov 16;24(1):412. doi: 10.1186/s12876-024-03510-6.

ABSTRACT

BACKGROUND: This systematic review and meta-analysis aimed to evaluate the impact of perioperative immunonutrition on postoperative outcomes in patients undergoing pancreaticoduodenectomy (PD).

METHODS: Conducted a comprehensive search in PubMed, Embase, Cochrane Library, Medline, and Web of Science databases to identify all randomized controlled trials (RCTs) on the topic of immunonutrition and PD. Subsequently screened literature, extracted data, and assessed the risk of bias in the included studies, and finally conducted a meta-analysis using RevMan 5.3 software.

RESULTS: The analysis included a total of 10 RCTs with 574 patients, among whom 288 were in the immunonutrition group and 283 in the control group. The meta-analysis revealed a significantly lower incidence of postoperative infection-related complications (OR = 0.45; 95% CI: 0.27-0.74; P = 0.002) and severe postoperative complications (OR = 0.61; 95% CI: 0.38-0.98; P = 0.04) in the immunonutrition group compared to the control group. Additionally, patients in the immunonutrition group had a significantly shorter length of hospital stay (MD= -1.87; 95%CI -3.29 – -0.44; P = 0.01). However, the analysis revealed no statistically significant difference in the overall complication rate between the two groups (P = 0.67). Furthermore, the incidence of specific complications and perioperative mortality rates also did not demonstrate any statistically significant differences (all P > 0.05).

CONCLUSIONS: Perioperative immunonutrition in PD patients can reduce postoperative infection-related complications, but more high-quality RCTs are needed for further validation.

PMID:39550568 | DOI:10.1186/s12876-024-03510-6

BMC Geriatr. 2024 Nov 16;24(1):955. doi: 10.1186/s12877-024-05515-y.

ABSTRACT

BACKGROUND: Adverse drug reactions are more prevalent in geriatric patients and are frequently associated with a range of polypharmacy-related issues as well as some physiological aging-related alterations. These affect the pharmacokinetic and pharmacodynamic properties of drugs. This study aimed to assess the magnitude of ADRs and their contributing factors among geriatric patients admitted at Comprehensive Specialized Hospitals of the Amhara Region.

METHODS: A multicenter prospective cohort study was carried out from May 2023 to August 2023 on geriatric patients admitted to four randomly selected comprehensive hospitals in the Amhara region. We used logistic regression to find the factors influencing the occurrence of ADRs. A P value of less than 0.05 was deemed statistically significant.

RESULTS: During the study’s follow-up period, 373 patients in total were included. An incidence rate of 31.10% (95% CI: 26.38-35.82) was obtained from the identification of 121 ADRs in total. The organ most frequently affected by ADRs was the gastrointestinal tract (28.92%), followed by the cardiovascular system (19.01%), and the drug class most often implicated in ADRs was antibiotics (21.49%), then anticoagulants (12.40%). ADRs were substantially linked to being overweight (P < 0.001), having been hospitalized in the previous six months (P = 0.000), and hyperpolypharmacy (p = 0.047). 93.39% of all ADRs received the interventions. 85.12% of the adverse drug reactions were successfully resolved.

CONCLUSIONS: This study found that over one-third of older people and individuals admitted to the hospital experienced ADRs. Overweight, hyperpolypharmacy, and patients who had previously been admitted during the preceding six months were significantly linked with the occurrence of ADRs. Improving the drug safety of elderly patients, particularly those who are admitted, should be a greater priority for healthcare professionals.

PMID:39550566 | DOI:10.1186/s12877-024-05515-y

Syst Rev. 2024 Nov 16;13(1):282. doi: 10.1186/s13643-024-02704-z.

ABSTRACT

BACKGROUND: Men who have sex with men (MSM) are disproportionately affected by sexually transmitted infections (STI) including Neisseria gonorrhoeae (Ng) and Chlamydia trachomatis (Ct). The lack of robust data on STIs among African MSM has limited the development of evidence-based screening strategies. This study aimed at documenting the pooled prevalence of Ng/Ct among MSM in sub-Saharan Africa (SSA).

METHODS: This systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) 2020 guidelines. Relevant articles from the following databases were searched: PubMed, Scopus, ISI Web of Science, and the Directory of Open Access Journals (DOAJ). Eligible studies reported on the prevalence of Ng/Ct among the MSM population in SSA. Publication bias was assessed using the Hoy tool, Doi plot, and LFK ratio. Due to heterogeneity among studies, subgroup analyses were performed using the MetaXL add-on tool for Microsoft Excel.

RESULTS: Of 525 articles screened, 20 were selected for inclusion. Six were cross-sectional, four had a prospective cohort study design, and one was an epidemiological study. The pooled prevalence of Ng/Ct in MSM was 27% (95% CI, 19-39%), with an I² of 98% signifying heterogeneity among the studies. Subgroup analysis by country revealed South Africa had the highest prevalence (38%).

DISCUSSION: Interpretation The high prevalence of Ng/Ct infection among MSM in SSA is of concern. Limitations Due to limited data available on Ng/Ct prevalence, the true prevalence of SSA and its associated risk factors is uncertain.

CONCLUSION: As the first study to systematically review the available literature on STI prevalence among the MSM population in SSA, it showed the burden of Ng/Ct is higher than in other regions, warranting the strengthening of health systems to improve education, testing, and treatment in MSM population.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022327095.

PMID:39550563 | DOI:10.1186/s13643-024-02704-z

BMC Cancer. 2024 Nov 16;24(1):1416. doi: 10.1186/s12885-024-13166-w.

ABSTRACT

BACKGROUND AND OBJECTIVES: Currently, research on the role of B cells in esophageal cancer (EC) is limited, and existing studies on their impact are controversial. Therefore, this study was conducted to elucidate the complex causal relationship between B cells and EC, expand the understanding of esophageal cancer immunology.

METHODS: Bidirectional two-sample Mendelian randomization (MR) was performed to assess the causal relationships between 190 B cell phenotypes and EC. To complement the MR analysis, Bayesian Weighted Mendelian Randomization (BWMR) was employed, and sensitivity analyses were conducted to evaluate the robustness of the findings. Positive results were further validated in independent cohorts of esophageal cancer studies. In addition, RNA sequencing (RNA-seq) data from The Cancer Genome Atlas (TCGA) were utilized for validation, incorporating B cell-related gene expression analysis and functional enrichment analysis to support the MR findings.

RESULTS: In the primary analysis, significant causal relationships were observed between 5 B cell types and the risk of EC; the onset of EC was causally linked to 3 B cell phenotypes. Validation in other cohorts revealed that 4 outcomes aligned with the primary analysis, included were CD19 on IgD + CD38-, CD20 on IgD- CD27-, CD20 on IgD- CD38br, and CD38 on PB/PC. Further validation using RNA-seq data showed that CD38 mRNA was significantly overexpressed in EC tissues, whereas CD19 and MS4A1 mRNA levels did not differ significantly between tumor and normal tissues. Functional enrichment analysis revealed that CD19, MS4A1, and CD38 are involved in multiple tumor-related immune pathways, suggesting their pivotal role in regulating the tumor immune microenvironment.

CONCLUSIONS: Our study suggests a potential connection between B cell phenotypes and EC through bidirectional two-sample MR combined with BWMR analysis, providing a preliminary basis for future research.

PMID:39550560 | DOI:10.1186/s12885-024-13166-w

BMC Pulm Med. 2024 Nov 16;24(1):570. doi: 10.1186/s12890-024-03396-w.

ABSTRACT

PURPOSE: Patients with alpha-1 antitrypsin deficiency (AATD) often experience substantial delays from the onset of symptoms to a diagnosis. We explored the impact of delayed diagnosis of AATD on healthcare costs and utilization by assessing costs/utilization before and after diagnosis.

METHODS: Retrospective claims data was used to conduct a longitudinal analysis of a cohort of patients with follow-up over four years in a commercial claims database was conducted. Patients with at least four years of claims experience between the years 2011 – 2017 were included in this study. Outcome measures were calculated for each year (Year 1 pre-index diagnosis, and Years 1, 2, and 3 post-index follow-up). Measures included healthcare costs (pharmacy and medical costs), medical costs, inpatient events, and emergency room visits. Unadjusted measures in the follow-up Year 1, Year 2, and Year 3 were compared to Year 1 pre-index. A separate multivariate analysis adjusting for age, sex, and comorbidities was conducted.

RESULTS: Among 1258 patients, mean adjusted healthcare costs were significantly higher in Year 1 post-index compared to Year 1 pre-index ($51,785 vs $41,441, p = < 0.05). In Year 2 ($36,937 vs $41,441, p = < 0.05) and 3 ($28,558 vs $41,441, p = < 0.05) post-index, mean adjusted healthcare costs decreased compared to Year 1 pre-index. Adjusted medical costs were similar in Year 1 ($25,034) post-index compared to Year 1 ($22,952) pre-index but were significantly lower in Year 2 ($15,242 vs $25,034, p = < 0.05) and Year 3 ($8,779 vs $25,034, p = < 0.05) post-index. The frequency of inpatient and emergency room events was significantly lower in all three observation periods following diagnosis in the unadjusted analysis. The adjusted analysis showed similar findings, except for emergency room visits, which were similar across all observation periods.

CONCLUSION: Patients with AATD had substantial healthcare costs/utilization in the year before diagnosis. Costs were significantly higher in the first year following diagnosis. However, subsequent years showed cost reductions to levels below pre-diagnosis. These data support the need for strategies to reduce the time from symptom onset to diagnosis.

PMID:39550556 | DOI:10.1186/s12890-024-03396-w

BMC Cancer. 2024 Nov 16;24(1):1415. doi: 10.1186/s12885-024-13186-6.

ABSTRACT

BACKGROUND: Cancer cells alter their metabolic phenotypes with nutritional change. Single agent approaches targeting mitochondrial metabolism in cancer have failed due to either dose limiting off target toxicities, or lack of significant efficacy in vivo. To mitigate these clinical challenges, we investigated the potential utility of repurposing FDA approved mitochondrial targeting anthelmintic agents, niclosamide, IMD-0354 and pyrvinium pamoate, to be combined with GLUT1 inhibitor BAY-876 to enhance the inhibitory capacity of the major metabolic phenotypes exhibited by tumors.

METHODS: To test this, we used breast cancer cell lines MDA-MB-231 and 4T1 which exhibit differing basal metabolic rates of glycolysis and mitochondrial respiration, respectively. Metabolic characterization was carried out using Seahorse XFe96 Bioanalyzer and statistical analysis was carried out via ANOVA.

RESULTS: Here, we found that specific responses to mitochondrial and glycolysis targeting agents elicit responses that correlate with tested cell lines basal metabolic rates and fuel preference, highlighting the potential to cater metabolism targeting treatment regimens based on specific tumor nutrient handling. Inhibition of GLUT1 with BAY-876 potently inhibited glycolysis in both MDA-MB-231 and 4T1 cells, and niclosamide and pyrvinium pamoate perturbed mitochondrial respiration that resulted in potent compensatory glycolysis in the cell lines tested.

CONCLUSION: In this regard, combination of BAY-876 with both mitochondrial targeting agents resulted in inhibition of compensatory glycolysis and subsequent metabolic crisis. These studies highlight targeting tumor metabolism as a combination treatment regimen that can be tailored by basal and compensatory metabolic phenotypes.

PMID:39550554 | DOI:10.1186/s12885-024-13186-6

BMC Oral Health. 2024 Nov 16;24(1):1396. doi: 10.1186/s12903-024-05166-w.

ABSTRACT

BACKGROUND: Dental age estimation is one of the most reliable methods for determining age, commonly used for forensic, criminal, and anthropological purposes. The purpose of this study was to assess and compare the precision of the Bedek models and the Cameriere-European Formula (CF) in determinating dental age in a sample of Turkish individuals.

METHODS: Retrospective panoramic radiographs of 1018 subjects (497 boys and 521 girls) aged 5-14 years were evaluated using the Bedek models and the CF. The differences between calculated dental age (DA) and chronological age (CA) for each sex and age group were analyzed using the paired sample t-test and the Wilcoxon signed-rank test. The accuracy of the methods used to estimate dental age was determined by calculating the mean absolute error (MAE) based on the proximity of the dental age to the chronological age.

RESULTS: The CF method overestimated CA by 0.1 year in the entire sample. Conversely, the Bedek models tended to overestimate CA, with the three-, four-, and seven-tooth models exhibiting the most significant difference. There was a statistically significant difference between boys and girls in the DA-CA calculation using the CF method in the entire sample. Among the Bedek models, the three- and four-tooth models had the lowest MAE in the entire sample, while the single-tooth model had the highest MAE.

CONCLUSION: The CF method showed higher accuracy in predicting the age of children living in eastern Turkey compared to the Bedek Models.

PMID:39550551 | DOI:10.1186/s12903-024-05166-w

BMC Infect Dis. 2024 Nov 16;24(1):1311. doi: 10.1186/s12879-024-10201-w.

ABSTRACT

BACKGROUND: With the continuous advancement of modern medical technology, the survival rate of premature infants has significantly increased. Klebsiella pneumoniae (K. pneumoniae) is one of the most common pathogens causing neonatal infections, particularly posing a serious risk to premature infants. This study aimed to analyze the clinical characteristics, antibiotic susceptibility profiles, and treatment outcomes of K. pneumoniae infections in these infants.

METHODS: We retrospectively compared cases of K. pneumoniae infection in premature and term infants admitted in a tertiary hospital from January 2017 to December 2022 in China. Clinical and microbiological characteristics were evaluated. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), with statistical significance defined as P < 0.05.

RESULTS: We enrolled 166 premature infants and 68 term infants. In premature infants, fetal distress, patent ductus arteriosus, patent foramen ovale, enteritis, anemia, hypoproteinemia, bloodstream infections, abdominal infection, mechanical ventilation, nasogastric feeding, drainage tube, parenteral nutrition, and prior exposure to carbapenem antibiotics were identified as significant risk factors for K. pneumoniae infections in univariate analysis. Furthermore, septic shock, bloodstream infections, abdominal infections, indwelling catheters, drainage tubes, parenteral nutrition, and previous exposure to glycopeptide antibiotics were significantly correlated with mortality. Independent risk factors for K. pneumoniae infections in premature infants included fetal distress (OR: 3.702, [95% CI: 1.056-12.986], P = 0.041), enteritis (OR: 4.434, [95% CI: 1.066-18.451], P = 0.041), anemia (OR: 4.028, [95% CI: 1.550-10.466], P = 0.004), bloodstream infections (OR: 1.221, [95% CI: 0.061-1.802], P = 0.022), mechanical ventilation (OR: 4.974, [95% CI: 1.685-14.685], P = 0.004) and prior exposure to carbapenem antibiotic (OR: 14.738, [95% CI: 2.393-90.767], P = 0.004). Additionally, abdominal infections (OR: 8.598, [95% CI: 2.000-36.957], P = 0.004) and indwelling catheters (OR: 7.698, [95% CI: 0.998-59.370], P = 0.050) were positive predictors of mortality.

CONCLUSION: K. pneumoniae isolates exhibit a notable prevalence of infection, poor treatment outcomes, and elevated resistance in preterm neonates. These findings enhance our understanding of K. pneumoniae infections and their association with clinical outcomes among premature infants.

PMID:39550549 | DOI:10.1186/s12879-024-10201-w

BMC Oral Health. 2024 Nov 16;24(1):1394. doi: 10.1186/s12903-024-05183-9.

ABSTRACT

BACKGROUND: This study aimed to investigate the in vitro effect of a charcoal-containing dentifrice with different toothbrush stiffness on enamel.

METHODS: Four main groups were applied: distilled water, conventional fluoridated toothpaste (Colgate^® Total^® 12 Clean Mint Toothpaste), charcoal toothpaste (Colgate^® Total^® Charcoal Toothpaste) and whitening toothpaste (Colgate Total^® Advanced Whitening Toothpaste). Three subgroups for each toothpaste were further included according to the toothbrush bristles’ stiffness (soft, medium, and hard). Enamel specimens were subjected to 1,250 and 2,500 cycles of brushing using toothbrushing simulation machine. The average surface roughness change (ΔRa) in nanometer (nm) was measured to estimate the changes following the brushing simulation model. Two-way ANOVA and Tukey tests analyzed the data.

RESULTS: The type of toothpaste and the bristles’ stiffness were determinant factors in increasing the ΔRa value (P = < 0.05). Generally, charcoal and whitening toothpastes with medium and hard bristles yielded higher ΔRa than fluoridated toothpaste and smooth bristles. Following 1,250 cycles of brushing simulation, charcoal toothpaste did not increase the enamel roughness compared to the controls. However, in prolonged brushing via 2,500 cycles of brushing simulation, using bristles with soft stiffness revealed that charcoal toothpaste was associated with increased surface roughness (55.86 ± 41.18 nm), which was statistically significant (P = 0.024) compared to the negative control. Using bristles with medium stiffness showed that the whitening (68.23 ± 48.58 nm) and charcoal (73.62 ± 34.66 nm) toothpastes significantly (P = < 0.05) increased the enamel roughness compared to the conventional toothpaste (36.53 ± 22.56 nm). There was no significant difference among the groups when brushes with hard bristles were used, as all the groups revealed increased enamel roughness.

CONCLUSION: The use of charcoal and whitening toothpastes increased enamel roughness, particularly with long-term use. The effect of bristle stiffness on enamel roughness was found to vary depending on the type of toothpaste used.

PMID:39550548 | DOI:10.1186/s12903-024-05183-9