Category: Statistics

BMC Psychol. 2024 Apr 27;12(1):241. doi: 10.1186/s40359-024-01746-1.

ABSTRACT

BACKGROUND: Climate change is seriously affecting human survival and development, and the anxiety caused by it is becoming increasingly prominent. How to alleviate people’s climate change anxiety, improve the ecological environment, and promote the formation of green lifestyles among people, especially young people, is an important topic that deserves to be explored. This study examined the relationship between climate change anxiety and pro-environmental behaviors and the underlying psychological mechanism in the adolescents.

METHODS: This study explored the crucial role of future self-continuity (FSC) between climate change anxiety (CCA) and pro-environmental behaviors (PEB) in adolescents and examined the moderating role of green self-efficacy (GSE). In this study, a total of 1,851 middle and high school students from five schools were selected for questionnaire survey.

RESULTS: The results showed that (1) in both middle and high school grades, there was a significant negative correlation between climate change anxiety and pro-environmental behaviors; future self-continuity was significantly positively correlated with pro-environmental behaviors; green self-efficacy was negatively correlated with climate change anxiety and positively correlated with pro-environmental behaviors; (2) climate change anxiety negatively predicted pro-environmental behaviors, and compared with middle school grades, high school grade adolescents’ climate change anxiety was significantly predicted pro-environmental behaviors. Future self-continuity mediated the relationship between climate change anxiety and pro-environmental behaviors in both grades. (3) green self-efficacy moderated the second half of the pathway of the mediation model only in middle grades. Specifically in middle school, future self-continuity did not significantly predict pro-environmental behaviors at low green self-efficacy level, but positively predicted pro-environmental behaviors at high green self-efficacy level. In high school, future self-continuity did not significantly predict pro-environmental behaviors in either high or low green self-efficacy level.

CONCLUSION: This study suggests that there is a moderated mediation model between adolescents’ climate change anxiety and pro-environmental behaviors, with different mediating and moderating effects among adolescents in various grades. This is of great significance in alleviating climate anxiety among adolescents and cultivating their pro-environmental behaviors.

PMID:38678287 | DOI:10.1186/s40359-024-01746-1

BMC Psychol. 2024 Apr 27;12(1):239. doi: 10.1186/s40359-024-01745-2.

ABSTRACT

The impact of free time management and leisure satisfaction on quality of life is distinct, however, the role of satisfaction in enhancing quality of life through free time management remains uncertain. Hence, the objective of this research is to explore how leisure satisfaction acts as a mediator between free time management and the levels of quality of life among university students. Additionally, this study aims to analyse these concepts in relation to gender, age and the number of days of activity participation. Within this particular framework, a total of 213 university students willingly participated in the survey, which included the administration of the “Free Time Management Scale,” “Leisure Satisfaction Scale,” and “Quality of Life Scale.” The analyses employed the Independent T-Test, Pearson Correlation, and Linear Regression methods. The mediating effect was analysed using Structural Equation Modelling. The study found significant relationships between gender, free time management, and life quality. There was a significant relationship between free time management, leisure satisfaction, and quality of life (p < 0.05). Leisure satisfaction partially mediated the quality of life-free time management relationship. As age and physical activity grow, males have a higher standard of living, and time allocation and quality of life improve. Furthermore, it was found that students who effectively managed their time experienced an enhanced quality of life, as evidenced by their increased satisfaction with leisure activities. Notably, the level of satisfaction with well-managed time was identified as a crucial factor in this association.

PMID:38678286 | DOI:10.1186/s40359-024-01745-2

World J Emerg Surg. 2024 Apr 27;19(1):16. doi: 10.1186/s13017-024-00544-9.

ABSTRACT

OBJECTIVE: For traumatic lower extremity artery injury, it is unclear whether it is better to perform endovascular therapy (ET) or open surgical repair (OSR). This study aimed to compare the clinical outcomes of ET versus OSR for traumatic lower extremity artery injury.

METHODS: The Medline, Embase, and Cochrane Databases were searched for studies. Cohort studies and case series reporting outcomes of ET or OSR were eligible for inclusion. Robins-I tool and an 18-item tool were used to assess the risk of bias. The primary outcome was amputation. The secondary outcomes included fasciotomy or compartment syndrome, mortality, length of stay and lower extremity nerve injury. We used the random effects model to calculate pooled estimates.

RESULTS: A total of 32 studies with low or moderate risk of bias were included in the meta-analysis. The results showed that patients who underwent ET had a significantly decreased risk of major amputation (OR = 0.42, 95% CI 0.21-0.85; I²=34%) and fasciotomy or compartment syndrome (OR = 0.31, 95% CI 0.20-0.50, I² = 14%) than patients who underwent OSR. No significant difference was observed between the two groups regarding all-cause mortality (OR = 1.11, 95% CI 0.75-1.64, I² = 31%). Patients with ET repair had a shorter length of stay than patients with OSR repair (MD=-5.06, 95% CI -6.76 to -3.36, I² = 65%). Intraoperative nerve injury was just reported in OSR patients with a pooled incidence of 15% (95% CI 6%-27%).

CONCLUSION: Endovascular therapy may represent a better choice for patients with traumatic lower extremity arterial injury, because it can provide lower risks of amputation, fasciotomy or compartment syndrome, and nerve injury, as well as shorter length of stay.

PMID:38678282 | DOI:10.1186/s13017-024-00544-9

Malar J. 2024 Apr 27;23(1):123. doi: 10.1186/s12936-024-04957-4.

ABSTRACT

BACKGROUND: Malaria is still a disease of global public health importance and children under-five years of age are the most vulnerable to the disease. Nigeria adopted the “test and treat” strategy in the national malaria guidelines as one of the ways to control malaria transmission. The level of adherence to the guidelines is an important indicator for the success or failure of the country’s roadmap to malaria elimination by 2030. This study aimed to assess the fidelity of implementation of the national guidelines on malaria diagnosis for children under-five years and examine its associated moderating factors in health care facilities in Rivers State, Nigeria.

METHODS: This was a descriptive, cross-sectional study conducted in Port Harcourt metropolis. Data were collected from 147 public, formal private and informal private health care facilities. The study used a questionnaire developed based on Carroll’s Conceptual Framework for Implementation Fidelity. Frequency, mean and median scores for implementation fidelity and its associated factors were calculated. Associations between fidelity and the measured predictors were examined using Mann Whitney U test, Kruskal Wallis test, and multiple linear regression modelling using robust estimation of errors. Regression results are presented in adjusted coefficient (β) and 95% confidence intervals.

RESULTS: The median (IQR) score fidelity score for all participants was 65% (43.3, 85). Informal private facilities (proprietary patent medicine vendors) had the lowest fidelity scores (47%) compared to formal private (69%) and public health facilities (79%). Intervention complexity had a statistically significant inverse relationship to implementation fidelity (β = – 1.89 [- 3.42, – 0.34]). Increase in participant responsiveness (β = 8.57 [4.83, 12.32]) and the type of malaria test offered at the facility (e.g., RDT vs. no test, β = 16.90 [6.78, 27.03]; microscopy vs. no test, β = 21.88 [13.60, 30.16]) were positively associated with fidelity score.

CONCLUSIONS: This study showed that core elements of the “test and treat” strategy, such as testing all suspected cases with approved diagnostic methods before treatment, are still not fully implemented by health facilities. There is a need for strategies to increase fidelity, especially in the informal private health sector, for malaria elimination programme outcomes to be achieved.

PMID:38678279 | DOI:10.1186/s12936-024-04957-4

BMC Health Serv Res. 2024 Apr 27;24(1):541. doi: 10.1186/s12913-024-11036-6.

ABSTRACT

BACKGROUND: Research on health resource allocation trends in ethnic minority and impoverished areas in China is limited since the 2009 Medical Reform. This study aimed to investigate the variations and inequalities in health resource distribution among ethnic minority, poverty-stricken, and non-minority regions in Sichuan Province, a multi-ethnic province in Southwest China, from 2009 to 2019.

METHODS: The numbers of beds, doctors and nurses were retrospectively sourced from the Sichuan Health Statistics Yearbook between 2009 and 2019. All the 181 counties in Sichuan Province were categorized into five groups: Yi, Zang, other ethnic minority, poverty-stricken, and non-minority county. The Theil index, adjusted for population size, was used to evaluate health resource allocation inequalities.

RESULTS: From 2009 to 2019, the number of beds (Bed_p1000), doctors (Doc_p1000), and nurses (Nur_p1000) per 1000 individuals in ethnic minority and poverty-stricken counties consistently remained lower than non-minority counties. The growth rates of Bed_p1000 in Yi (140%) and other ethnic minority counties (127%) were higher than in non-minority counties (121%), while the growth rates of Doc_p1000 in Yi (20%) and Zang (11%) counties were lower than non-minority counties (61%). Doc_p1000 in 33% and 50% of Yi and Zang ethnic counties decreased, respectively. Nur_p1000 in Yi (240%) and other ethnic minority (316%) counties increased faster than non-minority counties (198%). The Theil index for beds and nurses declined, while the index for doctors increased. Key factors driving increases in bed allocation include preferential policies and economic development levels, while health practitioner income, economic development levels and geographical environment significantly influence doctor and nurse allocation.

CONCLUSIONS: Preferential policies have been successful in increasing the number of beds in health facilities, but not healthcare workers, in ethnic minority regions. The ethnic disparities in doctor allocation increased in Sichuan Province. To increase the number of doctors and nurses in ethnic minority and poverty-stricken regions, particularly in Yi counties, more preferential policies and resources should be introduced.

PMID:38678273 | DOI:10.1186/s12913-024-11036-6

BMC Res Notes. 2024 Apr 27;17(1):119. doi: 10.1186/s13104-024-06780-1.

ABSTRACT

Drought and Pierce’s disease are common throughout many grapevine-growing regions such as Mexico and the United States. Yet, how ongoing water deficits affect infections of Xylella fastidiosa, the causal agent of Pierce’s disease, is poorly understood. Symptoms were observed to be significantly more severe in water-stressed plants one month after X. fastidiosa inoculation, and, in one experiment, titers were significantly lower in water-stressed than well-watered grapevines. Host chemistry examinations revealed overall amino acid and phenolic levels did not statistically differ due to water deficits, but sugar levels were significantly greater in water stressed than well-watered plants. Results highlight the need to especially manage Pierce’s disease spread in grapevines experiencing drought.

PMID:38678272 | DOI:10.1186/s13104-024-06780-1

BMC Med Genomics. 2024 Apr 27;17(1):111. doi: 10.1186/s12920-024-01884-w.

ABSTRACT

BACKGROUND: Statistical epistasis, or “gene-gene interaction” in genetic association studies, means the nonadditive effects between the polymorphic sites on two different genes affecting the same phenotype. In the genetic association analysis of complex traits, nevertheless, the researchers haven’t found enough clues of statistical epistasis so far.

METHODS: We developed a statistical model where the statistical epistasis was presented as an extra linkage disequilibrium between the polymorphic sites of different risk genes. The power of statistical test for identifying the gene-gene interaction was calculated and then compared in different hypothesis scenarios.

RESULTS: Our results show the statistical power increases with the increasing of interaction coefficient, relative risk, and linkage disequilibrium with genetic markers. However, the power of interaction discovery is much lower than that of regular single-site association test. When rigorous criteria were employed in statistical tests, the identification of gene-gene interaction became a very difficult task. Since the criterion of significance was given to be p-value ≤ 5.0 × 10^-8, the same as that of many genome-wide association studies, there is little chance to identify the gene-gene interaction in all kind of circumstances.

CONCLUSIONS: The lack of epistasis tends to be an inevitable result caused by the statistical principles of methods in the genetic association studies and therefore is the inherent characteristic of the research itself.

PMID:38678264 | DOI:10.1186/s12920-024-01884-w

Cardiovasc Diabetol. 2024 Apr 27;23(1):145. doi: 10.1186/s12933-024-02221-2.

ABSTRACT

BACKGROUND: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have been suggested to exert cardioprotective effects in patients with heart failure, possibly by improving the metabolism of ketone bodies in the myocardium.

METHODS: This post hoc analysis of the EMMY trial investigated the changes in serum β-hydroxybutyrate (3-βOHB) levels after acute myocardial infarction (AMI) in response to 26-week of Empagliflozin therapy compared to the usual post-MI treatment. In addition, the association of baseline and repeated measurements of 3-βOHB with cardiac parameters and the interaction effects of Empagliflozin were investigated. Cardiac parameters included N-terminal pro-B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), left ventricle end-systolic volume (LVESV), left ventricle end-diastolic volume (LVEDV), and left ventricular filling pressure (E/é ratio).

RESULTS: The mean 3-βOHB levels increased from baseline (46.2 ± 3.0 vs. 51.7 ± 2.7) to 6 weeks (48.8 ± 2.2 vs. 42.0 ± 2.3) and 26 weeks (49.3 ± 2.2 vs. 35.8 ± 1.9) in the Empagliflozin group compared to a consistent decline in placebo over 26 weeks (p_interaction < 0.001). Baseline and longitudinal measurements of 3-βOHB were not significantly associated with NT-proBNP and E/é ratio. Baseline 3-βOHB value was negatively associated with LVEF (coefficient: – 0.464, 95%CI – 0.863;- 0.065, p = 0.023), while an increase in its levels over time was positively associated with LVEF (0.595, 0.156;1.035, 0.008). The baseline 3-βOHB was positively associated with LVESV (1.409, 0.186;2.632, 0.024) and LVEDV (0.640, – 1.170;- 2.449, 0.488), while an increase in its levels over time was negatively associated with these cardiac parameters (LVESV: – 2.099, – 3.443;- 0.755, 0.002; LVEDV: – 2.406, – 4.341;- 0.472, 0.015). Empagliflozin therapy appears to modify the association between 3-βOHB, LVEF (p_interaction = 0.090), LVESV (p_interaction = 0.134), and LVEDV (p_interaction = 0.168), particularly at 26 weeks; however, the results were not statistically significant.

CONCLUSION: This post hoc analysis showed that SGLT2i increased 3-βOHB levels after AMI compared to placebo. Higher baseline 3-βOHB levels were inversely associated with cardiac function at follow-up, whereas a sustained increase in 3-βOHB levels over time improved these markers. This highlights the importance of investigating ketone body metabolism in different post-MI phases. Although more pronounced effect of 3-βOHB on cardiac markers was observed in the SGLT2i group, further research is required to explore this interaction effect.

PMID:38678253 | DOI:10.1186/s12933-024-02221-2

Respir Res. 2024 Apr 27;25(1):189. doi: 10.1186/s12931-024-02796-0.

ABSTRACT

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a debilitating and progressive lung disease of unknown aetiology, characterized by the relentless deposition of fibrotic tissue. Biomarkers may play a pivotal role as indicators of disease presence, progression, and treatment response. Sirtuins, a family of enzymes with ADP ribosyltransferase or deacetylase activity, have been implicated in several diseases, including pulmonary fibrosis.

METHODS: A cross-sectional, prospective, observational single-center study was conducted to investigate the potential role of serum SIRTs levels as biomarkers in patients with IPF. Demographic, clinical, and functional data and serological samples were collected from 34 patients with IPF followed at the Interstital Lung and Rare Diseases Outpatient Clinic of the Vanvitelli Pneumology Clinic, Monaldi Hospital, Naples, Italy and from 19 age-matched controls.

RESULTS: Serum SIRT-1 levels were significantly reduced in IPF patients compared to controls (median IPF 667 [435-858] pg/mL versus controls 925 [794-1173] pg/mL; p < 0.001 ). In contrast, serum SIRT-3 levels were significantly increased in IPF patients compared to controls (median IPF 338 [230-500] pg/mL versus controls 154 [99.8-246] pg/mL; p < 0.001). There were no statistically significant differences in serum SIRT-6 and SIRT-7 levels between IPF and controls. In addition, we found a significant positive correlation between SIRT-1 and lung function parameters such as FEV₁% (ϱ=0.417;p = 0.016), FVC% (ϱ=0.449;p = 0.009) and DL_CO% (ϱ=0.393;p = 0.024), while a significant negative correlation was demonstrated between SIR-1 and GAP score, demonstrating a significant reduction in SIRT-1 in advanced Gender-Age-Physiology (GAP) stages 2-3 compared to GAP stage 1 (p = 0.008).

CONCLUSIONS: This prospective, cross-sectional study showed that SIRT-1 was associated with lung function and IPF severity and that both SIRT-1 and SIRT-3 could be considered as potential biomarkers of IPF, whereas SIRT-6 and SIRT-7 were not associated with IPF.

PMID:38678247 | DOI:10.1186/s12931-024-02796-0

BMC Oral Health. 2024 Apr 27;24(1):498. doi: 10.1186/s12903-024-04166-0.

ABSTRACT

BACKGROUND: Orthodontic treatment presents challenges with plaque accumulation around brackets, archwires, and elastics, leading to retained plaque and gingival inflammation. Conventional toothbrushing may not be enough, requiring additional oral hygiene aids like interproximal brushes, dental flosses, and water flossers. Limited research exists on comparing water flossing and interdental flossing in orthodontic patients. Therefore, this study aims to assess their effectiveness in maintaining oral hygiene during active orthodontic treatment.

METHODS: A single-blind, randomized, parallel clinical study recruited orthodontic patients with full-mouth brackets and archwires. Thirty participants were randomly assigned to either water jet flossing or interdental flossing groups. All participants were instructed to brush twice daily with a provided toothbrush and toothpaste and use the assigned intervention once daily at night. Clinical measures, including the Gingival Bleeding Index (BI), Plaque Index (PI), and Gingival Index (GI), were recorded at baseline and day 14. Descriptive statistics and statistical tests were performed using SPSS software.

RESULTS: The water jet flossing group demonstrated a slightly higher, albeit non-significant, benefit in plaque removal (median difference of 6.79%%, P = 0.279) and bleeding reduction (median difference of 5.21%%, P = 0.172) compared to the interdental flossing group after two weeks. Both groups showed significant reductions in gingival bleeding index and plaque index from baseline to the 2-week follow-up. The interdental flossing group had median mean percentage differences of 16.13%% (plaque index) and 23.57% (gingival bleeding index), while the water jet flossing group had median percentage differences of 21.87% (plaque index) and 32.29% (gingival bleeding index). No significant changes in gingival index grades were observed in either group.

CONCLUSION: Both water jet flossing and interdental flossing were effective in reducing plaque accumulation and gingival bleeding among orthodontic patients. While no significant differences were found between the two methods, water jet flossing showed a potential advantage. Further research is needed to validate its effectiveness, assess long-term impact, and understand its benefits for orthodontic patients.

PMID:38678246 | DOI:10.1186/s12903-024-04166-0