Category: Statistics

J Psychiatr Res. 2024 Oct 5;180:462-472. doi: 10.1016/j.jpsychires.2024.09.052. Online ahead of print.

ABSTRACT

Disorders across the affective disorders-psychosis spectrum such as major depressive disorder (MDD), bipolar disorder (BD), schizoaffective disorder (SCA), and schizophrenia (SCZ), have overlapping symptomatology and high comorbidity rates with other mental disorders. So far, however, it is largely unclear why some of the patients develop comorbidities. In particular, the specific genetic architecture of comorbidity and its relationship with brain structure remain poorly understood. Therefore, we performed systematic analyses of clinical, genetics and brain structural measures to gain further insights into the neurobiological correlates of mental disorder’s comorbidity. We investigated a sub-sample of the Marburg/Münster Cohort Study (MACS), comprising DSM-IV-TR diagnosed patients with a single disorder in the affective disorders-psychosis spectrum (SD, n = 470, MDD; BD; SCA; SCZ), with additional mental disorder’s comorbidities (COM, n = 310), and healthy controls (HC, n = 649). We investigated group differences regarding a) the global severity index (based on SCL90-R), b) a cross-disorder polygenic risk score (PRS) calculated with PRS-continuous shrinkage (PRS-CS) using the summary statistics of a large genome-wide association study across mental disorders, and c) whole brain grey matter volume (GMV). The SCL90-R score significantly differed between groups (COM > SD > HC). While SD and COM did not differ in cross-disorder PRS and GMV, SD and COM versus HC displayed increased cross-disorder PRS and decreased GMV in the bilateral insula, the left middle temporal, the left inferior parietal, and several frontal gyri. Our results thus suggest that disorders in the affective disorders-psychosis spectrum with or without additional comorbidities differ in self-reported clinical data, but not on genetic or brain structural levels.

PMID:39541637 | DOI:10.1016/j.jpsychires.2024.09.052

J Psychiatr Res. 2024 Nov 7;180:451-461. doi: 10.1016/j.jpsychires.2024.10.030. Online ahead of print.

ABSTRACT

BACKGROUND: Schizophrenia is a brain dysconnectivity disorder. However, it is not well understood whether the experience of childhood trauma (CT) affects dysconnectivity in individuals with schizophrenia (SZ). Using a network-based approach, we examined whether self-reported CT would explain additional variance compared to whole-brain topology and structural connectivity changes in SZ versus healthy controls (HC).

MATERIAL AND METHODS: CT was assessed in 51 SZ (mean age ± standard deviation 44 ± 11 years) and 140 HC (34.0 ± 12 years). Structural brain networks were constructed from T1-weighted MR and diffusion-MRI scans using non-tensor based tractography. Group differences in whole-brain topology and permutation-based statistics were examined and corrected for age and sex.

RESULTS: SZ showed reductions in efficiency, strength, clustering and density (p < 0.01) as well as increases in path length (F_(range) = 4.71-18.1, p < 0.03) when compared to HC. We also observed hypoconnectivity in a subnetwork of frontotemporal, frontoparietal and occipital regions in SZ relative to HC (T > 4.0, p < 0.001). However, we did not find that high CT levels were related to structural network differences or structural connectivity changes in SZ.

CONCLUSIONS: CT did not impact on topology or subnetwork connectivity changes in SZ. High CT levels were also not associated with any differences in network organisation irrespective of diagnosis. However, our findings confirm that SZ showed both network-level reductions and increases in a subnetwork. These findings suggest that the patterns of neuroanatomical dysconnectivity in established schizophrenia may not be influenced by CT. Future studies are needed to investigate the association between CT and structural dysconnectivity in schizophrenia.

PMID:39541636 | DOI:10.1016/j.jpsychires.2024.10.030

Geriatr Nurs. 2024 Nov 13;61:6-12. doi: 10.1016/j.gerinurse.2024.10.079. Online ahead of print.

ABSTRACT

BACKGROUND: Most geriatric patients with prostate cancer experience not only external discomfort but also negative psychological consequences such as reduced feelings of masculinity and diminished self-esteem. Social support is a protective factor for dealing with and adapting to these stressors, which enhances quality of life.

AIM: To identify the relationship between social support, self-esteem, and sense of masculinity among geriatric patients with PC.

METHOD: The study is a cross-sectional survey adopting a descriptive correlational design. A convenience sample of one hundred ten (110) geriatric patients diagnosed with PC attending the oncology and urology outpatient clinics of Damanhur Oncology Center in El-Beharia Governorate, Egypt. Four tools were used: subjects’ basic information, The Personal Resources Questionnaire (PRQ-2000), the Rosenberg Self-esteem Scale (RSE), and The Masculine Self-esteem scale (MSES).

RESULTS: 74.6 % of the studied geriatric patients had high levels of social support, 86.4 % had moderate levels of self-esteem, and 55.4 % had low masculine self-esteem. Also, the relationship was a statistically significant between social support and self-esteem (p = .002), between social support and sense of masculinity (p = .038), and between self-esteem and sense of masculinity (p = .029).

CONCLUSION: social Support and self-esteem were significant predictors of high sense of masculinity with social support positively influencing and self-esteem negatively influencing the sense of masculinity.

PMID:39541633 | DOI:10.1016/j.gerinurse.2024.10.079

Eur J Radiol. 2024 Nov 9;181:111824. doi: 10.1016/j.ejrad.2024.111824. Online ahead of print.

ABSTRACT

PURPOSE: To assess the diagnostic accuracy of O-RADS Ultrasound (O-RADS US) v2022, O-RADS US v2020, and IOTA SR, and to evaluate whether combining imaging findings with tumor markers enhances the diagnosis of adnexal masses.

METHODS: This retrospective study, conducted between January 2018 and December 2023, included consecutive women with adnexal masses scheduled for surgery. Histopathologic results served as the reference standard. Risk factors for malignancy were identified using univariate and multivariate logistic regression analyses. ROC analysis was employed to assess diagnostic test performances, while Kappa statistics evaluated inter-reviewer agreement.

RESULTS: A total of 613 women (mean age, 49.39 ± 12.81 years; range, 16-87 years) with pelvic masses were included. O-RADS US v2022 exhibited comparable performance to O-RADS US v2020, with areas under the curve (AUC) values of 0.940 and 0.937, respectively (p = 0.02, exceeding the adjusted significance level of 0.0167). Both O-RADS models outperformed the IOTA SR, which had an AUC of 0.862 (p < 0.0001 for both comparisons). Multivariate analysis revealed that O-RADS US v2022 [OR 9.148, 95 %CI (4.912-17.039), p < 0.001] and HE4 [OR 1.023, 95 %CI (1.010-1.036), p = 0.001] were significant factors associated with malignant lesions. Furthermore, the combination of O-RADS US v2022 and HE4 demonstrated an AUC of 0.98, significantly outperforming either O-RADS US v2022 alone (AUC = 0.94) or HE4 alone (AUC = 0.92). The Kappa values for O-RADS US v2022, O-RADS US v2020 and IOTA SR were 0.933, 0.891 and 0.923, respectively, indicating substantial inter-reader agreement.

CONCLUSIONS: The O-RADS US v2022 demonstrates comparable performance in predicting ovarian malignant lesions when compared to O-RADS US v2020, while surpassing the performance of IOTA SR. Additionally, the combination of O-RADS US v2022 and HE4 provides improved diagnostic effectiveness over using either O-RADS US v2022 or HE4 alone.

PMID:39541614 | DOI:10.1016/j.ejrad.2024.111824

Eur J Radiol. 2024 Nov 10;181:111832. doi: 10.1016/j.ejrad.2024.111832. Online ahead of print.

ABSTRACT

OBJECTIVE: This study explores the clinical utility of dual-energy computed tomography (DECT) in discriminating thrombus types in ischemic stroke.

METHODS: Patients with acute ischemic stroke who underwent brain DECT non-contrast scanning and brain CT perfusion (CTP) before thrombectomy were included, and the thrombus composition was analyzed by postoperative pathology. DECT data was conducted to reconstruct polychromatic images and effective atomic number images. Computed tomography (CT) values, effective atomic numbers, and spectral curve slopes of the thrombus were measured and calculated. Thrombus attenuation increase was obtained from CTP data. Parameters were compared between red blood cell (RBC)-dominant thrombi and fibrin/platelet (F/P)-dominant thrombi. Thresholds, sensitivity, specificity, and area under the curve (AUC) were analyzed to distinguish these thrombi. The associations between DECT parameters and proportion of RBCs were analyzed by Spearman’s correlation.

RESULTS: Pathological analysis of 42 enrolled patients revealed 24 cases of RBC-dominant thrombi and 18 cases of F/P-dominant thrombi. Effective atomic numbers, spectral curve slopes, and polychromatic images CT values were significantly higher in the RBC-dominant thrombi group compared with the F/P-dominant thrombi group. Although the average thrombus attenuation increase was greater in the F/P-dominant thrombi group, this difference was not statistically significant. Among the DECT parameters, polychromatic images CT values had the greatest AUC at 0.924 (0.848-0.999) for discriminating RBC-dominant and F/P-dominant thrombi, with a threshold of 59 HU, sensitivity of 79.2 %, and specificity of 94.4 %. The combined diagnostic AUC reached 0.938 (0.863-1.012), with 87.5 % sensitivity and 94.4 % specificity. DECT polychromatic images CT values, effective atomic numbers, and spectral curve slopes were significantly correlated with proportion of RBCs (r = 0.673, 0.574, and 0.571, all p < 0.01).

CONCLUSION: DECT non-contrast scan parameters are associated with thrombus composition, which could be effective in distinguishing between RBC-dominant and F/P-dominant thrombi.

PMID:39541613 | DOI:10.1016/j.ejrad.2024.111832

Nutrition. 2024 Oct 9;129:112597. doi: 10.1016/j.nut.2024.112597. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Nutritional support after hospital discharge was found to enhance the nutritional condition of patients after cancer surgery. However, the effect of such support on long-term clinical outcomes is controversial. We thus investigated the effect of nutritional support after hospital discharge on long-term clinical outcomes in patients after gastric cancer surgery.

METHODS: This was a secondary analysis on individuals at nutritional risk who underwent gastric cancer surgery and were included in a randomized controlled trial. The intervention group received oral nutritional supplements combined with dietary advice, and the control group received dietary advice alone. The long-term mortality (primary outcome) and other clinical outcomes were compared between the groups.

RESULTS: In total, 321 patients were included in this analysis, with a median follow-up duration of 60.5 months. According to the Nutritional Risk Screening 2002 (NRS 2002), the presence of nutritional risk was found to be a significant predictor of death. This association remained independent even after adjusting for age, sex, comorbidity, and American Joint Committee on Cancer stage. The adjusted hazard ratio for mortality increased by 1.30 (95% confidence interval [CI] 1.05-1.60, P = 0.016) for each additional point rise in NRS. During the follow-up, a total of 64 individuals (39.5%) in the intervention group and 81 patients (50.9%) in the control group died. Consequently, the adjusted hazard ratio for mortality between the two groups was 0.69 (95% CI 0.50-0.96, P = 0.026). The results of interaction tests did not yield statistically significant variations in fatality rates across the age, sex, comorbidity, NRS, and American Joint Committee on Cancer stage subgroups. Nutritional support after hospital discharge significantly improved handgrip strength (adjusted coefficient 5.05, 95% CI 3.01-7.08, P = 0.000) in addition to other functional outcomes.

CONCLUSIONS: Nutritional support after hospital discharge reduced long-term mortality and improved handgrip strength among patients at nutritional risk after gastric cancer surgery. The current investigation provides evidence for the recommendation of nutritional support, for post-surgery patients after hospital discharge, in cancer management guidelines.

PMID:39541610 | DOI:10.1016/j.nut.2024.112597

Prev Chronic Dis. 2024 Nov 14;21:E89. doi: 10.5888/pcd21.240264.

ABSTRACT

INTRODUCTION: Understanding health outcomes among people with cardiovascular disease (CVD) is crucial for improving treatment strategies and patient quality of life. This study investigated racial and ethnic disparities in perceived health status among non-Hispanic Black, Hispanic, and non-Hispanic White adults with CVD.

METHODS: The study had a retrospective cross-sectional design and used data from the Medical Expenditure Panel Survey spanning 8 calendar years (2014-2021). The study population consisted of adults diagnosed with various CVDs. We used ordinal logistic regression models adjusted for demographic and socioeconomic characteristics, CVD severity, comorbidities, and health care expenditures to assess racial and ethnic differences in perceived health status.

RESULTS: Among the 11,715 (weighted frequency, 15,431,283) adults with CVD, we observed significant differences in perceived health status across racial and ethnic cohorts. The unadjusted analysis showed that non-Hispanic Black adults had significantly higher odds than non-Hispanic White adults of perceiving their health as poorer (odds ratio [OR]= 1.89; 95% CI, 1.74-2.07; P < .001), with a similar observation among Hispanic adults (OR = 2.05; 95% CI, 1.85-2.26; P < .001). Although female sex, higher education, and better income had protective effects on perceived health status independent of race, we found significant racial and ethnic differences in the effect of older age, physical and cognitive limitations, and health insurance status on perceived health status.

CONCLUSION: This study revealed substantial racial disparities in perceived health status among adults with CVD, with notable differences in the effects of predictive factors. Addressing these disparities requires targeted interventions to improve health care access and enhance socioeconomic conditions tailored to the needs and experiences of racial and ethnic populations.

PMID:39541588 | DOI:10.5888/pcd21.240264

Prev Chronic Dis. 2024 Nov 14;21:E90. doi: 10.5888/pcd21.240229.

ABSTRACT

We analyzed 2021 and 2022 National Health Interview Survey data to describe the prevalence of past 12-month telemedicine use among US adults with no prediabetes or diabetes diagnosis, diagnosed prediabetes, and diagnosed diabetes. In 2021 and 2022, telemedicine use prevalence was 34.1% and 28.2% among adults without diagnosed diabetes or prediabetes, 47.6% and 37.6% among adults with prediabetes, and 52.8% and 39.4% among adults with diabetes, respectively. Differences in telemedicine use were identified by region, urbanicity, insurance status, and education among adults with prediabetes or diabetes. Findings suggest that telemedicine use can be improved among select populations with prediabetes or diabetes.

PMID:39541587 | DOI:10.5888/pcd21.240229

JMIR Public Health Surveill. 2024 Nov 14;10:e57168. doi: 10.2196/57168.

ABSTRACT

BACKGROUND: Cataract is a leading cause of vision impairment. Obesity-related risk factors, including insulin resistance, increase the risk of cataract. The fatty liver index (FLI) is a biomarker for noninvasive fat layer prediction of nonalcoholic fatty liver disease. The FLI has been used to evaluate the metabolic contribution in other organs besides the eye. However, no study exists on the FLI and eye disease.

OBJECTIVE: This retrospective cohort study for the association between the FLI and incidence of cataract surgery in individuals older than 50 years was designed to show that a higher FLI is associated with an increased incidence of cataract surgery in individuals aged 50 years and older.

METHODS: This study was retrospectively designed based on the Korean National Health Insurance Service-Health Screening Cohort (NHIS-HEALS) cohort (median follow-up of 9.8 years). Participants were assigned to 1 of 3 groups based on the FLI: low (FLI<30), intermediate (FLI 30-59), or high (FLI≥60). Kaplan-Meier survival analysis was performed on the cumulative incidence of all-cataract and senile-cataract surgery. Multivariable Cox proportional hazards regression models were used to study the association between the FLI group and cataract surgery after adjusting for potential confounders.

RESULTS: Of the 138,347 included participants, the incidence of cataract surgery was 12.49% (4779/38,274), 13.95% (6680/47,875), and 14.16% (7496/52,930) in the low, intermediate, and high FLI groups, respectively. After adjusting for all confounding factors, hazard ratios (HRs; 95% CIs) in the high FLI group for all-cataract surgery were 1.111 (1.028-1.199) and 1.184 (1.101-1.274) in men and women, respectively, when compared with the low FLI group. HRs (95% CIs) in the high FLI group for senile-cataract surgery were 1.106 (1.022-1.197) and 1.147 (1.065-1.237) in men and women, respectively, when compared with the low FLI group. The project was conducted between August 2023 and February 2024 without donations from external bodies.

CONCLUSIONS: Individuals with a higher FLI had a higher risk of all-cataract surgery. This association was maintained even after limiting the analyses to senile-cataract surgery.

PMID:39541585 | DOI:10.2196/57168

JMIR Form Res. 2024 Nov 14;8:e57244. doi: 10.2196/57244.

ABSTRACT

BACKGROUND: Men who have sex with men (MSM) are increasingly using the internet to meet casual sexual partners. Those who do are at higher risk of sexually transmitted diseases. However, little is known about the rates and associations of frequent HIV testing and self-testing among such MSM.

OBJECTIVE: We aimed to examine HIV serostatus communication and perceptions regarding the HIV infection risk of internet-based partners, along with their associations with frequent HIV testing and self-testing.

METHODS: A cross-sectional study was conducted between May 2018 and April 2019 in Zhejiang Province, China. The study participants were assigned male at birth, were aged 18 years or older, had had casual sex with another male found through the internet in the last 6 months, and were HIV-negative. Information was obtained on HIV-testing behavior, along with demographic characteristics, HIV-related knowledge, internet-based behaviors, sexual behaviors with male partners, HIV serostatus communication, and perceptions regarding the HIV infection risk of internet-based partners. Uni- and multivariate logistic regression models were used to measure the associations of HIV testing and self-testing.

RESULTS: The study recruited 281 individuals who had sought casual sexual partners through the internet during the previous 6 months. Of the participants, 61.9% (174/281) reported frequent HIV testing (twice or more frequently) and 50.9% (119/234; 47 with missing values) reported frequent HIV self-testing. MSM who always or usually communicated about the HIV serostatus of internet-based partners in the previous 6 months had 3.12 (95% CI 1.76-5.52) and 2.45 (95% CI 1.42-4.22) times higher odds of being frequently tested or self-tested for HIV, respectively, compared with those who communicated about this issue minimally or not at all.

CONCLUSIONS: There remains a need to improve the frequency of HIV testing and self-testing among internet-based MSM. HIV serostatus communication should be improved within the context of social networking applications to promote frequent HIV testing among internet-based MSM, especially for those who communicated about this issue minimally or not at all.

PMID:39541583 | DOI:10.2196/57244