Category: Statistics

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Aug;31(Special Issue 1):857-861. doi: 10.32687/0869-866X-2023-31-s1-857-861.

ABSTRACT

One of the directions to increase the effectiveness of medical organizations in the region is the development of managerial tools for improving the quality of medical services. The aim of the study is to develop an approach to improving the quality of medical services based on the results of measuring patient satisfaction with the quality of medical services, mapping satisfaction criteria to medical and technological characteristics of the quality of services, substantiation and selection of appropriate corrective measures. The method of measuring patient satisfaction with the quality of the provided medical service and the method of deploying quality functions ensuring transformation of patient needs and expectations into characteristics of service quality were used. The measurement of patients’ satisfaction with the quality of medical services is carried out during medical and sociological research. The measurement results are obtained by statistical processing using a software set. To determine measures to improve the quality of cardiological services, the results of changing patient satisfaction were used in accordance with the method of deploying quality functions, which consists in implementing a number of steps that ensure the determination of a minimum set of additional requirements for medical services in order to meet the requirements of patients. This technique is supported by specialized software. Implementation of the proposed approach makes it possible to form tools aimed at creating an information model of medical services and ensure the change in the quality of such services demanded by patients.

PMID:37742263 | DOI:10.32687/0869-866X-2023-31-s1-857-861

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Aug;31(Special Issue 1):837-841. doi: 10.32687/0869-866X-2023-31-s1-837-841.

ABSTRACT

Adolescent girls aged 15-18 are in an active process of growth and development, as evidenced by the dynamics of changes in height and weight indicators. Low values of average growth indicators were determined among girls in Batken, on average 2 cm less than the average indicators of girls in Bishkek, however, the statistical analysis performed did not confirm the reliability of these differences. In 84.3% of the surveyed adolescent girls living in Naryn, iron deficiency anemia was detected. Kidney and urinary tract diseases (31.4%) took the first place in the structure of diseases among girls in Batken. Diffuse enlargement of the thyroid gland was found in 13% of women living in highlands. Inflammatory diseases of the genitourinary system are two or more times more common among girls in the middle and high mountains than in Bishkek: vulvitis in 8.7-11.4% of cases against 4.1% of cases, urogenital diseases in 6.5-17.4 versus 3.9 respectively. This indicates the need to introduce specific preventive programs for girls living in the middle and high mountains.

PMID:37742259 | DOI:10.32687/0869-866X-2023-31-s1-837-841

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Aug;31(Special Issue 1):752-755. doi: 10.32687/0869-866X-2023-31-s1-752-755.

ABSTRACT

The article discusses the issues of including the image of persons with disabilities in marketing and advertising practice. The data reflecting the statistics of disability and consumer behavior in the market of goods and services for the disabled and persons with disabilities are presented. The purpose of the study is to analyze the current practice of marketing and advertising activities using the image of disability and persons with disabilities. It is concluded that both advertising and any other forms of marketing initiatives reflect society, and therefore most advertisers at some point create communication products that somehow reflect their target audience. Good examples of images of people with disabilities and a well-thought-out advertising campaign are designed to increase brand loyalty and at the same time make the product more popular with a wide audience.

PMID:37742245 | DOI:10.32687/0869-866X-2023-31-s1-752-755

Aging (Albany NY). 2023 Sep 23;15. doi: 10.18632/aging.204888. Online ahead of print.

ABSTRACT

BACKGROUND: An increasing number of studies are shown how crucial a role cellular senescence plays in tumor development. In this study, we developed a senescence-related lncRNA prognostic index (SRLPI) to forecast radiosensitivity and the probability of biochemical recurrence (BCR) in patients with prostate cancer (PCa).

METHODS: PCa cohorts in TCGA and GEO databases were downloaded. Senescence-and prognosis-related lncRNA with differential expression in tumor and normal samples were identified and used to establish the SRLPI score. Mutation landscape, function pathway, tumor stemness and heterogeneity and tumor immune microenvironment were also analyzed. We performed the analysis using R 3.6.3 and the appropriate tools.

RESULTS: A SRLPI score was constructed based on SNHG1 and MIAT in the TCGA cohort. Our classification of PCa patients into high- and low-risk groups was based on the median SRLPI score. When compared to the low-SRLPI group, the high-SRLPI group was more vulnerable to BCR (HR: 3.33). In terms of BCR-free survival and metastasis-free survival, the GSE116918 showed similar findings. Surprisingly, the SRLPI score demonstrated a high level of radiosensitivity for diagnosis (AUC: 0.98). Age, Gleason score, T stage, N stage, positive lymph nodes, and residual tumor were all significantly greater in patients with high SRLPI scores. Furthermore, this score was significantly related to markers of senescence. Protein secretion and androgen response were found to be substantially enriched in the low-SRLPI group, whereas E2F targets were found to be strongly enriched in the high-SRLPI group for pathway analysis. For the tumor microenvironment assessment, B cells, CD8+ T cells, immune score and TIDE score were positively related to SRLPI score while endothelial level was negatively associated with SRLPI score with statistical significance.

CONCLUSIONS: We developed a SRLPI score that was related to prognosis and radiosensitivity and might be helpful in clinical practice.

PMID:37742230 | DOI:10.18632/aging.204888

Aging (Albany NY). 2023 Sep 22;15. doi: 10.18632/aging.205050. Online ahead of print.

ABSTRACT

Epidemiological investigations have indicated a correlation between elevated plasma levels of Dickkopf-related protein 1 (DKK1) and the presence of atherosclerosis. However, the exact causal relationship of DKK1 with the development of coronary artery disease (CAD) and ischemic stroke (IS) remains unclear. To address this gap, our study aimed to explore their causal association using a two-sample Mendelian randomization (MR) approach. We obtained summary statistics from genome-wide association studies (GWAS) meta-analyses conducted by Folkersen et al. and Nikpay et al., which included data from 21,758 individuals for DKK1 and 42,096 cases of CAD. Additionally, we obtained data from the FinnGen biobank analysis round 5, which included 10,551 cases of IS. Eight MR methods were employed to estimate causal effects and detect directional pleiotropy. Our findings demonstrated that genetic liability to DKK1 was associated with increased risks of CAD (odds ratio [OR]: 1.087; 95% confidence interval [CI]: 1.024-1.154; P = 0.006) and IS (OR: 1.096; 95% CI: 1.004-1.195; P = 0.039). These results establish a causal link between genetic liability to DKK1 and elevated risks of CAD and IS. Consequently, DKK1 may represent a promising therapeutic target for the prevention and treatment of CAD and IS.

PMID:37742224 | DOI:10.18632/aging.205050

J Sports Sci. 2023 Sep 24:1-12. doi: 10.1080/02640414.2023.2260237. Online ahead of print.

ABSTRACT

Motor synergies are defined as central nervous system mechanisms which adjust participating degrees of freedom to ensure dynamic stability (control) of certain performance variables and have been identified during many motor tasks. The potential for synergistic control of individual segments during full-body tasks is often overlooked. Thus, this study compared individual differences in the potential stabilization of multiple performance variables on the basis of experience during a full-body sport activity. Normalized time series of synergy indices from Uncontrolled Manifold analyses on experienced (n = 9) and inexperienced (n = 19) participants were analysed using statistical parametric mapping during simulated Nordic skiing. Regardless of experience, hand, upper arm, and whole-body centre of mass (COM) kinematics were found to be stabilized by kinematic motor synergies. Only experienced Nordic skiers stabilized trunk COM position at all, while trunk COM velocity was stabilized for a longer duration than inexperienced participants. However, inexperienced participants stabilized hand velocity for a greater duration overall and to a greater magnitude during early pull phase than the experienced skiers. That motor synergies for hand and trunk COM velocity differed between experience groups suggests potential utility for these performance variables as indicators of motor skill development for full-body tasks such as Nordic skiing.

PMID:37742214 | DOI:10.1080/02640414.2023.2260237

Nicotine Tob Res. 2023 Sep 24:ntad182. doi: 10.1093/ntr/ntad182. Online ahead of print.

ABSTRACT

INTRODUCTION: Cigarette smoke increases peripheral white blood cell (WBC) count. However, the dose-dependent association between smoking and C-reactive protein (CRP), an important inflammatory marker, has been reported inconsistent. Here, we evaluated the associations between smoking and CRP using both smoking questionnaires and urine cotinine as exposure markers.

METHODS: The Korea National Health and Nutrition Examination Survey data were used for analyzing the associations. Multiple regression analyses were performed to examine the associations between cigarette smoke exposure, as assessed by questionnaires and urine cotinine, and health effects, as measured by CRP and WBC count, controlling for potential confounders. The confounders, including age, sex, body mass index, blood pressure, cholesterol, glucose, alanine aminotransferase, and uric acid, were selected a priori based on the literature.

RESULTS: A total of 11,435 participants were included for analysis. For the exposure-response relationship, the results indicated a significant increase in CRP levels in male smokers compared to male non-smokers (p=0.002), whereas no significant increase was found in female smokers compared to female non-smokers (p=0.680). For the dose-response relationship, a significant positive association was observed between urine cotinine and CRP in male smokers (p=0.018), whereas no significant association was found in female smokers (p=0.508). WBC count consistently showed significant exposure-response and dose-response relationships in both sexes.

CONCLUSIONS: WBC count was found to be a consistent effect marker of cigarette smoke exposure, while the association between CRP level and smoking was inconsistent and varied by sex. The sex-specific response to cigarette smoke exposure warrants further exploration in future studies.

IMPLICATION: Cigarette smoke exposure is known to increase inflammation and has been thought to increase C-reactive protein (CRP), a significant inflammation marker. However, recent studies have reported conflicting results regarding the dose-dependent association between cigarette smoke exposure and CRP. This study found that the association between smoking and CRP is inconsistent and varies by sex, showing significant exposure-response in men but not in women. Furthermore, the study suggests that white blood cell count is a more consistent marker for cigarette smoke exposure.

PMID:37742212 | DOI:10.1093/ntr/ntad182

Facts Views Vis Obgyn. 2023 Sep;15(3):259-268. doi: 10.52054/FVVO.15.3.081.

ABSTRACT

BACKGROUND: Endometrial Cancer (EC), the most common genital tract malignancy in women, is recognised to be associated with a high Body Mass Index (BMI).

OBJECTIVE: The aim of the study was to evaluate the impact of obesity on intra and post-operative morbidity for patients treated for EC.

MATERIALS AND METHODS: This was a retrospective observational study including patients with EC that were surgically treated at Hospital de la Santa Creu i Sant Pau during nine consecutive years. The patients were divided in groups according to BMI: <30 Kg/m2, ≥30-<40 Kg/m2 and ≥40 Kg/m2. Demographic and pathological characteristics, surgical outcomes, perioperative complications and long-term outcomes were recorded.

RESULTS: The study included 290 patients; 164 patients with BMI <30 Kg/m2(56.5%), 107 patients with ≥30-<40 Kg/m2 36.9%) and 19 patients with ≥40 Kg/m2(6.65%). Patients with BMI ≥40Kg/m2 were younger, presented a higher percentage of endometrioid histology (84.2%, p<0.01), well-differentiated tumours (73.7%, p<0.01) and were more frequently in the initial stages at diagnosis (94.7%) compared to the other groups. A significant percentage of the patients were operated on laparoscopically (88.7%, 88.8%, 94.7% respectively). No significant differences were found in the evaluation of the surgical outcomes. The results relative to complications showed an overall tendency toward increase in the ≥40 Kg/m2 BMI group but no statistical differences were identified among the groups in terms of complications or long-term outcomes.

CONCLUSIONS: There was a rising trend towards increased complications with increasing BMI in the study population, however, this was found not to be statistically significant. Therefore, the optimisation of co-morbidities and the adaptation of surgical treatment is important for the management of obese patients with endometrial cancer.

WHAT IS NEW?: The study allows the comparison between groups with different BMI in patients with endometrial cancer. Different surgical outcomes, intra operative, early, and late complications are clearly identified, and survival outcomes are also investigated in our study.

PMID:37742203 | DOI:10.52054/FVVO.15.3.081

Facts Views Vis Obgyn. 2023 Sep;15(3):197-214. doi: 10.52054/FVVO.15.3.094.

ABSTRACT

BACKGROUND: Management of endometriosis should be based on the best available evidence. The pyramid of evidence reflects unbiased observations analysed with traditional statistics. Evidence-based medicine (EBM) is the clinical interpretation of these data by experts. Unfortunately, traditional statistical inference can refute but cannot confirm a hypothesis and clinical experience is considered a personal opinion.

OBJECTIVES: A proof of concept to document clinical experience by considering each diagnosis and treatment as an experiment with an outcome, which is used to update subsequent management.

MATERIALS AND METHODS: Experience and knowledge-based questions were answered on a 0 to 10 visual analogue scale (VAS) by surgery-oriented clinicians with experience of > 50 surgeries for endometriosis.

RESULTS: The answers reflect the collective clinical experience of managing >10.000 women with endometriosis. Experience-based management was overall comparable as approved by >75% of answers rated ≥ 8/10 VAS. Knowledge-based management was more variable, reflecting debated issues and differences between experts and non-experts.

CONCLUSIONS: The collective experience-based management of those with endometriosis is similar for surgery-oriented clinicians. Results do not conflict with EBM and are a Bayesian prior, to be confirmed, refuted or updated by further observations.

WHAT IS NEW?: Collective experience-based management can be measured and is more than a personal opinion. This might extend EBM trial results to the entire population and add data difficult to obtain in RCTs, such as many aspects of surgery.

PMID:37742197 | DOI:10.52054/FVVO.15.3.094

J Nepal Health Res Counc. 2023 Sep 10;21(1):159-164. doi: 10.33314/jnhrc.v21i1.4668.

ABSTRACT

BACKGROUND: Viral load assessment is the preferred method for diagnosing and confirming virologic failure for patients on antiretroviral therapy. This study aimed to assess the proportion of viral load suppression and identify associated factors among HIV-positive patients receiving antiretroviral therapy at the Pokhara academy of health science in Nepal.

METHODS: This institution-based retrospective cohort study was conducted at Pokhara academy of health science in Pokhara, Nepal. The study included 567 HIV patients who were enrolled between January 2016 and December 2019 and had their viral load measured within a one-year period. Statistical analysis was performed using STATA version 13.0. The proportions of viral load suppression and non-suppression were determined. Bivariate and multivariate logistic regressions were performed to identify factors associated with viral load suppression. Statistical significance was determined at a 95% confidence interval and p < 0.05 Results: Out of the 567 HIV patients, 95.76 % (95% CI: 94.10-97.42) achieved viral suppression. In multivariate analysis, longer duration of antiretroviral therapy treatment (> 3 years) was independently associated with higher odds of achieving viral suppression compared to those on antiretroviral therapy for less than 6 months (adjusted odds ratio [aOR] = 11.98, 95% confidence interval: 1.32-108.81, p < 0.0027). Conversely, individuals in second-line treatment had significantly lower odds of viral suppression compared to those in first-line treatment (aOR = 0.19, 95% CI: 0.05-0.66, p < 0.009).

CONCLUSIONS: Our study demonstrated a high rate of viral suppression among HIV patients receiving antiretroviral therapy, exceeding the UNAIDS 90-90-90 target. Longer duration of antiretroviral therapy and being in second-line treatment were identified as factors influencing viral load suppression. These findings emphasize the importance of early initiation and adherence to first-line treatment for optimal outcomes.

PMID:37742166 | DOI:10.33314/jnhrc.v21i1.4668