Category: Statistics

BMC Psychiatry. 2022 May 5;22(1):322. doi: 10.1186/s12888-022-03966-4.

ABSTRACT

BACKGROUND: Common mental disorders such as depression, anxiety, and somatic symptoms are a major public health concern because it is prevalent and chronic, and its impact on physical health, psychological and economic consequences is very serious. Evidence on the prevalence and predictors of common mental disorders is very limited in Ethiopia. This study aims to determine the prevalence and associated factors with common mental disorders.

METHODS: A community-based cross-sectional study was conducted among 731 south Gondar zone residents recruited with a multistage sampling method. Data were collected by face-to-face interviews on socio-demographic, clinical, and psychosocial factors. Common mental disorders (CMD) were assessed using a self-reporting questionnaire (SRQ-20). A-List of Threatening Experiences and the Oslo social support instruments were used to identify the factors. We used bivariate and multivariable binary logistic regressions to identify factors associated with common mental disorders. Statistical significance was declared at P-value < 0.05.

RESULTS: The prevalence of common mental disorders over the last four weeks was found to be 29.7% with 95% of confidence interval (CI) (26.4-33.1). After adjusting possible confounders, female sex, [AOR = 2.47, 95% CI (1.68, 3.62)], poor social support [AOR = 2.34, 95% CI (1.50, 3.64)], family history of mental illness [AOR = 2.15, (1.32-3.51)], rural resident [AOR = 2.01, 95% CI (1.35, 3.01)], current use of khat [AOR = 1.69, 95% CI (1 0.07, 2.64)] current use of tobacco (AOR = 1.71, 95% CI (1.04-2.84) and unemployment [AOR = 1.762, 95% CI; 1.193, 2.602)] were significantly associated with common mental disorders.

CONCLUSION: The prevalence of common mental disorders was high, especially in Female sex, current substance use (khat chewing (leaves) and tobacco smoking), unemployment, rural residence, family history mental illness, and poor social support are the main determinants of common mental disorders. Early detection and appropriate intervention for common mental disorders in the community level should be promoted. Governmental strategies should be focused on implementing substance rehabilitation centers to treat Khat and tobacco might be helpful to minimize the burden of CMD in Ethiopia.

PMID:35513829 | DOI:10.1186/s12888-022-03966-4

BMC Musculoskelet Disord. 2022 May 5;23(1):422. doi: 10.1186/s12891-022-05371-0.

ABSTRACT

BACKGROUND: Suture anchors (SAs) made of human allogenic mineralized cortical bone matrix are among the newest developments in orthopaedic and trauma surgery. Biomechanical properties of an allogenic mineralized suture anchor (AMSA) are not investigated until now. The primary objective was the biomechanical investigation of AMSA and comparing it to a metallic suture anchor (MSA) and a bioabsorbable suture anchor (BSA) placed at the greater tuberosity of the humeral head of cadaver humeri. Additionally, we assessed the biomechanical properties of the SAs with bone microarchitecture parameters.

METHODS: First, bone microarchitecture of 12 fresh frozen human cadaver humeri from six donors was analyzed by high-resolution peripheral quantitative computed tomography. In total, 18 AMSAs, 9 MSAs, and 9 BSAs were implanted at a 60° angle. All three SA systems were systematically implanted alternating in three positions within the greater tuberosity (position 1: anterior, position 2: central, position 3: posterior) with a distance of 15 mm to each other. Biomechanical load to failure was measured in a uniaxial direction at 135°.

RESULTS: Mean age of all specimens was 53.6 ± 9.1 years. For all bone microarchitecture measurements, linear regression slope estimates were negative which implies decreasing values with increasing age of specimens. Positioning of all three SA systems at the greater tuberosity was equally distributed (p = 0.827). Mean load to failure rates were higher for AMSA compared to MSA and BSA without reaching statistical significance between the groups (p = 0.427). Anchor displacement was comparable for all three SA systems, while there were significant differences regarding failure mode between all three SA systems (p < 0.001). Maximum load to failure was reached in all cases for AMSA, in 44.4% for MSA, and in 55.6% for BSA. Suture tear was observed in 55.6% for MSA and in 22.2% for BSA. Anchor breakage was solely seen for BSA (22.2%). No correlations were observed between bone microarchitecture parameters and load to failure rates of all three suture anchor systems.

CONCLUSIONS: The AMSA showed promising biomechanical properties for initial fixation strength for RCR. Since reduced BMD is an important issue for patients with chronic rotator cuff lesions, the AMSA is an interesting alternative to MSA and BSA. Also, the AMSA could improve healing of the enthesis.

PMID:35513813 | DOI:10.1186/s12891-022-05371-0

BMC Health Serv Res. 2022 May 5;22(1):603. doi: 10.1186/s12913-022-07838-1.

ABSTRACT

BACKGROUND: A growing number of studies show that integrated health care provides comprehensive and continuous care to patients with hypertension or diabetes. However, there is still no consensus about the effect of integrated health care on patients with hypertension or diabetes. The objective of this study was to verify the effectiveness of integrated health care for patients with hypertension or diabetes by using a systematic review and meta-analysis.

METHODS: The study searched multiple English and Chinese electronic databases. The search period was from database inception to 31 October 2020. Systematic reviews and meta-analyses were conducted after assessing the risk of bias of each study.

RESULTS: Sixteen studies that involved 5231 patients were included in this study. The results of the systematic review revealed that systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI) and glycosylated haemoglobin (HbA1c) are commonly used indicators for patients with hypertension or diabetes. Individual models and group- and disease-specific models are the most commonly used models of integrated health care. All the studies were from high-income and middle-income countries. Meta-analysis showed that integrated health care significantly improved SBP, DBP and HbA1c but not BMI. A comparison of interventions lasting 6 and 12 months for diabetes was conducted, and HbA1c was decreased after 12 months. The changes in SBP and DBP were statistically significant after using group- and disease-specific model but not individual models. HbA1c was significantly improved after using group- and disease-specific models and individual models.

CONCLUSION: Integrated health care is a useful tool for disease management, and individual models and group- and disease-specific models are the most commonly used models in integrated health care. Group- and disease-specific models are more effective than individual models in the disease management of hypertension patients. The duration of intervention should be considered in the disease management of patients with diabetes, and interventions longer than 12 months are recommended. The income level may affect the model of integrated health care in selecting which disease to intervene, but this point still needs support from more studies.

PMID:35513809 | DOI:10.1186/s12913-022-07838-1

BMC Med Educ. 2022 May 5;22(1):343. doi: 10.1186/s12909-022-03417-4.

ABSTRACT

BACKGROUND: During the novel COVID-19 pandemic, many universities adopted distance and hybrid learning as a modification to their teaching methods to ensure continuity of education, abiding by the worldwide recommendations of social distancing.

AIM: To compare learning environments created through hybrid learning versus distance learning, to deliver paediatric dentistry course, and to assess the correlation between the created learning environment and students’ satisfaction.

METHOD: In this cross-sectional study, students enrolled in a hybrid paediatric dentistry course were asked to participate in an electronic survey. The learning environment was assessed using Distance Educational Learning Environment Survey (DELES), students’ satisfaction was assessed using Satisfaction Scale (SS). Retrospective data for distance learning course was used for comparison. Ordinal data were compared using Mann-Whitney U test. Spearman’s rank order correlation coefficient was used to correlate students’ satisfaction with DELES. Multiple regression analysis was used to predict satisfaction.

RESULTS: A total of 376 students’ data were considered in the study. Hybrid learning had significantly higher scores than distance learning in 3 DELES scales. There was a statistically significant weak positive correlation between satisfaction and DELES. Multiple regression analysis model was statistically significant and accounted for (22.8%) of the variance in students’ satisfaction. Only “Instructor support” (p = 0.001) and “Student autonomy” (p < 0.001) had a significant effect on satisfaction.

CONCLUSION: This study supports the superiority of a hybrid learning environment over a complete distance learning environment, it also shows that satisfaction is correlated and can be predicted by the created learning environment.

TRIAL REGISTRATION: This study has been registered on clinicaltrials.gov on 21 May 2020 with an identifier: NCT04401371 .

PMID:35513807 | DOI:10.1186/s12909-022-03417-4

BMC Med. 2022 May 6;20(1):134. doi: 10.1186/s12916-022-02330-3.

ABSTRACT

BACKGROUND: Previous studies of primarily Western populations have reported contrasting associations of dairy consumption with certain cancers, including a positive association with prostate cancer and inverse associations with colorectal and premenopausal breast cancers. However, there are limited data from China where cancer rates and levels of dairy consumption differ importantly from those in Western populations.

METHODS: The prospective China Kadoorie Biobank study recruited ~0.5 million adults from ten diverse (five urban, five rural) areas across China during 2004-2008. Consumption frequency of major food groups, including dairy products, was collected at baseline and subsequent resurveys, using a validated interviewer-administered laptop-based food frequency questionnaire. To quantify the linear association of dairy intake and cancer risk and to account for regression dilution bias, the mean usual consumption amount for each baseline group was estimated via combining the consumption level at both baseline and the second resurvey. During a mean follow-up of 10.8 (SD 2.0) years, 29,277 incident cancer cases were recorded among the 510,146 participants who were free of cancer at baseline. Cox regression analyses for incident cancers associated with usual dairy intake were stratified by age-at-risk, sex and region and adjusted for cancer family history, education, income, alcohol intake, smoking, physical activity, soy and fresh fruit intake, and body mass index.

RESULTS: Overall, 20.4% of participants reported consuming dairy products (mainly milk) regularly (i.e. ≥1 day/week), with the estimated mean consumption of 80.8 g/day among regular consumers and of 37.9 g/day among all participants. There were significant positive associations of dairy consumption with risks of total and certain site-specific cancers, with adjusted HRs per 50 g/day usual consumption being 1.07 (95% CI 1.04-1.10), 1.12 (1.02-1.22), 1.19 (1.01-1.41) and 1.17 (1.07-1.29) for total cancer, liver cancer (n = 3191), female breast cancer (n = 2582) and lymphoma (n=915), respectively. However, the association with lymphoma was not statistically significant after correcting for multiple testing. No significant associations were observed for colorectal cancer (n = 3350, 1.08 [1.00-1.17]) or other site-specific cancers.

CONCLUSION: Among Chinese adults who had relatively lower dairy consumption than Western populations, higher dairy intake was associated with higher risks of liver cancer, female breast cancer and, possibly, lymphoma.

PMID:35513801 | DOI:10.1186/s12916-022-02330-3

BMC Microbiol. 2022 May 5;22(1):121. doi: 10.1186/s12866-022-02545-7.

ABSTRACT

OBJECTIVE: To explore the impact of pre-pregnancy vaginal Mycoplasma hominis (M. hominis) colonization of low abundance on female fecundability.

METHODS: In total, 89 females participating in a pre-pregnancy health examination program were included, and their pregnancy outcomes were followed up for 1 year. Vaginal swabs were collected, 16S rRNA genes were sequenced, and M. hominis colonization was confirmed by qPCR. Cox models were used to estimate the fecundability odds ratio (FOR) for women with M. hominis.

RESULTS: The prevalence of M. hominis was 22.47% (20/89), and the abundance was relatively low (the cycle thresholds of the qPCR were all more than 25). In terms of the vaginal microbiome, the Simpson index of the positive group was significantly lower than that of the negative group (P = 0.003), which means that the microbiome diversity appeared to increase with M. hominis positivity. The relative abundance of M. hominis was negatively correlated with Lactobacillus crispatus (rho = – 0.24, P = 0.024), but positively correlated with Gardnerella vaginalis, Atopobium vaginae and Prevotella bivia (P all < 0.05). The cumulative one-year pregnancy rate for the M. hominis positive group was lower than that in the negative group (58.96% vs 66.76%, log-rank test: P = 0.029). After controlling for potential confounders, the risk of pregnancy in the M. hominis positive group was reduced by 38% when compared with the positive group (FOR = 0.62, 95% CI: 0.42-0.93).

CONCLUSION: The vaginal colonization of M. hominis at a low level in pre-pregnant women is negatively correlated with female fecundability.

PMID:35513786 | DOI:10.1186/s12866-022-02545-7

Occup Med (Lond). 2022 May 5:kqac024. doi: 10.1093/occmed/kqac024. Online ahead of print.

ABSTRACT

BACKGROUND: The occupational well-being (OW) of educators can be defined as a balance between resources and workload factors as seen from four aspects of working life: (i) individual, (ii) working conditions, (iii) professional competence and (iv) work community. The research in this study examined the individual aspect as particular importance to the physical and mental workability of educators.

AIMS: To study the individual aspect of the OW of educators as well as the associating factors.

METHODS: A cross-sectional survey design was conducted among educators working in health and social care education in Finland. The data were collected with an electronic survey using the ‘Occupational well-being of social and health care teachers-index questionnaire’. The data were analysed with an SPSS version 27 using descriptive statistics, explorative factor analysis and linear regression analysis.

RESULTS: The educators (n = 552, response rate 31%) assessed their resources for managing their mental workload as quite poor (2.41, standard deviation [SD] 0.98). In addition, workplace support promoting OW was assessed as being quite poor (2.37, SD 0.88), and as especially requiring more measures during working hours. Associations with the individual aspect of OW were found between the personal and work-related background variables as well as overall OW.

CONCLUSIONS: The perceptions of the educators indicated that resources to cope with workload factors should be promoted. Investing in educators’ resources at work, enabling well-being actions during working hours and avoiding backlog situations would all help promote the educators’ OW.

PMID:35512455 | DOI:10.1093/occmed/kqac024

Eur J Prev Cardiol. 2022 May 5:zwac091. doi: 10.1093/eurjpc/zwac091. Online ahead of print.

ABSTRACT

BACKGROUND: Sex-specific risk predictive performance of N-terminal pro B-type natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin T (hs-cTnT) and creatine kinase myocardial band (CK-MB), for individual and composite cardiovascular outcomes remains unclear.

OBJECTIVES: To evaluate the sex-specific predictive value of NT-proBNP, hs-cTnT and CK-MB for 10-year risk prediction of coronary heart disease (CHD), stroke, heart failure (HF) and composite outcomes.

METHODS: 5430 individuals (mean age 68.6 years, 59.9% women) from the Rotterdam Study, with biomarker measurements between 1997-2001, were included. Participants were followed until 2015. We fitted ‘basic’ models using traditional cardiovascular risk factors. Improvements in c-statistics and net reclassification improvement (NRI) for events and non-events were calculated.

RESULTS: During a median follow-up of 14 years, 747 (13.8%), 563 (10.4%), and 664 (12.2%) participants were diagnosed with CHD, stroke, and HF respectively. NT-proBNP improved the discriminative performance of the ‘basic’ model for all endpoints (c-statistic improvements ranging from 0.007 to 0.050) and provided significant event-net reclassification improvement (NRI) for HF (14.3% in women; 10.7% in men) and for stroke in men (9.3%). The addition of hs-cTnT increased c-statistic for CHD in women by 0.029 (95%CI, 0.011-0.047) and for HF in men by 0.034 (95%CI, 0.014-0.053), and provided significant event-NRI for CHD (10.3%) and HF (7.8%) in women, and for stroke (8.4%) in men. The added predictive value of CK-MB was limited.

CONCLUSION: NT-proBNP and hs-cTnT provided added predictive value for various cardiovascular outcomes above traditional risk factors. Sex differences were observed in the predictive performance of these biomarkers.

PMID:35512434 | DOI:10.1093/eurjpc/zwac091

Mil Med. 2022 May 5:usac114. doi: 10.1093/milmed/usac114. Online ahead of print.

ABSTRACT

INTRODUCTION: Burns are common injuries on the battlefield. Given austere environments, surgical debridement of injured service members is often not feasible in these settings. Delays in surgical debridement create a risk of infection and deranged healing for burn patients. As such, this study attempts to identify the best commercially available off-the-shelf (OTS) therapies with field-deployable potential to improve prolonged field care (PFC) of burn-injured soldiers.

METHODS: Deep partial-thickness (DPT) burns (25 cm2) were created on the dorsum of 5 anesthetized pigs utilizing a thermocouple burn device at 100°C for 15 seconds. Nonsurgical debridement was done 1-hour after burn creation using sterile saline water and gauze to remove excess eschar tissue. Animals were then randomized into 5 experimental groups, and OTS therapies were applied to 6 of the 12 created DPT burns. The remaining 6 burns were treated with 1% silver sulfadiazine cream (Ascend Laboratories, LLC, Parsippany, NJ) as the PFC standard of care (SOC) controls. The 5 randomized OTS therapies were: irradiated sterile human skin allograft (IHS), biodegradable temporizing matrix (BTM), polylactic acid skin substitute, hyaluronic acid ester matrix (HAM), and decellularized fish skin graft (FSG). Wounds were serially assessed on post-burn days 3, 7, 14, 21, and 28. Assessments were conducted using a combination of photographs, histology, and quantitative bacteriology. Endpoints included burn wound progression, re-epithelialization, wound contraction, scar elevation index, and colony-forming units (CFU).

RESULTS: The analysis demonstrated that by day 3, the FSG prevented burn wound progression the most efficiently. In terms of wound healing, the results showed re-epithelialization percentages close to 100% by day 28 for all treatment groups. No statically significant differences were observed. Quality of healing analyses demonstrated that the BTM-treated wounds had contracted less and the difference to the IHS-treated wounds was statistically significant (P < .05). As regards to antimicrobial properties, the CFU results showed no statistically significant differences between the OTS therapies and the SOC on days 3, 7, and 14.

CONCLUSIONS: The impact of Food and Drug Administration-approved OTS therapies was compared to the current PFC SOC for the treatment of DPT burns in a porcine model. Several topical options exist for the management of burns prior to definitive treatment in the operating room and warrant further evaluation. These therapies are actively used on civilian burn counterparts and have far-forward, field-deployable potential for use at the point of injury so that injured service members may not need evacuation to higher roles of care and combat power may be preserved. Our results demonstrated that all the studied OTS therapies performed well when compared to the SOC in terms of burn wound progression, wound healing, quality of healing, and quantitative bacteriology.

PMID:35512410 | DOI:10.1093/milmed/usac114

J Natl Cancer Inst. 2022 May 5:djac094. doi: 10.1093/jnci/djac094. Online ahead of print.

ABSTRACT

BACKGROUND: The use of menopausal hormone therapy (MHT) may interact with genetic variants to influence colorectal cancer (CRC) risk.

METHODS: We conducted a genome-wide gene-environment interaction between single nucleotide polymorphisms and the use of any MHT, estrogen-only, and combined estrogen-progestogen therapy with CRC risk, among 28,486 postmenopausal women (11,519 cases and 16,967 controls) from 38 studies, using logistic regression, two-step method, and 2- or 3-degree-of-freedom (d.f.) joint test. A set-based score test was applied for rare genetic variants.

RESULTS: The use of any MHT, estrogen-only and estrogen-progestogen were associated with a reduced CRC risk [odds ratio (OR) with 95% confidence interval (95% CI) of 0.71 (0.64-0.78), 0.65 (0.53-0.79), and 0.73 (0.59-0.90), respectively]. The two-step method identified a statistically significant interaction between a GRIN2B variant rs117868593 and MHT use, whereby MHT-associated CRC risk was significantly reduced in women with the GG genotype [0.68 (0.64-0.72)] but not within strata of GC or CC genotypes. A statistically significant interaction between a DCBLD1 intronic variant at 6q22.1 (rs10782186) and MHT use was identified by the 2-d.f. joint test. The MHT-associated CRC risk was reduced with increasing number of rs10782186-C alleles, showing ORs of 0.78 (0.70-0.87) for TT, 0.68 (0.63-0.73) for TC, and 0.66 (0.60-0.74) for CC genotypes. In addition, five genes in rare variant analysis showed suggestive interactions with MHT (two-sided P < 1.2×10-4).

CONCLUSION: Genetic variants that modify the association between MHT and CRC risk were identified, offering new insights into pathways of CRC carcinogenesis and potential mechanisms involved.

PMID:35512400 | DOI:10.1093/jnci/djac094