Category: Statistics

AIDS Res Ther. 2022 Dec 28;19(1):68. doi: 10.1186/s12981-022-00495-8.

ABSTRACT

Married women have a higher risk of contracting human immunodeficiency virus (HIV) or develop acquired immune deficiency syndrome (AIDS) than men. Knowledge of HIV/AIDS contributes significantly to describing the prevalence and consequences of such virus/disease. The study aimed to investigate the level of HIV/AIDS knowledge and the socio-demographic variables that influence HIV/AIDS knowledge among married women in Bangladesh. We used three waves of Multiple Indicator Cluster Survey (MICS), which included 33,843, 20,727, and 29,724 married women from 2006, 2012, and 2019 MICS. A score was prepared through their interrogation to determine the level of knowledge and logistic regression models were used for analyzing the data. This study found that the prevalence of knowledge level of HIV/AIDS in different questions increased from 55.20% in 2006 to 58.69% in 2019. In our study, respondents having highest education had 4.03 (95% CI 3.50-4.64) times more chance to obtain “High Score” in 2019 MICS which is 5.30 times in 2012 MICS (95% CI 4.41-6.37) and 2.58 times in 2006 MICS (95% CI 2.28-2.93) compared to illiterate married women. Moreover, respondents from urban area were 1.13 times more likely to obtain “High Score” in 2019 MICS which is 1.14 times in 2012 MICS and 1.16 times in 2006 MICS, respectively than the rural married women. This study also found respondent’s age, division, mass media access, and wealth status have played an important role in HIV/AIDS knowledge. Although a significant proportion of women had adequate knowledge of HIV/AIDS, more knowledge is still required to protect against such viruses/diseases. Thus, we advocate for the implementation of educational program in the curriculum, counselling, particularly in rural areas, and mass media access to ensure quality knowledge throughout the country.

PMID:36577995 | DOI:10.1186/s12981-022-00495-8

BMC Public Health. 2022 Dec 28;22(1):2448. doi: 10.1186/s12889-022-14923-x.

ABSTRACT

Income and housing are pervasive social determinants of health. Subsidized housing is a prominent affordability mechanism in Canada; however, waitlists are lengthy. Subsidized rents should provide greater access to residual income, which may theoretically improve health outcomes. However, little is known about the health of tenants who wait for and receive subsidized housing. This is especially problematic for New Brunswick, a Canadian province with low population density, whose inhabitants experience income inequality, social exclusion, and challenges with healthcare access. METHODS: This study will use a longitudinal, prospective matched cohort design. All 4,750 households on New Brunswick’s subsidized housing wait list will be approached to participate. The survey measures various demographic, social and health indicators at six-month intervals for up to 18 months as they wait for subsidized housing. Those who receive housing will join an intervention group and receive surveys for an additional 18 months post-move date. With consent, participants will have their data linked to a provincial administrative database of medical records. DISCUSSION: Knowledge of housing and health is sparse in Canada. This study will provide stakeholders with a wealth of health information on a population that is historically under-researched and underserved.

PMID:36577991 | DOI:10.1186/s12889-022-14923-x

BMC Oral Health. 2022 Dec 28;22(1):649. doi: 10.1186/s12903-022-02668-3.

ABSTRACT

BACKGROUND: The ex vivo study is to compare the root canal preparation outcomes achieved by five nickel-titanium single-file instrumentation systems (M3-L, Reciproc Blue, V-Taper 2H, WaveOne Gold, XP-endo Shaper) in severely curved molar root canals.

METHODS: A total of 60 root canals were selected from extracted human molar teeth with curvatures ranging from 25° to 50° and divided into five groups based on the instrumentation system employed (n = 12). Before and after root canal preparation, a Micro-CT scan was taken, and pre- and post-operative data were analyzed to evaluate the following parameters: volume increment of root canals (VI), untouched root canal areas (UTA), and canal transportation (CT). Apically extruded debris (AD) was collected during preparation. After that, all samples were separated into two parts and examined respectively by scanning electron microscope (SEM) to assess cleaning ability. Data were statistically analyzed with ANOVA (UTA, AD, VI) or Kruskal-Wallis test (CT, SEM-score), the level of significance was set at α = 0.05.

RESULTS: There were no significant differences between the five systems regarding the AD, VI, and UTA parameters (P > 0.05). In terms of CT, no significant difference was noted at the straight section of canal and apical levels, while XP-endo Shaper showed less canal transportation than M3-L at the level of curved vertex (P < 0.05), and the centering ability of V-Taper 2H was significantly better than WaveOne Gold at the initial point of bending (P < 0.05). Debris and smear layers were present on the canal walls of all specimens, the apical thirds of the canal presented higher SEM scores than the coronal thirds in all groups (P < 0.05). Reciproc Blue and XP-endo Shaper showed fewer smear scores than WaveOne Gold in the apical thirds (P < 0.01 and P < 0.05, respectively), and no statistical difference was found between other groups in the middle and coronal thirds.

CONCLUSION: The five single-file systems evaluated performed equally in apically debris extrusion, dentin removal, and untouched root canal areas, while XP-endo Shaper and V-Taper 2H resulted in less canal transportation compared to M3-L and WaveOne Gold. Regarding cleaning ability, Reciproc Blue and XP-endo Shaper were associated with less smear layer than WaveOne Gold in the apical thirds.

PMID:36577985 | DOI:10.1186/s12903-022-02668-3

BMC Oral Health. 2022 Dec 28;22(1):651. doi: 10.1186/s12903-022-02666-5.

ABSTRACT

BACKGROUND: Magnetic resonance imaging (MRI) findings of temporomandibular joint (TMJ) in temporomandibular disorder (TMD) patients of different ages are still unclear. The aim of this study was to analyze and compare the characteristics of MRI features of TMJs in different age groups.

METHODS: A total of 1760 TMJs from 880 patients were included in the study and divided into three groups: ≤ 18Y (n = 195, 14.89 ± 2.35Y); 19-30Y (n = 475, 24.09 ± 3.23Y); and > 30Y (n = 210, 41.73 ± 10.45Y). T2-weighted image (T2WI) of MRI was obtained to evaluate the relationship between age and disc morphology, the degree of disc displacement, joint effusion, joint movement and changes of condylar bone morphology. Data were analyzed by Pearson Chi square test and Spearman correlation coefficient.

RESULTS: There was no statistical difference between left and right sides in all age groups. Except condylar morphology (χ2 = 0.943, P = 0.624), there were significant differences in the distribution of disc morphology, disc position, joint effusion and joint motion among different age groups (χ2 = 24.450, χ2 = 24.829, χ2 = 19.855, χ2 = 39.259, respectively). There were significant differences in the distribution of the degree of anterior disc displacement, condyle morphology and joint effusion in different types of disc morphology among the different age groups (except for joint effusion in > 30Y), among which the first two were significantly correlated with the disc morphology.

CONCLUSIONS: The morphology and position of the articular disc changed significantly with age, but the proportion of abnormal condylar bone remained about 50%. The greater the degree of disc folding, the more prone to bone abnormalities. Trial registration This study was retrospectively registered on 28/03/2022 and endorsed by the Ethics committee (LCYJ2022014).

PMID:36577982 | DOI:10.1186/s12903-022-02666-5

BMC Pediatr. 2022 Dec 28;22(1):739. doi: 10.1186/s12887-022-03606-6.

ABSTRACT

BACKGROUND: To investigate the correlation between N-terminal probrain natriuretic peptide (NT-proBNP), 25-hydroxyvitamin D (25-(OH) D), high-mobility group box 1(HMGB1), endogenous activin A (ACTA), blood glucose level, electrolyte levels and developmental quotient (DQ) scores of Hypoxic-ischemic encephalopathy (HIE).

METHODS: In this retrospective study, a total of 90 neonates diagnosed with HIE who were admitted to our hospital from January 2018 to June 2021 were retrospectively enrolled, and 40 healthy full-term neonates born in our hospital during the same period were randomly selected. Neonates with HIE and healthy conditions were set as the study group and control group, respectively. Neonates with HIE are divided into three subgroups, mild, moderate, and severe, based on the severity of HIE. The Gesell Developmental Scale (GDS) was used to assess neural development of neonates at 9 to 12 months postnatal. Biomarkers of peripheral venous blood were measured and collected in all neonates, including NT-proBNP, (25-(OH) D), HMGB1, ACTA, electrolyte levels and blood glucose levels. General demographic information and Apgar score were compared between the two groups. The differences between the two groups of biomarkers were compared and the correlation between these biomarkers and DQ scores was evaluated.

RESULTS: There was no significant difference in gestational age, maternal age, gender, way of birth, birth weight, gestational age and whether the mother was a primipara between the two groups (P>0.05). The 10 min Apgar score of the study group (5.87±0.36) was lower than that of the control group (9.37±0.32) with significant difference (P<0.05). The levels of NT-proBNP, HMGB1, and ACTA in the study group were higher than that in the control group (243.87±21.29 pmol/L vs. 116.98±22.19 pmol/L; 8.92±1.87 μg/L vs. 3.28±1.08 μg/L; 23.78±0.89 ng/ml vs. 2.98±0.38 ng/ml), while the levels of 25-(OH) D and electrolyte levels were lower than that in the control group (24.28±1.87 vs. 31.29±1.93; K+: 4.49±0.23 mmol/L vs. 4.73±0.21 mmol/L; Na+: 118.76±13.02 mmol/L vs. 134.28±12.29 mmol/L; Ca2+: 1.77±0.23 mmol/L vs. 2.35±0.26 mmol/L; Mg2+: 0.61±0.17 mmol/L vs. 0.91±0.17 mmol/L), with statistically significant differences (P<0.001). The levels of NT-probNP, HMGB1, ACTA and the incidence of hypoglycemia were the highest in the severe group, which were significantly higher than those in the moderate group and mild group (P<0.05). The levels of NT-probNP, HMGB1, ACTA and the incidence of hypoglycemia were the lowest in the mild group. The 25-(OH) D level, the incidence of hyperglycemia and electrolyte levels were the lowest in the severe group, which were significantly lower than those in the moderate and mild groups (all P<0.05). Meanwhile, the 25-(OH) D level, the incidence of hyperglycemia and electrolyte levels in the moderate group were lower than those in the mild group, and the differences were statistically significant (all P<0.05). The incidence of hyperglycemia in severe group (16 cases) was the lowest, significantly lower than that in moderate group (17 cases) and mild group (22 cases), and the difference was statistically significant (all P<0.05). The DQ scores of HIE neonates were negatively correlated with NT-proBNP, HMGB1, and ACTA (r=-0.671, -0.421, -0.518, all P< 0.001). The DQ scores was positively correlated with levels of 25-(OH) D and blood glucose level (r =0.621, 0.802, all P< 0.001). The DQ scores was also positively correlated with levels of potassium, sodium, calcium and magnesium (0.367, 0.782, 0.218, 0.678, all P<0.001).

CONCLUSION: The NT-proBNP, HMGB1, ACTA, 25-(OH) D, blood glucose levels and electrolyte levels are correlated with the severity of HIE, and developmental quotient scores in neonates with HIE. These biomarkers are suggestive for assessing the prognosis of neonate with HIE.

PMID:36577981 | DOI:10.1186/s12887-022-03606-6

BMC Public Health. 2022 Dec 28;22(1):2443. doi: 10.1186/s12889-022-14446-5.

ABSTRACT

BACKGROUND: Insecticides play a key role in rural farming; however, their over- or misuse has been linked with a negative impact on malaria vector control policies. This study was conducted amongst agricultural communities in Southern Côte d’Ivoire to identify which insecticides are used by local farmers and how it relates to the perception of farmers on malaria. Understanding the use of insecticides may help in designing awareness programme on mosquito control and pesticides management.

METHODS: A questionnaire was administered to 1399 farming households across ten villages. Farmers were interviewed on their education, farming practices (e.g. crops cultivated, insecticides use), perception of malaria, and the different domestic strategies of mosquito control they use. Based on some pre-defined household assets, the socioeconomic status (SES) of each household was estimated. Statistical associations were calculated between different variables, showing significant risk factors.

RESULTS: The educational level of farmers was significantly associated with their SES (p < 0.0001). Most of the householders (88.82%) identified mosquitoes as the principal cause of malaria, with good knowledge of malaria resulting as positively related to high educational level (OR = 2.04; 95%CI: 1.35, 3.10). The use of indoor chemical compounds was strongly associated to the SES of the households, their education level, their use of ITNs and insecticide in agricultural (p < 0.0001). Indoor application of pyrethroid insecticides was found to be widespread among farmers as well as the use of such insecticide for crops protection.

CONCLUSION: Our study shows that the education level remains the key factor influencing the use of insecticides by farmers and their awareness of malaria control. We suggest that better communication tailored to education level and including SES, controlled availability and access to chemical products, should be considered when designing campaigns on use of pesticides and vector borne disease control for local communities.

PMID:36577975 | DOI:10.1186/s12889-022-14446-5

BMC Public Health. 2022 Dec 28;22(1):2447. doi: 10.1186/s12889-022-14899-8.

ABSTRACT

BACKGROUND: The existing literature indicates that unemployment leads to deteriorated mental and somatic health, poorer self-assessed health, and higher mortality. However, it is not clear whether and to what extent the health consequences of unemployment differ between men and women. According to social role theory, women can alternate between several roles (mother, wife, friend, etc.) that make it easier to deal with unemployment, whereas the worker role is more important for men, and unemployment could therefore be more harmful to them. Thus, gender differences in the health consequences of unemployment should decrease as society grows more gender equal. Accordingly, this study examines changes over time in the gendered health consequences of unemployment in Norway. METHODS: Linked Norwegian administrative register data, covering the period from 2000 to 2017, were analysed by means of linear probability models and logistic regression. Four health outcomes were investigated: hospitalisation, receiving sick pay, disability benefit utilisation, and the likelihood of mortality. Two statistical models were estimated: adjusted for (1) age, and (2) additional sociodemographic covariates. All analyses were run split by gender. Three different unemployment cohorts (2000, 2006, and 2011) that experienced similar economic conditions were followed longitudinally until 2017.

RESULTS: The empirical findings show, first, that hospital admission is somewhat more common among unemployed males than among unemployed females. Second, receiving sick pay is much more common post-unemployment for men than for women. Third, excess mortality is higher among unemployed males than among unemployed females. Fourth, there is no gender component in disability benefit utilisation. There is a remarkable pattern of similarity when comparing the results for the three different unemployment cohorts (2000; 2006; 2011). Thus, the gendered health consequences of unemployment have hardly changed since the turn of the century.

CONCLUSION: This paper demonstrates that the health consequences of unemployment are serious, gendered, and enduring in Norway.

PMID:36577971 | DOI:10.1186/s12889-022-14899-8

Acad Med. 2023 Jan 1;98(1):98-104. doi: 10.1097/ACM.0000000000004952. Epub 2022 Aug 30.

ABSTRACT

PURPOSE: Standardized end-of-clerkship examinations typically occur on the last day of the clerkship. However, recent trends toward time-varying competency-based medical education have offered students more test scheduling flexibility, creating an opportunity to study the impact of student-selected examination timing.

METHOD: Starting with the graduating class of 2018, students took the required standardized end-of-core clerkship examinations at any available time they chose during their clinical years. Before this change, these examinations were administered to all students on the last day of the clerkship. Students’ examination dates relative to clerkship completion were analyzed between 2017 and 2020 (inclusive of before and after flexible exam timing) to assess the impact that student-selected exam timing had on test performance on National Board of Medical Examiners shelf clinical science examinations for required core clerkships.

RESULTS: Data on 146 medical students in 2017 (fixed exam timing) and 466 medical students between 2018 and 2020 (flexible exam timing) were included. Among students offered flexible exam timing, between 2.7% (internal medicine) and 14.6% (psychiatry) took their exam before actually taking clerkship, while between 22.7% (psychiatry) and 40.0% (surgery) took their exam more than 90 days after the clerkship ended. Exam scores were statistically higher for those who took the exam at a time of their choosing compared with those who were required to take it at the end of individual rotations and when the exam scores were combined (fixed exam timing mean = 73.9, standard deviation [SD] = 7.8; flexible exam timing mean = 77.4, SD = 6.0, P < .001). The percent of students with passing scores was statistically higher in internal medicine, pediatrics, and psychiatry.

CONCLUSIONS: Self-selection of shelf exam timing appears to increase shelf exam scores. As more medical schools transition to competency-based medical education, providing scheduling flexibility appears not to negatively affect student achievement.

PMID:36576771 | DOI:10.1097/ACM.0000000000004952

Acad Med. 2023 Jan 1;98(1):88-97. doi: 10.1097/ACM.0000000000004918. Epub 2022 Aug 9.

ABSTRACT

PURPOSE: Assessing expertise using psychometric models usually yields a measure of ability that is difficult to generalize to the complexity of diagnoses in clinical practice. However, using an item response modeling framework, it is possible to create a decision-aligned response model that captures a clinician’s decision-making behavior on a continuous scale that fully represents competing diagnostic possibilities. In this proof-of-concept study, the authors demonstrate the necessary statistical conceptualization of this model using a specific electrocardiogram (ECG) example.

METHOD: The authors collected a range of ECGs with elevated ST segments due to either ST-elevation myocardial infarction (STEMI) or pericarditis. Based on pilot data, 20 ECGs were chosen to represent a continuum from “definitely STEMI” to “definitely pericarditis,” including intermediate cases in which the diagnosis was intentionally unclear. Emergency medicine and cardiology physicians rated these ECGs on a 5-point scale (“definitely STEMI” to “definitely pericarditis”). The authors analyzed these ratings using a graded response model showing the degree to which each participant could separate the ECGs along the diagnostic continuum. The authors compared these metrics with the discharge diagnoses noted on chart review.

RESULTS: Thirty-seven participants rated the ECGs. As desired, the ECGs represented a range of phenotypes, including cases where participants were uncertain in their diagnosis. The response model showed that participants varied both in their propensity to diagnose one condition over another and in where they placed the thresholds between the 5 diagnostic categories. The most capable participants were able to meaningfully use all categories, with precise thresholds between categories.

CONCLUSIONS: The authors present a decision-aligned response model that demonstrates the confusability of a particular ECG and the skill with which a clinician can distinguish 2 diagnoses along a continuum of confusability. These results have broad implications for testing and for learning to manage uncertainty in diagnosis.

PMID:36576770 | DOI:10.1097/ACM.0000000000004918

Acad Med. 2023 Jan 1;98(1):75-79. doi: 10.1097/ACM.0000000000004964. Epub 2022 Sep 6.

ABSTRACT

PURPOSE: There continues to be a disparity in the representation of women across medicine, including in editor positions at major medical journals. The authors repeated a study they had conducted in 2011 to compare the representation of women in editor-in-chief and editorial board member positions in 2011 and 2021.

METHOD: The authors included in their analysis the 60 journals from their original 2011 study and the top 5 ranked journals by Journal Impact Factor in each of 12 disciplines in 2021. This led to the inclusion of 86 journals. The authors collected the names and genders of the editors-in-chief and editorial board members at these journals, using information provided by the journals and a Google search for the photos and/or pronouns of the remaining editors. They compared results across years (2021 vs 2011), editor positions, disciplines, Journal Impact Factors, and ranks.

RESULTS: Twenty-two of the 90 editors-in-chief (24.4%) were women in 2021 compared with 10 of 63 (15.9%) in 2011, an increase of 8.5%. Of the 6,285 editorial board members, 1,756 were women (27.9%) in 2021 compared with 719 of 4,112 (17.5%) in 2011, an increase of 10.4%. Journals with women editors-in-chief gained 3.5 ranks and 9.1 points in Journal Impact Factor on average over this 10-year period, compared with no gain in rank and an increase of 4.7 points in Journal Impact Factor for journals with men editors-in-chief; both are statistically significant differences (P = .045 and P = .016, respectively).

CONCLUSIONS: In almost all evaluated disciplines and editor positions, there was an increase in the percentage of women at top-ranked medical journals over a 10-year period. Despite this increase, improvements are still needed to accelerate the currently slow rate of change in these positions to enhance diversity, equity, and inclusion for women in medicine.

PMID:36576769 | DOI:10.1097/ACM.0000000000004964