Category: Statistics

Chin Neurosurg J. 2022 Dec 27;8(1):43. doi: 10.1186/s41016-022-00312-1.

ABSTRACT

BACKGROUND: Diagnosis and treatment of patients with glioblastoma (GBM) who are also diagnosed with primary non-central nervous system (CNS) tumors remain a challenge, yet little is known about the clinical characteristics and prognosis of these patients. The data presented here compared the clinical and pathological features between glioblastoma patients with or without primary non-CNS tumors, trying to further explore this complex situation.

METHODS: Statistical analysis was based on the clinical and pathological data of 45 patients who were diagnosed with isocitrate dehydrogenase (IDH) wild-type glioblastoma accompanied by non-CNS tumors between January 2019 and February 2022 in Beijing Tiantan Hospital. Univariate COX proportional hazard regression model was used to determine risk factors for overall survival.

RESULTS: It turned out to be no significant difference in the overall survival (OS) of the 45 patients with IDH-wild-type GBM plus non-CNS tumors, compared with the 112 patients who were only diagnosed with IDH-wild-type GBM. However, there was a significant difference in OS of GBM patients with benign tumors compared to those with malignant tumors.

CONCLUSIONS: Implications for the non-central nervous system tumors on survival of glioblastomas were not found in this research. However, glioblastomas complicated with other malignant tumors still showed worse clinical outcomes.

PMID:36575552 | DOI:10.1186/s41016-022-00312-1

BMC Nutr. 2022 Dec 27;8(1):153. doi: 10.1186/s40795-022-00655-z.

ABSTRACT

BACKGROUND: The present study aims to estimate the factors contributing to the change adequate diversified dietary intake (ADDI) from 2005-06 to 2015-16 among children aged 6-23 months in India.

METHODS: A cross-sectional study was conducted using a large representative survey data. Data from the National Family Health Survey 2005-06 and 2015-16 was used. The effective sample size for the present study was 14,422 and 74,132 children aged 6-23 months in 2005-06 and 2015-16, respectively. The outcome variable was minimum adequate dietary diversity intake. Binary logistic regression was used to evaluate the factors associated with ADDI. Additionally, the Fairlie method of decomposition was used, which allows quantifying the total contribution of factors explaining the decadal change in the probability of ADDI among children aged 6-23 months in India.

RESULTS: There was a significant increase in ADDI from 2005-06 to 2015-16 (6.2%; p < 0.001). Additionally, compared to the 2005-06 years, children were more likely to have ADDI [AOR; 1.29, CI: 1.22-1.35] in 2015-16. Mother’s education explained nearly one-fourth of the ADDI change among children. Further, the regional level contribution of 62.3% showed that the gap was widening across regions between the year 2005-06 and 2015-16 in ADDI among children. The child’s age explained 5.2% with a positive sign that means it widened the gaps. Whereas the household wealth quintile negatively contributed and explained by -5.2%, that means between the years the gaps has reduced in ADDI among children aged 6-23 months.

CONCLUSION: Our findings indicate that increasing awareness of the use of mass media and improving the education levels of mothers would be beneficial for adequate dietary diversity intake among children aged 6-23 months. Investments should support interventions to improve overall infant and young children feeding practices in India.

PMID:36575545 | DOI:10.1186/s40795-022-00655-z

BMC Nutr. 2022 Dec 27;8(1):157. doi: 10.1186/s40795-022-00647-z.

ABSTRACT

OBJECTIVE: To evaluate the effect of a diet pattern based on Dietary Guidelines for Americans (DGA), in a controlled feeding setting, on plasma markers of inflammation and on cytokine production by peripheral blood mononuclear cells (PBMC).

DESIGN: Women (n = 44) with one or more risk factors of metabolic syndrome (and BMI: 25.2-39.8 kg/m²) completed an 8-wk controlled feeding study. They were randomized to either a group following a diet based on DGA 2010 (DGA), or a group given a ‘typical American diet’ (TAD), based largely on a Western diet pattern. By design, women maintained their body weight. Fasting plasma and PBMC were collected at wk. 0 (baseline) and at wk. 8 (post-intervention). Sixteen plasma markers of inflammation and eight PBMC cytokines were measured at both time points, to evaluate if the diet had a significant effect on concentrations of these inflammatory markers. Data were analyzed using ANCOVA, followed by multiple-comparison adjustment using Benjamini-Hochberg method.

RESULTS: Significant changes observed in Serum Amyloid A (SAA) and Matrix Metalloproteinase 3 (MMP3) in plasma did not retain significance upon multiple comparison adjustment. SAA: p = 0.044, adj p = 0.450; DGA mean change [95% CI] = – 12.6[- 32.3 to 7.04]; TAD mean change [95% CI] = – 2.24 [- 9.99 to 5.51]. MMP3: p = 0.014, adj p = 0.35; DGA mean change [95% CI] = 2.72[- 4.16 to 9.59]; TAD mean change [95% CI] = – 0.98[- 16.7 to 14.7]). Other inflammation markers were not differently altered by DGA relative to TAD. Effect size of change (Cohens d) indicated a large/medium-large effect of intervention on MMP3 and CRP, and medium effect on IL-6.

CONCLUSIONS: No statistically significant changes were observed in the immune markers examined in this study. The biological roles and magnitude of the non-significant differences seen with two variables, CRP and MMP3, suggest that they be examined in future studies.

TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT02298725.

PMID:36575541 | DOI:10.1186/s40795-022-00647-z

Infect Dis Poverty. 2022 Dec 28;11(1):126. doi: 10.1186/s40249-022-01048-x.

ABSTRACT

BACKGROUND: A high-risk prevention strategy is an effective way to fight against human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The China AIDS Fund for Non-Governmental Organizations (CAFNGO) was established in 2015 to help social organizations intervene to protect high-risk populations in 176 cities. This study aimed to evaluate the role of social organizations in high-risk population interventions against HIV/AIDS.

METHODS: This study was based on the CAFNGO program from 2016 to 2020. The collected data included the number and types of social organizations participating in high-risk group interventions and the amount of funds obtained by these organizations each year. We explored the factors influencing the number of newly diagnosed AIDS cases using a spatial econometric model. Furthermore, we evaluated the effectiveness of intervention activities by comparing the percentages of the individuals who initially tested positive, and the individuals who took the confirmatory test, as well as those who retested positive and underwent the treatment.

RESULTS: Overall, from 2016 to 2020, the number of social organizations involved in interventions to protect HIV/AIDS high-risk populations increased from 441 to 532, and the invested fund increased from $3.98 to $10.58 million. The number of newly diagnosed cases decreased from 9128 to 8546 during the same period. Although the number of cities with overall spatial correlations decreased, the spatial agglomeration effect persisted in the large cities. City-wise, the number of social organizations (direct effect 19.13), the permanent resident population (direct effect 0.12), GDP per capita (direct effect 17.58; indirect effect – 15.38), and passenger turnover volume (direct effect 5.50; indirect effect – 8.64) were the major factors influencing new positive cases confirmed through the testing interventions performed by the social organizations. The initial positive test rates among high-risk populations were below 5.5%, the retesting rates among those who initially tested positive were above 60%, and the treatment rates among diagnosed cases were above 70%.

CONCLUSIONS: The spatial effect of social organizations participating in interventions targeting high-risk populations funded by CAFNGO is statistically significant. Nevertheless, despite the achievements of these social organizations in tracking new cases and encouraging treatment, a series of measures should be taken to further optimize the use of CAFNGO. Working data should be updated from social organizations to CAFNGO more frequently by establishing a data monitoring system to help better track newly diagnosed AIDS cases. Multichannel financing should be expanded as well.

PMID:36575532 | DOI:10.1186/s40249-022-01048-x

BMC Public Health. 2022 Dec 27;22(1):2431. doi: 10.1186/s12889-022-14865-4.

ABSTRACT

BACKGROUND: In China, the new TB control model of trinity form had been implemented in all parts, and the comprehensively evaluation to the performances in primary TB control institutions were closely related to the working capacity and quality of TB service, but there was still no an unified evaluation indicators framework in practice and few relevant studies. The purpose of this study was to establish an indicators framework for comprehensively evaluating the performances in primary TB control institutions under the new TB control model of trinity form in Guangxi, China.

METHODS: The Delphi method was used to establish an indicators framework for comprehensively evaluating the performances in primary TB control institutions under the new TB control model of trinity form, and the analytic hierarchy process(AHP) was used to determine the weights of all levels of indicators, from September 2021 to December 2021 in Guangxi, China.

RESULTS: A total of 14 experts who had at least 10 years working experience and engaged in TB prevention and control and public health management from health committee, CDC, TB designated hospitals and university of Guangxi were consulted in two rounds. The average age of the experts were (43.3 ± 7.549) years old, and the effective recovery rate of the questionnaire was 100.0%. The average value of authority coefficient of experts (Cr) in the two rounds of consultation was above 0.800. The Kendall’s harmony coefficient (W) of experts’ opinions on the first-level indicators, the second-level indicators and the third-level indicators were 0.786, 0.201 and 0.169, respectively, which were statistically significant (P < 0.05). Finally, an indicators framework was established, which included 2 first-level indicators, 10 second-level indicators and 37 third-level indicators. The results of analytic hierarchy process (AHP) showed that the consistency test of all levels of indicators were CI < 0.10, which indicating that the weight of each indicator was acceptable.

CONCLUSION: The indicators framework established in this study was in line with the reality, had reasonable weights, and could provide a scientific evaluation tool for comprehensively evaluating the performances in primary TB control institutions under the new TB control model of trinity form in Guangxi, China.

PMID:36575512 | DOI:10.1186/s12889-022-14865-4

Trop Med Health. 2022 Dec 27;50(1):98. doi: 10.1186/s41182-022-00490-9.

ABSTRACT

BACKGROUND: Although symptomatic SARS-CoV-2 infection predisposes patients to develop complications, the asymptomatic SARS-CoV-2 infection state is of public health importance being a hidden source of infection. Moreover, the asymptomatic state may camouflage the actual burden of the disease.

METHODS: Data of 1434 seropositive participants for SARS-CoV-2 spike (anti-S) and/or nucleocapsid antibodies (anti-N) were retrieved from a larger cross-sectional survey on COVID-19. Relevant data were retrieved from records including socio-demographic, medical, and behavioral characteristics of seropositive participants as well as history of COVID-19 symptoms during the last 6 months. Symptomatic/asymptomatic SARS-CoV-2 infection was categorized based on the history of the presence or absence of COVID-19 symptoms.

RESULTS: The rate of asymptomatic SARS-CoV-2 infection was 34.9%. There was a statistically significant difference between symptomatic and asymptomatic participants regarding age, residence, medical conditions, habits, and infection control measures. The number of symptoms was positively correlated with anti-S titer and both were positively correlated with adult body mass index. Slum areas residence, client-facing occupation or being a healthcare worker, having lung disease, having blood group type A, never practicing exercise or social distancing, never using soap for hand washing, and minimal engagement in online working/studying were independent factors associated with the symptomatic state. Patients having less than three symptoms were less likely to be diagnosed by any means.

CONCLUSIONS: One-third of SARS-CoV-2 infections in our study were asymptomatic. This mandates applying proper measures to prevent transmission even from apparently healthy individuals. Modifiable factors associated with symptomatic infection should be controlled to reduce the risk of COVID-19 complications.

PMID:36575501 | DOI:10.1186/s41182-022-00490-9

Hum Resour Health. 2022 Dec 27;20(1):88. doi: 10.1186/s12960-022-00785-2.

ABSTRACT

INTRODUCTION: The “Global strategy on human resources for health: Workforce 2030” was adopted by the 69th World Health Assembly. Among its objectives is the strengthening of data on human resources for health, to inform evidence-based policy decisions. These data include the course completion and drop-out rates, to inform mechanisms that support recruitment and retention.

OBJECTIVE: This paper sought to evaluate trends in course completion and drop-out rates of health workforce students. However, original data were only obtained for pre-service medical students, but no other health worker occupational groups.

METHODS: A mixed method approach was employed to obtain data presented in this paper. A structured questionnaire was sent out to targeted medical training institutions, regulatory bodies, and National Medical Associations, supplemented by a web and literature search for existing studies or data reports. Data were analyzed using IBM SPSS Statistics version 21.0 (Chicago, IL, USA) and Microsoft Excel 2010.

RESULTS: Eight previously published studies were identified originating from six countries, with course completion rates ranging from 84% in Pakistan to 98.6% in the United States of America, while the drop-out rates ranged from 1.4% in the United States of America to 16% in Pakistan. An analysis of pre-service medical students in Australia and New Zealand, revealed average course completion rates of 93.3% and 96.9%, respectively, and average drop-out rates of 6.7% and 3.1%, respectively. An analysis of pre-service medical students from Nigeria, revealed an average course completion rate of 88.3%, and an average drop-out rate of 11.7%. Data were not readily available for most countries targeted during the research, either because of lack of existing mechanisms for collation of required data or restrictions making such data publicly unavailable and inaccessible.

CONCLUSIONS: Drop-out rate for pre-service medical students varies across countries with some countries recording higher drop-out rates, which raise significant concerns about the capacity of such countries to scale up production of human resources for health. Data that monitor both course completion and drop-out rates, and seek to provide insight into reasons for observed numbers, can inform mechanisms to address the causes of course drop-out and support student retention.

PMID:36575493 | DOI:10.1186/s12960-022-00785-2

BMC Nutr. 2022 Dec 27;8(1):154. doi: 10.1186/s40795-022-00650-4.

ABSTRACT

BACKGROUND: Sickle cell disease (SCD) is a chronic disease with many complications among which is growth retardation. Here, we described the growth and nutritional status patterns of children with SCD and adolescents living in Douala, Cameroon.

METHODS: This cross-sectional study took place at the sickle cell treatment center of Douala Laquintinie Hospital from November 2015 to April 2016. The sociodemographic and anthropometric information of each SCD patient was determined, and then used for computing z-score indexes (weight for age, weight for height, body mass index for height, and height for age). The different indexes were used to determine the prevalence of malnutrition forms (stunting, wasting, underweight, and overweight/obesity) and compared to WHO standards by gender and age.

RESULTS: A total of 208 children and adolescents participated in the study. The mean age was 8 years (±5) and the median age was 7 years. Males accounted for 53.4% of cases, giving a sex ratio of 1:1.1. The proportions of wasting, stunting, underweight, and overweight/obesity in the overall population were 7.1% (n = 15), 9.1% (n = 19), 3.6% (n = 5) and 3.3% (n = 7) respectively. In children under 5, wasting, stunting, underweight, and overweight/obesity were noted in 1.4% (n = 1), 9.5% (n = 7), 1.4% (n = 1), and 5.4% (n = 4) respectively. In patients aged 5 years and above, a proportion of 10.5% (n = 14) was wasted, 9.0% (n = 12) were stunted, 5.9% (n = 4) were underweight and 2.2% (n = 7) were overweight/obese. The growth curve of children under five in our study was superimposable to the WHO standard growth curve. In children older than 5 years, the left shift for stunting was more pronounced for boys compared to girls.

CONCLUSION: Nine percent of children and adolescents with SCD are stunted. The growth deficit appeared to be higher in patients aged 5 years and above, more particularly in boys than girls. Overweight/obesity was uncommon in our series. More robust research designs and statistical analyses are needed to confirm or refute these findings.

PMID:36575492 | DOI:10.1186/s40795-022-00650-4

Reprod Health. 2022 Dec 27;19(1):231. doi: 10.1186/s12978-022-01518-3.

ABSTRACT

BACKGROUND: Despite the negative impact of unsafe abortions on women’s health and rights, the degree of abortion safety remains strikingly undocumented for a large share of abortions globally. Data on how women induce abortions (method, setting, provider) are central to the measurement of abortion safety. However, health-facility statistics and direct questioning in population surveys do not yield representative data on abortion care seeking pathways in settings where access to abortion services is highly restricted. Recent developments in survey methodologies to study stigmatized / illegal behaviour and hidden populations rely on the fact that such information circulates within social networks; however, such efforts have yet to give convincing results for unsafe abortions.

OBJECTIVE: This article presents the protocol of a study whose purpose is to apply and develop further two network-based methods to contribute to the generation of reliable population-level information on the safety of abortions in contexts where access to legal abortion services is highly restricted.

METHODS: This study plans to obtain population-level data on abortion care seeking in two Health and Demographic Surveillance Systems in urban Kenya and rural Burkina Faso by applying two methods: Anonymous Third-Party Reporting (ATPR) (also known as confidantes’ method) and Respondent Driven Sampling (RDS). We will conduct a mixed methods formative study to determine whether these network-based approaches are pertinent in the study contexts. The ATPR will be refined notably by incorporating elements of the Network Scale-Up Method (NSUM) to correct or account for certain of its biases (transmission, barrier, social desirability, selection). The RDS will provide reliable alternative estimates of abortion safety if large samples and equilibrium can be reached; an RDS multiplex variant (also including social referents) will be tested.

DISCUSSION: This study aims at documenting abortion safety in two local sites using ATPR and RDS. If successful, it will provide data on the safety profiles of abortion seekers across sociodemographic categories in two contrasted settings in sub-Saharan Africa. It will advance the formative research needed to determine whether ATPR and RDS are applicable or not in a given context. It will improve the questionnaire and correcting factors for the ATPR, improve the capacity of RDS to produce quasi-representative data on abortion safety, and advance the validation of both methods.

PMID:36575489 | DOI:10.1186/s12978-022-01518-3

BMC Womens Health. 2022 Dec 28;22(1):552. doi: 10.1186/s12905-022-02124-y.

ABSTRACT

BACKGROUND: Breast cancer has been a serious public health dilemma for women worldwide, with not only physical and social impairments but also psychological stress responses such as rumination. Rumination is a constant preoccupation with thoughts. The present study aimed to investigate the effectiveness of mindfulness-based stress reduction training in lowering rumination among women diagnosed with breast cancer.

METHOD: This randomized controlled trial with a pretest, posttest, control group, and one-month follow-up design included 46 female breast cancer survivors, recruited from the clinics and hematology wards of Bushehr, Iran. The inclusion criterion was that at least three months should have passed since the last chemotherapy/radiotherapy. The participants were randomly assigned to two experimental and control groups. The experimental group received eight sessions of mindfulness-based stress reduction training. A demographic information form and a rumination questionnaire were used for data collection, and the participants completed the questionnaire in the pretest, posttest, and follow-up stages. Chi-square, Mann-Whitney U, and repeated-measures ANOVA were used to analyze the data. P < 0.05 was considered statistically significant.

RESULTS: There was no significant difference in the rumination scores of the experimental group at three measurement stages. For the control group, the mean rumination scores on the posttest and follow-up were both significantly higher than on the pre-test (P < 0.001). The control group’s mean follow-up rumination score was significantly higher than that of the post-test (P = 0.02). A comparison of the two groups adjusted for the baseline showed a significant difference between them in terms of the mean rumination score on the post-test (P = 0.01) and follow-up (P < 0.001).

CONCLUSION: The experimental group was more successful in avoiding increased rumination than the control group, an ability that can be attributed to the effect of mindfulness training. The use of this method is recommended because it is non-invasive, non-pharmacological, free from complications, and can be easily performed by women. However, future studies should consider larger samples and long-term follow-ups.

PMID:36575482 | DOI:10.1186/s12905-022-02124-y