Category: Statistics

Reprod Health. 2022 May 8;19(1):114. doi: 10.1186/s12978-022-01408-8.

ABSTRACT

BACKGROUND: Parents’ communication on sexual and reproductive health issues with their adolescent plays a great role in preventing morbidity and mortality associated with sexual behavior. However lack of parent to adolescent communication was a serious problem in Ethiopia resulted in teenage pregnancy, unsafe abortions, sexually transmitted infections, school problems, and other sexual risk behaviors. Parents have high responsibility on cultivating their son and daughter regarding to sexual and reproductive health issues. Therefore, the objective of this study was to determine the magnitude of parent’s communication with their adolescents and affecting factors in Ethiopia.

METHODS: A community-based, cross-sectional study was conducted on 347 respondents. A systematic sampling method was used to select the study participants. Data were collected by trained interviewers using a structured questionnaire, entered into Epi-Info version 7.1.2 and exported to SPSS version 23 for analysis. Descriptive statistics, bivariate and multivariate logistic regression analyses were used. Variables at P-value < 0.05 were considered as significant associations.

RESULTS: Slightly more than one-fifth of the parents (21.3%) had communicated with their adolescents on sexual and reproductive health issues. Associated factors like: being knowledgeable [AOR = 3.08, 95% CI: 1.89-5.39] and being having positive attitudes [AOR 3.03, 95% CI: 1.37-6.70] towards sexual reproductive health issues were significantly associated with communication.

CONCLUSION: Overall a low proportion of parental communication with their children was identified on sexual and reproductive health issues. This was affected by multidimensional factors to determine their discussion. Thus, promotion of parent to adolescent communication, parents training and addressing the importance of parent to young people communication along with health care providers was important.

PMID:35527271 | DOI:10.1186/s12978-022-01408-8

Int J Exp Pathol. 2022 May 8. doi: 10.1111/iep.12443. Online ahead of print.

ABSTRACT

The purpose of the present study was to investigate the expression of α-SMA and SM22α in airway smooth muscle (ASM) of bronchioles from children younger than 14 years who died of acute interstitial pneumonia (AIP). This is based upon the hypothesis that as contractile marker proteins α-SMA and SM22α can serve as an index of the overcontractile phenotype of ASM that is seen in AIP. Lung tissue samples of children were obtained from autopsies and divided into the AIP group (55.9% male and 44.1% female, between 0.4 and 132 months old, n = 34) and the control group (60% male and 40% female, between 2 and 156 months old, n = 10). We recorded the post-mortem interval (PMI), height, clinical symptoms and abdominal fat thickness (AFT) of each case. Haematoxylin-and-eosin-stained sections were used to examine the luminal area and observe the morphological changes in the bronchioles. Immunohistochemistry and Masson’s trichrome staining were used to detect the expression of contractile marker proteins and the degree of pulmonary fibrosis respectively. Compared with the control group, the luminal areas of bronchioles in the AIP group were smaller (p < .001). The expression differences in α-SMA and SM22α between the two groups were statistically significant (p = .01 and p = .02 respectively). Also, there was no significant correlation of the contractile marker proteins expression with PMI, height, clinical symptoms and AFT. The collagen deposition difference in lung between the two groups was not statistically significant (p = .224). These findings suggest that enhancement of ASM contractile function appears to be involved in the death mechanism of children with AIP, which affords more insights into the understanding of AIP.

PMID:35527237 | DOI:10.1111/iep.12443

J Geriatr Oncol. 2022 May 5:S1879-4068(22)00103-5. doi: 10.1016/j.jgo.2022.04.011. Online ahead of print.

ABSTRACT

BACKGROUND: A decade ago, it was demonstrated that the difference in survival between older patients and younger patients with colorectal cancer (CRC) was mainly due to mortality in the first postoperative year. Over the last few years, improvements – especially in perioperative care – have increased survival. The current research investigates whether a survival gap between younger and older patients with CRC still exists on a national level in four European countries.

METHODS: Population-based data from Belgium, the Netherlands, Norway, and Sweden were collected from patients that underwent surgical resection for primary stage I-III CRC between 2007 and 2016. Relative survival and conditional relative survival (CS), with the condition of surviving the first postoperative year, were calculated for colon and rectal cancer separately, stratified for country and age category (<65, 65-75, ≥75 years). In addition, relative excess risk of death (RER) was estimated, and one-year excess mortality was calculated.

RESULTS: Data of 206,024 patients were analyzed. In general, compared to patients <65 years, patients ≥75 years had a worse survival during the first year after surgery, which was most pronounced in Belgium (RER colon cancer 2.5 [95% confidence interval (CI) 2.3-2.8] and RER rectal cancer 2.6 [95% CI 2.3-2.9]). After surviving the first year, CS was mostly not statistically different between patients <65 years and patients ≥75 years with stage I-II, with the exception of stage II colon cancer in Belgium. However, CS remained worse in the largest part of the patients ≥75 years with stage III colon or rectal cancer (except for rectal cancer in Norway).

CONCLUSIONS: Although differences exist between the countries, the survival gap between young and older patients is based mainly on early mortality and remains only for stage III disease after surviving the first year.

PMID:35527207 | DOI:10.1016/j.jgo.2022.04.011

Value Health. 2022 May 5:S1098-3015(22)00091-2. doi: 10.1016/j.jval.2022.01.015. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to identify the most commonly used internal validity tests in the discrete choice experiment (DCE) literature and establish their sensitivity and specificity.

METHODS: A structured literature review of recent DCE articles (2018-2020Q1) published in the health, marketing, transport economics, and environmental science literature was used to identify commonly used internal validity tests. The 2 most frequently used internal validity tests were incorporated in 4 new data collections. Respondent preferences in each application were summarized using a mixed logit model, which served as the benchmark for the subsequent sensitivity and specificity calculations. The performance of the internal validity tests was also compared with that of the root likelihood (RLH) test, which is a likelihood-based statistical validity test that is commonly used in marketing applications.

RESULTS: Dominant and repeated choice tasks were most commonly included in health-related DCE designs. Based on 4 applications, their specificity and sensitivity depend on the type of incorrect response pattern to be detected and on design characteristics such as the number of choice options per choice task and the number of internal validity tests as included in the experimental design. In all but one scenario, the performance of the dominant and repeated choice tasks was considerably worse than that of the RLH test.

CONCLUSIONS: Dominant and repeated choice tasks are unreliable screening tests and costly in terms of statistical power. The RLH test, which is a statistical test that does not require additional choice tasks to be included in the DCE design, provides a more reliable alternative.

PMID:35527163 | DOI:10.1016/j.jval.2022.01.015

Prim Care Diabetes. 2022 May 5:S1751-9918(22)00079-1. doi: 10.1016/j.pcd.2022.04.003. Online ahead of print.

ABSTRACT

BACKGROUND: Data on glycemic control and its determinants among Brazilian patients with type-2 diabetes (DM2) are scarce. The BrazIliaN Type 1 & 2 DiabetEs Disease Registry (BINDER) is a multicenter, longitudinal study, designed to investigate the glycemic control in a real-word scenario.

METHODS: 1142 patients participated in the five visits of the BINDER study between April/2017 and October/2019. For each visit, glycemic control was assessed using the last measure available for HbA1c. Sociodemographic and anthropometric characteristics were also analyzed.

RESULTS: At baseline, the median HbA1c level was 7.1% (4.1-15.0%); 259 (31.4%) participants had HbA1c ≤ 6.5% and 396 (48.2%) had HbA1c ≤ 7.0%. Younger age (p = 0.014), low educational level (p = 0.025) and the type of healthcare service (public sector; p = 0.0058) were independently associated with the elevated HbA1c. After 2 years, there were no statistically significant differences in HbA1c median values in relation to baseline.

CONCLUSIONS: In this sample of DM2 patients, younger age, low educational level and being treated at the public service were associated with worse glycemic control. Over a 2-year follow-up, there was no significant change in the median HbA1c. These findings suggest that strategies are needed to improve glycemic control, especially in those treated in the public service.

PMID:35527171 | DOI:10.1016/j.pcd.2022.04.003

Mater Sci Eng C Mater Biol Appl. 2021 Nov 23:112559. doi: 10.1016/j.msec.2021.112559. Online ahead of print.

ABSTRACT

Hydrogels are a popular substrate for cell culture due to their mechanical properties closely resembling natural tissue. Stimuli-responsive hydrogels are a good platform for studying cell response to dynamic stimuli. Poly(N-isopropylacrylamide) (pNIPAM) is a thermo-responsive polymer that undergoes a volume-phase transition when heated to 32 °C. Conducting polymers can be incorporated into hydrogels to introduce electrically responsive properties. The conducting polymer, polypyrrole (PPy), has been widely studied as electrochemical actuators due to its electrochemical stability, fast actuation and high strains. We determine the volume-phase transition temperature of pNIPAM hydrogels with PPy electropolymerised with different salts as a film within the hydrogel network. We also investigate the electro-mechanical properties at the transition temperature (32 °C) and physiological temperature (37 °C). We show statistically significant differences in the Young’s modulus of the hybrid hydrogel at elevated temperatures upon electrochemical stimulation, with a 5 kPa difference at the transition temperature. Furthermore, we show a three-fold increase in actuation at transition temperature compared to room temperature and physiological temperature, attributed to the movement of ions in/out of the PPy film that induce the volume-phase transition of the pNIPAM hydrogel. Furthermore, cell adhesion to the hybrid hydrogel was demonstrated with mouse articular chondrocytes.

PMID:35527144 | DOI:10.1016/j.msec.2021.112559

Acad Radiol. 2022 May 5:S1076-6332(22)00207-0. doi: 10.1016/j.acra.2022.03.030. Online ahead of print.

ABSTRACT

RATIONALE AND OBJECTIVES: Female carriers of pathogenic sequence variants (PSVs) in the BRCA1 /BRCA2 (Breast Cancer gene – BRCA) genes are at a substantially high-risk for developing breast cancer (BC), hence are offered active surveillance scheme based on semiannual breast exam and imaging from age 25 years to facilitate BC early detection (mammography/breast ultrasound depending on the age, and MRI). However, there are not specific guidelines for screening in case of pregnancy or lactation. In the current study, we summarize the experience at the largest high-risk clinic in Israel.

MATERIALS AND METHODS: Data of consecutive BRCA-PSV carriers undergoing surveillance as well as diagnostic ultrasound at the Meirav high-risk clinic from January 2014 to 2021 who were pregnant and/or breastfeeding at time of follow-up were identified. Relevant clinical data including results of breast exam, breast ultrasonography, biopsies and histological results were retrieved. Percentage of biopsies with malignancy, cancer detection rate and positive predictive values were calculated. Data is presented in descriptive statistics.

RESULTS: A total of 263 BRCA-carriers were included. Of these, 593 breast-ultrasonograms were performed in 263 BRCA-carriers for 292 pregnancies and 409 breast-ultrasonograms for 175 breastfeeding carriers. Of 36 breast biopsies in 292 pregnancies, 4 (PPV = 11%) had BC diagnosed (high grade invasive). Of 175 breastfeeding women, 25 biopsies were performed and 2 (PPV = 8%) were high grade invasive BC. Five of 6 BC were diagnosed in BRCA1 carriers, and 4/6 were screen detected. The rate of pregnancy-associated breast cancer was 6/292 (2.05%).

CONCLUSION: The overall detection rate of pregnancy-associated BC in BRCA-carriers is relatively low (2.05%), but still much higher than that in the general population. Two thirds of the BC were detected by screening. Therefore, despite the changes of the glandular breast tissue at time of pregnancy and breastfeeding, screening plays an important role in early detection. Ultrasound should be considered as a screening tool during this period of life of high-risk patients.

PMID:35527100 | DOI:10.1016/j.acra.2022.03.030

Rehabilitacion (Madr). 2022 May 5:S0048-7120(22)00012-3. doi: 10.1016/j.rh.2022.02.008. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the periodicity of hyaluronic acid (HA) reinjection in patients with knee osteoarthritis. Secondary aim: To relate the degree of arthrosis with the time between infiltrations and the possible study by subgroups between the different commercial preparations.

DESIGN: Retrospective observational study.

MATERIALS AND METHOD: Review of medical records and X-rays of patients with knee osteoarthritis that had been treated with intra-articular HA at the Rehabilitation Service in the period between January 2017 and June 2019.

VARIABLES: Socio-demographic, Laterality, Intervention Date, Degree of Arthrosis according to Kellgren and Lawrence, HA used, Time between filtrations. Statistical analysis carried out by Kaplan-Meier curves, taking into account the reinfiltration as final event, and Kruskal-Wallis test for non-parametric quantitative data.

RESULTS: We analysed 110 infiltration acts in 67 patients: average age at the time of infiltration 72.12 years, 85.1% women, 59.1% right knee. 4 types of HA: 33 cases at 1%. MW: 0.9MDa (HA1), 12 at 1.5%. MW: 1.5-2MDa (HA2), 42 at 2%. MW: 1.2MDa (HA3) and 6 Hylan G-F20. MW: 6MDa (HA4). We reinfiltrated in 31 occasions (28.2%). Average of months (IC 95%) between infiltrations: HA1 6.9 (5.7-8.16), HA2 12.5 (0-35), HA3 9.3 (5.5-13.1), HA4 5 (3-6.9). In 2 cases where it was not possible to establish the type of infiltrated formulations, the mean value between reinfiltrations was 8.5 (5.6-11.4) There were no statistically significant results by relating the HA type or the degree of arthrosis with the reinfiltration time.

CONCLUSIONS: In our study, we observe that the HA3 presented a longer time between infiltrations in comparison with other types, with no possibility to detect significant differences.

PMID:35527076 | DOI:10.1016/j.rh.2022.02.008

Arch Med Res. 2022 Apr 29:S0188-4409(22)00047-9. doi: 10.1016/j.arcmed.2022.04.005. Online ahead of print.

ABSTRACT

AIM: We aimed at performing a situation analysis to identify challenges that Mexico’s peritoneal dialysis centers (PDCs) have faced before and during the COVID-19 pandemic.

METHODS: From May-August 2021, we conducted a cross-sectional nationwide online survey with the heads of 136 PDCs at the Mexican Institute of Social Security. The survey gathered information about PDCs characteristics and the adaptations and challenges they faced before and during the COVID-19 pandemic. The response rate to the survey was 79.5% (136 out of 171 PDCs). We used descriptive statistics to analyze the data.

RESULTS: The survey responses suggest wide variations between PDCs regarding their number of patients, healthcare staff availability, and compliance with the International Society for Peritoneal Dialysis recommendations. In the pre-pandemic period, PDCs faced staff shortages (71.3%); scarcity of supplies (39.0%); catheter dysfunctions (29.4%); poor patient adherence to peritoneal dialysis (PD) (28.6%); and lack of patient support networks (25.7%). During the pandemic, PDCs faced emergent challenges, such as losing designated PDC areas within hospitals (61.0%), and staff and supply shortages (60.2%, 41.1%, respectively) because of a reallocation of human and physical resources towards the COVID-19 response. The pandemic prompted 86.7% of PDCs to implement preventive public health measures, delay non-urgent consultations and procedures (63.6%), and introduce telemedicine (37.3%). Additionally, fewer patients visited PDCs because of their fear of COVID-19 contagion (36.0%).

CONCLUSIONS: Actions are urgently needed to ensure adherence to evidence-based PD guidelines and sufficient resources, including trained staff, supplies, and designated spaces to strengthen PDCs and provide safe and effective PD.

PMID:35527074 | DOI:10.1016/j.arcmed.2022.04.005

J Prosthet Dent. 2022 May 5:S0022-3913(22)00220-7. doi: 10.1016/j.prosdent.2022.04.003. Online ahead of print.

ABSTRACT

STATEMENT OF PROBLEM: Sintering-based computer-aided metal manufacturing strategies have been proposed as an alternative to hard metal milling. While these fabrication methods have been evaluated in terms of marginal and internal discrepancies and bond strength to porcelain, limited information on metal frameworks is available regarding their flexural yield strength.

PURPOSE: The purpose of this in vitro study was to evaluate the flexural yield strength of 3-unit cobalt-chromium (Co-Cr) metal frameworks fabricated by hard metal milling (HMM), presintered soft metal milling (PSMM), and direct metal laser melting (DMLM) with 25-μm and 50-μm layer thicknesses.

MATERIAL AND METHODS: Three-unit master metal die models were prepared. A total of 40 metal frameworks (n=10) were fabricated by using HMM (group HM), PSMM (group PSM), and DMLM with 25-μm (group LM25) and 50-μm layer thicknesses (group LM50). Metal frameworks were cemented to the master die and then subjected to a 3-point bend test. The flexural yield force was used to calculate the flexural yield strength. The data were statistically analyzed (α=.05). One metal framework from each group was evaluated with scanning electron microscopy for microstructural analysis.

RESULTS: The group LM50 exhibited the lowest significant (P<.001) flexural yield strength values. The group HM exhibited higher flexural yield strength values than the other groups. No significant difference was found between the groups LM25 and PSM (P=.954) or between the groups PSM and HM (P=.111).

CONCLUSIONS: The fabrication method significantly affected the flexural yield strength of metal frameworks. Metal frameworks fabricated by DMLM with a 50-μm layer thickness exhibited considerably lower flexural yield strength values.

PMID:35527067 | DOI:10.1016/j.prosdent.2022.04.003