Category: Statistics

Anat Cell Biol. 2022 Jun 7. doi: 10.5115/acb.21.251. Online ahead of print.

ABSTRACT

Palmar creases are unique, permanent, and genetically controlled morphological variables. Recognizing palmar crease types are important for personal identification, criminal investigations, and diagnosis of congenital diseases. This study aimed to reveal the anthropological characteristics as well as contribute to the diagnosing of congenital disease of Ethiopian people. In this study, a cross-sectional study design with a multistage sampling technique were used. Chi-square test, bivariable, and multivariable multinomial logistic regression models were employed. At bivariable analysis variables with a P-value of ≤0.2 were selected for multivariable analysis and at multivariable analysis variables with a P-value of ≤0.05 were considered as statistically significant factors. Most of study participants had normal palmar crease patterns (90.8%), followed by simian crease patterns (5.0%), whereas sydney crease patterns was the least (1.92%). Being male was more likely to have simian crease and sydney crease than normal crease. Right-handed subjects were less likely to have simian crease and suwon crease than normal crease. The simian crease was more common among students whose fathers were from Gurage ethnicity than normal creases. Students who have one point of origin of the primary palmar creases were more likely to have simian crease, sydney crease, and suwon crease than normal crease. In this study, the normal type of palmar crease patterns was the most prevalent. Whereas the simian crease pattern was the commonest type among the variant palmar creases. Palmar crease patterns are affected by sex, ethnicity, handedness, and points of origin of the primary palmar crease.

PMID:35668477 | DOI:10.5115/acb.21.251

Arch Public Health. 2022 Jun 6;80(1):152. doi: 10.1186/s13690-022-00905-3.

ABSTRACT

BACKGROUND: Minimum dietary diversity is the consumption of five or more food groups from the eight World Health Organization recommended food groups. Adequately diversified diet, in terms of amount and composition, is critical for optimal growth, development, and long-term health outcomes in the first 2 years. Understanding the regional variation of dietary diversity and the underlying factors is crucial for developing and implementing interventions. However, the use of spatial approaches in dietary studies has not been widely established. Therefore, this study aimed to explore the spatial patterns and determinates of minimum dietary diversity practice among 6-23 months children in Ethiopia.

METHODS: Secondary data analysis was conducted based on the Demographic and Health Surveys data conducted in Ethiopia. A total weighted sample of 1578 children aged 6-23 months was included for this study. The Global Moran’s I was estimated to look into the regional variation of dietary diversity and hotspot and cold spot areas. Further, multivariable multilevel logistic regression was used for factor analyses. Adjusted Odds Ratio with 95% CI was used to declare the strength and significance of the association.

RESULTS: Overall, 87.4% (95% CI: 85.7 to 88.9%) of children in 2019 had inadequate Minimum dietary diversity. We identified statistically significant clusters of high inadequate dietary diversity (hotspots) notably observed in Somali, Afar, Eastern and western Amhara, western Tigray, Benishangul, and Northeastern and western parts of the southern nations, nationality and peoples’ regions. Inadequate dietary diversity was significantly higher among young children, uneducated mother, married women, younger mother, no postnatal check, community with higher level of poverty and community level uneducated woman.

CONCLUSION: According to the findings of this study inadequate Minimum dietary diversity for children as measured by World Health Organization dietary assessment shows high. Children’s dietary diversity was distributed non-randomly in different districts across Ethiopia’s regions. The findings of the study provided critical evidence about dietary diversity and associated factors. Hence, policy should focused on improve education status of Mother, boosting economic status of the community, increased maternal continuum of care and focused on young children nutrition may advance dietary diversity.

PMID:35668474 | DOI:10.1186/s13690-022-00905-3

Infect Dis Poverty. 2022 Jun 6;11(1):66. doi: 10.1186/s40249-022-00985-x.

ABSTRACT

BACKGROUND: Unsafe drinking water, poor sanitation and hygiene, exposure to household air pollution and low cognitive and socio-emotional stimulation are risk factors affecting children in low- and middle-income countries. We implemented an integrated home-environmental intervention package (IHIP), comprising a kitchen sink, hygiene education and a certified improved biomass cookstove, and an early child development (ECD) programme to improve children´s health and developmental outcomes in the rural high-altitude Andes of Peru.

METHODS: We conducted a one-year cluster-randomised controlled trial among 317 children < 36 months divided into 4 arms (IHIP + ECD, IHIP, ECD, and Control) and 40 clusters (10 clusters per arm). ECD status (socio-emotional, fine and gross motor, communication, cognitive skills, and an overall performance) measured with the Peruvian Infant Development Scale and the occurrence of self-reported child diarrhoea from caretakers were primary outcomes. Secondary outcomes included the occurrence of acute respiratory infections and the presence of thermo-tolerant faecal bacteria in drinking water. The trial was powered to compare each intervention against its control arm but it did not allow pairwise comparisons among the four arms. Primary analysis followed the intention-to-treat principle. For the statistical analysis, we employed generalised estimating equation models with robust standard errors and an independent correlation structure.

RESULTS: We obtained ECD information from 101 children who received the ECD intervention (individually and combined with IHIP) and 102 controls. Children who received the ECD intervention performed better in all the domains compared to controls. We found differences in the overall performance (64 vs. 39%, odd ratio (OR): 2.8; 95% confidence interval (CI): 1.6-4.9) and the cognitive domain (62 vs 46%, OR: 1.9; 95% CI: 1.1-3.5). Data analysis of child morbidity included 154 children who received the IHIP intervention (individually and combined with ECD) and 156 controls. We recorded 110,666 child-days of information on diarrhoea morbidity and observed 1.3 mean episodes per child-year in the children who received the IHIP intervention and 1.1 episodes in the controls. This corresponded to an incidence risk ratio of 1.2 (95% CI: 0.8-1.7).

CONCLUSIONS: Child stimulation improved developmental status in children, but there was no health benefit associated with the home-environmental intervention. Limited year-round access to running water at home and the possible contamination of drinking water after boiling were two potential factors linked to the lack of effect of the home-environmental intervention. Potential interactions between ECD and home-environmental interventions need to be further investigated.

TRIAL REGISTRATION: ISRCTN, ISRCTN-26548981. Registered 15 January 2018-Retrospectively registered, https://doi.org/10.1186/ISRCTN26548981 .

PMID:35668472 | DOI:10.1186/s40249-022-00985-x

Parasit Vectors. 2022 Jun 6;15(1):189. doi: 10.1186/s13071-022-05316-5.

ABSTRACT

BACKGROUND: Canine vector-borne disease (CVBD) has been an area of increasing interest in Europe over the last few decades, and there have been changes in the prevalence and distribution of many of these diseases. Monitoring CVBD infections in Europe is often done by individual countries, but aggregated data for the European countries are helpful to understand the distribution of CVBDs.

METHODS: We used an extensive retrospective database of results from point-of-care rapid enzyme-linked immunosorbent assay (ELISA) tests on dogs across Europe to identify distribution and seropositivity in animals tested for selected CVBDs (Anaplasma spp., Ehrlichia spp., Borrelia burgdorferi, Leishmania spp., and Dirofilaria immitis) from 2016 through 2020. Geographic distribution of positive tests and relative percent positive values were mapped by the Nomenclature of Territorial Units for Statistics classification for regions with sufficient test results for reporting.

RESULTS: A total of 404,617 samples corresponding to 1,134,648 canine results were available from dogs tested in 35 countries over the 5-year study period. Over this period the number of test results per year increased whereas test positivity decreased. Leishmania spp. had the largest increase in total test results from 25,000 results in 2016 to over 60,000 results in 2020. Test positivity for Leishmania spp. fell from 13.9% in 2016 to 9.4% in 2020. Test positivity fell for Anaplasma spp. (7.3 to 5.3%), Ehrlichia spp. (4.3 to 3.4%), and Borrelia burgdorferi (3.3 to 2.4%). Dirofilaria immitis test positivity trended down with a high of 2.7% in 2016 and low of 1.8% in 2018. Leishmania spp. test positivity was highest in endemic areas and in several non-endemic countries with low numbers of test results. Co-positivity rates were significantly higher than expected for all pathogen test positive pairs except for Ehrlichia spp. with Borrelia burgdorferi and D. immitis with Borrelia burgdorferi.

CONCLUSIONS: This study represents the largest data set on CVBD seropositivity in Europe to date. The increase in the number of test results and decreasing test positivity over the study period may reflect changes in testing behavior and increased screening of healthy animals. The Europe-wide mapping of CVBD provides expected test positivity that can help inform veterinarians’ decisions on screening and improve prevention and identification of these important, sometimes zoonotic, diseases.

PMID:35668469 | DOI:10.1186/s13071-022-05316-5

Microbiome. 2022 Jun 7;10(1):86. doi: 10.1186/s40168-022-01266-3.

ABSTRACT

BACKGROUND: The relationship between host conditions and microbiome profiles, typically characterized by operational taxonomic units (OTUs), contains important information about the microbial role in human health. Traditional association testing frameworks are challenged by the high dimensionality and sparsity of typical microbiome profiles. Phylogenetic information is often incorporated to address these challenges with the assumption that evolutionarily similar taxa tend to behave similarly. However, this assumption may not always be valid due to the complex effects of microbes, and phylogenetic information should be incorporated in a data-supervised fashion.

RESULTS: In this work, we propose a local collapsing test called phylogeny-guided microbiome OTU-specific association test (POST). In POST, whether or not to borrow information and how much information to borrow from the neighboring OTUs in the phylogenetic tree are supervised by phylogenetic distance and the outcome-OTU association. POST is constructed under the kernel machine framework to accommodate complex OTU effects and extends kernel machine microbiome tests from community level to OTU level. Using simulation studies, we show that when the phylogenetic tree is informative, POST has better performance than existing OTU-level association tests. When the phylogenetic tree is not informative, POST achieves similar performance as existing methods. Finally, in real data applications on bacterial vaginosis and on preterm birth, we find that POST can identify similar or more outcome-associated OTUs that are of biological relevance compared to existing methods.

CONCLUSIONS: Using POST, we show that adaptively leveraging the phylogenetic information can enhance the selection performance of associated microbiome features by improving the overall true-positive and false-positive detection. We developed a user friendly R package POSTm which is freely available on CRAN ( https://CRAN.R-project.org/package=POSTm ). Video Abstract.

PMID:35668471 | DOI:10.1186/s40168-022-01266-3

Int J Health Geogr. 2022 Jun 6;21(1):4. doi: 10.1186/s12942-022-00304-5.

ABSTRACT

BACKGROUND: Local policymakers require information about public health, housing and well-being at small geographical areas. A municipality can for example use this information to organize targeted activities with the aim of improving the well-being of their residents. Surveys are often used to gather data, but many neighborhoods can have only few or even zero respondents. In that case, estimating the status of the local population directly from survey responses is prone to be unreliable.

METHODS: Small Area Estimation (SAE) is a technique to provide estimates at small geographical levels with only few or even zero respondents. In classical individual-level SAE, a complex statistical regression model is fitted to the survey responses by using auxiliary administrative data for the population as predictors, the missing responses are then predicted and aggregated to the desired geographical level. In this paper we compare gradient boosted trees (XGBoost), a well-known machine learning technique, to a structured additive regression model (STAR) designed for the specific problem of estimating public health and well-being in the whole population of the Netherlands.

RESULTS: We compare the accuracy and performance of these models using out-of-sample predictions with five-fold Cross Validation (5CV). We do this for three data sets of different sample sizes and outcome types. Compared to the STAR model, gradient boosted trees are able to improve both the accuracy of the predictions and the total time taken to get these predictions. Even though the models appear quite similar in overall accuracy, the small area predictions at neighborhood level sometimes differ significantly. It may therefore make sense to pursue slightly more accurate models for better predictions into small areas. However, one of the biggest benefits is that XGBoost does not require prior knowledge or model specification. Data preparation and modelling is much easier, since the method automatically handles missing data, non-linear responses, interactions and accounts for spatial correlation structures.

CONCLUSIONS: In this paper we provide new nationwide estimates of health, housing and well-being indicators at neighborhood level in the Netherlands, see ‘Online materials’. We demonstrate that machine learning provides a good alternative to complex statistical regression modelling for small area estimation in terms of accuracy, robustness, speed and data preparation. These results can be used to make appropriate policy decisions at a local level and make recommendations about which estimation methods are beneficial in terms of accuracy, time and budget constraints.

PMID:35668432 | DOI:10.1186/s12942-022-00304-5

BMC Med Educ. 2022 Jun 6;22(1):433. doi: 10.1186/s12909-022-03504-6.

ABSTRACT

BACKGROUND: This study aimed to examine the satisfaction, educational linkage, and self-perceived competence of dental students enrolled in either 4 + 4 dental program, comprising an undergraduate degree and Doctor of Dental Surgery degree (DDS), or 3 + 4 program, which is a BS/DDS combined degree program, in the Korean dental education system.

MATERIALS AND METHODS: The survey questionnaire using a 5-point Likert scale was developed and validated by four dental education experts, consisting of satisfaction with undergraduate courses, the interconnection of undergraduate courses with the DDS curriculum, and self-assessed core competency for dental graduates. A total of 252 students provided informed consent and voluntarily responded to the survey, among whom 109 students were in the 3 + 4 system and 143 were in the 4 + 4 system. Cronbach’s correlation analysis and independent t-test were conducted for each evaluation item.

RESULTS: Students’ overall satisfaction level with the undergraduate education was higher in the 4 + 4 system than in the 3 + 4 system (P = 0.003). Students enrolled in the 4 + 4 system recognized that natural sciences are more connected to the graduate-level DDS program (P < 0.001), while the 3 + 4 students recognized that studies in medicine are closely interconnected to the DDS program (P = 0.001). There was almost no statistically significant difference in the students’ perception of competency between the two education systems.

DISCUSSION: Even though this study analyzed the case of a single university operating both 3 + 4 and 4 + 4 systems, it can be used as the groundwork for developing new opportunities and models of dental education system.

PMID:35668421 | DOI:10.1186/s12909-022-03504-6

BMC Endocr Disord. 2022 Jun 7;22(1):153. doi: 10.1186/s12902-022-01062-y.

ABSTRACT

BACKGROUND: The aim of this study is to compare muscle strength and architecture between type 1 diabetes patients and healthy volunteers and to assess whether there is an ultrasonographic structural change in this population.

METHODS: Thirty-two patients with T1D (23 female, 9 male) with an age average of 31.3 ± 8.7 years, matched in terms of age, gender, height, weight and physical activity were included in the study. In the T1D and control group, ultrasonographic measurements of quadriceps femoris muscle (RF, VI, VM, VL) and pennate angle (VI, VM, VL) were performed. Muscle strength values were measured using isokinetic dynamometer system at angular velocities of 60º/s and 180º/s in both groups.

RESULTS: Initially, both groups were similar in demographic and clinical characteristics (p > 0.05). In the T1D group, there was a statistically significant difference in flexion/extension peak torque measurements at an angular velocity of 60º/s compared to the control group (p < 0.05). In support of these isokinetic measurements, RF, VI, VM, VL muscle thicknesses and VI, VM pennate angle measurements in T1Ds were significantly lower (p < 0.05). When the T1D group was subgrouped according to HbA1C and diabetes duration, there was no significant difference in ultrasonographic and isokinetic measurements between the two groups (p > 0.05). When the T1D group was subgrouped, in the group that used insulin pump RF, VI, VM muscle thickness measurements were significantly higher (p < 0.05) than the group using subcutaneous insulin.

CONCLUSIONS: This study supports that muscle strength and architecture are adversely affected in the T1D patient group, insulin deficiency is a risk factor for sarcopenia and this can be shown through ultrasonography. It can also be said that insulin pump use has more positive effects in terms of diabetic myopathy than subcutaneous insulin, and diabetic myopathy develops independently of other diabetic complications. As a result, the muscle architecture of T1D people is adversely affected by insulin deprivation, so regular physical activity should be an integral part of diabetes treatment.

PMID:35668406 | DOI:10.1186/s12902-022-01062-y

BMC Med Educ. 2022 Jun 7;22(1):437. doi: 10.1186/s12909-022-03514-4.

ABSTRACT

BACKGROUND: To investigate the effect of the bridge-in, objective, preassessment, participatory learning, post assessment, and summary (BOPPPS) model combined with case-based learning (CBL) on ophthalmology teaching for five-year paediatric undergraduates.

METHODS: The effects of the BOPPPS model combined with CBL (BOPPPS-CBL) and traditional lecture-based learning (LBL) on ophthalmology teaching were compared among students in a five-year programme. The questionnaire surveys of the students were collected and statistically analysed after the class. The final examination scores, including on elementary knowledge and case analysis, in the two groups were analysed.

RESULTS: There were no statistically significant differences between the teachers and students in the baseline data. More students agreed that the BOPPPS-CBL model helped develop their problem-solving skills, analytical skills and motivation for learning better than the LBL model. There was no significant difference in learning pressure between the two groups. The final examination scores of the BOPPPS-CBL group were significantly higher than those of the LBL group. The overall course satisfaction of the BOPPPS-CBL group was obviously higher than that of the LBL group.

CONCLUSIONS: The BOPPPS-CBL model is an effective ophthalmology teaching method for five-year paediatric undergraduates.

PMID:35668389 | DOI:10.1186/s12909-022-03514-4

BMC Public Health. 2022 Jun 6;22(1):1127. doi: 10.1186/s12889-022-12655-6.

ABSTRACT

PURPOSE: Despite a maturing literature on the association between subjective wellbeing (SWB) and mental condition, little is known regarding the happiness-physical health relation in China, among middle-aged and elderly women (MAEW) in particular. This study aimed to understand the effect of physical health on the SWB of MAEW in China.

METHODS: Data from the 2014 and 2018 China Family Panel Study were used to analyse the SWB of women over the age of 45 years. In addition, descriptive statistics was used to describe the population distribution and panel ordered logit regression for regression analysis.

RESULTS: Majority of the respondents reported satisfactory SWB, and the proportion of the respondents who were very happy and happy was more than 68%. In terms of health factors, self-rated health, 2-week morbidity and BMI were significantly related to the SWB of MAEW (all P-values < 0.05). Physical exercise (P-value < 0.01) was positively associated with SWB, whereas smoking status and drinking status were not related to SWB. In addition, demographic indicators, such as registered residence (P-value < 0.01), income (P-value < 0.01) and social status (P-value < 0.01), significantly affected the SWB of MAEW.

CONCLUSION: This study showed that MAEW’s physical health could affect their SWB. Increased attention should be paid to the physical health of MAEW to improve their SWB. Policy mechanisms could be designed to motivate MAEW to take the initiative to engage in regular physical activity to improve their SWB. In addition, increased attention be paid to groups with low socioeconomic status and high stress, especially those who are employed, to improve residents’ happiness.

PMID:35668385 | DOI:10.1186/s12889-022-12655-6