Category: Statistics

PLoS One. 2022 Feb 25;17(2):e0264004. doi: 10.1371/journal.pone.0264004. eCollection 2022.

ABSTRACT

BACKGROUND: Childhood immunization is one of the most cost-effective prevention measures for children’s mortality and morbidity, saving 2-3 million lives per year. In Ethiopia, under-five mortality rates, about 190,000 children die each year. Different research conducted in Ethiopia on childhood vaccination have focused on either vaccination coverage of individual vaccine or complete and incomplete vaccination. As far as my literature searching, studies separated the vaccination status into non-vaccinated, partially vaccinated and full vaccinated and assorted factors among children age 12-23 month in Ethiopia were limited. Therefore, the aim of this study was to identify factors associated with vaccination status among children 12-23 months of age in Ethiopia.

METHOD: A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Survey (EDHS). A total weighted sample of 1911 children age 12-23 months of age were included in the study. Logit based Multinomial logistic regression analysis was computed to distinguish factors associated with routine vaccination of children aged 12-23 months. P-value less than 0.05 was used to declare statistical significance of each independent variables, and adjusted odd ratio (AOR) with 95% confidence interval were used to present the result and STATA 14 was utilized for data management and analysis.

RESULT: Overall the prevalence of full vaccinated children was 35%, while 49% of children were partially vaccinated and 16% were non-vaccinated. In multinomial analysis, having focused ANC (at least four visits) contrasted to no ANC visits at all had 9.7 higher odd of being fully vaccinated than not vaccinated [AOR = 9.74, 95% CI = 3.52-26.94], and 5 times higher odd of being partially vaccinated than not vaccinated [AOR = 4.97, 95% CI = 2.00-12.33].

CONCLUSION: The present study found that childhood full vaccination status was low compared with the World Health Organization targets. Frequency of ANC visit and visited by field worker were significantly associated both partially and full vaccination whereas, visited health facility last 12 months and wealth status were significantly associated with childhood full vaccination.

PMID:35213589 | DOI:10.1371/journal.pone.0264004

PLoS One. 2022 Feb 25;17(2):e0264166. doi: 10.1371/journal.pone.0264166. eCollection 2022.

ABSTRACT

BACKGROUND: As global populations age, cross-national comparisons of cognitive health and dementia risk are increasingly valuable. It remains unclear, however, whether country-level differences in cognitive function are attributable to population differences or bias due to incommensurate measurement. To demonstrate an effective method for cross-national comparison studies, we aimed to statistically harmonize measures of episodic memory and language function across two population-based cohorts of older adults in the United States (HRS HCAP) and India (LASI-DAD).

METHODS: Data for 3,496 HRS HCAP (≥65 years) and 3,152 LASI-DAD (≥60 years) participants were statistically harmonized for episodic memory and language performance using confirmatory factor analysis (CFA) methods. Episodic memory and language factor variables were investigated for differential item functioning (DIF) and precision.

RESULTS: CFA models estimating episodic memory and language domains based on a priori adjudication of comparable items fit the data well. DIF analyses revealed that four out of ten episodic memory items and five out of twelve language items measured the underlying construct comparably across samples. DIF-modified episodic memory and language factor scores showed comparable patterns of precision across the range of the latent trait for each sample.

CONCLUSIONS: Harmonization of cognitive measures will facilitate future investigation of cross-national differences in cognitive performance and differential effects of risk factors, policies, and treatments, reducing study-level measurement and administrative influences. As international aging studies become more widely available, advanced statistical methods such as those described in this study will become increasingly central to making universal generalizations and drawing valid conclusions about cognitive aging of the global population.

PMID:35213581 | DOI:10.1371/journal.pone.0264166

PLoS One. 2022 Feb 25;17(2):e0263884. doi: 10.1371/journal.pone.0263884. eCollection 2022.

ABSTRACT

INTRODUCTION: Dream enactment behavior is one of the features of rapid eye movement sleep behavior disorder. It might be a manifestation of neurodegenerative diseases and can lead to fall associated injuries. There is no evidence of dream enactment behavior and its associated factors in Ethiopia. Hence, this study targeted to pinpoint the predictors of dream enactment behavior among Medical students at the University of Gondar.

METHODS: The cross-sectional survey was carried out at the University of Gondar among Medical students selected by simple random sampling technique from Dec 2020 to Feb 2021. We used a structured pretested questionnaire to collect the data and dream enactment behavior was evaluated using rapid eye movement sleep behavior disorder single question. Descriptive statistics were computed, and determinant factors were identified using binary logistic regression model. In the final model, explanatory variables with a p<0.05 were considered as predictors (statistically significant) of the dream enactment behavior. The strength of association was determined using adjusted odds ratio (AOR) with its 95% CI.

RESULTS: Four-hundred and twelve students took part in the study with 97.4% response rate. The mean age of participants was 20.82(±1.88) years and 291(70.63%) were males. The prevalence of dream enactment was 34.47% (95% CI: 30.02-39.20). Daytime sleepiness score (AOR = 1.104; 95% CI: 1.053-1.160), age (AOR = 1.15; 95% CI: 1.019-1.290), monthly pocket money (AOR = 0.9991; 95% CI: 0.9985-0.9997), alcohol drink (AOR = 2.71; 95% CI: 1.076-6.846), and perceived stress (AOR = 3.854; 95% CI: 1.802-8.242) were statistically significant factors of dream enactment behavior.

CONCLUSIONS: In this study, the magnitude of dream enactment behavior was high which was significantly associated with daytime sleepiness score, age, monthly pocket money, alcohol drink, and perceived stress all of which are modifiable except age. The University of Gondar has to plan a strategy to avert the condition via the prevention of the determinant factors. Students need to reduce stress and avoid alcohol drink. We strongly urge forthcoming scholars to ascertain association of dream enactment and academic performance of university students.

PMID:35213585 | DOI:10.1371/journal.pone.0263884

J Cachexia Sarcopenia Muscle. 2022 Feb 25. doi: 10.1002/jcsm.12956. Online ahead of print.

ABSTRACT

BACKGROUND: Although the obesity paradox is a topic of immense interest for oncologists and epidemiologists, the mechanism underlying this unexpected benefit of obesity is poorly understood. We explored the prognostic value of obesity and its association with skeletal muscle mass.

METHODS: This retrospective study evaluated the data of patients who underwent surgical excision for lung adenocarcinoma between January 2011 and December 2015. Body mass index was categorized according to the criteria of the Asia-Pacific classification. Cross-sectional areas of the skeletal muscle, subcutaneous fat, and visceral fat were measured. Skeletal muscle mass status was defined based on the cut-offs of skeletal muscle index (cm² /m² ), calculated as the area of skeletal muscle divided by height squared. Overall survival was estimated using the Kaplan-Meier method, and differences in survival probabilities were compared using the log-rank test. Cox proportional hazards regression analysis was conducted to determine the association with overall survival.

RESULTS: A total of 636 patients with a median age of 61 years (interquartile range, 54.0-68.5 years; 321 men and 315 women) were included. Obese patients (body mass index ≥ 25 kg/m² ) had longer overall survival than non-obese patients (mean, 110.2 months vs. 98.7 months; log-rank P = 0.015). Under multivariable Cox proportional hazard regression analysis, obesity was associated with longer overall survival after adjusting for covariates (hazard ratio, 0.59; 95% confidence interval, 0.40-0.86; P = 0.007). The prognostic value of obesity remained and predicted favourable overall survival after additional adjusting for skeletal muscle mass status (hazard ratio, 0.57; 95% confidence interval, 0.36-0.89; P = 0.014), skeletal muscle index (hazard ratio, 0.53; 95% confidence interval, 0.33-0.84; P = 0.008), or skeletal muscle area (hazard ratio, 0.61; 95% confidence interval, 0.38-0.98; P = 0.041). No association was observed between skeletal muscle mass status and the impact of body mass index on overall survival (P for interaction = 0.512).

CONCLUSIONS: Obesity was associated with favourable overall survival, independent of skeletal muscle mass, after surgical excision of lung adenocarcinoma.

PMID:35212195 | DOI:10.1002/jcsm.12956

Birth Defects Res. 2022 Feb 24. doi: 10.1002/bdr2.1993. Online ahead of print.

ABSTRACT

BACKGROUND: Trisomy 21 (T21) is common, with affected infants having an increased risk of infant mortality (5.9-7.1%). Maternal smoking is associated with infant mortality in the general population, and we evaluated if similar associations were present among infants with T21.

METHODS: We identified infants with T21 from the Texas Birth Defects Registry, and maternal smoking and infant vital status were obtained from linked birth and death certificate data, respectively. Cox proportional hazards regression models were used to calculate hazard ratios between maternal smoking and death between 0 to ≤ 364 days, 28-364 days, and 0-27 days.

RESULTS: We found a significant association between maternal smoking and death between 0 to ≤ 364 (unadjusted HR 1.72, 95% CI 1.07, 2.77), which was no longer statistically significant after adjustment for covariates (adjusted HR 1.55, 95% CI 0.94, 2.56). A similar pattern was observed for death between 28-364 days (adjusted HR: 1.68, 95% CI 0.93, 3.03), whereas the association for 0-27 days (adjusted HR: 1.30, 95% CI 0.51, 3.29) was not statistically significant before and after adjustment.

CONCLUSIONS: The observed magnitudes of associations were similar to previous estimates among the general population. Further work considering the role of other maternal and infant risk factors and social determinants of health is necessary to better understand the observed results.

PMID:35212191 | DOI:10.1002/bdr2.1993

Endocrinol Diabetes Metab. 2022 Feb 24:e00331. doi: 10.1002/edm2.331. Online ahead of print.

ABSTRACT

OBJECTIVES: To determine the frequency of diabetes mellitus and diabetic ketoacidosis and associated factors in COVID-19-positive patients.

BACKGROUND: High mortality amongst SARS-Cov2 patients may be attributed to diabetes and diabetic ketoacidosis.

METHODS: A total of 220 COVID-19 positive patients, hospitalized in North West General Hospital & Research Center, Peshawar, KP, Pakistan, from April to September 2020, were analysed using STATA 14. Patients with positive PCR were labelled as COVID-19 positive and were included in the study. Patients with a clinical picture of COVID-19 and negative PCR were excluded from the study. Those having ketonemia >0.6 and random blood glucose level >250mg/dl, while HCO3 (bicarbonate) ≤18, were labelled as diabetic ketoacidosis. The statistical significance level was set at p < .05.

RESULTS: A total of 220 COVID-19 patients were admitted; 166 (75.4%) were male and 54 (24.5%) were female. The mean age in years of the patients was 55.95 (SD13.9). About 57.7% of patients had diabetes mellitus, and 15 (6.8%) patients developed diabetic ketoacidosis. Amongst those with DKA, 5 patients died during hospital admission. The use of steroids was significantly higher (p < .001) in the DKA group compared with non-DKA patients. Hypertension (103,46.8%) and fever (170,77.3%) were the most reported comorbidity and symptom respectively.

CONCLUSION: The proportion of diabetes mellitus is high in patients with COVID-19. Diabetic ketoacidosis is a frequent complication in this group associated with in-hospital mortality. Steroid administration for COVID-19 should be balanced with strict glycemic control to prevent diabetic ketoacidosis and increase hospital survival.

PMID:35212184 | DOI:10.1002/edm2.331

Thorac Cancer. 2022 Feb 24. doi: 10.1111/1759-7714.14363. Online ahead of print.

ABSTRACT

BACKGROUND: Advances in chest computed tomography (CT) have resulted in more frequent detection of subcentimeter pulmonary nodules (SCPNs), some of which are non-benign and may represent invasive lung cancer. The present study aimed to explore the correlation between pathological diagnosis and the CT imaging manifestations of SCPNs.

METHODS: This retrospective study included patients who underwent pulmonary resection for SCPNs at Shandong Provincial Hospital in China. Lesions were divided into five categories according to their morphological characteristics on CT: cotton ball, solid-filled with spiculation, solid-filled with smooth edges, mixed-density ground-glass, and vacuolar. We further analyzed lesion size, enhancement patterns, vascular aggregation, and SCPN traversing. Chi-square tests, Fisher’s exact tests, and Welch’s one-way analysis of variance were used to examine the correlation between CT imaging characteristics and pathological type.

RESULTS: There were statistically significant differences in the morphological distributions of SCPNs with different pathological types, including benign lesions and malignant lesions at different stages (p < 0.01). The morphological distributions of the four subtypes of invasive lung adenocarcinoma also exhibited significant differences (p < 0.01). In addition, size and enhancement patterns differed significantly among different pathological types of SCPNs.

CONCLUSION: Different pathological types of SCPNs exhibit significant differences based on their morphological category, size, and enhancement pattern on CT imaging. These CT characteristics may assist in the qualitative diagnosis of SCPNs.

PMID:35212152 | DOI:10.1111/1759-7714.14363

ANZ J Surg. 2022 Jan;92(1-2):180-187. doi: 10.1111/ans.17183. Epub 2021 Sep 13.

ABSTRACT

BACKGROUND: Paediatric neck injuries are a common presenting complaint to emergency departments (EDs). Medical imaging can assist diagnosis, however previous research suggests computed tomography (CT) scan results do not alter management in this patient group and therefore expose children to unnecessary radiation. Following an audit by the hospital Trauma Service that identified unnecessary cervical spine CTs in patients at Women’s and Children’s Hospital (WCH), Adelaide, the Clinical Procedure for imaging and clearance of the cervical spine in conscious patients was modified to include CT scan only at the request of the orthopaedic service. The aim of this study was to evaluate whether a change in hospital guideline resulted in a change in practice and radiation exposure.

METHODS: A retrospective review was performed for patients that presented to the WCH ED with a suspected cervical spine injury during two defined time periods pre- and post-guideline change. Mechanism of injury, imaging requested, radiation exposure and final diagnosis were compared.

RESULTS: Three hundred seventy-nine patients were included, with 164 (43.3%) post-guideline changes. Radiograph use was similar between groups, 132/215 (61.4%) versus 101/164 (61.6%) (p = 0.97). CT scan use was lower post-guideline modification 19/215 (8.8%) versus 12/164 (7.3%), however was not statistically significant (p = 0.59), with an absolute reduction of 17%.

CONCLUSION: Guideline modification at our hospital did not significantly reduce CT scan use or eliminate unnecessary CTs. Unnecessary CT scans followed lack of knowledge of and therefore compliance with guidelines. Individual hospitals should consider strategies to reduce unnecessary CTs, given the association with cancer risk in children.

PMID:35212120 | DOI:10.1111/ans.17183

J Cosmet Dermatol. 2022 Feb 25. doi: 10.1111/jocd.14876. Online ahead of print.

ABSTRACT

BACKGROUND: Warts are common in children and can be difficult to treat. Many treatments for warts are destructive and painful in contrast to intralesional immunotherapy using different types of antigens.

AIM: to evaluate the efficacy, safety, and tolerability of intralesional purified protein derivative (PPD) versus intralesional zinc sulfate 2% in the treatment of pediatric warts.

METHODS: This randomized clinical trial included 120 children with multiple warts divided into two equal groups. Group Ⅰ received intralesional 10 IU (0.1 ml) of PPD, group Ⅱ received intralesional zinc sulfate 2% in the largest wart every 2 weeks till improvement or for a maximum five treatment sessions. The follow up period was 6 months after the last treatment session.

RESULTS: the overall response was equal in both groups (81.7%), but the response of the injected wart was higher in the zinc sulfate group (93.4%) versus PPD group (83.3%) with no significant difference. The highest cure rates were after the 5^th session in the PPD group and the 1^st session in the zinc sulfate group with slightly lower numbers of sessions needed for cure in the zinc sulfate group (3 sessions) versus the PPD group (4 sessions). The zinc sulfate group showed statistically significant higher rates of complications (pain, inflammation, necrosis, and scar) than PPD group. The zinc sulfate group showed non-significant higher rates of recurrence during the follow up period.

CONCLUSION: Both intralesional PPD and zinc sulfate 2% are effective in pediatric warts with higher safety profile of PPD.

PMID:35212136 | DOI:10.1111/jocd.14876

Geriatr Gerontol Int. 2022 Feb 25. doi: 10.1111/ggi.14363. Online ahead of print.

ABSTRACT

AIM: We carried out a randomized controlled trial using ipragliflozin. We analyzed changes in diastolic function using echocardiography in patients with type 2 diabetes and heart failure with preserved ejection fraction.

METHODS: We carried out an open-label, multicenter, randomized, two-arm interventional trial. A total of eligible 68 participants were randomly assigned into two groups (ipragliflozin group n = 36; conventional treatment group n = 32). Primary end-points were the change in E/e’ and e’. Secondary end-points were other parameters of echocardiography, plasma NT-proBNP level, New York Heart Association class, hemoglobin A1c and blood pressure.

RESULTS: After 24 weeks of follow up, E/e’ decreased in both groups (ipragliflozin: 11.0 vs 10.4; conventional treatment 10.5 vs 10.1; multivariate-adjusted P = 0.95). There were no significant differences in the amount of change in E/e’, e’, echocardiography parameters, plasma NT-proBNP level, New York Heart Association class, hemoglobin A1c and blood pressure between the two groups. In the subgroup analysis, ipragliflozin treatment decreased in left ventricular mass index in patients aged ≥70 years and also decreased in NT-proBNP levels in patients with baseline NT-proBNP ≥400 pg/mL.

CONCLUSIONS: In this randomized controlled study carried out in patients with type 2 diabetes and heart failure with preserved ejection fraction, 24-week ipragliflozin treatment did not improve left ventricular diastolic function compared with conventional treatment. As the subgroup, ipragliflozin treatment decreased in left ventricular mass index in participants aged ≥70 years. Geriatr Gerontol Int 2022; ••: ••-••.

PMID:35212104 | DOI:10.1111/ggi.14363