Category: Statistics

Metab Syndr Relat Disord. 2022 Apr 18. doi: 10.1089/met.2021.0136. Online ahead of print.

ABSTRACT

Background: The rs7903146 variant in the TCF7L2 gene is associated with defects in postprandial insulin and glucagon secretion and increased risk of type 2 diabetes. However, it is unclear if this variant has effects on glucose metabolism that are independent of islet function. Methods: We studied 54 nondiabetic subjects on two occasions where endogenous hormone secretion was inhibited by somatostatin. Twenty-nine subjects were homozygous for the diabetes-associated allele (TT) and 25 for the diabetes-protective allele (CC) at rs7903146, but otherwise matched for anthropometric characteristics. On 1 day, glucagon infused at a rate of 0.65 ng/kg/min, and at 0 min prevented a fall in glucagon (nonsuppressed day). On the contrary, infusion commenced at 120 min to create a transient fall in glucagon (suppressed day). Subjects received glucose (labeled with [3-³H]-glucose) infused to mimic the systemic appearance of oral glucose. Insulin was infused to mimic a prandial insulin response. Endogenous glucose production (EGP) was measured using the tracer dilution technique. Results: Lack of glucagon suppression increased postchallenge glucose concentrations and impaired EGP suppression. However, in the presence of matched insulin and glucagon concentrations, genetic variation in TCF7L2 did not alter glucose metabolism. Conclusion: These data suggest that genetic variation in TCF7L2 alters glucose metabolism through changes in islet hormone secretion.

PMID:35442800 | DOI:10.1089/met.2021.0136

J Womens Health (Larchmt). 2022 Apr 18. doi: 10.1089/jwh.2021.0449. Online ahead of print.

ABSTRACT

Background: Excessive gestational weight gain (GWG) is consistently linked with maternal risk of obesity. However, the literature on its long-term cardiovascular risk is minimal and conflicting. We evaluated whether excessive GWG is associated with a high-risk cardiovascular profile among parous women in midlife. Materials and Methods: Participants were women in the multiethnic cohort Study of Women’s Health Across the Nation with a history of live birth(s). Excessive GWG was defined according to Institute of Medicine guidelines and collected by self-recall. Outcomes were the atherosclerotic cardiovascular disease (ASCVD) risk score and C-reactive protein (CRP), measured at the study baseline when mean age was 47 years, and at 10 follow-up visits (1996-2017). We estimated the association of excessive GWG with outcomes through linear mixed model regression. Results: The analytic sample included 1318 women with 3049 singleton births. Over 40% (536) reported one or more pregnancies with excessive GWG. Longitudinal models estimated that at a mean age of 67, women with a history of excessive GWG had a 9.8% (9.2, 10.5) 10-year ASCVD risk, compared to 9.5% (8.9, 10.1) for those without, and mean CRP of 2.20 mg/L (1.89, 2.57) versus 1.85 mg/L (1.61, 2.14), respectively, adjusted for participant characteristics. Conclusions: In this multiethnic cohort of parous women, a history of excessive GWG was associated with a small, but statistically significant difference in ASCVD risk, and a moderate, statistically significant difference in CRP across midlife. More research is necessary to understand the mechanistic pathway between excessive GWG and long-term maternal cardiovascular health.

PMID:35442810 | DOI:10.1089/jwh.2021.0449

Popul Health Manag. 2022 Apr;25(2):164-171. doi: 10.1089/pop.2021.0268.

ABSTRACT

Stigma is one of the most harmful forces affecting population health. When stigma exists in clinical settings, environments that should be pro-patient and stigma-free, stigma may become internalized and affect patients’ well-being. Informed by prior stigma research and the Intergroup Contact Theory, the authors elucidate statistical relationships between patients’ perceptions of clinic-based stigma and stigma’s impact on health among New York City’s diverse residents. The authors hypothesize that perceiving stigma in clinical settings would mediate the relationships between depression, general health, diabetes, and hypertension; they tested this through multiple logistic regressions conducted on pooled data from the New York City Community Health Survey (N = 18,596, 2016-2017). Among women, depression was associated with stigma (α = 4.07, P < 0.01), hypertension (γ = 2.31, P < 0.01), diabetes (γ = 2.18, P < 0.01), and poor general health (γ = 6.34, P < 0.01). Among men, depression was associated with stigma (α = 3.7, P < 0.01), hypertension (γ = 2.35, P < 0.01), diabetes (γ = 1.86, P < 0.01), and poor general health (γ = 5.14, P < 0.01). Overall, perceived stigma in clinics significantly increased adjusted odds of self-reporting poor general health (adjusted ORs [AOR] = 1.87 men; AOR = 2.05 women). Findings contribute to the literature on the Intergroup Contact Theory, which suggests that stigma should be low in diverse communities; findings indicate that stigma may be a mediator, justifying inclusion in epidemiological and health services research. In addition, study outcomes suggest that depression may be associated with clinic-based stigma, and this stigma has deleterious effects on physical health. Thus, clinicians should emphasize stigma reduction in their facilities, potentially through the adoption of trauma-informed approaches or delivery of care using non-stigmatizing communication strategies, such as Motivational Interviewing.

PMID:35442794 | DOI:10.1089/pop.2021.0268

Braz Oral Res. 2022 Apr 15;36:e054. doi: 10.1590/1807-3107bor-2022.vol36.0054. eCollection 2022.

ABSTRACT

This in vitro study evaluated the potential of CO2 laser (10.6 μm) combined with a stannous/fluoride-containing solution for preventing erosion in human/bovine enamel. Forty-eight samples of each substrate were randomly allocated to four groups (n = 12): W – distilled water; E – AmF/NaF/SnCl2 solution; L – CO2 laser; and LE – CO2 laser+AmF/NaF/SnCl2 solution. After surface treatments, samples were submitted to a 5-day erosive challenge, alternating immersions in 0.5% citric acid (2 minutes, 6x/day) and in artificial saliva. Optical profilometry (μm) and scanning electron microscopy (SEM) were used to determine surface loss and surface morphology, respectively. Data were statistically analyzed by two-way ANOVA and Tukey’s tests (p < 0.05). For human enamel, tissue loss was lower in group L (12.37 ± 4.46) than in group W (16.45 ± 2.76), and higher than in the groups treated with AmF/NaF/SnCl2 solution (E-5.44 ± 2.37; LE-5.55 ± 2.31). In group L, SEM images reveled a disorganized surface but fewer projections than in group W and LE showed fewer irregularities than W, E, and L. For bovine enamel, tissue loss in group L (13.90 ± 3.50) did not differ from that in group W (14.10 ± 2.98), and was higher than losses in groups E (5.70 ± 2.12) and LE (8.12 ± 2.56), which were statistically similar to each other. Groups W and L had similar aspects of demineralization, whereas groups E and LE showed homogenous surfaces. Surface-treated samples had no changes in their surfaces. CO2 laser was able to slightly prevent surface loss only on human enamel surface, but did not enhance the AmF/NaF/SnCl2 effect on the prevention of enamel erosion.

PMID:35442383 | DOI:10.1590/1807-3107bor-2022.vol36.0054

JAMA Psychiatry. 2022 Apr 20. doi: 10.1001/jamapsychiatry.2022.0685. Online ahead of print.

ABSTRACT

IMPORTANCE: All of Us is a landmark initiative for population-scale research into a variety of health conditions, including psychiatric disorders.

OBJECTIVE: To analyze the prevalence, comorbidity, and sociodemographic covariates of psychiatric disorders in the All of Us biobank.

DESIGN, SETTING, AND PARTICIPANTS: We estimated prevalence, overlap, and sociodemographic correlates for psychiatric disorders as reported in electronic health records for All of Us release 5 (N = 331 380).

EXPOSURES: Social and demographic covariates.

MAIN OUTCOMES AND MEASURES: Psychiatric disorders derived from International Statistical Classification of Diseases, Tenth Revision, Clinical Modification, codes across 6 broad domains: mood disorders, anxiety disorders, substance use disorders, stress-related disorders, schizophrenia, and personality disorders.

RESULTS: The analytic sample (N = 329 038) was 60.7% female (mean [SD] age, 50.9 [16.8] years). The prevalence of disorders ranged from 11.00% (95% CI, 10.68% to 11.32%) for any mood disorder to less than 1% (eg, obsessive-compulsive disorder, 0.18%; 95% CI, -0.16% to 0.52%), with mood disorders being the most common and personality disorders being the least. There was substantial overlap among disorders, with the majority of participants with a disorder (30 113/58 806, approximately 51%) having 2 or more registered diagnoses and tetrachoric correlations ranging from 0.43 to 0.74. Comparisons of prevalence across demographic categories revealed that non-Hispanic White people, individuals with low socioeconomic status, women and individuals assigned female at birth, and sexual minority individuals are at greatest risk for most disorders.

CONCLUSIONS AND RELEVANCE: Although rates of disorders among the All of Us cohort are lower than in the general population, considerable variation, comorbidity, and disparities exist across social groups. To improve the practice of equitable precision medicine, researchers can use comprehensive health data from large-scale resources such as All of Us.

PMID:35442391 | DOI:10.1001/jamapsychiatry.2022.0685

Braz Oral Res. 2022 Apr 15;36:e053. doi: 10.1590/1807-3107bor-2022.vol36.0053. eCollection 2022.

ABSTRACT

This study assessed the ability of XP-endo Finisher R (FKG, La Chaux-de-Fonds, Switzerland) to remove filling remnants from curved mesiobuccal canals of maxillary molars, using the passive ultrasonic irrigation (PUI) technique as a comparison. Twenty-four curved main mesiobuccal canals (MB1) of maxillary molars were instrumented with Wave One (#25/07) and filled with gutta-percha points and AH Plus Sealer. Samples were then re-treated with a standardized protocol with Wave One (#35/06) as the master apical file. Micro-CT scans measured baseline volume of remaining filling material (in mm3). Samples were divided into two groups (n = 12) according to the supplementary cleaning approach: (PUI) or XP-endo Finisher R. Statistics compared baseline and final volume of filling material (within-group); and the percentage of filling material reduction (between-group). Mean baseline volumes, final volumes, and percentages of reduction (%) of filling material for XP-endo Finisher R and PUI were respectively: 0.060 mm3, 0.042 mm3, and 31.28%; and 0.064 mm3, 0.054 mm3, and 16.57%. Both tested protocols reduced the amount of filling material (p < 0.05). XP-endo Finisher R had higher percentage of reduction as compared to PUI (p < 0.05). XP-endo Finisher R and PUI used as supplementary cleaning protocols during re-treatment improved the removal of root filling material in curved canals; but XP-endo Finisher R was approximately twice more efficient. The complete filling material removal during re-treatment procedures is still a challenge. Supplementary cleaning protocols may help to remove the remaining material after the complete mechanical preparation of curved canals. XP-endo Finisher R was approximately twice more efficient than PUI.

PMID:35442382 | DOI:10.1590/1807-3107bor-2022.vol36.0053

Braz Oral Res. 2022 Apr 15;36:e052. doi: 10.1590/1807-3107bor-2022.vol36.0052. eCollection 2022.

ABSTRACT

The aim of this cross-sectional study was to evaluate the factors associated with the search by Brazilian and Portuguese dentists for oral health information on social networks during the COVID-19 pandemic. A total of 597 Brazilian and Portuguese dentists answered an online questionnaire between January 17 and 31, 2021. Respondents were asked about sociodemographic data, weight and height, hours of sleep per night, screen time for work and leisure, and where they sought information about general and/or oral health for themselves and for their loved ones and information about COVID-19. Descriptive statistics and binary regression were used for the statistical analysis. Most participants were Brazilian (62.8%) and 451 (75.5%) were female. Mean age was 42.1 years (± 12.5 years). For every lost hour of sleep, the chances of participants frequently or always searching for information about self-perceived oral health problems on lay websites increased by 1.33 times. For every additional hour spent on social networks or on the Internet, the likelihood of participants frequently searching for self-perceived oral health problems on lay websites increased by 17% (OR = 1.17; 95% CI: 1.06-1.30). Individuals who searched the Internet for information about COVID-19 symptoms before consulting their doctors were 3.85 times more likely (95% CI: 2.22-6.67) to frequently or always search for information about self-perceived oral health problems on lay websites. Dentists used lay websites to search for general and oral health knowledge during the COVID-19 pandemic, and shorter sleep duration favored screen use.

PMID:35442381 | DOI:10.1590/1807-3107bor-2022.vol36.0052

Rev Assoc Med Bras (1992). 2022 Mar;68(3):395-399. doi: 10.1590/1806-9282.20211127.

ABSTRACT

OBJECTIVE: The aim of this study was to explore the efficacy of imipenem combined with glutamine in the treatment of severe acute pancreatitis with abdominal infection in mainland China using meta-analysis.

METHODS: We searched China National Knowledge Network, Wanfang Medical Network, Chinese Science Citation Database, PubMed, and Embase Databases for publications of imipenem combined with glutamine in the treatment of severe acute pancreatitis abdominal infection. The search time limit was from the establishment of the database to April 10, 2021. Stata software version 12.0 was used for statistical analysis; the combined effect size odds ratio and standardized mean difference values were calculated for the count data and measurement data, respectively; and the heterogeneity test was performed in this study.

RESULTS: A total of five randomized controlled trials were included. A total of 499 cases were included, with 251 in the observation group and 248 in the control group. Meta-analysis results showed that the efficacy of imipenem combined with glutamine in the treatment of severe acute pancreatitis with abdominal infection was significantly better than that of imipenem alone (odds ratio=0.78, 95%CI 0.71-0.86, p=0.040).

CONCLUSION: Imipenem combined with glutamine can significantly improve the efficacy in the treatment of severe acute pancreatitis with abdominal cavity infection.

PMID:35442370 | DOI:10.1590/1806-9282.20211127

Rev Assoc Med Bras (1992). 2022 Mar;68(3):329-336. doi: 10.1590/1806-9282.20210710.

ABSTRACT

OBJECTIVE: The objective of this study was to evaluate the quality of life of patients with noncystic fibrosis bronchiectasis during a 1-year follow-up by using the EuroQol – 5 Dimensions – 3 Levels (EQ-5D-3L) questionnaire.

METHODS: A cohort study was conducted with 100 patients with noncystic fibrosis bronchiectasis and followed up with face-to-face visits or by telephone contact every 3 months for 1 year. All patients were recruited from a single referral center for bronchiectasis. At the time of recruiting and at the end of 1 year, the EQ-5D-3L questionnaire was applied to evaluate the patients’ quality of life. Variables, such as exacerbation, emergency care, comorbidities, hemoptysis, colonization, and hospitalization, were assessed.

RESULTS: Of the 100 patients, 99 completed the study and 72% were women. There were no marked limitations in the mobility and self-care domains during the follow-up. At the end of the follow-up, 32 patients were extremely anxious or depressed. The quality of life assessed by using EQ-5D-3L had an initial mean score of 0.545 and of 0.589 after 1 year, which was statistically significant (p=0.011).

CONCLUSION: Patients with noncystic fibrosis bronchiectasis have a poor quality of life, and the EQ-5D-3L questionnaire may be a tool for monitoring patients with bronchiectasis.

PMID:35442359 | DOI:10.1590/1806-9282.20210710

Rev Assoc Med Bras (1992). 2022 Mar;68(3):389-394. doi: 10.1590/1806-9282.20211071.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the anxiety experienced by health care workers in different branches during the COVID-19 pandemic.

METHODS: The cross-sectional study included 373 health care workers. Data were collected using an online questionnaire consisting of the Sociodemographic Form (32 items related to the working conditions of health care professionals during the COVID-19 pandemic) and the Penn State Concern Questionnaire.

RESULTS: The anxiety levels of the female workers were significantly higher (p<0.001). The total Penn State Concern Questionnaire points were determined to be statistically significantly higher in those who need to protect the family during the pandemic (p=0.03), who were dissatisfied with their profession (p<0.001), and those whose workload had increased during the pandemic (p=0.007).

CONCLUSIONS: The study results demonstrated that the levels of anxiety of health care workers during the COVID-19 pandemic could be increased by young age, low level of experience, female gender, increased workload, and dissatisfaction with the profession.

PMID:35442369 | DOI:10.1590/1806-9282.20211071