Tag: statistics

Influenza Other Respir Viruses. 2024 Nov;18(11):e70039. doi: 10.1111/irv.70039.

ABSTRACT

BACKGROUND: Respiratory syncytial virus (RSV) is an important cause of acute lower respiratory infections worldwide, including Thailand. This study aimed to assess clinical and economic burdens of RSV infections across different age groups in Thailand.

METHOD: A retrospective cohort study was conducted using data from a tertiary care hospital from 2014 to 2021. Patients who tested at least one positive RSV were included and stratified into five age groups (< 2, 2-5, 5-18, 18-65, and > 65 years). Healthcare resource utilization, direct medical costs, and clinical outcomes were analyzed with descriptive statistics. Generalized linear models with gamma distributions and log link were used to model cost outcomes. Costs were reported in 2021 US dollars (USD), with 1 USD = 31.98 Thai Baht.

RESULTS: A total of 2122 RSV-positive patients were identified, half of which (1097) were hospitalized. The median (interquartile range [IQR]) total hospitalization costs ranged from USD780 (IQR: USD488-USD1185) in those < 2 years to USD2231 (IQR: USD1250-USD4989) in those aged 65+ years. Case fatality rates among hospitalized patients also varied from 2.5% to 28.4% depending on age. Increased age, presence of comorbidities, and need for critical care were associated with higher hospitalization costs.

CONCLUSION: Among RSV-positive patients, younger children experienced the greatest burden, but poorer outcomes were observed in older adults. Higher costs were associated with older age, comorbidities and critical care needs. Understanding RSV economic burdens is crucial for assessing the cost-effectiveness and public health value of vaccination programs that prioritize at-risk groups to mitigate the public health impact.

PMID:39497189 | DOI:10.1111/irv.70039

J Health Popul Nutr. 2024 Nov 4;43(1):178. doi: 10.1186/s41043-024-00654-9.

ABSTRACT

BACKGROUND: Hepatitis virus infection remains a serious public health concern worldwide. Percutaneous, mucosal, or non-intact skin exposure to infectious blood, semen, and other body fluids are the major routes of infection in endemic areas, including Ethiopia, where little is known about the community’s knowledge, attitudes, and practice toward hepatitis infection. Thus, this study aimed to determine the knowledge, attitude, and practices towards hepatitis infection among adults in Gondar town.

METHODS: A community-based cross-sectional study was conducted from July to August 2021 on a total of 390 participants. Proportional sample allocation was used in 3 randomly selected sub-cities. Then, study participants from randomly selected households were recruited by using a systematic random sampling technique. Socio-demographic data and questions regarding KAP were collected via a self-administered and interviewer-administered questionnaire. Statistical analysis was performed using SPSS version 20. Logistic regression analyses were used to identify the associated factors and a p-value < 0.05 was considered statistically significant.

RESULTS: The mean age of the study participants was 30 ± 8.43 years and more than half ½ (53.3%) ranged from 26 to 40 years old. In this study, 335 (85.9%) of study participants had poor knowledge about hepatitis infection. About 344 (88.2%) had a negative attitude toward hepatitis infections, and 344 (88.2%) of the participants had a poor practice to prevent hepatitis infections. Multivariate analysis affirmed that having vaccination for hepatitis infection was significantly associated with a positive attitude (AOR, with 95% CI: 2.135 (1.006-4.532) and good practice levels (AOR, with 95% CI: 22.623 (0.032-0.156).

CONCLUSIONS AND RECOMMENDATIONS: In this study majority of the participants have poor knowledge, attitudes, and practices toward hepatitis infection. Therefore, targeted community-based interventions are necessary. However, this study revealed that having vaccination for hepatitis infection was significantly associated with a positive attitude and good practice levels among the study participants.

PMID:39497180 | DOI:10.1186/s41043-024-00654-9

BMC Psychol. 2024 Nov 4;12(1):621. doi: 10.1186/s40359-024-02131-8.

ABSTRACT

BACKGROUND: Suicidal ideation may be a warning sign for suicide and previous work has indicated a higher prevalence of suicidal ideation during the COVID-19 pandemic. Job loss and job insecurity are potential risk factors for suicidal ideation, but their importance during the pandemic, and the role of organizational changes for suicidal ideation, is unclear. This study examined the association between various experiences associated with job loss and job insecurity during the pandemic and thoughts of suicide/self-harm in Sweden.

METHODS: The study sample was drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH). Auxiliary data collections in February 2021 and 2022 assessed exposure to job loss/unemployment, furlough, workplace downsizing, or increased job insecurity versus stable employment and thoughts of suicide or self-harm (PHQ-9) during the pandemic. The analyses were based on 1558 individuals (2 349 observations) participating in either or both waves and who had been working before the pandemic. Logistic regression models with cluster-robust standard errors were fitted, including sociodemographic factors and prior mental health problems to control for potential confounding. Measures of personality based on a brief version of the Big-Five personality inventory were also added.

RESULTS: The results indicated an association between all experiences, except furlough, and thoughts of suicide/self-harm, when adjusting for sex, age, civil status, socioeconomic status and prior mental health (job loss odds ratio (OR) = 3.70, 95% confidence interval (CI) 1.79-7.63, downsizing OR = 2.41, CI 1.24-4.70, job insecurity OR = 2.77, CI 1.15-6.67). The associations for job loss and insecurity were attenuated by adjustment for personality, although it remained statistically significant for downsizing.

CONCLUSIONS: The results suggested a higher risk of suicidal ideation connected with loss of employment and survival of a downsizing, but not a forced reduction in working times/pay during the COVID-19 pandemic. The association for subjective job insecurity was less robust and may be partly explained by personality.

PMID:39497179 | DOI:10.1186/s40359-024-02131-8

Scand J Trauma Resusc Emerg Med. 2024 Nov 4;32(1):106. doi: 10.1186/s13049-024-01279-x.

ABSTRACT

BACKGROUND: Pre-hospital incidents involving pediatric and neonatal patients are infrequent, and clinical characteristics and care for these patients differ from the adult population. Lack of knowledge, guidelines, and experience can make pre-hospital pediatric care challenging, and there is limited research on the epidemiology and best practice of care for this population. We examined the pre-hospital pediatric population in the county of Sør-Trøndelag, Norway, to improve our understanding of this population in our region.

METHODS: We conducted a retrospective observational cohort study of emergency incidents involving children under twelve years of age with dispatch of Emergency Medical Services (EMS) in Sør-Trøndelag between 2018 and 2022. Incidents and patient characteristics were extracted from the Emergency Medical Communication Center (EMCC) database. In addition, data on patient characteristics and interventions for more serious incidents seen by the Helicopter Emergency Medical Service (HEMS) were included from the database LABAS. We provided descriptive statistics and estimated population incidences using Poisson regression.

RESULTS: The catchment area of EMCC Sør-Trøndelag has a population of approximately 43,000 children under the age of twelve years. During the five-year study period, there were 7005 emergency calls concerning this patient population, representing 6% of all emergency calls (total no. 108,717). Of these, 3500 (50%) resulted in the dispatch of an ambulance and/or HEMS, yielding an annual incidence of EMS dispatches of 17 per 1000 children. The three most common primary medical problems were respiratory distress, altered consciousness, and trauma. Among the 309 HEMS patients, 131 (42%) received advanced interventions from the HEMS physician. Assisted ventilation was the most frequent intervention.

CONCLUSIONS: Pediatric and neonatal patients make up a small proportion of pre-hospital patient dispatches in Sør-Trøndelag. Consequently, each EMS provider infrequently encounters children in the pre-hospital environment, resulting in less experience with pediatric advanced medical interventions. This study identifies some clinical characteristics and interventions regarding pediatric and neonatal patients that have been pointed out as focus areas for pediatric pre-hospital research.

PMID:39497176 | DOI:10.1186/s13049-024-01279-x

Breast Cancer Res. 2024 Nov 4;26(1):150. doi: 10.1186/s13058-024-01908-4.

ABSTRACT

BACKGROUND: Gestational diabetes mellitus (GDM) is a common pregnancy complication characterized by insulin resistance. A link has been suggested between insulin resistance and breast cancer, which is the most common cancer in women. Hence, women with previous GDM may be at increased risk of developing breast cancer, yet, the existing evidence is conflicting. This study explored the association between GDM and incident breast cancer, including age at cancer diagnosis. Additionally, we investigated the potential impact of severity of insulin resistance during pregnancy and of subsequent diabetes development on the breast cancer risk.

METHODS: We conducted a nationwide, register-based cohort study including all women giving birth in Denmark from 1997 to 2018. We defined GDM and breast cancer based on ICD-10 codes. Premenopausal and postmenopausal breast cancer was pragmatically defined as age at outcome < 50 years and ≥ 50 years, respectively. A proxy for severity of insulin resistance during pregnancy was based on insulin treatment; subsequent diabetes was defined as presence of ICD-10 codes and/or antidiabetic medication after pregnancy. The statistical analyses included Cox regression, logistic regression and t-test.

RESULTS: Of 708,121 women, 3.4% had GDM. The median follow-up period was 11.9 years (range 0-21.9). The overall breast cancer risk was comparable in women with and without previous GDM (adjusted hazard ratio 0.96 [95% CI 0.83-1.12]). Premenopausal and postmenopausal breast cancer risk also did not differ; however, women with previous GDM had a breast cancer diagnosis at younger age (42.6 vs. 43.5 years, p-value 0.01). All-cause mortality was similar regardless of GDM history. Severity of insulin resistance during pregnancy and subsequent diabetes did not affect breast cancer risk.

CONCLUSIONS: This large, population-based cohort study showed no higher risk of incident breast cancer in women with previous GDM compared to women without previous GDM after a median of almost 12 years of follow-up. This was evident irrespective of menopausal state. The breast cancer risk was not influenced by the severity of insulin resistance during pregnancy and by subsequent diabetes development. Regardless of GDM history, attention towards prevention, early detection and treatment of breast cancer should be prioritized.

PMID:39497166 | DOI:10.1186/s13058-024-01908-4

BMC Zool. 2024 Nov 4;9(1):28. doi: 10.1186/s40850-024-00217-9.

ABSTRACT

Grant’s gazelles (Nanger granti) are classified as of least concern by the IUCN, although their number is declining due to several factors. A few research studies have been conducted on Grant’s gazelle in Ethiopia. Thus, the present study was carried out to determine the population size and habitat association of Grant gazelle in the Ene Forest of western Ethiopia, comprising the dry and wet seasons. The study area was stratified into four habitats: woodland, mixed woodland, riverine forest, and grassland habitats. The data were collected using the direct observation technique. The data were analyzed using descriptive statistics and Pearson’s chi-square (χ²) test. The average estimated Grant gazelle population was 136 ± 23 individuals, with a density of 9/km². The adult male-to-adult female sex ratio was 1:1.40 and 1:1.26 during the wet and dry seasons, respectively. The largest herd size (N = 6) was observed during the wet season, and the smallest (N = 4) was observed during the dry season. The highest numbers of Grant gazelles were observed in the grassland habitat during the wet season and in the woodland during the dry season. More Gazelles (N = 65) were observed in the woodland habitat compared to the other habitat types. The continued existence of the Grant’s gazelle population in the area and the suitability of the environment depend significantly on ongoing assessments of habitat change and management intervention.

PMID:39497155 | DOI:10.1186/s40850-024-00217-9

Thromb J. 2024 Nov 4;22(1):96. doi: 10.1186/s12959-024-00667-8.

ABSTRACT

We congratulate Hägg et al. on their study investigating cancer incidence and mortality following first-ever venous thromboembolism (VTE), which provides valuable insights into VTE as a potential marker for underlying malignancies. However, we highlight concerns regarding healthy user bias, the unclear follow-up duration, and inconsistent adjustment in the statistical analysis. We also suggest the use of the Fine-Gray subdistribution hazard model to address competing risks, and the accurate reporting of sex-gender terminology. Lastly, we advise caution in concluding a high incidence of cancer following first-ever VTE without pre-VTE data for comparison and recommend acknowledging potential surveillance bias when interpreting the higher cancer detection rate within 6 months of VTE diagnosis.

PMID:39497151 | DOI:10.1186/s12959-024-00667-8

BMC Musculoskelet Disord. 2024 Nov 4;25(1):879. doi: 10.1186/s12891-024-07983-0.

ABSTRACT

BACKGROUND: This study aimed to assess the quality and readability of large language model-generated responses to frequently asked questions (FAQs) about Kienböck’s disease (KD).

METHODS: Nineteen FAQs about KD were selected, and the questions were divided into three categories: general knowledge, diagnosis, and treatment. The questions were inputted into the Chat Generative Pre-trained Transformer 4 (ChatGPT4) webpage using the zero-shot prompting method, and the responses were recorded. Hand surgeons with at least 5 years of experience and advanced English proficiency were individually contacted over instant WhatsApp messaging and requested to assess the responses. The quality of each response was analyzed by 33 experienced hand surgeons using the Global Quality Scale (GQS). The readability was assessed with the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease Score (FRES).

RESULTS: The mean GQS score was 4.28 out of a maximum of 5 points. Most raters assessed the quality as good (270 of 627 responses; 43.1%) or excellent (260 of 627 responses; 41.5%). The mean FKGL was 15.5, and the mean FRES was 23.4, both of which are considered above the college graduate level. No statistically significant differences were found in the quality and readability of responses provided for questions related to general knowledge, diagnosis, and treatment.

CONCLUSIONS: ChatGPT-4 provided high-quality responses to FAQs about KD. However, the primary drawback was the poor readability of these responses. By improving the readability of ChatGPT’s output, we can transform it into a valuable information resource for individuals with KD.

LEVEL OF EVIDENCE: Level IV, Observational study.

PMID:39497130 | DOI:10.1186/s12891-024-07983-0

BMC Med Educ. 2024 Nov 4;24(1):1252. doi: 10.1186/s12909-024-06261-w.

ABSTRACT

BACKGROUND: The analytical rubric serves as a permanent reference for guidelines on clinical performance for undergraduate dental students. This study aims to assess the rubric system used to evaluate clinical class II composite restorations performed by undergraduate dental students and to explore the impact of gender on overall student performance across two academic years. Additionally, we investigated the relationship between cumulative grade point averages (CGPAs) and students’ clinical performance.

METHODS: An analytical rubric for the assessment of clinical class II composite restoration in the academic years of 2022/2023 and 2023/2024 was used by two evaluators. These two evaluators were trained to use the rubric before doing the evaluations. The scores were based on a 4-point scale for the evaluation of five major parameters for pre-operative procedures (10 points), cavity preparation (20 points), restoration procedures (20 points), and time management (4 points). At the same time, chairside oral exam parameter was 15 points based on a 5-point scale. Descriptive statistics were calculated for the different analytical rubric parameters, and the independent t-test was used to compare the scores between the student groups and the evaluators. Other tests, such as the Kappa test and Pearson’s correlation coefficient, were used to measure the association among CGPA, evaluators, and gender participants.

RESULTS: The overall score out of 69 slightly increased for females/males (61.28/59.42) and (61.18/59.49) in the 2022/2023 and 2023/2024 academic years, respectively, but the differences were not statistically significant. In the 2022/2023 academic year, female students scored significantly higher than male students in pre-operative procedures, as evaluated by both evaluators (p = 0.001), and in time management, as assessed by both evaluators (p = 0.031). The Kappa test demonstrated a moderate to substantial level of agreement between the two evaluators in both academic years. Strong and significant correlations were noted between students’ CGPA and some tested parameters (p = 0.000).

CONCLUSION: The overall performance was very good and high among both genders, but it was marginally higher among females than among males. This study found some differences in performance between male and female students and variability in the evaluations by the two raters ranging from moderate to substantial agreement and similar performances for students with different CGPA.

PMID:39497127 | DOI:10.1186/s12909-024-06261-w

Addict Sci Clin Pract. 2024 Nov 4;19(1):77. doi: 10.1186/s13722-024-00502-5.

ABSTRACT

BACKGROUND: Addiction medicine providers have a key role in HIV prevention amidst rising HIV incidence in persons who inject drugs (PWID). Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are vastly underutilized in this population. Inpatient hospitalization represents a potential touchpoint for initiation of HIV prophylaxis, though little research explores the role of addiction providers. Here we describe rates of PrEP/PEP delivery to hospitalized PWID seen by an Addiction Consult Service (ACS) at an urban, essential hospital.

METHODS: We performed a cross-sectional study of hospitalized patients who were seen by the ACS from January 1, 2020 to December 31, 2022 and had plausible injection drug use. We calculated the proportion of patients who received a new prescription for PrEP/PEP at discharge. We used descriptive statistics to characterize demographics, substance use, reason for admission, and indications for PrEP/PEP. Secondarily, we calculated the monthly proportion of all patients discharged from the hospital with PrEP/PEP who were seen by the ACS compared to those not seen by the ACS.

RESULTS: The average monthly proportion of ACS consults with plausible injection drug use who received PrEP/PEP was 6.4%. This increased from 4.2% in 2020 to 7.5% in 2022. Those seen by the ACS who received PrEP/PEP had high rates of opioid use disorder (97.5%), stimulant use disorder (77.8%), and homelessness (58.1%); over half were admitted for an injection-related infection. The indications for PrEP/PEP were injection drug use only (70.6%), followed by combined injection and sexual risk (20.2%); 71.9% of prescriptions were for PrEP and 28.1% for PEP. Overall, the ACS was involved in 83.9% of hospital-wide discharges with PrEP/PEP prescriptions (n = 242).

CONCLUSIONS: PWID who were seen by the ACS received PrEP/PEP prescriptions at rates exceeding national averages. The ACS was also involved with the care of the majority of admitted patients who received PrEP/PEP at discharge. While PrEP/PEP use for PWID remains low, the inpatient ACS represents a key resource to improve uptake by leveraging the reachable moment of an inpatient hospitalization.

PMID:39497126 | DOI:10.1186/s13722-024-00502-5