Tag: statistics

Virol J. 2023 Jul 21;20(1):162. doi: 10.1186/s12985-023-02124-w.

ABSTRACT

BACKGROUND: Hepatitis C virus (HCV) is well-known to be associated with multiple extrahepatic manifestations such as arthralgia, myalgia, arthritis, and vasculitis. Many studies reported frequent rheumatologic manifestations among patients infected by HCV. The purpose of this study was to determine the prevalence of HCV among chronic unexplained arthralgia patients in order to aid in the early detection and treatment of silent HCV infection.

METHODS: This study was a cross-sectional observational study conducted from July 2020 to May 2022. It included 145 individuals suffering from chronic unexplained arthralgia, with vast majority having oligoarticular joint pain (110, 75.9%). They were 103 (71%) females and 42 (29%) males. Serum samples from all patients were examined for the presence of anti-HCV antibodies using a rapid immunochromatographic assay. Seropositive samples were further examined using polymerase chain reaction (PCR) for detection of HCV RNA to confirm HCV infection.

RESULTS: Out of 145 patients who complained of arthralgia, seven patients tested positive for anti-HCV with a seroprevalence of 4.8% while five patients tested positive for HCV-RNA with a molecular prevalence of 3.4%. All positive patients were males (11.9%) with high statistical significance (χ² = 12.7 and p = 0.002). No association was found between HCV infection and age, blood transfusion, surgery, using personal shaving tools, or being a health-care worker.

CONCLUSIONS: The prevalence of HCV was high among males who complained of arthralgia. Patients with arthralgia, especially male patients, are recommended to perform HCV screening test.

PMID:37480120 | DOI:10.1186/s12985-023-02124-w

J Orthop Surg Res. 2023 Jul 22;18(1):519. doi: 10.1186/s13018-023-04024-9.

ABSTRACT

BACKGROUND: We compared the clinical efficacy of mini-open reduction and autologous bone grafting (G_M) and closed reduction (G_C) using intramedullary nailing for the treatment of tibial shaft fractures.

METHODS: This retrospective study included 70 tibial shaft fractures treated with G_M or G_C between January 2018 and December 2021. The demographic characteristics and clinical outcomes were compared between the two treatment methods.

RESULTS: This study included 70 patients who were followed-up for 12.4 months. In total, 31 and 39 patients were treated with G_M and G_C, respectively. The operative duration was significantly shorter for G_M (95.2 ± 19.3 min) than for G_C (105.5 ± 22.2 min, p = 0.0454). The number of radiation times was significantly lower for G_M (14.7 ± 6.3) than for G_C (22.2 ± 9.2, p < 0.005). There were no statistically significant differences between the groups in terms of the wound complication or infection rates. The malunion and nonunion rates were high after G_C than after G_M, but there are no significant differences between the groups.

CONCLUSIONS: Closed reduction and intramedullary nailing remains the first choice for tibial shaft fractures. G_M is a safe and effective treatment worth considering. Future prospective randomized controlled trials are warranted.

PMID:37480093 | DOI:10.1186/s13018-023-04024-9

World J Surg Oncol. 2023 Jul 22;21(1):215. doi: 10.1186/s12957-023-03094-7.

ABSTRACT

INTRODUCTION: In Western countries, right-sided colon cancers (RSCC) present at an older age and advanced stage. Researchers believe that there is a difference between left-sided colon cancer (LSCC) and RSCC. In Uganda, however, it is unknown whether differences exist in the pathological profile between RSCC and LSCC. The aim of this study was to determine the differences in clinicopathological characteristics between RSCC and LSCC in Ugandan patients.

METHODOLOGY: A cross-sectional study was conducted in which colorectal adenocarcinoma formalin-fixed paraffin-embedded tissue (FFPE) blocks were obtained from 2008 to 2021. Colorectal specimens were obtained from prospectively recruited patients. In the retrospective study arm, FFPE blocks and data were obtained from the archives of pathology laboratory repositories. Parameters studied included age, sex, location of the tumour, grade, stage, lymphovascular (LVI) status, and histopathological subtype between LSCC and RSCC.

RESULTS: Patients with RSCC were not older than those with LSCC (mean age, 56.3 years vs 53.5 years; p = 0.170). There was no difference in the stage between RSCC and LSCC. Poorly differentiated tumours were more commonly found in RSCC than in LSCC (18.7% vs 10.1%; p = 0.038). Moderately and poorly differentiated colonic tumours were more common with RSCC (89.3%) than with LSCC (75.1%) (p = 0.007). Younger patients had more poorly differentiated tumours than older patients (19.6% versus 8.6%; p = 0.002). LVI was more common with RSCC than with LSCC (96.8% vs 85.3%; p = 0.014). Mucinous adenocarcinoma (MAC) was more common with RSCC (15.8%) compared with LSCC (8.5%) (p = 0.056) although statistical significance was borderline.

CONCLUSIONS: Clinicopathological features of RSCCs tend to be different from those of LSCCs. RSCCs tend to be associated with MAC, a higher grade and LVI status compared to LSCC. LSCC and RSCC present predominantly with an advanced stage; therefore, national screening programmes for the early detection of CRC are necessary to reduce mortality in our Ugandan population.

PMID:37480083 | DOI:10.1186/s12957-023-03094-7

BMC Health Serv Res. 2023 Jul 21;23(1):781. doi: 10.1186/s12913-023-09736-6.

ABSTRACT

BACKGROUND: A full understanding of the economic burden associated with treatment-related adverse events (AEs) can aid estimates of the incremental costs associated with incorporating new technologies and support cost-effective economic modeling in Brazil. In this context, the main objective of this work was to evaluate in a real-life database: (i) the direct medical cost of monitoring the occurrence of AEs (CMO); (ii) the direct medical cost of managing an identified AE (CMN); and (iii) the total direct medical cost of monitoring and managing AEs (TMC), in quarterly periods from 0 to 24 months of the monitoring of cancer patients who used a PD-1 inhibitor from the perspective of the supplementary health system in Brazil.

METHODS: This study was conducted from the supplementary health system (SSS) perspective and followed the methodological guidelines related to cost-of-illness studies. A bottom-up (person-based) approach was used to assess the use of health resources to monitor and manage AEs during the use of PD-1 inhibitors, which made it possible to capture differences in the mean frequency of the use of health services with stratification results for different subgroups. As the Brazilian SSS is complex, asymmetric, and fragmented, this study used information from different sources. The methodology was divided into three parts: (i) Data Source: clinical management of AEs; (ii) Microcosting: management of the economic burden of AEs; (iii) Statistical analysis: stratification of results for different subgroups.

RESULTS: Analysis of the economic burden of toxicity showed higher CMO costs than CMN in all the periods analyzed. In general, for every BRL 100 on average invested in the TMC of AEs, BRL 95 are used to monitor the occurrence of the AE and only BRL 5 to manage an identified AE. This work also showed that the sociodemographic characteristics of patients, the journey of oncological treatment, and the toxicity profile affect the economic burden related to AE.

CONCLUSION: This study provided real-world evidence of the economic burden of AEs associated with the use of PD-1 inhibitors in Brazil. This work also made methodological contributions by evaluating the economic burden of AE of PD-1 inhibitors considering the kinetics of toxicity occurrence and categorizing the costs in terms of CMO, CMN and TMC.

PMID:37480058 | DOI:10.1186/s12913-023-09736-6

BMC Bioinformatics. 2023 Jul 21;24(1):296. doi: 10.1186/s12859-023-05405-x.

ABSTRACT

BACKGROUND: Statistical correlation analysis is currently the most typically used approach for investigating the risk factors of type 2 diabetes mellitus (T2DM). However, this approach does not readily reveal the causal relationships between risk factors and rarely describes the causal relationships visually.

RESULTS: Considering the superiority of reinforcement learning in prediction, a causal discovery approach with reinforcement learning for T2DM risk factors is proposed herein. First, a reinforcement learning model is constructed for T2DM risk factors. Second, the process involved in the causal discovery method for T2DM risk factors is detailed. Finally, several experiments are designed based on diabetes datasets and used to verify the proposed approach.

CONCLUSIONS: The experimental results show that the proposed approach improves the accuracy of causality mining between T2DM risk factors and provides new evidence to researchers engaged in T2DM prevention and treatment research.

PMID:37480046 | DOI:10.1186/s12859-023-05405-x

Contracept Reprod Med. 2023 Jul 21;8(1):38. doi: 10.1186/s40834-023-00238-8.

ABSTRACT

OBJECTIVE: Given high unmet need for contraception in Ethiopia, this study aimed to determine prevalence and factors associated with early discontinuation of long-acting reversible contraceptives (LARC).

METHODS: This institution-based cross-sectional study was conducted with 389 participants using exit interviews with clients presenting for removal of LARC at the family planning clinic of four government hospitals in Addis Ababa. SPSS version 26 was used for analysis. Descriptive statistics, bivariate, and multivariate logistic regression were computed.

RESULT: Among the 389 clients, 236 (60.7%) discontinued early. In multivariate regression, lack of pre-insertion counseling on side effects (AOR = 3.5, p = 0. 000; 95% C.I = 1.8-6.8), presence of side effects (AOR = 1.9, p = 0. 017; 95% C.I = 1. 1- 3.4), history of abortion (AOR = 3.5, p = 0. 001; 95% C.I = 1. 6- 7.4); and no prior contraception use (AOR = 2.9, p = 0. 000; 95% C.I = 1. 6- 5.3) were positively associated with early discontinuation. Whereas insertion outside of Saint Paul’s Hospital Millennium Medical College (AOR = 0.4, p = 0. 000; 95% C.I = 0. 2- 0.6), and influence on choice of contraceptives by others (AOR = 0.2, p = 0. 000; 95% C.I = 0. 2- 0.4) were negatively associated with early discontinuation.

CONCLUSION: Early discontinuation of LARC was high among study participants. Counseling about possible side effects and giving women the opportunity to decide their own choice of contraception might help in reducing early discontinuation.

PMID:37480045 | DOI:10.1186/s40834-023-00238-8

Environ Health. 2023 Jul 21;22(1):53. doi: 10.1186/s12940-023-01001-x.

ABSTRACT

BACKGROUND: Early-life environmental exposures are suspected to be involved in the development of chronic diseases later in life. Most studies conducted so far considered single or few exposures and single-health parameter. Our study aimed to identify a childhood general health score and assess its association with a wide range of pre- and post-natal environmental exposures.

METHODS: The analysis is based on 870 children (6-12 years) from six European birth cohorts participating in the Human Early-Life Exposome project. A total of 53 prenatal and 105 childhood environmental factors were considered, including lifestyle, social, urban and chemical exposures. We built a general health score by averaging three sub-scores (cardiometabolic, respiratory/allergy and mental) built from 15 health parameters. By construct, a child with a low score has a low general health status. Penalized multivariable regression through Least Absolute Shrinkage and Selection Operator (LASSO) was fitted in order to identify exposures associated with the general health score.

FINDINGS: The results of LASSO show that a lower general health score was associated with maternal passive and active smoking during pregnancy and postnatal exposure to methylparaben, copper, indoor air pollutants, high intake of caffeinated drinks and few contacts with friends and family. Higher child’s general health score was associated with prenatal exposure to a bluespace near residency and postnatal exposures to pets, cobalt, high intakes of vegetables and more physical activity. Against our hypotheses, postnatal exposure to organochlorine compounds and perfluorooctanoate were associated with a higher child’s general health score.

CONCLUSION: By using a general health score summarizing the child cardiometabolic, respiratory/allergy and mental health, this study reinforced previously suspected environmental factors associated with various child health parameters (e.g. tobacco, air pollutants) and identified new factors (e.g. pets, bluespace) warranting further investigations.

PMID:37480033 | DOI:10.1186/s12940-023-01001-x

BMC Med Educ. 2023 Jul 21;23(1):523. doi: 10.1186/s12909-023-04503-x.

ABSTRACT

BACKGROUND: The acceptance of online courses by medical and dental students, especially during the coronavirus disease 2019 crisis, is substantial, as reported in various studies. However, the unfavourable online learning experiences of the students during the pandemic were also highlighted. As the teaching-learning process is returning to the “new normal,” it is necessary to identify online learning domains implemented during the pandemic crisis that may be applied in pre-clinical courses in the future.

METHODS: A validated Student Online Learning Readiness questionnaire assessed pre-clinical students’ online learning competence. Students’ academic performance in face-to-face post-pandemic was compared with their performance in online settings during the pandemic crisis. Students’ satisfaction with online learning was evaluated using a self-made survey questionnaire. Descriptive statistics, the t-test, and multiple regression analysis were used to analyze the data gathered with a p-value ≤ 0.05 considered statistically significant.

RESULTS: Except for social skills with classmates and groupmates, in which 47.5% of respondents indicated unreadiness, most students were prepared for online learning. Theory-wise, online learners outperformed traditional learners, but the difference was insignificant. In contrast, students’ practical skills in face-to-face modality are significantly higher (p = 0.029). Students rated their satisfaction with online learning higher for interactions with instructors and staff and lower for interactions with classmates and group mates and skill acquisition.

CONCLUSION: Providing high-quality pre-clinical online teaching was achieved for theoretical components but not practical skills acquisition. Students’ social engagement with peers is one of the key elements crucial to online learning success. Academic leaders and curriculum developers must recognize potential gaps as they transition to online learning.

PMID:37480021 | DOI:10.1186/s12909-023-04503-x

Int J Phytoremediation. 2023 Jul 21:1-14. doi: 10.1080/15226514.2023.2238818. Online ahead of print.

ABSTRACT

This study was carried out to examine the interaction of enzyme activities, microbial biomass carbon, and CO₂ respiration with heavy metals under different land uses in terms of quality and sustainability of the soil. There is a statistically significant positive correlation between dehydrogenase enzyme activity and Mn, Pb, Cd, and Co, while it was negative between Cr. There was a positive correlation between catalase enzyme activity and Mn and Pb and between urease and Co. The higher interaction of dehydrogenase activity with heavy metals, which is included in the endo enzyme group, has been explained as a much stronger effect of heavy metals on living microorganisms and endoenzymes than extracellular enzymes stabilized on clay minerals and organic matter. The high clay content of the soil is thought to reduce some of the negative effects of heavy metals on enzymes. The results of this study may be good indicators of enzyme activities, especially dehydrogenase, catalase, and urease, for soil health and quality, chemical degradation and restoration processes, and ecosystem functioning in soils contaminated or to be contaminated with heavy metals. It shows that the activities of these enzymes are very sensitive and can decrease rapidly in case of high concentrations of heavy metals.

PMID:37480015 | DOI:10.1080/15226514.2023.2238818

BMC Anesthesiol. 2023 Jul 21;23(1):246. doi: 10.1186/s12871-023-02206-w.

ABSTRACT

BACKGROUND: Cesarean section is becoming increasingly common. Well-managed postoperative analgesia improves patient comfort while encouraging early ambulation and breastfeeding. The analgesic efficacy of transversalis facial plane block (TFPB) vs. anterior quadratus lumborum block (QLB) was compared in this study.

METHODS: We analyzed the data of 49 pregnant women (gestation, ≥ 37weeks; age, 18-45years) scheduled for elective cesarean delivery (CD) under general anesthesia. They were randomly divided into TFPB and anterior QLB groups. All blocks were administered bilaterally with 25mL of 0.25% bupivacaine under ultrasound guidance prior to extubation. Postoperative morphine consumption and numerical rating scale (NRS) pain scores (static and dynamic [during coughing]) were recorded at 1, 3, 6, 9, 12, 18, and 24h.

RESULTS: There was no difference in postoperative morphine consumption between the groups at the third, sixth, and ninth hours, but the anterior QLB group consumed less morphine at the 12th, 18th, and 24th hours. Except for the first hour, resting and dynamic NRS scores were comparable between the groups. The first-hour resting and dynamic NRS scores were lower in the TFPB group (resting NRS, anterior QLB group, median [interquartile range], 2 [2-3] vs. TFPB group, 2 [0-2], p = 0.046; dynamic NRS, anterior QLB group, median [interquartile range], 3 [2-4] vs. TFPB group 2 [0-3], p = 0.001).

CONCLUSIONS: In patients undergoing CD, anterior QLB decreased morphine consumption in the late period (9-24h) compared to TFPB, while pain scores were similar between both groups. The reduction in morphine consumption was statistically significant, but not clinically significant.

PMID:37480008 | DOI:10.1186/s12871-023-02206-w