Tag: statistics

Int J Health Plann Manage. 2025 Apr 21. doi: 10.1002/hpm.3939. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to illustrate the state of stroke care and rehabilitation in the Philippines through the perspectives of local government officials, policymakers, and organisational leaders. It sought to identify challenges, opportunities, and recommendations for improving stroke policies and services across different administrative levels.

METHODS: Mixed-methods approach involving a structured survey of 131 local government officials and in-depth interviews with eight key stakeholders. Survey participants included Department of Health (DoH) officials, local chief executives, policymakers, Local Government Unit (LGU) employees, and representatives from non-government agencies. Interviewees comprised leads and managers from the DoH and representatives from organisations including the Philippine Academy of Rehabilitation Medicine (PARM), Physicians for Peace Philippines, and the Philippine Council for Health Research and Development (PCHRD). Quantitative survey data were analysed using descriptive statistics and qualitative interview data were thematically analysed, then the two types of data were triangulated and organised by theme.

RESULTS: Findings revealed significant gaps in funding, healthcare infrastructure, and policy implementation. Challenges included inadequate facilities, lack of qualified staff, financial barriers, and regional disparities in service provision. Survey and interview participants emphasised the need for increased government support, comprehensive policies, and community-based rehabilitation (CBR) programmes. Improving stroke survivors’ quality of life was ranked as the most critical aspect of rehabilitation programmes.

CONCLUSIONS: The study highlights the critical need for more equitable and accessible stroke care and rehabilitation in the Philippines. This can be facilitated by sustained government support, inter-agency collaboration, community engagement, and the implementation of holistic, evidence-based, and cost-effective CBR initiatives.

PMID:40259445 | DOI:10.1002/hpm.3939

Int J Cancer. 2025 Apr 21. doi: 10.1002/ijc.35451. Online ahead of print.

ABSTRACT

Lynch-like syndrome (LLS) presents very similar clinicopathological characteristics to Lynch syndrome (LS) but the mechanism for cancer predisposition remains unknown. The present study aims to investigate the causal mechanism of LLS by a comprehensive genetic and epigenetic approach. Thirty-two LLS and 34 LS patients with colorectal cancer (CRC) fitting the Amsterdam and Bethesda criteria were included, along with 29 CRC sporadic patients, and analyzed for the presence of pathogenic variants in 94 genes associated with hereditary tumors. The cohorts were also characterized for the methylation profile and examined through a sample group analysis and a Stochastic Epigenetic Mutations (SEMs) analysis in comparison with 29 age-matched healthy controls. The multigene panel analysis revealed the presence of pathogenic variants in non-mismatch repair (MMR) genes and three variants classified as pathogenic/likely pathogenic possibly predisposing to LLS. The epigenetic analysis showed epivariations targeting genes associated with LS or DNA repair, most of them associated with the Fanconi Anemia pathway, which could explain the susceptibility to cancer. Our results highlight the need for using extended genetic and epigenetic analyses to understand the causal mechanism of LLS.

PMID:40259440 | DOI:10.1002/ijc.35451

Alzheimers Res Ther. 2025 Apr 21;17(1):86. doi: 10.1186/s13195-025-01738-2.

ABSTRACT

BACKGROUND AND OBJECTIVES: The association between obesity and young-onset dementia (YOD, defined as dementia diagnosed before age 65) is established, but the specific impact of abdominal obesity in women remains unclear. Abdominal obesity, driven by excess visceral fat, may increase dementia risk through metabolic and vascular pathways. We investigated the association between abdominal obesity and YOD risk in women using a large nationwide cohort.

METHODS: We analyzed 964,536 Korean women aged 40-60 years who underwent national health checkups in 2009. General obesity was defined by body mass index (BMI), and abdominal obesity was categorized by waist circumference (WC) into < 75 cm, 76-84 cm, 85-94 cm, and ≥ 95 cm. YOD was identified using ICD-10 codes and dementia medication prescriptions. Hazard ratios (HRs) for YOD were estimated using multivariable Cox proportional hazard models adjusted for lifestyle and clinical factors.

RESULTS: Over a median follow-up of 8.2 years, YOD incidence increased progressively with higher WC. Women with WC ≥ 95 cm had a 55% increased risk of YOD (HR 1.55; 95% CI 1.34-1.79) compared to those with WC < 75 cm. The association was particularly strong for vascular dementia (VD), with HR 1.83 (95% CI 1.30-2.57). By contrast, BMI showed a U-shaped relationship, with the lowest YOD risk observed in women with normal BMI (18.5-22.9 kg/m²), and significantly elevated risks in both underweight (BMI < 18.5 kg/m²; HR 1.39, 95% CI 1.13-1.71) and morbidly obese women (BMI ≥ 30 kg/m²; HR 1.26, 95% CI 1.10-1.45).

DISCUSSION: Abdominal obesity is a significant, independent risk factor for YOD in women, particularly for VD. These findings underscore the importance of addressing abdominal obesity in middle-aged women to reduce dementia risk.

PMID:40259430 | DOI:10.1186/s13195-025-01738-2

J Health Popul Nutr. 2025 Apr 21;44(1):130. doi: 10.1186/s41043-025-00870-x.

ABSTRACT

BACKGROUND: Tuberculosis (TB) is known to be a disease associated with underprivileged social conditions such as poverty, malnutrition, and overcrowding. Homeless individuals are at a higher risk of contracting TB due to factors such as substance misuse, alcohol disorder, smoking, and malnutrition. Recognizing this risk, the World Health Organization recommends TB screening in these vulnerable populations. As a result, this study aims to evaluate the prevalence of TB and its associated factors among people who experience homelessness living in Wolaita Zone Towns.

METHOD: A cross-sectional study was conducted on 352 homeless individuals with presumed TB from May 1 to July 30, 2023. Data was collected using pre-tested structured questionnaires. The symptom was assessed using WHO guidelines. Sputum samples were screened for TB using GeneXpert MTB/RIF assay technique and those found to be positive were confirmed via the Lowenstein-Jensen(LJ) culture method by comparing equal numbers of positives and negatives. The data was analyzed using statistical software packages (SPSS) version 26. Logistic regression analysis was used to identify factors associated with TB and a P-value of less than 0.05 at a 95% confidence interval was considered statistically significant.

RESULTS: The prevalence of bacteriological confirmed TB among homeless individuals was 7.7% [95% CI: 4.8- 10.5] and rifampicin-resistant TB (RR-TB) was not detected. Multivariate logistic regression analysis revealed that smoking cigarettes[AOR = 7.673, 95% CI: 1.622,36.303], smoking benzene[AOR = 8.348, 95% CI: 2.061,33.813], chewing tobacco [AOR = 4.138, 95% CI: 1.249,13.709], duration of being homeless[AOR = 6.749, 95% CI: 1.914, 23.797], taking any medication currently [AOR = 4.686, 95% CI:1.216,18.064], BMI [AOR = 5.328, 95% CI: 1.663,17.070] and having HIV infection [AOR = 5.234, 95% CI: 1.558, 17.585] were significantly associated with the prevalence of PTB in people who experience homelessnesss.

CONCLUSIONS: This study indicates a higher prevalence of pulmonary TB (PTB) in homeless individuals compared to the general population. It is strongly recommended to implement targeted TB preventive and control measures and actively monitor for the diseases within those vulnerable population.

PMID:40259425 | DOI:10.1186/s41043-025-00870-x

Eur J Med Res. 2025 Apr 22;30(1):315. doi: 10.1186/s40001-025-02579-3.

ABSTRACT

BACKGROUND AND OBJECTIVE: The timing of enteral nutrition initiation in critically ill patients in the intensive care unit (ICU) plays a crucial role in clinical outcomes. This study aimed to evaluate the impact of early (within 48 h of ICU admission) versus delayed enteral feeding on 28-day mortality, ventilator dependency, and ICU length of stay.

METHODS: A retrospective cohort study was conducted involving 295 patients across four ICUs in two Tehran hospitals, admitted between 2017 and 2018. Participants were grouped into early (n = 161) and delayed (n = 134) enteral feeding categories. Baseline characteristics were analyzed using the Mann-Whitney and Chi-Square tests. Mortality was assessed using Kaplan-Meier survival analysis and Cox proportional hazards models, while logistic and linear regression models were applied to examine associations with ventilator dependency and ICU length of stay, respectively.

RESULTS: Early enteral feeding (EEF) was significantly associated with reduced 28-day mortality (25.5% vs. 50.0%, p < 0.001), lower incidence of mechanical ventilation (66.5% vs. 80.6%, p = 0.007), and a shorter ICU stay (13.07 ± 16.44 days vs. 16.23 ± 13.57 days, p < 0.001). Kaplan-Meier analysis revealed a higher survival probability at 28 days in the early feeding group (log-rank test, p < 0.001). However, after adjusting for potential confounders (age, gender, BMI, baseline APACHEII, baseline SOFA score, number of comorbid, primary diagnosis and admission category), the relationships between delayed feeding and mortality (HR: 1.49, 95% CI 0.98, 2.26, p = 0.062), ventilator dependency (OR: 1.28, 95% CI 0.59, 2.70, p = 0.558), and ICU length of stay (LOS) (β: 1.96, 95% CI – 1.52, 5.45, p = 0.268) were not statistically significant. Subgroup analyses revealed that delayed enteral feeding was significantly associated with higher mortality risk in surgical patients (adjusted HR: 1.85, 95% CI 1.02, 3.35, p = 0.043) and prolonged ICU stay (β: 3.75, 95% CI 0.27, 7.23, p = 0.035), whereas no significant associations were observed in medical patients.

CONCLUSION: Initiating enteral feeding within 48 h of ICU admission is associated with improved clinical outcomes, although these benefits may be influenced by individual patient factors and disease severity. Future studies should focus on tailoring enteral feeding strategies to optimize outcomes across varied ICU populations.

PMID:40259420 | DOI:10.1186/s40001-025-02579-3

BMC Nutr. 2025 Apr 21;11(1):82. doi: 10.1186/s40795-025-01068-4.

ABSTRACT

BACKGROUND: Communities afflicted by armed conflict are characterized by pervasive malnutrition and widespread hunger. For nearly two years, there has been an unbroken conflict in Tigray. However, little is understood about the coping mechanisms people used in reaction to a lack of food and cash. This study evaluated the coping mechanisms used by urban residents of Mekelle City in Tigray, Northern Ethiopia.

METHODOLOGY: A community-based cross-sectional survey was conducted among 315 randomly selected households in Mekelle City. Data were collected from May to June 2022 using a pre-tested structured questionnaire and entered, cleaned, coded, and analyzed using Stata version 14. We used descriptive statistics to describe the mean, frequency distribution, and percentages. The t-test was used to analyze the consumption-based coping strategy index.

RESULTS: The current analysis indicates that 272 households, or 87%, experienced food shortages. To cope with this situation, 101 households (32.6%) reduced the size of their meals. Additionally, 85 households (27.3%) opted to lower the quality of their meals or substituted less preferred dishes. Furthermore, approximately 72 households (23.2%) skipped meals as a strategy to manage food scarcity. The mean reduced coping strategy index (rCSI) for households that skipped meals is 181.84 (SD: 112.5), whereas it is 38.6 for those that did not skip meals (p < 0.01). For households that reduced the food content, the mean rCSI is 152.4, compared to 51.12 for those who did not reduce food content (p < 0.01).

CONCLUSION: The study revealed that the communities affected by the war faced a tough struggle due to the food crisis. The study highlights the food crisis in war-affected communities, highlighting coping mechanisms like reducing meal quantity and quality and eating less desirable foods. Thus, targeted food ration distributions and blanket supplemental feeding programs should be in place through humanitarian agents to reduce acute malnutrition and mortality, and enable recovery.

PMID:40259413 | DOI:10.1186/s40795-025-01068-4

Orphanet J Rare Dis. 2025 Apr 21;20(1):191. doi: 10.1186/s13023-025-03680-w.

ABSTRACT

BACKGROUND: This study aims to investigate the clinical characteristics, imaging features, treatment, and prognostic factors of jaw Langerhans cell histiocytosis (JLCH), providing valuable insights for its clinical diagnosis and management.

METHOD: This study retrospectively analyzed the clinical and follow-up data of JLCH patients treated between January 2010 and January 2024. Data collected included gender, age, symptoms, imaging findings, treatment strategies, and outcomes. Univariate and multivariate Cox regression analyses were performed using SAS software to identify factors affecting treatment outcomes, with P ≤ 0.05 considered statistically significant.

RESULTS: A total of 68 patients (50 males, 18 females; median age 13.5 years) were included. Forty percent of patients were under 10 years old, and 71% had mandibular involvement. Disease classification included 49 cases of single-system unifocal (SS-s) disease, 10 cases of single-system multifocal (SS-m) disease, and 9 cases of multi-system (MS) disease. Common symptoms included jaw or tooth pain (28 cases), facial swelling (22), gingival ulceration (10), and loose teeth (9). Imaging revealed periodontal disease-like (7), cyst-like (17), and osteomyelitis-like (44) lesions. Univariate and multivariate Cox regression analyses identified that female patients had a lower risk of progression (P = 0.014, HR 0.071), while SS-m (P = 0.019, HR 4.992) and MS patients (P = 0.030, HR 4.182) exhibited higher progression risks compared to SS-s patients. Cyst-like (P = 0.001, HR 0.054) and osteomyelitis-like lesions (P < 0.001, HR 0.023) were associated with lower progression risks compared to alveolar lesions.

CONCLUSION: JLCH can affect individuals of all ages, though it is more common in children. Factors such as gender, lesion multiplicity, and lesion type (alveolar) are significant in predicting disease progression. Complete surgical resection combined with radiotherapy offers the highest likelihood of cure for SS-type JLCH.

PMID:40259405 | DOI:10.1186/s13023-025-03680-w

Eur J Med Res. 2025 Apr 21;30(1):311. doi: 10.1186/s40001-025-02567-7.

ABSTRACT

OBJECTIVE: The purpose of this study was to investigate the role of ⁶⁸Ga-labeled prostate specific membrane antigen HBED-CC (⁶⁸Ga-PSMA-11) PET/MRI in primary staging and to evaluate the relationship between PSMA-derived parameters and clinicopathological characteristics in newly diagnosed prostate cancer (PCa).

MATERIALS AND METHODS: This study reports the findings from 72 patients newly diagnosed with primary PCa, all of whom underwent ⁶⁸Ga-PSMA-11 PET/MRI scans. Calculated the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ⁶⁸Ga-PSMA-11 PET/MRI for T, N, M staging, respectively. The maximum standardized uptake value (SUVmax), PSMA-tumor volume (PSMA-TVp), and total lesion-PSMA (TL-PSMAp) of primary lesion, PSMA-TV of total lesions (PSMA-TVt), and TL-PSMA of total lesions (TL-PSMAt) were measured, and Spearman correlation analysis was performed to assess their correlation with baseline prostate-specific antigen (PSA). Non-parametric Mann-Whitney U test was conducted to assess the difference of PSMA-derived parameters among clinicopathological characteristics of PCa. Receiver operating characteristic (ROC) curve was used to evaluate the performance of PSMA-derived parameters in diagnosing the clinicopathological characteristics of PCa.

RESULTS: The overall accuracy of ⁶⁸Ga-PSMA-11 PET/MRI in detecting T staging of PCa was 80.7%. Diagnostic accuracy for T2a, T2b, T2c, T3a, and T3b were 94.2%, 92.3%, 90.4%, 90.4%, and 94.2%, respectively. Diagnostic accuracy for N and M staging were 96.1% and 97.2% based on patients-level, respectively. There were significant correlation between the SUVmax, PSMA-TVp, TL-PSMAp, PSMA-TVt, TL-PSMAt and baseline PSA values. Significant differences were observed in SUVmax, PSMA-TVp, TL-PSMAp, PSMA-TVt, and TL-PSMAt between T3 and T2 staging. Statistical differences were observed in SUVmax, TL-PSMAp, PSMA-TVt, and TL-PSMAt between Gleason Score (GS) > 7 and GS ≤ 7, as well as positive and negative regional lymph node metastasis. TL-PSMAt show the highest value in assessing clinicopathological characteristics.

CONCLUSIONS: ⁶⁸Ga-PSMA-11 PET/MRI can provide accurate TNM staging for PCa, particularly in local staging. TL-PSMAt accurately evaluate overall tumor burden and aids in diagnosing clinicopathological characteristics in mid-to-late-stage patients, outperforming SUVmax.

PMID:40259392 | DOI:10.1186/s40001-025-02567-7

BMC Palliat Care. 2025 Apr 21;24(1):109. doi: 10.1186/s12904-025-01745-y.

ABSTRACT

PURPOSE: Head and neck cancer is the seventh most prevalent cancer, with over 660,000 new cases and 325,000 annual fatalities, accounting for 30% of all cancer cases. Chronic cancer-related pain affects 15-75% of patients, with myofascial pain being especially common in those with head and neck cancers, ranging from 11.9 to 44.8%. Surgery and radiotherapy, the primary treatments for these cancers, contribute to myofascial pain development. Additionally, head and neck cancer patients face higher psychological distress, with rates up to 50%. This study estimates the prevalence, topography of the musculoskeletal group, and emotional impact of myofascial pain in terms of depression in patients three months post-treatment, emphasizing early diagnosis for improved quality of life.

METHODS: We conducted a time-bound cross-sectional observational study using convenience sampling of 120 patients with head and neck cancer who were post-surgery or radiotherapy over a 12-month period from April 2023 to March 2024. Data were collected using structured proforma and validated tools. Descriptive statistics summarized continuous variables, and chi-square tests compared categorical variables. Pearson correlation measured linear relationships, while regression analysis estimated the relationship between pain and explanatory variables. A two-sided p-value of < 0.05 was considered statistically significant.

RESULTS: The prevalence of myofascial pain was 68.3% (n = 82), though no statistically significant relationship was found between its occurrence and time since therapy (p > 0.05). The most affected muscle was sternocleidomastoid (55%), followed by masseter (29.2%), trapezius (25.8%), temporalis (15%), levator scapulae (8.3%), posterior cervical (5.8%), and splenius capitis (3.3%). Additionally, 75.8% (n = 91) of participants had depression on PHQ-9, with 85.4% (n = 70) with myofascial pain experiencing depressive symptoms. Pain score and depression in patients with myofascial pain were positively correlated with a value of 0.579 (p-value < 0.05).

CONCLUSION: Myofascial pain is common in patients with head and neck cancer post-treatment with a negative impact on emotional well-being. It primarily affects the muscles involved in the neck and shoulder movements. It is important to identify early and manage the complications to enhance quality of life.

CLINICAL TRIAL REGISTRATION: The study is registered with the Clinical Trials Registry India and the assigned registration number for this study is CTRI/2023/03/050268 on 02/03/2023.

PMID:40259373 | DOI:10.1186/s12904-025-01745-y

BMC Oral Health. 2025 Apr 21;25(1):614. doi: 10.1186/s12903-025-05988-2.

ABSTRACT

BACKGROUND: To evaluate surface microhardness, roughness, and gloss changes of tooth-colored restorative materials [a direct composite (G-aenial A’Chord), an indirect composite (Gradia Plus), an ormocer (Admira Fusion), a giomer (Beautifil II), and an alkasite (Cention N)] after exposure to simulated gastric acid.

METHODS: A total of 110 disc-shaped specimens (22 discs of each material) were prepared using silicone molds (8 mm×2 mm) and exposed to either gastric acid or artificial saliva (control). Surface roughness (Ra), gloss (GU), and microhardness (VHN) were measured at baseline and after 96-hour of immersion in the solutions and the respective changes (∆Ra, ∆GU, ∆VHN) were calculated. Intergroup comparisons were performed using ANOVA (Tukey post hoc) or Kruskal-Wallis tests (Bonferroni correction). Independent samples t-test or Mann-Whitney U test was used for comparisons of each material across immersion media, while paired t-test was applied for time-dependent analyses.

RESULTS: In the gastric acid medium, changes in all parameters led to significant differences among restorative materials, while in the artificial saliva medium, significant differences were observed in ∆VHN and ∆GU. The statistically significant difference between immersion media was observed in both ∆VHN and ∆Ra values for the giomer group, and in only ∆VHN values for the alkasite and indirect composite groups. In the gastric acid medium, the decrease in VHN and GU values was significant across all subgroups, while the increase in Ra was statistically significant only in the giomer and alkasite groups.

CONCLUSIONS: While the giomer group exhibited the most significant changes in roughness and microhardness following exposure to gastric acid, all tested materials executed clinically admissible results regarding surface gloss.

CLINICAL TRIAL NUMBER: Not applicable.

PMID:40259372 | DOI:10.1186/s12903-025-05988-2