Tag: statistics

Health Promot Chronic Dis Prev Can. 2025 Jan;45(1):39-53. doi: 10.24095/hpcdp.45.1.03.

ABSTRACT

INTRODUCTION: The aim of this study was to assess the potential impacts of the introduction of a smoke-free generation (SFG) policy in Canada with a perpetual ban on cigarette sales to anyone born after 2009 instigated on 1 January 2025.

METHODS: An existing Canadian model relating to smoking cessation was adapted and augmented to assess the impact of an SFG policy on quality-adjusted life years (QALYs), life expectancy, health care costs, smoking-related taxes, and Canadian tobacco industry gross domestic product (GDP). The cumulative impact of the policy for the entire Canadian population was assessed for time horizons up to 90 years with an annual discount rate of 1.5%.

RESULTS: After 50 years, this SFG policy would lead to 476 814 more QALYs, $2.3 billion less in health care costs, $7.4 billion less in smoking-related taxes and a $3.1 billion reduction in tobacco industry GDP. The combined value of health benefits gained and health care costs averted would exceed the sum of tax revenues foregone and reduced GDP, if the value of a QALY was at least $17 147. Use of higher discount rates and inclusion of unrelated health care costs had little impact on the interpretation of the results.

CONCLUSION: The implementation of an SFG policy will bring substantive health benefits to the population in Canada. Although health care cost savings are lower than the combination of lost tax revenues and the decline in the GDP from the Canadian tobacco industry, the value of the health benefits realized outweigh the negative offsets.

PMID:39817710 | DOI:10.24095/hpcdp.45.1.03

Health Promot Chronic Dis Prev Can. 2025 Jan;45(1):20-38. doi: 10.24095/hpcdp.45.1.02.

ABSTRACT

INTRODUCTION: This study provides a descriptive overview of the prevalence of posttraumatic stress disorder (PTSD) in Canada, across sociodemographic characteristics, mental health-related variables and negative impacts of the COVID-19 pandemic.

METHODS: Data were obtained from cycles 1 and 2 of the Survey on COVID-19 and Mental Health (SCMH), collected in fall 2020 (N = 14 689) and spring 2021 (N = 8032). The prevalence of PTSD was measured using the PTSD Checklist for DSM-5 (PCL-5) Cross-sectional associations were quantified using logistic regression, while controlling for sociodemographic characteristics.

RESULTS: The overall prevalence of PTSD was 6.9%. Factors associated with higher PTSD prevalence were female gender; younger age; lower income (females only); living in an urban area; frontline worker status or not being at work in the past week (males only); fair or poor mental health; a weak sense of community belonging; symptoms of generalized anxiety disorder and major depressive disorder; suicidal ideation; heavy alcohol use; daily cannabis use; increased alcohol and cannabis use since the start of the pandemic; decreased alcohol consumption since the start of the pandemic (males only); concerns about violence in the home; and negative impacts of the pandemic.

CONCLUSION: PTSD prevalence in Canada varies significantly across sociodemographic groups and is more common among those with indicators of lower mental health and well-being, as well as those more adversely affected by the COVID-19 pandemic. Ongoing and enhanced surveillance of PTSD in Canada is important to better understand and address the burden and impacts of this condition.

PMID:39817709 | DOI:10.24095/hpcdp.45.1.02

Prehosp Disaster Med. 2025 Jan 16:1-6. doi: 10.1017/S1049023X24000645. Online ahead of print.

ABSTRACT

BACKGROUND: Drowning persists as a preventable pediatric cause of severe morbidity and mortality. This study aims to investigate the risk factors, circumstances, and medical consequences associated with pediatric drowning incidents in order to identify patterns that can inform targeted interventions.

METHODS: This was a retrospective analysis of a cohort of pediatric drowning cases. The study encompassed children aged 0-18 years who presented to the pediatric emergency departments (PEDs) of Hadassah Medical Centers in Jerusalem from January 1, 2004 through April 30, 2023. Inclusion criteria were individuals with main registration diagnosis containing the terms “drowning” or “submersion.”

RESULTS: Analysis revealed 129 cases of pediatric drowning, males comprising 66% of the cohort. The average age was 4.9 years (SD = 4.5). Predominantly, drownings occurred in private (38%) or public pools (27.1%). Forty-eight percent of children required hospitalization in intensive care. Notably, children from the Arab minority were significantly younger at the time of drowning (3.8 years; P = .04) and were at elevated risk of severe neurologic outcomes necessitating rehabilitation (P = .03). Incidents occurring on weekends were associated with younger victim ages (3.5 years; P = .04) and with increased likelihood of outcomes necessitating rehabilitation (P = .04). Conversely, children from families with four or more siblings were notably older at the time of drowning (5.3 years; P = .01). No other statistically significant differences were observed among demographic groups.

CONCLUSIONS: Strategies aimed at promoting child health and preventing drowning must surmount feasibility barriers. Intervention efforts should be tailored to populations at heightened risk, including younger children, minority groups, and incidents occurring during weekends.

PMID:39817689 | DOI:10.1017/S1049023X24000645

CA Cancer J Clin. 2025 Jan 16. doi: 10.3322/caac.21871. Online ahead of print.

ABSTRACT

Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence and outcomes using incidence data collected by central cancer registries (through 2021) and mortality data collected by the National Center for Health Statistics (through 2022). In 2025, 2,041,910 new cancer cases and 618,120 cancer deaths are projected to occur in the United States. The cancer mortality rate continued to decline through 2022, averting nearly 4.5 million deaths since 1991 because of smoking reductions, earlier detection for some cancers, and improved treatment. Yet alarming disparities persist; Native American people bear the highest cancer mortality, including rates that are two to three times those in White people for kidney, liver, stomach, and cervical cancers. Similarly, Black people have two-fold higher mortality than White people for prostate, stomach, and uterine corpus cancers. Overall cancer incidence has generally declined in men but has risen in women, narrowing the male-to-female rate ratio (RR) from a peak of 1.6 (95% confidence interval, 1.57-1.61) in 1992 to 1.1 (95% confidence interval, 1.12-1.12) in 2021. However, rates in women aged 50-64 years have already surpassed those in men (832.5 vs. 830.6 per 100,000), and younger women (younger than 50 years) have an 82% higher incidence rate than their male counterparts (141.1 vs. 77.4 per 100,000), up from 51% in 2002. Notably, lung cancer incidence in women surpassed that in men among people younger than 65 years in 2021 (15.7 vs. 15.4 per 100,000; RR, 0.98, p = 0.03). In summary, cancer mortality continues to decline, but future gains are threatened by rampant racial inequalities and a growing burden of disease in middle-aged and young adults, especially women. Continued progress will require investment in cancer prevention and access to equitable treatment, especially for Native American and Black individuals.

PMID:39817679 | DOI:10.3322/caac.21871

CA Cancer J Clin. 2025 Jan 16. doi: 10.3322/caac.21877. Online ahead of print.

NO ABSTRACT

PMID:39817675 | DOI:10.3322/caac.21877

J Adv Nurs. 2025 Jan 16. doi: 10.1111/jan.16690. Online ahead of print.

ABSTRACT

AIMS: To explore the relationship between neighbourhood environments and mental health by integrating subjective and objective perspectives.

DESIGN: A cross-sectional study.

METHODS: From September 2023 to January 2024, adult residents at the physical examination centers of two public hospitals in China completed measurements of subjective neighbourhood environment, depressive and anxiety symptoms, psychological stress, and socio-demographic characteristics. Geographic information systems (GIS) were employed to extract objective environmental data including parks, bus stops, sports facilities, leisure facilities, residential housing, restaurants, food retail facilities, and street connectivity within a buffer zone of 500-m radius of the participants’ residential areas. Data were analysed using univariate and multiple logistic regression analyses.

RESULTS: This study included 438 participants (mean age, 36.98 ± 11.05 years; 55.3% female). The mean scores for depression, anxiety, and psychological stress were 3.55 ± 2.99, 3.16 ± 2.91, and 13.11 ± 4.88, respectively. The total score of the subjective neighbourhood environment was 78.33 ± 10.63, with the mean scores of each dimension ranging from 5.14 to 23.76. After adjusting for potential confounders, higher scores on street environment and higher density of sports facility were statistically significantly associated with reduced risk of depressive symptoms and psychological stress. Additionally, higher scores on walking environment and social cohesion were significantly associated with reduced risk of anxiety symptoms.

CONCLUSIONS: This study found that street environments, walking environments, social cohesion, and density of sports facilities were independently associated with the mental health of adult residents in China.

IMPLICATIONS: The findings provide valuable insights for healthcare providers to consider specific health-related environmental factors and develop tailored interventions to promote the mental health of the residents.

IMPACT: Understanding the relationship between the subjective and objective environmental factors on mental health is crucial for developing effective intervention strategies, preventing psychological issues, enhancing the quality of care, and advancing public health policies and research.

REPORTING METHOD: The study was reported following the strengthening of the reporting of observational studies in epidemiology (STROBE) guidelines.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

PMID:39817660 | DOI:10.1111/jan.16690

J Vasc Access. 2025 Jan 16:11297298241308147. doi: 10.1177/11297298241308147. Online ahead of print.

ABSTRACT

OBJECTIVE: To develop and validate a nomogram model for predicting central venous catheter-related infections (CRI) in patients with maintenance hemodialysis (MHD).

METHODS: MHD patients with central venous catheters (CVCs) visiting the outpatient hemodialysis (HD) center of Xuzhou Medical University Affiliated Hospital from January 2020 to December 2023 were retrospectively selected through a HD monitoring system. Patient data were collected, and the patients were divided into training and validation sets in a 7:3 ratio. The training set was used to establish the model, which was verified using the validation set. Multiple logistic regression analysis was performed to identify risk factors for central venous CRI and develop a nomogram prediction model.

RESULTS: A total of 300 MHD patients were enrolled. Multivariate analysis showed that catheter duration, catheter site, catheter reinsertion, history of catheter infection, diabetes, and albumin <35 g/L were risk factors for central venous CRI. The area under the receiver operating characteristic (ROC) curve (AUC) for the training set was 0.902 (95% confidence interval (CI) = 0.862-0.941), with a sensitivity of 85.7%, specificity of 80%, and a Youden index of 65.7%, and that for the validation set was 0.826 (95% CI = 0.726-0.905), with a sensitivity of 80.5%, specificity of 77.9%, and a Youden index of 58.4%. The model demonstrated good discrimination and calibration (Hosmer-Lemeshow goodness-of-fit test statistics: training set: χ² = 4.709, p = 0.788; validation set: χ² = 7.171, p = 0.518).

CONCLUSION: This study identified six risk factors associated with central venous CRI in MHD patients. This predictive model demonstrates good prognostic performance and can be used by clinicians to screen for high-risk patients with central venous CRI, thereby enabling the early implementation of risk management strategies.

PMID:39817420 | DOI:10.1177/11297298241308147

Environ Sci Technol. 2025 Jan 16. doi: 10.1021/acs.est.4c13351. Online ahead of print.

ABSTRACT

The ubiquitous distribution of microplastics (MPs) in aquatic environments is linked to their transport in rivers and streams. However, the specific mechanism of bedload microplastic (MP) transport, notably their stochastic behaviors, remains an underexplored area. To investigate this, particle tracking velocimetry was employed to examine the continuous near-bed movements of four types of MPs under nine setups with different experimental conditions in a laboratory flume, with an emphasis on their streamwise transport. It was found that the streamwise velocity of MPs follows a normal distribution, which can be characterized using the proposed equations to estimate the ensemble mean and standard deviation of MP streamwise velocity. The proposed equations show low relative errors of ∼5% when compared to experimental data. This study also revealed similarities in the continuous movement of MPs and sediments in the streamwise diffusion process. A superdiffusive regime was observed, with particle inertia identified as the primary source of this anomalous diffusion. These results indicate that adopting a probabilistic framework may provide a promising avenue for improving numerical models and enhancing the understanding of MP transport behavior.

PMID:39817418 | DOI:10.1021/acs.est.4c13351

J Pathol Clin Res. 2025 Jan;11(1):e70017. doi: 10.1002/2056-4538.70017.

ABSTRACT

Distinct molecular subtypes of muscle-invasive bladder cancer (MIBC) may show different platinum sensitivities. Currently available data were mostly generated at transcriptome level and have limited comparability to each other. We aimed to determine the platinum sensitivity of molecular subtypes by using the protein expression-based Lund Taxonomy. In addition, we assessed the tumor heterogeneity within the primary tumor and between the primary and lymph node (LN) metastatic sites. Thirteen immunohistochemical markers were stained in a tissue microarray with an overall number of 1,508 cores. Statistical evaluation was performed in 199 patients divided into three chemo-naïve MIBC cohorts: (1) pT3/4 and/or LN+ patients who received radical cystectomy without platinum treatment, (2) patients who received adjuvant chemotherapy (AC), and (3) patients who underwent palliative platinum treatment for metastatic disease or postoperative progression. Overall survival (OS) was used as the primary endpoint. Patients with the genomically unstable (GU) subtype had significantly better OS in the AC group compared to the radical cystectomy group (HR: 0.395, 95% CI: 0.205-0.795, p = 0.005). In contrast, no such association was observed for the basal/squamous (Ba/Sq) subtype. Intratumor heterogeneity was present in 19% of cases, with the lowest level in the Ba/Sq and GU tumors (14% each) and the highest level of 43% in small-cell/neuroendocrine-like tumors. There was greater subtype heterogeneity between primary tumors and LN metastases. In conclusion, immunohistochemistry-based Lund Taxonomy subtypes remain stable within the same primary tumor, with the GU subtype deriving the greatest OS benefit from AC. However, high tumor heterogeneity between the primary tumor and metastatic sites can impact the effectiveness of therapies.

PMID:39817402 | DOI:10.1002/2056-4538.70017

Curr Med Imaging. 2025 Jan 14. doi: 10.2174/0115734056330364250109072154. Online ahead of print.

ABSTRACT

BACKGROUND: The neuroanatomical basis of white matter fiber tracts in gait impairments in individuals suffering from Parkinson’s Disease (PD) is unclear.

METHODS: Twenty-four individuals living with PD and 29 Healthy Controls (HCs) were included. For each participant, two-shell High Angular Resolution Diffusion Imaging (HARDI) and high-resolution 3D structural images were acquired using the 3T MRI. Diffusion-weighted data preprocessing was performed using the orientation distribution function to trace the main fiber tracts in PD individuals. Clinical characteristics between the two groups were compared, and the correlation between the FA value and behavioral data was analyzed. Quantitative gait and clinical parameters were recorded in PD at ON and OFF states, respectively.

RESULTS: The mean tract-specific FA values of the right Cingulum Cingulate (rCC) were statistically different between the PD group and the HC group (p =0.047). The FA value of 34-58 equidistant nodes in rCC was positively correlated with Mini-Mental State Examination (MMSE) (r=0.527, p=0.024), Berg Balance Scale (BBS)-OFF (r=0.480, p =0.040), and BBS-ON (r=0.528, p =0.024) scores, while it was negatively correlated with the MDS-UPDRS-III-ON score (r=-0.502, p =0.030). Regarding the gait analysis, the FA value was significantly correlated with velocity, cadence, and stride time of the pace and rhythm domains in both ‘ON’ and ‘OFF’ states, respectively (p<0.05).

CONCLUSION: This study served as an initial exploration to establish that HARDI sequences could be employed as a robust tool for analyzing microstructural alterations in white matter fiber bundles among PD patients, although the sample size was small. We confirmed microstructural integrity impairment of rCC to be significantly associated with both gait and cognitive deficits in patients with PD. Early detection of microstructural changes in rCC and targeted treatment can help improve behavioral disorders. In the future, we intend to further integrate multimodal data with assessments of patient behavior both prior to and following intervention. We will validate our findings within an independent cohort to monitor disease progression and evaluate the efficacy of therapeutic interventions.

PMID:39817395 | DOI:10.2174/0115734056330364250109072154