Tag: statistics

Ann Ig. 2025 Mar 11. doi: 10.7416/ai.2025.2690. Online ahead of print.

ABSTRACT

BACKGROUND: Seafarers experience unique challenges related to their profession, including risks for mental health. The present study explored the correlates of depression among seafarers in India.

METHODS: Following ethics clearance, this cross-sectional study was conducted at an international shipping company in Mumbai, India. Using time-bound convenience sampling, 105 multi-state seafarers were recruited following verbal consent. The Beck Depression Inventory and Work-Related Quality of Life scale were used to screen for the study outcomes. Data analysis was performed using Jamovi 2.0. Descriptive statistics and Chi-square tests were used to assess associations, and logistic regression was performed to identify correlates of depression.

RESULTS: Of 105 seafarers, the majority (98.1%) were male, most were married (80%), and were aged between 18-35 years (56.2%). About 42.9% had an income of INR 3 lakh (≈$3604) and above monthly. An overwhelming majority had mild mood disturbances, which was found among 90.5% and 8.6% reported depression. Seafarers who engaged in regular physical activity and had higher monthly incomes had higher Work-Related Quality of Life. A significant association was found between depression and isolation (p=0.031) as well as with Work-Related Quality of Life (p=0.012). On logistic regression, we found that the number of hours of work per day, experiencing isolation and Work-Related Quality of Life, significantly predicted depression.

CONCLUSIONS: The existing burden and treatment gap for mental health morbidity among seafarers needs to be addressed. To address early indications of mental health conditions among seafarers, implementing mental health screening and offering counseling services on board may be the way forward.

PMID:40066682 | DOI:10.7416/ai.2025.2690

Epidemiol Prev. 2025 Jan-Feb;49(1):35-43. doi: 10.19191/EP25.1.A788.011.

ABSTRACT

OBJECTIVES: to analyse the prevalence and characteristics of the hikikomori phenomenon in Italy within a representative sample of students aged 15 to 19 years, assessing the factors associated with this behaviour to guide preventive interventions.

DESIGN: cross-sectional study based on anonymous data collected through the ESPAD®Italia (European School Survey Project on Alcohol and other Drugs) survey using a self-administered questionnaire.

SETTING AND PARTICIPANTS: a representative sample of Italian high-school students is selected annually to ensure the comparability of ESPAD®Italia estimates. In this study, the pooled 2021-2023 sample consists of 36,868 students (50.8% male), with an average age of 17.0 years (standard deviation: 1.4).

MAIN OUTCOMES MEASURES: the outcomes analysed are having experienced voluntary social withdrawal for at least six months over a lifetime (Lifetime Hikikomori) and the current behaviour of never leaving the house during the week (Current Withdrawal).

RESULTS: in 2023, 2.0% of students reported having voluntarily isolated themselves for at least six months in their lifetime, with a slightly higher prevalence among girls. Current withdrawal involved 11.3% of students, a significant increase compared to the previous two years. In the pooled 2021-2023 sample, the analysis of independent variables showed that the hikikomori phenomenon is associated with the use of psychotropic drugs, cigarette smoking, having been a victim of cyberbullying, feelings of exclusion, dissatisfaction in friendships, risky behaviours related to internet and video game use, and belonging to non-traditional families. The current withdrawal is directly associated with cigarette smoking, lack of enjoyment in social interactions, overweight/obesity, and belonging to non-traditional families.

CONCLUSIONS: the study provided the first quantitative estimate of voluntary social withdrawal among Italian students aged 15-19 years, confirming that the phenomenon is widespread and concerning, especially among girls. Factors such as the perception of social exclusion, problematic online behaviours and the use of psychotropic drugs are strongly associated with the phenomenon. Future longitudinal research could further explore these relationships and support the development of integrated educational strategies in schools to identify and support at-risk students.

PMID:40066636 | DOI:10.19191/EP25.1.A788.011

Epidemiol Prev. 2025 Jan-Feb;49(1):27-34. doi: 10.19191/EP25.1.A749.003.

ABSTRACT

OBJECTIVES: to describe the ‘IDA’ study, which aims to estimate the prevalence of School Readiness Vulnerability (SRV) in children at the beginning of primary school and the associated socioeconomic characteristics, to stimulate the attention of decision-makers on the consequences of the COVID-19 pandemic and the need for specific and timely interventions by the school community, thus preventing negative effects on children’s present and future health.

DESIGN: cross-sectional study based on a random sample of children extracted using the cluster sampling technique on the first primary school classes.

SETTING AND PARTICIPANTS: in October 2022, the IDA study assessed the SRV prevalence and associated risk factors in 628 children of the Lazio Region, aged 67-89 months, 328 males and 292 females.

MAIN OUTCOMES MEASURES: the individual school readiness score was calculated by a validated questionnaire (Early Identification of Learning Difficulties, IPDA); socioeconomic characteristics were measured by administering a questionnaire to parents (child’s age, kindergarten attendance, parents’ education, parents’ occupation).

RESULTS: the SRV prevalence was 44.9%. The most affected development areas were motor skills, pre-mathematics, and pre-literacy. SRV was associated with low educational levels of the mother, father, or both parents, and maternal and paternal unemployment. The comparison with reference values (pre-pandemic) places the subjects studied one year behind in terms of psycho-motor development.

CONCLUSIONS: because of potential negative effects, institutions and stakeholders need to intervene to promote children’s reinforcement activities and equity of access to education.

PMID:40066635 | DOI:10.19191/EP25.1.A749.003

Geriatr Gerontol Int. 2025 Mar 11. doi: 10.1111/ggi.70019. Online ahead of print.

ABSTRACT

AIM: Rehospitalization of patients with heart failure (HF) incurs high health care costs and increased mortality. Infection-related rehospitalizations in patients with HF occur frequently, and the risk increases with age. This study aimed to identify the factors associated with infection-related rehospitalizations in older patients with HF.

METHODS: Demographic, clinical, and pharmacological data from 1061 patients with acute HF who were enrolled in the Kochi Registry of Subjects With Acute Decompensated Heart Failure (Kochi YOSACOI study) were analyzed. Additionally, a machine learning approach was applied in addition to the traditional statistical analysis model. Of the patients hospitalized for HF, 729 were ultimately analyzed.

RESULTS: During the 2-year postdischarge follow-up period, 121 (17%) patients were readmitted for infections. Logistic regression analysis identified a Japanese Cardiovascular Health Study (J-CHS) score of ≥3 (odds ratio, 1.83 [95% confidence interval, 1.18-2.83]; P = 0.007) at discharge as a key factor for infection-related rehospitalizations. Machine learning models confirmed that a higher J-CHS score and lower estimated glomerular filtration rate (eGFR) increased the risk of infection-related rehospitalizations. Decision tree analysis classified the risk into high (J-CHS score ≥3), medium (J-CHS score <3; eGFR ≤35.0) and low (J-CHS score <3; eGFR >35.0) groups.

CONCLUSIONS: Infection-related rehospitalizations occur in older patients with HF and are associated with frailty and eGFR. These findings provide valuable insights for health care providers to better manage the risk of infection-related rehospitalizations in older patients with HF, potentially improving patient outcomes. Geriatr Gerontol Int 2025; ••: ••-••.

PMID:40066617 | DOI:10.1111/ggi.70019

Clin Exp Dent Res. 2025 Feb;11(1):e70061. doi: 10.1002/cre2.70061.

ABSTRACT

OBJECTIVES: Various attempts have been made to increase the rate of orthodontic tooth movement (OTM). The aim of this study was to determine the effect of different doses of heparin on OTM and paraclinical factors related to bone metabolism in rats.

METHODS AND MATERIALS: A total of 24 Sprague-Dawley rats were randomly divided into three groups of 8 animals each and injected with 0 (control), 3000, and 6000 U/Kg/d heparin sulfate for 4 weeks. Radiographs were obtained at the initiation and at the end of the study period. Orthodontic forces were applied on Day 14 and continued for the next 2 weeks, after which, OTM, optical density, parathyroid hormone (PTH) level, and histologic variables were assessed for each rat. The latter was performed on hematoxylin/eosin-stained sections of the mesial roots of the first molar and included calculation of the osteoclast number, and resorption lacunae depth and number. One-way analysis of variance, the Tukey test, and a paired-t-test were used for statistical analysis (p < 0.05).

RESULTS: A significant increase in OTM, the number of resorptive lacunae, and PTH secretion was observed in the group that received 6000 U/Kg/d compared with both the other groups. There was no significant difference in optical density, and, therefore, bone density, among the study groups (p > 0.05).

CONCLUSION: Heparin injection affects bone metabolism in rats, as shown by the increases in OTM and PTH and its impact on histologic parameters. These effects seem to be dose-dependent and may be a factor that should be taken into consideration during orthodontic treatment planning.

PMID:40066602 | DOI:10.1002/cre2.70061

Ann Med. 2025 Dec;57(1):2476735. doi: 10.1080/07853890.2025.2476735. Epub 2025 Mar 11.

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) remains a major health concern globally, contributing to a considerable disease burden. However, few studies have considered long-term cumulative blood pressure (cBP) exposure in middle-aged and older population in China. The aim of this study was to investigate whether long-term cBP was associated with subsequent cardiovascular outcomes among participants without CVD at baseline in Chinese over 45 years old.

METHODS: 6435 participants in China of the CHARLS (The China Health and Retirement Longitudinal Study) were included. Cumulative BP was calculated as the area under the curve using measurements from wave 1 (2011) to wave 2 (2013). Outcomes included CVD, heart disease and stroke.

RESULTS: During a median follow-up period of 5 years, 1101 CVD events, 826 heart disease, and 351 stroke were recorded. Each 1-SD increase in cumulative systolic blood pressure (cSBP), cumulative diastolic blood pressure (cDBP), and cumulative mean arterial pressure (cMAP) was associated with increased risk of CVD (HR, 1.12; 95%, 1.05-1.20, HR, 1.14; 95%, 1.07-1.22, HR, 1.14; 95%, 1.07-1.22), heart disease (HR, 1.05; 95%, 0.97-1.13, HR, 1.09; 95%, 1.01-1.17, HR, 1.08; 95%, 1.00-1.16) and stroke (HR, 1.35; 95%, 1.21-1.51, HR, 1.31; 95%, 1.17-1.46, HR, 1.36; 95%, 1.22-1.51). The relationship between cBP and CVD has only been found in people younger than 60 years of age. A significant association was observed for cumulative pulse pressure (cPP) with stroke (HR, 1.23; 95%, 1.10-1.38). None nonlinear relationships were identified (p-nonlinear > .05). For the prediction of cardiovascular outcomes, cBP load outperformed baseline BP in terms of C statistics (p < .001).

CONCLUSIONS: Long-term cSBP, cDBP and cMAP were associated with subsequent CVD and only found in people younger than 60 years of age, whereas cPP was associated with stroke only across all ages. Cumulative BP may provide a better prediction of cardiovascular outcomes compared with single BP measurement. Efforts are required to control long-term BP in assessing cardiovascular risks.

PMID:40066575 | DOI:10.1080/07853890.2025.2476735

Circ Heart Fail. 2025 Mar 11:e011381. doi: 10.1161/CIRCHEARTFAILURE.123.011381. Online ahead of print.

ABSTRACT

BACKGROUND: Despite favorable hemodynamic and neurohormonal effects, endothelin receptor antagonists have not improved outcomes in patients with heart failure (HF), possibly because they cause fluid retention.

METHODS: In this randomized, double-blind, multicenter trial (SERENADE [Macitentan in Heart Failure With Preserved Ejection Fraction and Pulmonary Vascular Disease]), we evaluated the effects of an endothelin receptor antagonist, macitentan, in patients with HF, left ventricular ejection fraction ≥40%, and pulmonary vascular disease. After a 4-week placebo run-in (to ensure clinical stability), followed by a 5-week single-blind macitentan run-in, patients who did not exhibit fluid retention were randomized to macitentan or placebo. The primary end point was change in NT-proBNP (N-terminal pro-B-type natriuretic peptide; baseline to 24 weeks); secondary end points included change in KCCQ (Kansas City Cardiomyopathy Questionnaire) clinical summary score (baseline to 24 weeks) and time to worsening HF by 52 weeks.

RESULTS: Of 230 patients enrolled, 28 were excluded during the placebo run-in, 60 excluded during the macitentan run-in, and 142 were randomized. Macitentan had no effect on change in NT-proBNP (geometric mean ratio [macitentan/placebo], 1.02 [90% CI, 0.88-1.19]; P=0.79) or on secondary end points (placebo-corrected change in KCCQ clinical summary score, -3.5 [90% CI, -8.2 to +1.2]; P=0.22). Worsening HF occurred in 20 (28%) patients assigned to macitentan and 13 (18%) assigned to placebo (hazard ratio, 1.48 [90% CI, 0.83-2.67]; P=0.24). More macitentan-treated patients developed fluid retention (16 [23%] versus 10 [14%]) and cardiac adverse events (33 [46%] versus 22 [31%]) versus placebo.

CONCLUSIONS: Despite a novel enrichment trial design to target pulmonary vascular disease and exclude treatment-related fluid retention in patients with HF and preserved/mildly reduced left ventricular ejection fraction, macitentan neither lowered NT-proBNP nor improved HF outcomes.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifiers: NCT03153111 and NCT03714815.

PMID:40066571 | DOI:10.1161/CIRCHEARTFAILURE.123.011381

Psychol Med. 2025 Mar 11;55:e78. doi: 10.1017/S0033291725000522.

ABSTRACT

BACKGROUND: It is unknown whether there is a general factor that accounts for the propensity for both physical and mental conditions in different age groups and how it is associated with lifestyle and well-being.

METHODS: We analyzed health conditions data from the Millennium Cohort Study (MCS) (age = 17; N = 19,239), the National Child Development Study (NCDS) (age = 44; N = 9293), and the English Longitudinal Study of Ageing (ELSA) (age ≥ 50; N = 7585). The fit of three Confirmatory Factor models was used to select the optimal solution by Comparative Fit Index, Tucker-Lewis Index, and Root Mean Square Error of Approximation. The relationship among d factor, lifestyles, and well-being was further explored.

RESULTS: Supporting the existence of the d factor, the bi-factor model showed the best model fit in 17-year-olds (MCS:CFI = 0.97, TFI = 0.96, RMSEA = 0.01), 44-year-olds (NCDS:CFI = 0.96, TFI = 0.95, RMSEA = 0.02), and 50+ year-olds (ELSA:CFI = 0.97, TFI = 0.96, RMSEA = 0.02). The d factor scores significantly correlated with lifestyle and well-being, suggesting healthier lifestyles were associated with a reduced likelihood of physical and mental health comorbidities, which in turn improved well-being.

CONCLUSIONS: Contrary to the traditional dichotomy between mental and physical conditions, our study showed a general factor underlying the comorbidity across mental and physical diseases, related to lifestyle and well-being. Our results inform the conceptualization of mental and physical illness as well as future research assessing risk and pathways of disease transmission, intervention, and prevention. Our results also provide a strong rationale for a systematic screening for mental disorders in individuals with physical conditions and vice versa, and for integrated services addressing multimorbidity.

PMID:40066566 | DOI:10.1017/S0033291725000522

Clin Lab. 2025 Mar 1;71(3). doi: 10.7754/Clin.Lab.2024.240827.

ABSTRACT

BACKGROUND: Alloimmunization to red blood cells (RBCs) presents a significant challenge in blood transfusion for individuals afflicted with sickle cell disease (SCD) and thalassemia. However, there is a scarcity of data regarding the prevalence of RBC alloimmunization in such patients in Saudi Arabia. To address this gap, a comprehensive meta-analysis was undertaken to ascertain the rate of RBC alloimmunization in SCD and thalassemia patients who receive regular transfusions in Saudi Arabia.

METHODS: A systematic search and subsequent meta-analysis, following PRISMA guidelines, were carried out. We meticulously combed through six prominent scientific databases, including PubMed, Web of Science, SCOPUS, EMBASE, MEDLINE, and Google Scholar, up to July 20, 2023, to identify pertinent English-language articles. Data were meticulously extracted from the selected studies. The meta-analysis adopted a random-effects model and included subgroup analyses to delineate the RBC alloimmunization rates specifically for SCD and thalassemia patients receiving regular transfusions. Heterogeneity was assessed through Cochran’s Q and I2 tests. The study protocol was registered under PROSPERO, with the code CRD42023440761.

RESULTS: Our comprehensive search yielded a total of 983 articles, with 12 meeting the criteria for the final analysis, encompassing a total of 1,811 SCD and thalassemia patients. The collective RBC alloimmunization rate across all the eligible articles for patients with SCD and thalassemia who received regular transfusions in Saudi Arabia was determined to be 18.2%. Subgroup analysis, comprising nine articles, indicated that the RBC alloimmunization rate among SCD patients was 18.6%, while analysis of six articles revealed that the rate among thalassemia patients stood at 19.5%.

CONCLUSIONS: This meta-analysis underscores that the RBC alloimmunization rate in SCD and thalassemia patients who regularly receive transfusions in Saudi Arabia stands at 18.2%. Considering these findings, it is essential to prioritize extended phenotyping prior to transfusion to significantly reduce the risk of RBC alloimmunization.

PMID:40066558 | DOI:10.7754/Clin.Lab.2024.240827

Clin Lab. 2025 Mar 1;71(3). doi: 10.7754/Clin.Lab.2024.240146.

ABSTRACT

BACKGROUND: The incidence of colorectal cancer (CRC) is rapidly increasing, and early detection plays a crucial role in improving the prognosis and survival rates of patients. This study aimed to assess the diagnostic ability of combined SDC2-KCNQ5-IKZF1 methylation levels in plasma for CRC detection.

METHODS: A total of 92 patients were recruited from the Department of General Surgery at the Second Hospital of Hebei Medical University, including 56 CRC patients, 22 polyp and adenoma patients, and 14 healthy controls. Plasma cfDNA was extracted for methylation test of SDC2, KCNQ5, and IKZF1. Sanger sequencing was conducted to verify the methylation results. The performance of single-gene methylation and triple-gene methylation combined test were analyzed. The positive detection rates of methylation and CEA test were compared to the colonoscopy gold standard. ROC curve was utilized to evaluate the diagnostic value in CRC.

RESULTS: The positive detection rates of triple-gene tests in CRC and precancerous lesions were 87.50% and 95.45%, respectively. The triple-gene test performed better than single-gene or CEA test. Combined analysis of triple-gene and CEA test could further improve the detection rate. Univariate analysis showed no statistical correlation between the methylation levels and patients’ gender, age, history of diabetes, tumor site, lymph node metastasis, and tumor stage. In ROC curve analysis, AUC areas of SDC2, KCNQ5, and IKZF1 were 0.700, 0.646, and 0.645, respectively. The AUC area of triple-gene test was 0.924.

CONCLUSIONS: The triple-gene combined methylation test demonstrated excellent diagnostic performance for CRC and precancerous lesions.

PMID:40066557 | DOI:10.7754/Clin.Lab.2024.240146