Tag: statistics

Front Nutr. 2024 Aug 5;11:1390668. doi: 10.3389/fnut.2024.1390668. eCollection 2024.

ABSTRACT

OBJECTIVE: Studies on the baseline vitamin D levels in osteogenesis imperfecta (OI) patients before medication are scarce. This study assessed the vitamin D status of a population with OI at both the overall level and within different age groups. It correlated baseline 25-hydroxyvitamin D (25(OH)D) levels with other bone-related factors, biochemical markers, and bone density.

PATIENTS AND METHODS: We collected 25(OH)D levels from 95 OI patients in East China (59 under 18 years old and 36 over 18 years old). Postmenopausal women and men over 50 years old are excluded. Measurements included body indicators, biochemical markers, and bone mineral density (BMD) assessed by Dual-energy X-ray absorptiometry (DXA). Data analysis was performed using SPSS 26.0.

RESULTS: In the overall population, among those under 18 years old, and among those over 18 years old, 87.4, 83.1, and 94.4%, respectively, were vitamin D deficient (<30 ng/mL), while 47.4, 40.7, and 58.3% had vitamin D deficiency (<20 ng/mL), respectively. In the overall population and among those under 18 years old, serum 25(OH)D levels were negatively correlated with age and parathyroid hormone (PTH) levels, and 25(OH)D levels (<10 ng/mL, 10-20 ng/mL, 20-30 ng/mL, >30 ng/mL) showed a negative correlation with BMI. In OI patients under 18 years old, serum 25(OH)D was negatively correlated with serum β-CTX levels. In adult male OI population, 25(OH)D levels were negatively correlated with OI severity (Type I, IV, III). No statistically significant correlation was found between 25(OH)D levels and BMD Z-scores.

CONCLUSION: This study on OI in East China reveals significant vitamin D insufficiency and deficiency in baseline levels among pediatric, adolescent and adult OI patients. It assesses the correlation of 25(OH)D levels with various influencing factors, providing crucial insights into understanding the impact of OI on vitamin D status across different age groups and aiding in better clinical management of OI patients.

PMID:39161912 | PMC:PMC11333034 | DOI:10.3389/fnut.2024.1390668

Front Nutr. 2024 Aug 5;11:1359697. doi: 10.3389/fnut.2024.1359697. eCollection 2024.

ABSTRACT

BACKGROUND: Previous studies showed the conflicting associations between circulating micronutrient levels and systemic lupus erythematosus (SLE). Therefore, we aimed to clarify the causal association between circulating micronutrient levels and the risk of SLE by two-sample Mendelian randomization (MR) analysis.

METHODS: 56 single nucleotide polymorphisms (SNPs) significantly associated with 14 circulating micronutrients (vitamin A, B6, B9, B12, C, D and E, phosphorus, calcium, magnesium, copper, iron, zinc, and selenium) in published genome-wide association studies (GWAS) were used as instrumental variables (IVs). And summary statistics related to SLE were obtained from the IEU OpenGWAS database. We used the MR Steiger test to estimate the possible causal direction between circulating micronutrients and SLE. In the MR analysis, inverse variance weighting (IVW) method and the Wald ratio was as the main methods., Moreover, the MR-Pleiotropy residuals and outliers method (MR-PRESSO), Cochrane’s Q-test, MR-Egger intercept method and leave-one-out analyses were applied as sensitivity analyses. Additionally, we conducted a retrospective analysis involving the 20,045 participants from the Third National Health and Nutritional Examination Survey (NHANES III). Weight variables were provided in the NHANES data files. Univariate and multivariate logistic regression analyses were performed to determine the associations between circulating micronutrients and SLE.

RESULTS: The MR estimates obtained from the IVW method revealed potential negative correlations between circulating calcium (OR: 0.06, 95% CI: 0.01-0.49, P = 0.009), iron levels (OR: 0.63, 95% CI: 0.43-0.92, P = 0.016) and the risk of SLE. The results remained robust, even under various pairs of sensitivity analyses. Our retrospective analysis demonstrated that the levels of vitamin D, serum total calcium, and serum iron were significantly lower in SLE patients (N = 40) when compared to the control group (N = 20,005). Multivariate logistic regression analysis further established that increased levels of vitamin D and serum total calcium served as protective factors against SLE.

CONCLUSION: Our results provided genetic evidence supporting the potential protective role of increasing circulating calcium in the risk of SLE. Maintaining adequate levels of calcium may help reduce the risk of SLE.

PMID:39161911 | PMC:PMC11333035 | DOI:10.3389/fnut.2024.1359697

Front Nutr. 2024 Aug 5;11:1401581. doi: 10.3389/fnut.2024.1401581. eCollection 2024.

ABSTRACT

INTRODUCTION: Food waste (FW) represents a significant social and environmental problem, with 1.3 billion tons of food wasted yearly worldwide. Even if consumers are increasingly aware of the phenomenon, it remains relevant, and understanding the behaviors of specific target audience segments appears instrumental to the planning of effective interventions. To this end, we designed an observational study to investigate, throughout an online questionnaire, FW-related habits of university students in a Southern Italian region.

METHODS: A representative sample of 431 students from the University of Catanzaro Magna Graecia completed an online survey aimed at investigate FW related behaviors. A descriptive analysis was performed on the whole cohort, and a formal statistical analysis was carried out after excluding responders who had not correctly followed the survey instructions (n = 85). Differences were assessed by chi square (χ ²) tests. A food wasting score was generated, and differences in the score values were analyzed by Student T-test. Linear and multiple regression analyses were performed to identify factors contributing to the score.

RESULTS: Overall, the results of our survey show a high prevalence of virtuous behaviors in the food purchasing phase; while, at home, less than 50% of respondents apply easy-to-implement waste prevention rules. The statistical analysis showed that the major determinants of FW were: no direct involvement in grocery shopping and male gender. Indeed, even if we observed several significant differences comparing subgroups based on established or putative determinants of FW behaviors, none survived matching for group size, gender and relevant food managing (shopping, storing, cooking) habits. The only exception was the more appropriate handling of “use by” products by respondents who received structured nutrition teaching, as opposed to students whose academic courses do not include this subject (adjusted p = 0.008).

CONCLUSION: Our data suggest that young adults are trying to implement strategies to reduce FW, even if there is room for improvement, particularly in the storage phase. Extending nutrition education to all university programs may be helpful in reaching this goal.

PMID:39161909 | PMC:PMC11333036 | DOI:10.3389/fnut.2024.1401581

Front Pharmacol. 2024 Aug 5;15:1391972. doi: 10.3389/fphar.2024.1391972. eCollection 2024.

ABSTRACT

BACKGROUND: In individuals receiving treatment with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), those exhibiting positive PD-L1 expression might experience reduced progression-free survival (PFS). However, the effects on overall survival (OS) and the determination of efficacious treatment approaches are still not well-defined.

METHODS: In our retrospective study, we examined data from 193 NSCLC patients with advanced EGFR mutations who received first-line TKI treatments, treated at two centers of Shaw Hospital in Zhejiang, China. This analysis covered a period from 1 January 2016 to 30 April 2023.

RESULTS: Patients with PD-L1 positivity exhibited a markedly shorter average PFS (9.5 months versus 17.8 months, P < 0.001) and OS (44.4 months versus 65.7 months, P = 0.016) relative to those without PD-L1 expression. This difference in both PFS and OS remained statistically significant even after adjusting for multiple factors (P < 0.001 for PFS and P = 0.028 for OS). In the PD-L1-positive cohort, introducing combination antiangiogenic significantly extended both PFS (from 9.1 to 25.7 months, P = 0.026) and OS (from 42 to 53.5 months, P = 0.03). Post-first-line TKI therapy, 39.3% of PD-L1-positive patients and 54.5% of PD-L1-negative patients developed the T790M mutation (P = 0.212), with no notable difference in PFS from second-line TKI treatments between the groups. Additionally, subsequent combination therapy with immunotherapy markedly prolonged OS in the PD-L1-positive group. However, for PD-L1-negative patients, neither combination antiangiogenic therapy nor later-line immunotherapy demonstrated significant benefits in PFS or OS.

CONCLUSION: For PD-L1-positive patients, combined antiangiogenic treatments and immunotherapy can significantly improve survival outcomes. In contrast, PD-L1-negative patients show less benefit from these therapies, highlighting the greater efficacy of these treatments in PD-L1-positive individuals.

PMID:39161896 | PMC:PMC11330760 | DOI:10.3389/fphar.2024.1391972

Data Brief. 2024 Jul 15;55:110749. doi: 10.1016/j.dib.2024.110749. eCollection 2024 Aug.

ABSTRACT

The utilization of actual biological tissue (e.g., pork meat samples) and tissue-mimicking phantoms for optical-based in-body data and energy transfer studies is crucial. Near-infrared (NIR) light, a part of the light spectrum that falls between visible light and infrared, is highly advantageous as a carrier for data transmission due to its superior ability to penetrate biological tissue, for instance, the human body. Using pork meat samples as a propagation medium for prolonged experiments is challenging due to the deterioration of meat quality caused by drying in the temperature chamber. Typically, a controlled-temperature chamber can be utilized to warm the tissue samples to 37 °C. Some experiments need to be carried out over long periods, in some cases exceeding one hour, including the demonstration of transmitting large-size data (e.g., high-definition images or videos) in real-time through biological tissue using NIR LED. Moreover, for statistical analysis, some experiments need to be repeated, therefore degradation of the tissue sample should be avoided. Furthermore, experiments may also encompass investigations into optical wireless power transfer (OWPT) conducted on biological tissues under NIR illumination and employing energy harvester-based commercial photovoltaic cells (PV) at the receiving ends, which would require a long time to charge the storage (e.g., battery or supercapacitor) fully. Using phantoms for such an experiment is also not straightforward, requiring careful consideration, such as standardization issues. One possible approach to address this challenge is to conduct experiments in a free-space environment (e.g., sample-free) while guaranteeing that the optical power received in free-space is equivalent to that obtained through biological tissue. This can be achieved by carefully controlling the LED’s current and arranging the optical channel’s distance to achieve comparable results. The received optical power is the primary parameter for comparing free-space and biological tissue setups. This dataset provides settings for NIR LEDs ( P m a x = 375 mW and λ = 810 nm), allowing in-body communication experiments in a free-space environment. The LED’s current settings in this dataset (free-space) are equivalent in comparison to those used in a test-bed using biological tissue with 5 (five) different variations of LED currents (i.e., 500 mA, 400 mA, 300 mA, 200 mA, and 100 mA). The dataset consists of six pork meat samples with different thicknesses and fat-muscle layer compositions, resulting in 36 data points. This dataset holds significant potential for reuse in any biomedical research, particularly in the fields of in-body communication and energy transfer utilizing light.

PMID:39161879 | PMC:PMC11332801 | DOI:10.1016/j.dib.2024.110749

Front Neurol. 2024 Aug 5;15:1378682. doi: 10.3389/fneur.2024.1378682. eCollection 2024.

ABSTRACT

BACKGROUND: The relationship between epilepsy and risk of acute myocardial infarction (AMI) is not fully understood. Evidence from the Stockholm Heart Study indicates that the risk of AMI is increased in people with epilepsy. This study aims to analyze the temporal trends in prevalence, adverse clinical outcomes, and risk factors of AMI in patients with epilepsy (PWE).

METHODS: Patients aged 18 years or older, diagnosed with epilepsy with or without AMI and hospitalized from January 1, 2008, to December 31, 2017, were identified from the National Inpatient Sample (NIS) database. The Cochran-Armitage trend test and logistic regressions were conducted using SAS 9.4. Odds ratios (ORs) were generated for multiple variables.

RESULTS: A total of 8,456,098 inpatients were eligible for our analysis, including 181,826 comorbid with AMI (2.15%). The prevalence of AMI diagnosis in PWE significantly increased from 1,911.7 per 100,000 hospitalizations in 2008 to 2,529.5 per 100,000 hospitalizations in 2017 (P_trend < 0.001). Inpatient mortality was significantly higher in epilepsy patients with AMI compared to those without AMI (OR = 4.61, 95% CI: 4.54 to 4.69). Factors significantly associated with AMI in PWE included age (≥75 years old vs. 18 ~ 44 years old, OR = 3.54, 95% CI: 3.45 to 3.62), atherosclerosis (OR = 4.44, 95% CI: 4.40 to 4.49), conduction disorders (OR = 2.21, 95% CI: 2.17 to 2.26), cardiomyopathy (OR = 2.11, 95% CI: 2.08 to 2.15), coagulopathy (OR = 1.52, 95% CI: 1.49 to 1.54), dyslipidemia (OR = 1.26, 95% CI: 1.24 to 1.27), peptic ulcer disease (OR = 1.23, 95% CI: 1.13 to 1.33), chronic kidney disease (OR = 1.23, 95% CI: 1.22 to 1.25), smoking (OR = 1.20, 95% CI: 1.18 to 1.21), and weight loss (OR = 1.20, 95% CI: 1.18 to 1.22).

CONCLUSION: The prevalence of AMI in PWE increased during the decade. Mortality rates were high among this population, highlighting the need for comprehensive attention to prophylaxis for risk factors and early diagnosis of AMI in PWE by physicians.

PMID:39161871 | PMC:PMC11330761 | DOI:10.3389/fneur.2024.1378682

BMJ Open. 2024 Aug 19;14(8):e082224. doi: 10.1136/bmjopen-2023-082224.

ABSTRACT

BACKGROUND: The sixth United Nations Sustainable Development Goal emphasises universal access to clean water, sanitation and hygiene (WASH) to ensure human well-being as a fundamental human right for sustainable development. In Zimbabwe, WASH reforms began more than a century ago from the preindependence to postindependence era. However, countries face pressing challenges in improving their related health outcomes. Therefore, this scoping review aims to explore WASH status and how it influences health outcomes in Zimbabwe.

METHODS AND ANALYSIS: The leading databases to be searched for relevant sources published in English with an unrestricted search back until May 2024 include PubMed, EBSCO, SAGE, SpringerLink, Cochrane Library, ScienceDirect, Scopus, Web of Science and African Journals Online. A search string was developed for retrieving literature, and reports from key stakeholders in the WASH sector will be included in this study as grey literature. The study will employ a two-step screening process for identifying relevant literature incorporating Cohen’s kappa coefficient statistics to estimate the inter-rater reliability between two independent reviewers using Mendeley and Rayyan software. The Strengthening the Reporting of Observational Studies in Epidemiology checklist for observational studies and the Consolidated Standards of Reporting Trials checklist for randomised controlled trials will be used for the quality checks. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews will guide this study in terms of data collection, extraction and analysis from relevant literature. Data charting was used to present and interpret the findings. The entire process is scheduled to commence in June 2024, with the manuscript anticipated to be submitted to a journal in October 2024.

ETHICS AND DISSEMINATION: This review will use only published data; therefore, no ethical clearance is required. The findings will be disseminated to relevant stakeholders through peer-reviewed journals, meetings, conferences, seminars and forums.

PMID:39160105 | DOI:10.1136/bmjopen-2023-082224

BMJ Open. 2024 Aug 19;14(8):e079839. doi: 10.1136/bmjopen-2023-079839.

ABSTRACT

OBJECTIVES: The current study aimed to find the distribution and factors associated with undernutrition among children aged 6-36 months in Kabul.

DESIGN: Cross-sectional study.

SETTING: Public Ataturk Children’s Hospital, Kabul.

PARTICIPANTS: 385.

METHODS: A structured questionnaire was used to collect data on sociodemographic conditions and anthropometry of children. Logistic regression was used to find determinants of undernutrition.

RESULTS: The distribution of stunting, wasting and underweight was 38.7%, 11.9% and 30.6%, respectively. Among the children studied, 54% did not receive breast milk within the first hour of birth, 53.2% were not exclusively breastfed, 21% received complementary feeding before the age of 6 months, 22.1% lacked access to safe water and 44.7% did not practise hand washing with soap. The odds of stunting were lower (p<0.05) in girls (AOR 5.511, 95% CI 3.028 to 10.030), children of educated fathers (OR 0.288, 95% CI 0.106 to 0.782), those from nuclear families (OR 0.280, 95% CI 0.117 to 1.258), those exclusively breastfed (OR 0.499, 95% CI 0.222 to 1.51) and those practising good hygienic practices (OR 0.440, 95% CI 0.229 to 0.847). Boys had high odd of girls (OR 6.824, 95% CI 3.543 to 13.143) while children of educated fathers (OR 0.340, 95% CI 0.119 to 0.973), those receiving complementary food at 6 months (OR 0.368, 95% CI 0.148 to 1.393) and those practising good hygiene (OR 0.310, 95% CI 0.153 to 0.631) had lower odds (p<0.05) of being underweight. Boys (OR 3.702, 95% CI 1.537 to 8.916) had higher odds of being wasted, whereas children of educated mothers (OR 0.480, 95% CI 0.319 to 4.660), those from nuclear families (OR 0.356, 95% CI 0.113 to 1.117), those receiving early breast feeding (OR 0.435, 95% CI 0.210 to 1.341) and those practising hand washing (OR 0.290, 95% CI 0.112 to 0.750) had lower odds (p<0.05) of being wasted.

CONCLUSION: This study demonstrated the sex of the child, illiteracy of fathers, not practising hand washing and not observing hygiene, late initiation of breast milk, complementary feeding timings, and lack of proper exclusive breast feeding as contributing factors to the under-nutrition of the children in the study population.

PMID:39160103 | DOI:10.1136/bmjopen-2023-079839

BMJ Open. 2024 Aug 19;14(8):e081241. doi: 10.1136/bmjopen-2023-081241.

ABSTRACT

BACKGROUND: Understanding diagnostic capacities is essential to addressing healthcare provision and inequity, particularly in low-income and middle-income countries. This study used routine data to assess trends in rapid diagnostic test (RDT) reporting, supplies and unmet needs across national and 47 subnational (county) levels in Kenya.

METHODS: We extracted facility-level RDT data for 19 tests (2018-2020) from the Kenya District Health Information System, linked to 13 373 geocoded facilities. Data quality was assessed for reporting completeness (ratio of reports received against those expected), reporting patterns and outliers. Supply assessment covered 12 RDTs reported by at least 50% of the reporting facilities (n=5251), with missing values imputed considering reporting trends. Supply was computed by aggregating the number of tests reported per facility. Due to data limitations, demand was indirectly estimated using healthcare-seeking rates (HIV, malaria) and using population data for venereal disease research laboratory test (VDRL), with unmet need computed as the difference between supply and demand.

RESULTS: Reporting completeness was under 40% across all counties, with RDT-specific reporting ranging from 9.6% to 89.6%. Malaria RDTs showed the highest annual test volumes (6.3-8.0 million) while rheumatoid factor was the lowest (0.5-0.7 million). Demand for RDTs varied from 2.5 to 11.5 million tests, with unmet needs between 1.2 and 3.5 million. Notably, malaria testing and unmet needs were highest in Turkana County, as well as the western and coastal regions. HIV testing was concentrated in the western and central regions, with decreasing unmet needs from 2018 to 2020. VDRL testing showed high volumes and unmet needs in Nairobi and select counties, with minimal yearly variation.

CONCLUSION: RDTs are crucial in enhancing diagnostic accessibility, yet their utilisation varies significantly by region. These findings underscore the need for targeted interventions to close testing gaps and improve data reporting completeness. Addressing these disparities is vital for equitably enhancing diagnostic services nationwide.

PMID:39160102 | DOI:10.1136/bmjopen-2023-081241

BMJ Open. 2024 Aug 19;14(8):e082802. doi: 10.1136/bmjopen-2023-082802.

ABSTRACT

INTRODUCTION: Traumatic brain injury (TBI) and spinal cord injury (SCI) are both major contributors to permanent disability globally, with an estimated 27 million new cases of TBI and 0.93 million new cases of SCI globally in 2016. In Australia, the National Disability Insurance Scheme (NDIS) provides support to people with disability. Reports from the NDIS suggest that the cost of support for people with TBI and SCI has been increasing dramatically, and there is a lack of independent analysis of the drivers of these increases. This data linkage seeks to better understand the participant transition between rehabilitation hospitals and the NDIS and the correlation between functional independence in rehabilitation and resource allocation in the NDIS.

METHODS AND ANALYSIS: This is a retrospective, population-based cohort study using Australia-wide NDIS participant data and rehabilitation hospital episode data. The linked dataset provides a comparison of functional independence against which to compare the NDIS resource allocation to people with TBI and SCI. This protocol outlines the secure and separated data linkage approach employed in linking partially identified episode data from the Australasian Rehabilitation Outcomes Centre (AROC) with identified participant data from the NDIS. The linkage employs a stepwise deterministic linkage approach. Statistical analysis of the linked dataset will consider the relationship between the functional independence measure score from the rehabilitation hospital and the committed funding supports in the NDIS plan. This protocol sets the foundation for an ongoing data linkage between rehabilitation hospitals and the NDIS to assist transition to the NDIS.

ETHICS AND DISSEMINATION: Ethics approval is from the Macquarie University Human Research Ethics Committee. AROC Data Governance Committee and NDIS Data Management Committee have approved this project. Research findings will be disseminated to key stakeholders through peer-reviewed publications in scientific journals and presentations to clinical and policy audiences via AROC and NDIS.

PMID:39160099 | DOI:10.1136/bmjopen-2023-082802