Tag: statistics

BMC Pregnancy Childbirth. 2024 Dec 31;24(1):889. doi: 10.1186/s12884-024-06912-2.

ABSTRACT

OBJECTIVE: To study the implementation value of abdominal B-ultrasound combined with cervical cerclage in the prevention and treatment of recurrent late abortion.

METHODS: From October 2020 to December 2023, 196 pregnant patients who had a history of late abortions at our institution were chosen. They were divided into groups based on the treatments used. In the observational team, 98 instances received abdominal B-ultrasound along with cervical cerclage, while 98 instances in the controlling team underwent traditional conservative treatment. Vaginal flora, inflammatory factor levels, labor outcomes, uterine artery parameters, and adverse effects were observed in both groups of pregnant women.

RESULTS: Comparing the detection of vaginal flora between the two groups, the difference was not statistically significant (P > 0.05); the detection values of WBC, neutrophil percentage and neutrophil absolute value in the observation group were lower than those in the control group (P < 0.05). The recurrent late abortion rate (4.08%) and premature delivery rate (16.33%) were lower than those of the control group, and the full-term delivery rate (79.59%) and total fetal survival rate (93.88%) were higher than those of the control group, and the difference was statistically significant (P < 0.05). The resistance index (RI) and pulsatility index (PI) of pregnant women with abortion were higher than those of live birth pregnant women. The RI and PI of group A (pregnant women with recurrent late abortion) at 7, 12, 24 and 32 weeks of gestation were also higher than those of group B (pregnant women without recurrent late abortion), and the difference was statistically significant (P < 0.05). At 7 weeks of gestation, there was no statistical difference between the observation and control groups in terms of RI and PI (P > 0.05)0.12 By 32 weeks of gestation, the RI and PI were lower in the observation group than in the control group (P < 0.05)0.13 In the observation group, the RI and PI were lower than in the control group (P < 0.05). The incidence of gestational hypertension, gestational diabetes mellitus, and eclampsia were significantly lower in the observation group compared to the control group (P < 0.05).

CONCLUSION: Abdominal ultrasound combined with cervical cerclage reduces the risk of miscarriage by improving the hemodynamic status of the uterus and placenta, and also optimizes the pregnancy environment by reducing the inflammatory response in the uterine cavity, which has important clinical applications in the prevention and treatment of late recurrent spontaneous abortion.

PMID:39741251 | DOI:10.1186/s12884-024-06912-2

Int J Emerg Med. 2024 Dec 31;17(1):204. doi: 10.1186/s12245-024-00798-9.

ABSTRACT

BACKGROUND: Elevated initial serum lactate (iSL) levels are frequently employed to assess trauma severity, but their predictive value for mortality and morbidity remains inconsistent. We evaluated the association of iSL with mortality and morbidity at Puerto Rico Trauma Hospital (PRTH).

METHODS: This IRB-approved retrospective study included trauma patients ≥ 18 years with iSL measured within the first 48 h of admission to PRTH (July 2014-June 2019). Patients were classified as normal (4.5-19.8 mg/dL) or elevated (≥ 19.9 mg/dL) iSL levels. Group comparisons were conducted using t-tests, Wilcoxon rank-sum tests, Pearson’s chi-squared, or Fisher’s exact tests. Associations were evaluated with regression and ROC analyses.

RESULTS: Among 536 patients, 54.3% had elevated iSL levels. Initially, elevated iSL was associated with in-hospital mortality (OR: 2.18, 95%CI: 1.36-3.51, p < 0.001), traumatic intensive care unit (TICU) admission (OR: 2.06, 95%CI: 1.46-2.92, p < 0.001), and need for mechanical ventilation (MV) (OR: 2.80, 95%CI: 1.97-3.98, p < 0.001). However, adjusted analyses showed no significant associations (Mortality-AOR: 1.72, 95%CI: 0.97-3.04, p = 0.06; TICU-AOR: 1.11, 95%CI: 0.71-1.75, p = 0.65; MV-AOR: 1.49, 95%CI: 0.89-2.49, p = 0.13). Both iSL (AUC: 0.59, 95%CI: 0.54-0.64) and ISS (AUC: 0.59, 95%CI: 0.54-0.64) demonstrated limited ability to predict mortality, with no statistically significant difference between them (p > 0.99). Patients with elevated iSL experienced prolonged hospital and TICU stays and severe injuries.

CONCLUSIONS: Elevated iSL levels may not independently predict mortality, TICU admission, or the need for MV in trauma patients. However, their rapid availability supports their use alongside other clinical markers to guide trauma care decision-making and improve trauma outcomes.

PMID:39741239 | DOI:10.1186/s12245-024-00798-9

BMC Womens Health. 2024 Dec 31;24(1):677. doi: 10.1186/s12905-024-03530-0.

ABSTRACT

BACKGROUND: We aimed to analyze the correlation between serum lipid levels [total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)] and recurrence after uterine fibroids (UF) resection, and explore the predictive value of serum lipid levels in determining recurrence after myomectomy.

METHODS: In this retrospective cohort study, 323 patients undergoing first myomectomy who came from Li Huili Hospital, Ningbo Medical Center between December 2019 and January 2023 were included. The primary endpoint was the recurrence of UF within 12 months following surgery. Univariate and multivariate logistic regression analyses were adopted to evaluate the association between four serum lipid parameters and the risk of UF recurrence. All included patients were randomly assigned to the training group for nomogram development and the testing group for nomogram validation, with a ratio of 7:3. Receiver operator characteristic, calibration curves, and decision curve analysis were used to assess the predicting performance of constructed nomograms.

RESULTS: Totally, 98 developed the recurrence of UF within 12 months following surgery. Multivariate logistic regression analyses indicated that high levels of TC [odds ratio (OR) = 9.98, 95% confidence interval (CI): 4.28-23.30], LDL-C (OR = 11.31, 95% CI: 4.66-27.47) and HDL-C (OR = 2.37, 95% CI: 1.21-4.64) were associated with recurrence of UF risk. The association between TG level and UF recurrence risk did not statistical significance (P > 0.05). Four online prediction nomograms by integrating serum lipid levels and clinical features for predicting the risk of recurrence of UF were developed (TC-model, TG-model, LDL-C-model and HDL-C-model). Through verification, these models may have good prediction performance for predicting the recurrence of UF risk.

CONCLUSION: This study developed and validated prediction nomograms for predicting the risk of UF recurrence. These nomograms can provide individual risk assessment for UF recurrence.

PMID:39741237 | DOI:10.1186/s12905-024-03530-0

BMC Pulm Med. 2024 Dec 31;24(1):638. doi: 10.1186/s12890-024-03439-2.

ABSTRACT

BACKGROUND: During the COVID-19 pandemia, the imaging test of choice to diagnose COVID-19 pneumonia as chest computed tomography (CT). However, access was limited in the hospital setting and patients treated in Primary Care (PC) could only access the chest x-ray as an imaging test. Several scientific articles that demonstrated the sensitivity of lung ultrasound, being superior to chest x-ray [Cleverley J et al., BMJ 370, 202013] and comparable to CT scan [Tung-Chen Y et al., Ultrasound Med Biol 46:2918-2926, 2020], promoted the incorporation of this technique in the assessment of COVID-19 patients in PC. [Pérez J et al., Arch. Bronconeumol 56:27-30, 2020; Gargani L et al., Eur Heart J Cardiovasc Imaging 21:941-8, 2020, Soldati G et al., J Ultrasound Med 39:1459, 2020] A prior study in our territory (Lleida, Spain) was designed to predict complications (hospital admission) of COVID-19 pneumonia in PC patients, being different patterns of Lung ultrasounds (LUS) risk factors for hospital admission. [Martínez Redondo J et al., Int J Environ Res Public Health 18:3481, 2021] The rationale for conducting this study lies in the urgent need to understand the determinants of severity and prognosis in COVID-19 patients with interstitial pneumonia, according to its lung ultrasound patterns. This research is crucial to provide a deeper understanding of how these pre-existing ultrasound patterns related to disease progression influence the medical treatment.

METHODS: The objective of the study is to generate predictive models of lung ultrasound patterns for the prediction of lung areas characteristics associated with hospitalizations and admissions to the Intensive Care Unit (ICU) associated with COVID-19 disease, using ultrasound, sociodemographic and medical data obtained through the computerized medical history.

RESULTS: A single relevant variable has been found for the prediction of hospitalization (number of total regions with potentially pathological presence of B lines) and one for the prediction of ICU admission (number of regions of the right lung with potentially pathological presence of B lines). In both cases it has been determined that the optimal point for classification was 2 or more lung affected areas. Those areas under the curve have been obtained with good predictive capacity and consistency in both cohorts.

CONCLUSIONS: The results of this study will contribute to the determination of the ultrasound prognostic value based on the number of lung areas affected, the presence of pulmonary condensation or the irregularity of pleural effusion patterns in COVID-19 patients, being able to be extended to other lung viral infections with similar patterns.

PMID:39741236 | DOI:10.1186/s12890-024-03439-2

BMC Ophthalmol. 2024 Dec 31;24(1):554. doi: 10.1186/s12886-024-03823-w.

ABSTRACT

BACKGROUND: Prostaglandin analogs are first-line treatments for open-angle glaucoma due to their proven efficacy in reducing intraocular pressure. Despite their topical administration, systemic adverse drug Events (ADEs) have been reported. This study investigates the systemic ADEs associated with topical prostaglandin analogs using the United States Food and Drug Administration (USFDA) Adverse Drug Event Reporting System (AERS) database.

METHODS: The USFDA AERS database was queried for reports on prostaglandin analogs from March 2004 to March 2024 in this retrospective pharmacovigilance study. Data were deduplicated and analyzed using disproportionality analysis with both frequentist and Bayesian approaches. Reports on systemic ADEs where topical prostaglandin analogs were the primary suspect were included. Statistical analysis was performed using descriptive statistics and the chi-square test for categorical variables.

RESULTS: A total of 30,853 reports were analyzed, predominantly involving latanoprost and bimatoprost, with most patients being elderly and female. In general, hypersensitivity reactions were the most common systemic adverse events reported with prostaglandin analogs. Varied systemic adverse events were observed within the class as latanoprost was linked to conditions like angina pectoris, atrial tachycardia and Meniere’s disease, bimatoprost to lentigo maligna melanoma, and tafluprost to labyrinthitis and skin discoloration. Notably, tafluprost had a significantly higher occurrence of death compared to other prostaglandin analogs, yet the causal relationship has not been established for this association due to unavailability of critical data on temporality and potential confounders including concomitant diseases/drugs and severity of the disease.

CONCLUSION: Prostaglandin analogs are associated with systemic ADEs, particularly in elderly and female patients. The most reported systemic adverse event was hypersensitivity reactions for the class and cardiac events for latanoprost. Tafluprost was observed with higher mortality statistically, yet causal relationship could not be established in the absence of details on the potential confounders. The findings emphasize the need for continuous monitoring of adverse reactions, and consideration of patient-specific factors when prescribing these medications.

PMID:39741235 | DOI:10.1186/s12886-024-03823-w

BMC Gastroenterol. 2024 Dec 31;24(1):483. doi: 10.1186/s12876-024-03577-1.

ABSTRACT

BACKGROUND/AIMS: The increasing use of biologic therapies for moderate to severe inflammatory bowel disease (IBD) highlights the importance of optimal treatment sequencing, particularly after vedolizumab (VDZ) exposure. Studies comparing the effectiveness of ustekinumab (UST) and antitumor necrosis factor (anti-TNF) agents post-VDZ are limited.

METHODS: This retrospective study analyzed VDZ-experienced IBD patients treated with UST or anti-TNF (adalimumab and infliximab) from May 2019 to January 2024. We conducted a comparative analysis of the 52-week treatment persistence between UST and anti-TNF therapies, while also identifying independent predictors that influence 52-week persistence.

RESULTS: The study included 110 participants, with 40 diagnosed with ulcerative colitis (UC) and 70 with Crohn’s disease (CD). Demographics were comparable across treatment groups. The primary discontinuation reason for VDZ was secondary non-response. Kaplan-Meier analysis revealed that UST demonstrated superior 52-week persistence in overall IBD, CD and UC patients, compared to anti-TNF. Cox regression analysis also showed UST’s superiority in overall IBD (HR: 0.15, 95% CI: 0.05-0.45, p < 0.001), CD (HR: 0.09, 95% CI: 0.01-0.68, p = 0.02), and UC (HR: 0.28, 95% CI: 0.08-0.996, p = 0.049). The independent predictors for 52-week treatment persistence are Crohn’s disease (Odds Ratio: 7.151, 95% CI: 1.763-28.995, p = 0.006) and UST treatment (Odds Ratio: 7.912, 95% CI: 1.789-34.992, p = 0.006). Notably, UST required more frequent dosing adjustments than anti-TNF, although both treatments exhibited comparable safety profiles.

CONCLUSIONS: UST demonstrated superior 52-week treatment persistence in IBD patients previously treated with VDZ compared to anti-TNF agents, albeit with a need for more frequent dose adjustments.

PMID:39741232 | DOI:10.1186/s12876-024-03577-1

BMC Infect Dis. 2024 Dec 31;24(1):1481. doi: 10.1186/s12879-024-10351-x.

ABSTRACT

BACKGROUND: The COVID-19 pandemic resulted in the rapid implementation of telemedicine for HIV care at federally qualified health centers (FQHCs) in the United States. We sought to understand use of telemedicine (telephone and video) at two FQHCs in Los Angeles, and the client attitudes towards and experiences with telemedicine as part of future HIV care.

METHODS: We conducted surveys with 271 people living with HIV (PLHIV), with questions covering sociodemographic factors, telemedicine attitudes and experiences, technological literacy, and access to technological resources and privacy. Survey data were analyzed utilizing summary statistics, chi-square analyses, and Fisher’s exact test to understand associations between sociodemographic factors and telemedicine attitudes and experiences.

RESULTS: Sixty percent of the sample had used any telemedicine and, of these, 93% utilized only telephone visits. Almost all respondents (95%, n = 257) had access to a functioning smartphone and self-rated their technological literacy as high. Most had consistent access to privacy (88%, n = 239), and those without privacy noted this as a barrier to the use of telemedicine. The main benefits of telemedicine (compared to in person) were savings of time and money, convenience, and ability to complete appointments as scheduled. Just over half of PLHIV said they would feel more comfortable discussing sensitive topics (e.g., substance use, relationship issues) in person than over telephone (60%, n = 164) or video (55%, n = 151). Despite limited experience with video telemedicine, half of all participants desired a mix of telephone and video visits as part of their future HIV care.

CONCLUSIONS: During a mature phase of the COVID-19 pandemic, PLHIV in our study showed high satisfaction with telemedicine, largely conducted as telephone visits, and high interest in telemedicine visits as a component of their future HIV care. Future studies should explore barriers to implementing video telemedicine in FQHCs and determine telemedicine’s impact on clinical outcomes, including engagement and viral suppression.

PMID:39741230 | DOI:10.1186/s12879-024-10351-x

BMC Psychiatry. 2024 Dec 31;24(1):965. doi: 10.1186/s12888-024-06377-9.

ABSTRACT

BACKGROUND: Smartphone use has rapidly increased worldwide. It was estimated that worldwide use of smartphones surpassed 4.3 billion in 2023, which means 54% of the world’s population now uses smartphones. However, research shows that excessive smartphone use poses health risks and decreases sleep quality, which can be detrimental for students. This study investigates the impact of problematic smartphone usage on health status, mental health, and sleep quality among medical students enrolled in Sudanese universities.

METHODS: A cross-sectional study was conducted from January to March 2024, targeting medical students and recent graduates from Sudanese universities through an online survey. Data were collected using validated scales for smartphone addiction, sleep quality, suboptimal health status, and mental health. Descriptive and correlation analyses were performed using SPSS software v28.0.0.

RESULTS: Out of 231 respondents (69% female, mean age 22.7), 67.6% exhibited high levels of smartphone addiction. Significant correlations were found between smartphone addiction and poor sleep quality (r = 0.462, p < 0.001), suboptimal health (r = 0.527, p < 0.001), and mental health issues (r = 0.365, p < 0.001). Single students had higher addiction and stress scores, while those living in Sudan showed higher suboptimal health scores.

CONCLUSIONS: Problematic smartphone use (PSU) is prevalent among Sudanese medical students, negatively affecting mental health and sleep.

PMID:39741229 | DOI:10.1186/s12888-024-06377-9

Sci Rep. 2024 Dec 30;14(1):31553. doi: 10.1038/s41598-024-82918-2.

ABSTRACT

The study suggests a better multi-objective optimization method called 2-Archive Multi-Objective Cuckoo Search (MOCS2arc). It is then used to improve eight classical truss structures and six ZDT test functions. The optimization aims to minimize both mass and compliance simultaneously. MOCS2arc is an advanced version of the traditional Multi-Objective Cuckoo Search (MOCS) algorithm, enhanced through a dual archive strategy that significantly improves solution diversity and optimization performance. To evaluate the effectiveness of MOCS2arc, we conducted extensive comparisons with several established multi-objective optimization algorithms: MOSCA, MODA, MOWHO, MOMFO, MOMPA, NSGA-II, DEMO, and MOCS. Such a comparison has been made with various performance metrics to compare and benchmark the efficacy of the proposed algorithm. These metrics comprehensively assess the algorithms’ abilities to generate diverse and optimal solutions. The statistical results demonstrate the superior performance of MOCS2arc, evidenced by enhanced diversity and optimal solutions. Additionally, Friedman’s test & Wilcoxon’s test corroborate the finding that MOCS2arc consistently delivers superior optimization results compared to others. The results show that MOCS2arc is a highly effective improved algorithm for multi-objective truss structure optimization, offering significant and promising improvements over existing methods.

PMID:39738304 | DOI:10.1038/s41598-024-82918-2

Sci Rep. 2024 Dec 30;14(1):31727. doi: 10.1038/s41598-024-82531-3.

ABSTRACT

To evaluate the safety and efficacy of the Saroa Surgical Robot System in robot-assisted laparoscopic radical prostatectomy (RARP). We enrolled 60 patients who underwent RARP using either the Saroa (n = 9) or da Vinci Xi (n = 51) systems at Jikei University Kashiwa Hospital from January 2022 to March 2024. We compared preoperative characteristics, perioperative outcomes, complications, and postoperative urinary continence at three months between the two groups. No significant differences were found in preoperative characteristics. The Saroa group had a longer median operative time compared to the da Vinci group. Postoperative urinary continence rates were slightly lower in the Saroa group (77.8 % vs. 84.6%), though not statistically significant. When the tactile feedback function was activated, the organs were grasped with less force compared to when it was off. This study is the first to assess the Saroa system’s effectiveness and safety in RARP. While the system shows promise, especially with tactile feedback that aids in delicate tissue handling, further investigation is needed to evaluate long-term oncological and functional outcomes.

PMID:39738294 | DOI:10.1038/s41598-024-82531-3