Tag: statistics

J Cancer Res Clin Oncol. 2024 Dec 4;151(1):4. doi: 10.1007/s00432-024-06049-x.

ABSTRACT

PURPOSE: Multidisciplinary tumor boards (MTB) are associated with improved outcomes. Yet, most patients in Western countries receive cancer care at non-academic medical centers. Guideline adherence of MTB recommendations in non-academic medical centers as well as factors contributing to non-adherence remain largely unexplored.

METHODS: This retrospective study followed the STROBE recommendations. All cases discussed at the MTB of the Landesklinikum Baden-Moedling, Austria, were eligible for inclusion. Guideline non-adherence was assessed by two reviewers independently using the AWMF S3 guidelines. Factors associated with guideline non-adherence were investigated using multivariable ordinal regression.

RESULTS: In total, 579 patients were included in the final analysis: 486 were female (83.9%) and 93 were male (16.1%), with a median age of 70 years (IQR 60-80). Most had breast cancer (n = 451; 77.9%), while 128 had colorectal cancer (22.1%). Complete adherence to guidelines was observed in 453 patients (78.2%), major deviations in 60 (10.4%), and minor deviations in 66 (11.4%) patients. Non-adherence was primarily due to patient preferences (n = 24; 40.0%), lack of surgical treatment recommendation (n = 24; 40.0%), and comorbidities (n = 9; 15.0%). After adjusting for relevant variables, predictors of non-adherence included older age at diagnosis (OR 1.02, 95% CI 1.00-1.04), colorectal cancer (OR 3.84, 95% CI 1.99-7.42), higher ECOG status (OR 1.59, 95% CI 1.18-2.16), and a more recent MTB conference (OR 1.20, 95% CI 1.03-1.41).

CONCLUSION: Overall, guideline adherence was high for colorectal and breast cancer and comparable to results from academic medical centers. However, results need to be confirmed in other tumor entities.

PMID:39630280 | DOI:10.1007/s00432-024-06049-x

Environ Monit Assess. 2024 Dec 4;197(1):16. doi: 10.1007/s10661-024-13358-8.

ABSTRACT

Soil biological characteristics are highly sensitive to land use changes, making them valuable indicators of soil quality. This study assesses the effects of three land use types (agriculture, rangeland, and forest) and elevation variations on soil microbial parameters and their spatial distribution in the Khaneghah region. Standard physicochemical and biological properties of the soil were measured on a total of 72 soil samples collected using systematic and random sampling techniques. Spatial distribution maps of the biological indices were generated using geostatistical techniques, specifically the Kriging method, within a geographic information system (GIS). The results revealed significantly higher values for microbial biomass carbon (MBC = 900 mg C_mic-CO₂ kg^-1), nitrogen (MBN = 8.97 mg N_mic kg^-1), basal respiration (BR = 25.1 mg C-CO₂ g^-1 day^-1), and the total microbial population (MPN = 0.63 × 10⁹ cells g^-1) in forest soils compared to rangeland and agricultural soils. The alignment between land use maps and biological index maps reinforced these findings. Although the correlations between biological indices and physicochemical properties were generally weak (positive or negative), organic matter content, field capacity moisture, and silt percentage exhibited a slight positive correlation with most of the microbial indices evaluated. The comparison of soil microbial indices with the digital elevation model map indicated higher levels of MBC, MBN, BR, and MPN at elevated regions. However, the microbial quotient and metabolic quotient (qCO₂) did not show significant changes with increasing elevation. The study also confirmed the effectiveness of Kriging interpolation in mapping specific soil microbial indices, as the correlation between Kriging estimates and measured values at sampling points exceeded 0.2, demonstrating statistical significance at a 5% confidence level.

PMID:39630273 | DOI:10.1007/s10661-024-13358-8

Soc Psychiatry Psychiatr Epidemiol. 2024 Dec 4. doi: 10.1007/s00127-024-02799-8. Online ahead of print.

ABSTRACT

PURPOSE: To determine the prevalence of childhood mental and emotional health concerns and care seeking patterns among foreign-born MENA children compared to US- and foreign-born White children before and after adjusting for covariates.

METHODS: Data from the 2000-2018 National Health Interview Survey (NHIS) were analyzed. Poor toddler mental health in the past two months (2-3 years) and childhood emotional difficulties (4-17 years) in the past six months were measured. Parents also reported whether (yes/no) their child saw a doctor for behavioral or emotional concerns in the past 12 months.

RESULTS: Parents of foreign-born MENA young children (ages 2-3 years) were less likely to report mental health concerns (44.8%) compared to US-born White counterparts (67.3%; p <.05). Parents of foreign-born MENA children were less likely to report emotional difficulties compared to US- and foreign-born White children (21.9% and 19.3%, respectively; p’s < 0.05). Foreign-born MENA children with mental or emotional health concerns had lower odds of seeing a doctor in the last 12 months for emotional/behavioral problems (OR = 0.45; 95% CI = 0.24-0.86) or mental health concerns (OR = 0.47; 95% CI = 0.27-0.83) compared to their US-born White counterparts after adjusting for sociodemographic factors.

CONCLUSION: Parents of foreign-born MENA children reported fewer mental and emotional health concerns compared to US-born Whites. Those with mental and emotional health concerns were less likely to seek mental health care compared to their US-born White counterparts. Further research is needed to confirm and expand on these findings once a unique racial/ethnic identifier for MENA children is made available for measuring national mental health statistics.

PMID:39630271 | DOI:10.1007/s00127-024-02799-8

Eur J Pediatr. 2024 Dec 4;184(1):63. doi: 10.1007/s00431-024-05900-0.

ABSTRACT

During the COVID-19 pandemic, lockdown posed a number of unprecedented problems. Accidents to children are a major public health concern. This study sought to determine the impact of France’s 2020 COVID-19 lockdown on hospital admissions for paediatric accidents. This study was a retrospective cohort analysis of data from the French national inpatient database. Children admitted to a French hospital for an accident from January to July 2020 and 2019 were included. The number of admissions for accidents between January and July in 2020 (the study period) vs. the same period (the control period) in 2019 was recorded. Hospital admission rate ratios (HRRs) comparing 2020 with 2019 were calculated for three periods in 2020 and 2019: before lockdown (P1, January 1 to March 15), during lockdown (P2, March 16 to May 10), and after lockdown (P3, May 11 to July 31). A total of 72,089 children were admitted to hospital for accidents between January and July 2020 (mean (SD) age, 8.7 (5.8)), and 84,961 between January and July 2019 (mean (SD) age, 9.2 (5.7)). A total of 12,864 children (18%) were admitted during the lockdown period (P2) in 2020, and 23,098 (27%) during the equivalent period in 2019 (HRR, 0.56; 95% confidence interval (CI), 0.55-0.57; p < .001). There were significantly fewer admissions for accidents in 2020 than in 2019; the HRR was 0.97 (95% CI, 0.96-0.99; p = .003) for P1 and 0.95 (95% CI, 0.93-0.96; p < .001) for P3. During the 2020 lockdown period (P2), the risk of accident-related paediatric admissions with critical care lasting for at least 1 day was lower than in 2019 (HRR 0.67; 95% CI, 0.62-0.73; p < .001).

CONCLUSIONS: Further research could usefully examine how parents create a safe home environment for their children.

WHAT IS KNOWN: • During the COVID-19 pandemic, lockdown posed a number of unprecedented problems. Accidents to children are a major public health concern. This study sought to determine the impact of France’s 2020 COVID-19 lockdown on hospital admissions for paediatric accidents.

WHAT IS NEW: • The first nationwide COVID-19 lockdown in France was associated with a decrease in the absolute number of hospital admissions for paediatric accidents, for all age groups, as well as the number of accident-related paediatric hospital stays involving critical care.

PMID:39630265 | DOI:10.1007/s00431-024-05900-0

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2024 Dec 4. doi: 10.1007/s00103-024-03986-3. Online ahead of print.

ABSTRACT

National mortality registers provide important data for monitoring population health. Analyses of cardiovascular mortality in particular-and especially mortality from coronary heart disease-are frequently the basis for conclusions about the quality of healthcare and prevention. To be able to interpret disease-specific mortality differences between countries and changes in mortality over time, it is necessary to know the basics of monocausal cause-of-death statistics and the associated limitations in comparative statements.Conclusions from disease-specific mortality data can be problematic due to the highly subjective selection of diseases that are entered on a death certificate after a post-mortem examination. In death certification, unawareness of the different “roles” of specific diseases-known at the time of death-within the causal chain leading to death can result in incomplete death certificates as a data basis for mortality statistics. Comparisons of disease-specific mortality rates are difficult due to different proportions of non-informative-including unknown-causes of death and due to country-specific preferences for which diseases are recorded on a death certificate-especially in the prevalence of multimorbidity. A population’s morbidity is therefore only reflected to a limited extent by mortality rates. Conceptual ambiguities with regard to the concepts of lethality and mortality when describing mortality rates can also lead to erroneous conclusions.Training of medical staff on how to complete a death certificate and the introduction of an electronic death certificate can improve the quality of mortality data. Irrespective of this, knowing potential pitfalls when analyzing mortality data will improve the quality of health reporting.

PMID:39630243 | DOI:10.1007/s00103-024-03986-3

Pediatr Radiol. 2024 Dec 4. doi: 10.1007/s00247-024-06105-1. Online ahead of print.

ABSTRACT

OBJECTIVE: Accurate and early prediction of neurodevelopmental impairment is a crucial endeavor in caring for very preterm infants (<31 weeks’ gestation). Sequential cranial ultrasound is the standard of care for the evaluation of preterm brain injury. However, there is no consensus on the timing and frequency of ultrasound screening. At Izaak Walton Killam (IWK) Health Centre, Halifax, Canada, four-time points for routine ultrasound of very preterm infants are performed at weeks 1, 2, 6, and term age. The hypothesis behind this work is that a three-time-point model will be appropriate for neurodevelopmental impairment prognostication.

MATERIALS AND METHODS: In this retrospective cohort, all very preterm infants (22⁰-30⁶ weeks) born between January 2004 and December 2018 with a neurodevelopmental assessment at 36 months corrected age were included. Three prediction models of neurodevelopmental impairment were compared: 1. A reference model including the gestational age, infant sex, and 2-week and 6-week ultrasound 2. A model including the gestational age, infant sex, and 6-week ultrasound 3. A model including the gestational age, infant sex, and 2-week ultrasound RESULTS: Of 786 eligible preterm infants born during the study period, 656/786 survivors were included in the analysis (mean gestational age 27⁵ weeks, mean birth weight 1,133 g, and 55% male infants). At 36 months of corrected age, 30% developed neurodevelopmental impairment. All three models provided comparable discrimination areas under the curve (AUC) of neurodevelopmental impairment at 36 months of corrected age. Both the 6-week and the reference model had similar AUC of 0.68 (95% CI 0.63-0.72) and were not noticeably different from the 2-week model (AUC 0.66 (95% CI 0.61-0.70)). The 6-week model provided the best prediction with the lowest Akaike information criterion (AIC) of 766 for the 6-week-only model, AIC 769 for combined weeks 2 and 6 (reference model), and AIC 784 for the 2-week-only model.

CONCLUSION: In this cohort of very preterm infants, a model including 6-week ultrasound only was comparable to a reference model combining 2-week and 6-week ultrasound and showed nearly identical predictive performance of neurodevelopmental impairment at 36 months corrected age across a broad set of metrics; thus, it is redundant to do both the 2-week and 6-week ultrasound.

CLINICAL RELEVANCE STATEMENT: Late ultrasound at 6 weeks of age provided comparable diagnostic and prognostic information to a reference model combining 2-week and 6-week ultrasound and, if anything, was slightly superior to the 2-week ultrasound model, across a broad set of metrics. The 2-week ultrasound can be eliminated with no impact on the prediction of neurodevelopmental impairment at 36 months, promoting prudent resource allocation and stewardship in healthcare.

PMID:39630240 | DOI:10.1007/s00247-024-06105-1

World J Urol. 2024 Dec 4;43(1):12. doi: 10.1007/s00345-024-05365-8.

ABSTRACT

PURPOSE: Ureteroscopy (URS) is considered one of the first-line surgical treatments for urinary stones < 2 cm. Preoperative stenting (PS) employment in URS for urolithiasis remains debated, with evidence differing in terms of outcomes and recommendations. We sought to evaluate the influence of PS on surgical outcomes compared to non-PS (NPS) in patients with renal and ureteral stones undergoing ureteroscopic lithotripsy.

METHODS: Databases were searched until December 2023 for randomized and non-randomized studies reporting perioperative outcomes for PS and NPS. Pooled data were analyzed through a Random-Effects model when Higgins I2% heterogeneity values were > 50%; otherwise, a Fixed-Effects model was employed. Results were reported as risk ratios (RR), or mean differences (MD) with 95% confidence intervals (CI). Statistical significance was set at p < 0.05.

RESULTS: The analysis included 23,668 patients from 25 included studies (5 non-randomized prospective and 20 retrospective studies). Higher stone-free rates (SFR) were observed in kidney and ureteral stones (RR 1.05; 95%CI 1.03-1.08; p ≤ 0.0001), especially if managed with flexible URS (RR 1.05; 95%CI 1.01-1.09) in the PS cohort. Additionally, lower rates of intraoperative (RR 0.70; 95%CI 0.49-0.99; p = 0.04) and postoperative complications (RR 0.82; 95%CI 0.70-0.95; p = 0.008) were seen with PS. Both groups had a comparable operative time, length of stay (LOS), ureteral access sheath (UAS) placement success, and SFR in semi-rigid URS.

CONCLUSION: Higher SFR with PS were seen in kidney and ureteral stones, especially if f-URS was employed. Moreover, perioperative complications did not increase with PS. Future randomized studies, evaluating cost-effectiveness and quality of life are needed.

PMID:39630233 | DOI:10.1007/s00345-024-05365-8

Med Mol Morphol. 2024 Dec 4. doi: 10.1007/s00795-024-00412-0. Online ahead of print.

ABSTRACT

This study aimed to evaluate corneal findings of pterygium cases using in vivo confocal microscopy (IVCM) which is a non-invasive and repeatable method. In this case-control study, 54 patients diagnosed with pterygium and 50 healthy controls were investigated, between 2020 and 2021. After a comprehensive ophthalmological examination, the central corneas of all participants were evaluated by corneal IVCM. Surface epithelial cell, wing cells, basal epithelial cells, nerve fiber density, nerve branch density, anterior and posterior stroma keratocyte densities were measured. Corneas from cases with and without pterygium were similar in terms of age (p = 0.306) and gender (p = 0.564). No statistically significant differences were found in the epithelium cell counts including surface, wing, and basal cells between the two groups (p = 0.950, p = 0.334, and p = 0.624, respectively). No statistically significant differences were observed in subepithelial nerve fiber density (p = 0.849), nerve branch density (p = 0.752), and posterior stromal keratocyte density (p = 0.683) between corneas from cases with and without pterygium. However, corneas from cases with pterygium had significantly higher scores in anterior stromal keratocyte density than those from cases without pterygium (p = 0.045). Corneas from grades 1, 2, and 3 pterygium were similar in cell counts, anterior and posterior stromal keratocyte densities (p > 0.05). However, patients with grade 1 had significantly increased nerve fiber density (p = 0.015) and nerve branch density (p = 0.001) than those with grade 2 and grade 3 pterygium. Corneal IVCM may be useful to better understand the corneal microstructure in cases with pterygium. Comprehensive research on the subject is needed.

PMID:39630225 | DOI:10.1007/s00795-024-00412-0

Eur Arch Paediatr Dent. 2024 Dec 4. doi: 10.1007/s40368-024-00973-9. Online ahead of print.

ABSTRACT

BACKGROUND: Bruxism is defined as the recurring muscular activity of the jaw, which is distinguished by the unconscious grinding or clenching of teeth or pushing and forcing of the lower jaw. The present study was conducted to assess sleep bruxism and its association with sleep quality, stress levels, and dental health in the paediatric population.

METHODOLOGY: 384 children aged 6-12 years were recruited for the study. Ethical approval from the institutional ethical committee and informed consent from parents and guardians were obtained. Children with systemic diseases, mental or developmental disorders, CNS-affecting medications, or those whose parents did not provide consent were not included. Bruxism was identified using the American Academy of Sleep Medicine (AASM) criteria through parental reports. Sleep quality and stress levels were assessed using AASM guidelines and the Perceived Stress Scale for Children (PSS-C). A chi-square test was applied to assess association, with a p value < 0.05 considered to be significant.

RESULTS: The number of siblings and the mother’s education level were also significantly associated. It was found that sleep bruxism is significantly associated with all parameters of sleep quality except the usage of pillows. When stress levels among children were assessed, it was found that 60 (15.6%) children had very low stress, 131 (34.1%) children had low stress, 95 (24.7%) children had average stress, 92 (24%) children had high stress, and 6 (1.6%) children had a very high level of stress. A statistically highly significant (p = 0.001) association was found between bruxism and stress levels among children.

CONCLUSION: The results of the present study concluded that sleep bruxism was significantly linked with sleep quality and stress levels among children, which ultimately affect dental health.

PMID:39630217 | DOI:10.1007/s40368-024-00973-9

Bratisl Lek Listy. 2024;125(12):844-850. doi: 10.4149/BLL_2024_129.

ABSTRACT

BACKGROUND: Fractures of thoracolumbar spine in the field of ankylosing diseases such as ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH) can by surgically treated with miniinvasive posterior transpedicular fixation. The exact length of implant is the subject of several studies. In our study, we retrospectively evaluated the treatment of B3 fractures of the ankylosed thoracolumbar spine with use a shorter versus longer implant, always with 8 screws.

METHODS: A total of 46 patients were included in the study (36 men and 10 women). Sixteen patients had AS and 30 patients had DISH. Patients treated between 2018 and 2022 with minimally invasive dorsal transpedicular fixation using 8 transpedicular screws were included in this study. We compared two groups where the first consisted of patients operated on with fixation of a maximum of 4 segments and the second group of patients consisted of patients in whom longer stabilization was used, at least 5 to 8 segments, with skipping of some vertebra between screws. We compared the effect of fixation length on reduction and retention before surgery, after surgery, and after 6 and 12 months. We evaluated the effect of reduction and retention on the basis of differences in the measurement of the Cobb angle and the angle, which we called “vege”, which was formed by dislocation of the fracture. Furthermore, we monitored demographic data, the length of surgery, the number of complications, the number of concomitant injuries, the presence of a neurological deficit, and the result was assessed by the AO Spine PROST questionnaire.

RESULTS: In the entire group of 46 patients, the difference in the “vege” angle was significant (p<0.001). When comparing the reduction between the groups with short and longer fixation, the difference was not significant (p=0.829). The difference of the Cobb angle before and after the surgery in the comparison between the two groups did not show a statistically significant difference (p=0.434). Measurements of the Cobb angle bisegmentally after 6 and 12 months showed a progressive change in terms of kyphotization, which was smaller in the group with longer fixation, this difference was not statistically significant (p=0.709). Complete reduction was achieved in the group with short fixation vs 75% vs 63.3% with longer fixation (p-0.739). At the check-up after 6 months, all incomplete intraoperative reductions were spontaneously reduced.

CONCLUSIONS: Based on this study, we could conclude that both used constructions are comparable in terms of treatment results. It can be observed that longer fixation is more resistant to kyphotization at 6 and 12 months, but we would need a larger group of patients to confirm this hypothesis. In all incomplete reduced fractures through the surgery, complete reduction after verticalization occurred within 6 months in both groups. The angle of reduction was greater in the group with longer fixation, but the difference was not significant (Tab. 6, Fig. 8, Ref. 31).

PMID:39629657 | DOI:10.4149/BLL_2024_129