Tag: statistics

Matern Child Health J. 2024 Jun 3. doi: 10.1007/s10995-024-03948-w. Online ahead of print.

ABSTRACT

OBJECTIVES: Gestational diabetes commonly occurs during pregnancy and increases lifetime risk of type 2 diabetes following pregnancy. Engaging in physical activity postnatally can reduce this subsequent risk. Interventions aiming to increase physical activity after gestational diabetes may not address the wide range of post-pregnancy barriers. A socio-ecological approach highlights the need to include multi-level factors such as social, community and organisational factors. The aim of the review was to map intervention components to prevent type 2 diabetes after gestational diabetes using the socio-ecological model as a framework and investigate how physical activity changes align with different intervention components utilised.

METHODS: Eligible studies included any study type within 5 years of a gestational diabetes diagnosis and targeted physical activity. A systematic search of MEDLINE, Cochrane Library, Web of Science, CINAHL Complete, and Scopus was conducted in October 2022. Results were categorised based on whether findings demonstrated no increases, non-statistically significant increases or statistically significant increases in physical activity.

RESULTS: Forty-eight studies were included (37 different interventions). Thirty-eight studies were assessed as “adequate” quality, only two studies were “good” quality, and the remaining were limited quality. Mixed physical activity outcomes were observed across components used at the intrapersonal level, with components across other levels of the socio-ecological model showing more increases in physical activity. Intervention components within the social and organisational levels, for example childcare provision, providing group-based sessions and offering remote delivery, were more often present in interventions with physical activity increases.

CONCLUSIONS FOR PRACTICE: Future interventions targeting physical activity after gestational diabetes should aim to include social and organisational-level components in their intervention design. This systematic review was registered in PROSPERO (ID: CRD42021272044).

PMID:38829517 | DOI:10.1007/s10995-024-03948-w

Environ Sci Pollut Res Int. 2024 May 30. doi: 10.1007/s11356-024-33810-z. Online ahead of print.

ABSTRACT

Significant investigations were performed on the use and impact on physical properties along with mechanical strength of the recycled and reused e-glass waste powder. However, it has been modeled how recycled display e-waste glass may affect the characteristics and qualities of dune sand mortar. This study investigates the long-term feasibility of using recycled display e-glass waste as a partial substitute for dune sand at varying percentages (5%, 10%, 15%, and 20%). The main focus is on evaluating its effectiveness in radiation shielding, strength properties, and durability for long-term development under the heating environmental process. Statistical analyses, including analysis of variance, are used to assess the significance of factors and their interactions on these characteristics. Additionally, a regression equation derived from the model offers insights into the quantitative relationship between the factors and properties. The results of the experiments led to the conclusion that the most effective proportion of e-glass waste to include in mortar is 20%, with the weight of dune sand. Including e-glass waste, they significantly increased the five characteristics of the mortar, making it suitable for high-strength mortar applications continue up to 68 MPa. The ANOVA model used in this study was trained using the same experimental research design and was critical in predicting the properties of the mortar. The model produced an accurate result with an R² value greater than 0.99. E-glass replacements exhibit remarkable radiation shielding, characterized by pozzolanic activity and superior internal bonding due to its compact texture, contributing to enhanced long-term strength.

PMID:38829500 | DOI:10.1007/s11356-024-33810-z

Drugs Real World Outcomes. 2024 Jun 3. doi: 10.1007/s40801-024-00431-4. Online ahead of print.

ABSTRACT

BACKGROUND: Levetiracetam is an anti-seizure medication (ASM) with an established safety profile. However, a potential safety signal of hypokalemia following levetiracetam use was published in the World Health Organization newsletter.

OBJECTIVE: To investigate the possible causal association between the use of levetiracetam and the development of hypokalemia.

METHOD: This was a new-user, active-comparator retrospective cohort study using Real-world Evidence Research Network data at the Saudi Food and Drug Authority from 2016 to 2022. Adults (≥ 18 years old) with an incident prescription for either levetiracetam or carbamazepine were followed for up to 6 months from the prescription date. Hypokalemia was ascertained by using diagnostic code (i.e., E87.6) or by serum potassium level below 3.5 mmol/L. A Cox proportional hazards model, adjusted with stabilized inverse probability of treatment weight, was fitted to compare the hazard of hypokalemia between levetiracetam and carbamazepine exposed patients.

RESULTS: A total of 8,982 patients entered the study cohort. The incidence rate of hypokalemia was 303 cases per 10,000 patient-years in the levetiracetam-exposed cohort compared to 57 cases per 10,000 patient-years among carbamazepine users. Compared to carbamazepine users, patients exposed to levetiracetam had an adjusted hazard ratio related to induced hypokalemia of 1.99 (95% confidence interval, 0.88-4.49). Results of sensitivity analyses were comparable to the main analysis.

CONCLUSION: The hazard ratio for hypokalemia with the use of levetiracetam versus carbamazepine was statistically comparable. However, the potential association between levetiracetam use and hypokalemia cannot be ruled out given the elevated hazard ratios from the main and sensitivity analyses. Further studies may provide a more precise assessment of this association.

PMID:38829496 | DOI:10.1007/s40801-024-00431-4

Psychometrika. 2024 Jun 3. doi: 10.1007/s11336-024-09977-2. Online ahead of print.

ABSTRACT

The deployment of statistical models-such as those used in item response theory-necessitates the use of indices that are informative about the degree to which a given model is appropriate for a specific data context. We introduce the InterModel Vigorish (IMV) as an index that can be used to quantify accuracy for models of dichotomous item responses based on the improvement across two sets of predictions (i.e., predictions from two item response models or predictions from a single such model relative to prediction based on the mean). This index has a range of desirable features: It can be used for the comparison of non-nested models and its values are highly portable and generalizable. We use this fact to compare predictive performance across a variety of simulated data contexts and also demonstrate qualitative differences in behavior between the IMV and other common indices (e.g., the AIC and RMSEA). We also illustrate the utility of the IMV in empirical applications with data from 89 dichotomous item response datasets. These empirical applications help illustrate how the IMV can be used in practice and substantiate our claims regarding various aspects of model performance. These findings indicate that the IMV may be a useful indicator in psychometrics, especially as it allows for easy comparison of predictions across a variety of contexts.

PMID:38829495 | DOI:10.1007/s11336-024-09977-2

Biol Trace Elem Res. 2024 Jun 3. doi: 10.1007/s12011-024-04253-x. Online ahead of print.

ABSTRACT

The prevalence of diabetes has reached alarming levels in India, making it essential to understand the concentration of nutritional-trace elements (Fe, Cu, Zn, Cr. and Se) in blood samples from diabetic adults. In this study, 208 whole blood samples from diabetic (n = 104) and non-diabetic (n = 104) adults across various age groups were analyzed using total reflection X-ray fluorescence (TXRF) spectroscopy with a sample dilution method. Statistical analysis was performed to assess descriptive statistics and determine a significant correlation between elemental concentrations in the blood samples of diabetic and non-diabetic adults. The mean concentration of nutritional-related trace elements in diabetic blood was as follows: Fe (46 ± 5) > Zn (1.28 ± 0.14) > Cu (0.10 ± 0.01) > Cr (0.05 ± 0.004) > Se (0.013 ± 0.001) in mg/L, respectively. Additionally, this study investigated the influence of nutrition-related trace element concentrations across various age groups such as 25-40 years (young adults), 41-55 years (middle-aged adults), and 56-70 years (older adults). In this investigation, Zn (p < 0.001) and Cr (p < 0.05) concentrations differed significantly between diabetic and non-diabetic adults aged 56-70 years. These findings will help us to understand age-dependent changes in element concentrations, clarify their role in diabetes, and improve risk factor management associated with diabetes.

PMID:38829478 | DOI:10.1007/s12011-024-04253-x

Infect Dis Ther. 2024 Jun 3. doi: 10.1007/s40121-024-00996-1. Online ahead of print.

ABSTRACT

INTRODUCTION: Antimicrobial resistance (AMR) is a global public health challenge. Global efforts to decrease AMR through antimicrobial stewardship (AMS) initiatives include education and optimising the use of diagnostic technologies and antibiotics. Despite this, economic and societal challenges hinder AMS efforts. The objective of this study was to obtain insights from healthcare professionals (HCPs) on current challenges and identify opportunities for optimising diagnostic test utilisation and AMS efforts.

METHODS: Three hundred HCPs from six countries (representing varied gross national incomes per capita, healthcare system structure, and AMR rates) were surveyed between November 2022 through January 2023. A targeted literature review and expert interviews were conducted to inform survey development. Descriptive statistics were used to summarise survey responses.

RESULTS: These findings suggest that the greatest challenges to diagnostic test utilisation were economic in nature; many HCPs reported that AMS initiatives were lacking investment (32.3%) and resourcing (40.3%). High resistance rates were considered the greatest barriers to appropriate antimicrobial use (52.0%). Most HCPs found local and national guidelines to be very useful (≥ 51.0%), but areas for improvement were noted. The importance of AMS initiatives was confirmed; diagnostic practices were acknowledged to have a positive impact on decreasing AMR (70.3%) and improving patient outcomes (81.0%).

CONCLUSION: AMS initiatives, including diagnostic technology utilisation, are pivotal to decreasing AMR rates. Interpretation of these survey results suggests that while HCPs consider diagnostic practices to be important in AMS efforts, several barriers to successful implementation still exist including patient/institutional costs, turnaround time of test results, resourcing, AMR burden, and education. While some barriers differ by country, these survey results highlight areas of opportunities in all countries for improved use of diagnostic technologies and broader AMS efforts, as perceived by HCPs. Greater investment, resourcing, education, and updated guidelines offer opportunities to further strengthen global AMS efforts.

PMID:38829440 | DOI:10.1007/s40121-024-00996-1

J Neurol. 2024 Jun 3. doi: 10.1007/s00415-024-12437-7. Online ahead of print.

ABSTRACT

BACKGROUND: In Amyotrophic Lateral Sclerosis (ALS) patients with SOD1 mutation the intrathecal administration of tofersen slowed down the progression of disease in a controlled clinical study, but results were not statistically significant.

METHODS: In this multicentre, observational study, we evaluated a cohort of 27 ALS-SOD1 patients who were treated with tofersen, focussing on 17 patients who were followed for at least 48 weeks (median period of 84 weeks, range 48-108). We compared the clinical slopes, as measured by ALSFRS-R, MRC scale and Forced Vital Capacity, during tofersen treatment with retrospective data at 1 year prior to therapy. Cerebrospinal fluid (CSF) and serum neurofilament light chains (NFL) were measured in all patients.

RESULTS: Cumulative evaluation of the ALSFRS-R and MRC progression rates showed a statistically significant change during treatment with respect to the period prior to therapy (p = 0.023 and p = 0.007, respectively). The analysis of individual patients showed that nine of the seventeen patients substantially stabilized or slightly improved. Four patients deteriorated during treatment, while in the remaining patients the very slow course did not allow to identify significant changes. CSF and serum NFL concentration markedly decreased in the near totality of patients. Increased levels of white blood cells and proteins in the CSF were found in 60% of patients. Such alterations were clinically asymptomatic in all but two patients who showed an acute pure motor radiculitis, which responded to steroid therapy.

CONCLUSIONS: Clinical findings and NFL analysis strongly suggest that tofersen may have a disease-modifying effect in a subset of SOD1-ALS patients.

PMID:38829431 | DOI:10.1007/s00415-024-12437-7

J Dev Orig Health Dis. 2024 Jun 3;15:e12. doi: 10.1017/S2040174424000114.

ABSTRACT

Obesity is associated with osteoarthritis (OA), but few studies have used fetal origin to explore the association. Our study aims to disentangle the causality between birth weight, childhood obesity, and adult OA using Mendelian randomization (MR). We identified single nucleotide polymorphisms (SNPs) related to birth weight (n = 298,142) and childhood obesity (n = 24,160) from two genome-wide association studies contributed by the Early Growth Genetics Consortium. Summary statistics of OA and its phenotypes (knee, hip, spine, hand, thumb, and finger OA) from the Genetics of Osteoarthritis Consortium (n = 826,690) were used to estimate the effects of SNPs on OA. Multivariable MR (MVMR) was conducted to investigate the independent effects of exposures. It turned out that genetically predicted standard deviation increase in birth weight was not associated with OA. In contrast, there was a marginally positive effect of childhood obesity on total [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.00, 1.15 using IVW], knee (OR = 1.13, 95% CI = 1.05, 1.22 using weighted median), hip (OR = 1.13, 95% CI = 1.04, 1.24 using IVW), and spine OA (OR = 1.12, 95% CI = 1.03, 1.22 using IVW), but not hand, thumb, or finger OA. MVMR indicated a potential adulthood body mass index-dependent causal pathway between childhood obesity and OA. In conclusion, no association of birth weight with OA was suggested. Childhood obesity, however, showed a causality with OA in weight-bearing joints, which seems to be a general association of obesity with OA.

PMID:38828686 | DOI:10.1017/S2040174424000114

Ultrastruct Pathol. 2024 Jun 3:1-7. doi: 10.1080/01913123.2024.2362758. Online ahead of print.

ABSTRACT

OBJECTIVE: Thyroid carcinoma ranks as the 9th most prevalent global cancer, accounting for 586,202 cases and 43,636 deaths in 2020. Computerized image analysis, utilizing artificial intelligence algorithms, emerges as a potential tool for tumor evaluation.

AIM: This study aims to assess and compare chromatin textural characteristics and nuclear dimensions in follicular neoplasms through gray-level co-occurrence matrix (GLCM), fractal, and morphometric analysis.

METHOD: A retrospective cross-sectional study involving 115 thyroid malignancies, specifically 49 papillary thyroid carcinomas with follicular morphology, was conducted from July 2021 to July 2023. Ethical approval was obtained, and histopathological examination, along with image analysis, was performed using ImageJ software.

RESULTS: A statistically significant difference was observed in contrast (2.426 (1.774-3.412) vs 2.664 (1.963-3.610), p = .002), correlation (1.202 (1.071-1.298) vs 0.892 (0.833-0.946), p = .01), and ASM (0.071 (0.090-0.131) vs 0.044 (0.019-0.102), p = .036) between NIFTP and IFVPTC. However, morphometric parameters did not yield statistically significant differences among histological variants.

CONCLUSION: Computerized image analysis, though promising in subtype discrimination, requires further refinement and integration with traditional diagnostic parameters. The study suggests potential applications in scenarios where conventional histopathological assessment faces limitations due to limited tissue availability. Despite limitations such as a small sample size and a retrospective design, the findings contribute to understanding thyroid carcinoma characteristics and underscore the need for comprehensive evaluations integrating various diagnostic modalities.

PMID:38828684 | DOI:10.1080/01913123.2024.2362758

Laryngoscope. 2024 Jun 3. doi: 10.1002/lary.31558. Online ahead of print.

ABSTRACT

OBJECTIVES: Vestibular disorders can impact cognitive domains, including spatial orientation and memory, which are also affected in Alzheimer’s disease. This study aimed to examine the association between Alzheimer’s disease and a prior diagnosis of peripheral vestibular disorders in the elderly Taiwanese population.

METHODS: The case-control study sample was retrieved from Taiwan’s Longitudinal Health Insurance Database 2010. We included 3138 cases with Alzheimer’s disease and 9414 propensity-matched controls. We conducted multivariable logistic regression modeling to investigate the association between Alzheimer’s disease and a prior diagnosis of peripheral vestibular disorders after accounting for sociodemographic characteristics and medical comorbidities including diabetes, coronary heart disease, hypertension, hyperlipidemia, and hearing loss.

RESULTS: The results revealed a statistically significant difference in the prevalence of prior peripheral vestibular disorders between patients with Alzheimer’s disease and controls; 20.6% among patients with Alzheimer’s disease and 11.4% among controls (p < 0.001). Multivariable logistic regression analysis found that patients with Alzheimer’s disease were twice as likely as controls to have had a prior diagnosis of peripheral vestibular disorders, adjusted odds ratio 2.040 (95% confidence interval: 1.829-2.274).

CONCLUSIONS: The findings suggest the possibility of shared or related pathophysiological pathways in Alzheimer’s disease and vestibular dysfunction disorders.

LEVEL OF EVIDENCE: 3 Laryngoscope, 2024.

PMID:38828678 | DOI:10.1002/lary.31558