Tag: statistics

Cureus. 2023 Jun 4;15(6):e39937. doi: 10.7759/cureus.39937. eCollection 2023 Jun.

ABSTRACT

Background Mycobacterium is certainly one individual organism contributing to the most deaths of children among the world’s lower- and medium-income nations. According to earlier studies, vitamin D insufficiency is one of the risk factors. We undertook this study since very few case-control studies are present. This study aimed to evaluate the role of vitamin D in tuberculosis (TB). Methods This case-control study was carried out in a tertiary care center at Niloufer Hospital over a period of one year and five months. The sample size was 140. SPSS (Statistical Package for the Social Sciences) Version 19 (IBM Corp., Armonk, NY) was used for statistical analysis. Two-tailed p-values and odds ratios were obtained. The chi-square test was applied to differentiate between two categorical variables. For means, the Student t-test was applied. We usually take baseline investigations before starting ATT (anti-TB treatment) with the blood sample we tested for vitamin D levels. Results With p-values of 0.767 and 0.866, the age and sex distributions in the cases and controls were comparable. Rural and urban area distribution and malnutrition distribution were not similar in both groups, with a p-value of 0.001. The mean vitamin D level in cases was 10.4, while controls it was 22.8, and this difference is statistically significant (p = 0.001). Conclusion Vitamin D deficiency is more common in children with TB than in normal children. In addition, a severe form of vitamin D deficiency (less than 10 ng/mL) was higher among children with TB. Clinicians should be aware of associated malnutrition and low socioeconomic status as risk factors for severe vitamin D deficiencies among them.

PMID:37409212 | PMC:PMC10319357 | DOI:10.7759/cureus.39937

Cureus. 2023 Jun 4;15(6):e39946. doi: 10.7759/cureus.39946. eCollection 2023 Jun.

ABSTRACT

BACKGROUND: Corporate social responsibility (CSR) is an evolving business strategy worldwide, focusing on the sustainability of the enterprise and the provision of multiple benefits to the societies and economies.

OBJECTIVE: The aim of this paper was to explore the encouraging and deterrent factors for the implementation of CSR actions in companies specializing in pharmaceutical and biomedical products as well as in medical equipment in Greece.

METHODS: A cross-sectional study was conducted (April to June 2021) in member-companies of the Hellenic Association of Pharmaceutical Companies, the Panhellenic Association of Pharmaceutical Industry and the Association of Health-Research and Biotechnology Industry. Data collection was carried out via an anonymous, self-administered questionnaire. Descriptive and inferential statistical analyses were performed, using SPSS version 25 (IBM Corp., Armonk, NY, USA). The significance level was set at p≤0.05.

RESULTS: One hundred twelve questionnaires were distributed, out of which 87 were returned (response rate 77.7%). 81.1% of companies included CSR in their annual strategy, while only 32.4% of them follow the Global Reporting Initiative standards. The majority (62.2%) disposes ≤€100.000 from their annual turnover for CSR actions. The contribution to society and the ethical commitment of the enterprise are stated as the main encouraging factors for CSR, while bureaucracy and the lack of incentives as deterrents. Pharmaceutical companies reported social acceptance as the major CSR enabler compared to other companies (p=0.034), while companies specializing only in medical equipment/biotechnology mentioned industry competition (p=0.003). Bureaucracy has been revealed as the major disincentive for all participating companies. Corporate advertising is found as an important encouraging factor for the adoption of CSR for the international companies compared to the national ones (p=0.023). Moreover, 97.3% stated that the government should reward socially responsible companies by increasing financial incentives. Conclusion: The health technology industry in Greece implements CSR actions. The company’s contribution to society and its ethical commitment are important encouraging factors for CSR, while bureaucracy and lack of government incentives are the main deterrents. The reward of socially sensitive companies by the government would provide significant entrepreneurial and societal benefits, supporting the overall Greek economy.

PMID:37409209 | PMC:PMC10319453 | DOI:10.7759/cureus.39946

Cureus. 2023 Jun 3;15(6):e39921. doi: 10.7759/cureus.39921. eCollection 2023 Jun.

ABSTRACT

Background and objective Due in part to its effect on intraocular pressure (IOP) measurements, the assessment of central corneal thickness (CCT) is recognized as an essential part of the initial glaucoma assessment. The most widely utilized clinical technique to measure CCT is ultrasound pachymetry (USP). In recent years, many dedicated anterior-segment optical coherence tomography scanners (AS-OCTs) have been developed. Previous studies have compared CCT measurements between USP and various AS-OCTs. This study aimed to assess the degree of agreement between USP and CASIA2 (Tomey Corporation, Nagoya, Japan), a second-generation swept-source AS-OCT developed in Japan. Methodology The data on CCT screening measurements of 156 eyes (88 patients) performed over a period of three months, from January to March 2020, on glaucoma patients attending the Royal Hallamshire Hospital (RHH) in Sheffield, UK were collected retrospectively and statistically analyzed. Results The average age of the 88 patients included in the study was 66 years (range: 20-86 years). Our findings show that when compared to CASIA2 measurements, USP measurement of the CCT resulted in significantly thicker values (paired t-test: t=23.15,p<2.2 x 10^-16). The average difference between the two methods was 19.98 ± 10.78 μm. It is hypothesized that this difference may be due in part to inaccurate probe placement during ultrasound probe measurement, resulting in thicker CCT values. Conclusion The observed difference may be clinically significant as it could induce clinical discrepancy in terms of perceived glaucoma risk in patients. Therefore, USP and CASIA2 should not be used interchangeably, and clinicians should take into account the significant difference between these methods.

PMID:37409208 | PMC:PMC10317844 | DOI:10.7759/cureus.39921

Cureus. 2023 Jun 3;15(6):e39899. doi: 10.7759/cureus.39899. eCollection 2023 Jun.

ABSTRACT

INTRODUCTION: This study evaluated the nutrition literacy and perceived emotional burden of disease in young adults with type-1 diabetes. All participants are current or past members of the non-profit organization The Diabetes Link, formally known as the College Diabetes Network. The Diabetes Link is a 501(c)(3) nonprofit organization working to connect and support young adults with type-1 diabetes through the transitional periods of their lives, most commonly the transition from high school to college. Previous research shows that there is a significant uptick in glycated hemoglobin (HbA1c) levels in people with type-1 diabetes between the ages of 18 and 24, a period associated with many transitional events. While there are numerous hypothesized reasons why HbA1c levels spike during these ages, the lack of nutritional knowledge is frequently highlighted as a root cause of this increase.

METHODS: Participants were asked to complete a 40-question survey via Google Forms (Google LLC, Mountain View, California, United States) that contained questions pertaining to their treatment, dietary habits, confidence in healthcare professionals to provide nutrition advice, and overall feelings toward their diagnosis of type-1 diabetes. The survey also included four questions aimed at evaluating the participants’ carbohydrate-counting skills to determine a basis of their nutritional knowledge. A binary logistic regression was performed using IBM SPSS Statistics for Windows, Version 27 (Released 2020; IBM Corp., Armonk, New York, United States) to assess the influences of the burden and carbohydrate-counting knowledge on the participants’ diabetes care, eating habits, and emotional outlook on nutrition.

RESULTS: Data from this study show that the participants who scored high on the carbohydrate-counting quiz were 2.389 times more likely to avoid eating because of an out-of-range blood sugar level (p-value = 0.05), and the participants who reported higher levels of burden were 9.325 times more likely to avoid social gatherings because of food (p-value = 0.002). Conclusion: Results from this study demonstrate that the emotional burden associated with eating and not nutrition knowledge could contribute to the previously listed spike in HbA1c levels.

PMID:37409198 | PMC:PMC10317788 | DOI:10.7759/cureus.39899

Ophthalmol Sci. 2023 May 26;3(4):100339. doi: 10.1016/j.xops.2023.100339. eCollection 2023 Dec.

ABSTRACT

PURPOSE: To evaluate the relationship between full-thickness macular hole (FTMH) onset and perifoveal posterior vitreous detachment using OCT data.

DESIGN: Retrospective study.

PARTICIPANTS: A total of 742 patients with FTMH or impending macular hole (MH) in ≥ 1 eye, as determined by ophthalmoscopy and OCT.

METHODS: Macular holes were staged using OCT results. Patients with the posterior vitreous membrane clearly detected in the OCT images and vitreoretinal adhesion size ≤ 1500 μm-eyes with MH stages 1-3-were included in the study. The contralateral eyes were also included in the analyses if they showed the focal type of vitreomacular adhesion (VMA) (i.e., vitreoretinal adhesion ≤ 1500 μm). The distance between the posterior vitreous membrane and the surface of the retina was defined as the posterior vitreous separation height (PVSH). Using the OCT images, PVSHs of each eye in 4 directions (nasal, temporal, superior, and inferior) at 1 mm from the center of the MH or fovea were calculated.

MAIN OUTCOME MEASURES: The main outcome measures were PVSHs according to the MH stage and VMA, the relationship of the foveal inner tear with PVSH, and the likelihood of a foveal inner tear based on the direction.

RESULTS: The PVSH trends in each of the 4 directions were as follows: VMA < MH stage 1 = MH stage 2 < MH stage 3. Initial MH stage 2 (onset of FTMH) was defined as the presence of a gap in only 1 of the 4 directions from the center of the MH. With increased PVSH, the likelihood of a gap increased (P = 0.002), and a temporal gap was more likely to occur than a nasal gap (P = 0.002).

CONCLUSIONS: At FTMH onset, a foveal inner tear likely appears on the temporal side or the side showing a high PVSH value.

FINANCIAL DISCLOSURES: The author(s) have no proprietary or commercial interest in any materials discussed in this article.

PMID:37409190 | PMC:PMC10318498 | DOI:10.1016/j.xops.2023.100339

Neurology. 2023 Jul 5:10.1212/WNL.0000000000207538. doi: 10.1212/WNL.0000000000207538. Online ahead of print.

ABSTRACT

BACKGROUND: and purpose: It is unclear whether intravenous thrombolysis (IVT) outperforms early dual antiplatelet therapy (DAPT) in the acute setting of mild ischemic stroke. The aim of this study was to compare early safety and efficacy of IVT to DAPT.

METHODS: Data of mild non-cardioembolic stroke patients with admission NIHSS <=3 who received IVT or early DAPT in the period 2018-2021 were extracted from a nationwide, prospective stroke unit registry. Study endpoints included symptomatic intracerebral hemorrhage (sICH), early neurological deterioration ≥4 NIHSS points (END), and 3-months functional outcome by modified Rankin Scale (mRS).

RESULTS: 1195 mild stroke patients treated with IVT and 2625 treated with DAPT were included. IVT patients were younger (68.1 versus 70.8 years), had less hypertension (72.8% versus 83.5%), diabetes (19% versus 28.8%) and history of myocardial infarction (7.6% versus 9.2%) and slightly higher admission NIHSS scores (median 2 versus median 1) as compared to DAPT patients. After propensity score matching and multivariable adjustment, IVT was associated with sICH (4 (1.2%) vs 0), END (aOR 2.8, CI 1.1-7.5), and there was no difference in mRS 0-1 at 3 months (aOR 1.3, CI 0.7-2.6).

CONCLUSIONS: This analysis from a prospective nationwide stroke unit network indicates that IVT is not superior to DAPT in the setting of mild non-cardioembolic stroke and may eventually be associated with harm. Further research focusing on acute therapy of mild stroke is highly warranted.

CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that IVT is not superior to dual antiplatelet therapy in patients with acute mild (NIHSS<=3) non-cardioembolic stroke. The study lacks the statistical precision to exclude clinically important superiority of either therapy.

PMID:37407270 | DOI:10.1212/WNL.0000000000207538

Infect Chemother. 2023 Jun;55(2):306-307. doi: 10.3947/ic.2023.0060.

NO ABSTRACT

PMID:37407245 | DOI:10.3947/ic.2023.0060

Infect Chemother. 2023 Jun;55(2):237-246. doi: 10.3947/ic.2023.0028.

ABSTRACT

BACKGROUND: This study aimed to identify the trends in pharmaceutical expenditure (PE), share of PE in health expenditure (HE), and trends in expenditure by pharmacological groups (ATC level 1 classification) in Korea for a 10-year period (2011 – 2020) and compare the data with those of other Organisation for Economic Co-operation and Development (OECD) countries. Using the findings, we determined the current status of pharmaceutical expenditure (PE) management in Korea and derived the implications for establishing future macroscopic policies on PE.

MATERIALS AND METHODS: We analyzed the OECD Health Statistics and the Korean national health insurance claims database from January 2011 through December 2020. The outcome measures were HE, PE, and pharmaceutical sales data for ATC level 1 medicines from OECD Health Statistics data during 2011 – 2020. As OECD collects limited ATC level 1 data, we used the HIRA health insurance claims data for PEs of ATC level-1 classification, including D, L, P, and S.

RESULTS: PE in Korea increased by 38.5% from 19.9 billion USD in 2011 to 27.6 billion USD in 2020, whereas the share of PE in HE decreased by 6.3%p from 26.4% in 2011 to 20.1% in 2020. In 2020, Korea ranked third in PE per capita (760.9 USD PPP) and had the highest share of PE (20.1%) among the 19 OECD countries studied. By ATC level 1 class, the highest PE was A (alimentary tract and metabolism) at 4.3 billion USD, and L (antineoplastic and immunomodulating agents) had the highest increase at 13.4%; in contrast, J (anti-infectives for systemic use) had the lowest increase in annual average PE at -0.2% in 2020 relative to 2011. Among the 17 OECD countries, Korea had the highest and the third-highest expenditures for ATC codes A and J, respectively.

CONCLUSION: PE in Korea has continued to increase between 2011 and 2020, indicating the need for macroscopic management of PE. Our results on PE by ATC code may help health authorities in establishing future policies on PE.

PMID:37407241 | DOI:10.3947/ic.2023.0028

BMJ Glob Health. 2023 Jul;8(7):e011837. doi: 10.1136/bmjgh-2023-011837.

ABSTRACT

BACKGROUND: The world will face a human resource gap of 10 million health workers in 2030. Community health workers (CHWs) can contribute to mitigating this workforce gap while improving equitable access to care and health outcomes. However, questions on how to best implement and optimise CHW programmes, especially across varied contexts, remain. As each context has its determinants for a successful CHW programme, this research identifies and assesses pertinent factors needed for optimal CHW programmes in conflict settings, specifically Northwest Syria.

METHODS: A mixed-methods study in Northwest Syria consisting of a literature and document review, semistructured interviews with CHWs’ team leaders and programme managers, key informant interviews with policymakers and a survey with CHWs was conducted across three research phases from 2018 to 2022. The three phases aimed to identify, refine and finalise a framework for CHW optimisation in humanitarian conflict contexts, respectively. Qualitative data were analysed thematically, and quantitative data were statistically analysed to identify critical trends.

RESULTS: 16 interviews and 288 surveys were conducted, supplemented by key reports and literature. The framework underwent two iterative rounds of refinement, reflecting varying stakeholders’ perceptions of CHW optimisation. The resulting framework presents important implementation factors with subthemes across identified topics of institutionalisation, integration and representation for CHW optimisation in Northwest Syria and other humanitarian conflict contexts. The presented factors are similar in various ways to other fragile low/middle-income country settings. However, in protracted conflict settings like Syria, careful consideration should be given to strategic dimensions such as integration and representation.

CONCLUSION: For CHW programmes to impact health outcomes in humanitarian conflict settings, they require a set of implementation and design factors relevant to the context. The dynamics of humanitarian funding restrictions, health system capacity and governance structures confront achieving these requirements. Nevertheless, pioneering projects which use available resources are possible. Evidence is needed to understand the impact of CHWs’ interventions and further support implementation across humanitarian contexts.

PMID:37407227 | DOI:10.1136/bmjgh-2023-011837

Fam Process. 2023 Jul 5:e12914. doi: 10.1111/famp.12914. Online ahead of print.

ABSTRACT

Relationship dissolution is a critical life event individuals have to cope with. Factors like relationship duration and relationship quality or having a new partner are likely to affect how people recover emotionally from a separation, which is linked to long-term adjustment. However, prospective evidence on the role of these factors is scarce. Hence, this study aims to investigate predictors of emotional recovery following relationship dissolution. Pooled data of the German Family Panel pairfam on 3734 separation events of 2709 individuals aged 18 to 48 were used, applying a statistical model called seemingly unrelated regressions to predict emotional outcomes (relief, anger, guilt, and sadness) and the general emotional state regarding separation. Sociodemographic and relationship characteristics, indicators of relationship quality, conditions of the separation, and features of the current situation were considered as potential predictors. Regression analyses evidence strong links of initiator status, having a new partner, time since separation, and satisfaction with the social network to less negative emotional outcomes following separation. Relationship quality or serious problems before the separation only affected some of the investigated emotional outcomes. Interestingly, the predictors investigated were less powerful in explaining respondents’ feelings of guilt compared to the other emotions. Overall, these findings provide deeper insight into short-term adjustment to separation. Understanding these processes may help to assess risk factors for negative coping mechanisms and improve tailored counseling strategies.

PMID:37407225 | DOI:10.1111/famp.12914