Tag: statistics

J Liver Cancer. 2021 Mar;21(1):58-68. doi: 10.17998/jlc.21.1.58. Epub 2021 Mar 31.

ABSTRACT

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer-related death in Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2015.

METHODS: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative sample of patients newly diagnosed with HCC in Korea, were analyzed. A total of 1,558 patients with HCC registered in the KPLCR in 2015 were investigated.

RESULTS: The median age was 61.0 years (interquartile range, 54.0-70.0 years), and men accounted for 79.7% of the subjects. Hepatitis B virus infection was the most common underlying liver disease (58.1%). According to the Barcelona Clinic Liver Cancer (BCLC) staging system, stage 0, A, B, C, and D HCCs accounted for 14.2%, 31.5%, 7.6%, 39.0%, and 7.8% of patients, respectively. Transarterial therapy (32.1%) was the most commonly performed initial treatment, followed by surgical resection (23.2%), best supportive care (20.2%), and local ablation therapy (10.7%). Overall, 34.5% of patients were treated in accordance with the BCLC guidelines: 59.2% in stage 0/A, 48.4% in stage B, 18.1% in stage C, and 71.6% in stage D. The 1-, 3-, and 5-year OS rates were 67.1%, 50.9%, and 27.0%, respectively.

CONCLUSIONS: In 2015, approximately 45% of Korean HCC cases were diagnosed at a very early or early stage, and 35% of patients underwent potentially curative initial treatment. BCLC guidance was followed in 34.5% of patients; in patients with stage B or C disease, there was relatively low adherence.

PMID:37384267 | PMC:PMC10035724 | DOI:10.17998/jlc.21.1.58

Lancet Reg Health Southeast Asia. 2022 Jun 9;3:100016. doi: 10.1016/j.lansea.2022.05.005. eCollection 2022 Aug.

ABSTRACT

BACKGROUND: Previous literature suggests that thrombosis is more common in lowlanders sojourning at high altitude (HA) compared to near-sea-level. Though the pathophysiology is partly understood, little is known of its epidemiology. To elucidate this, an observational prospective longitudinal study was conducted in healthy soldiers sojourning for months at HA.

METHODS: A total of 960 healthy male subjects were screened in the plains, of which 750 ascended, to altitudes above 15,000ft (4,472m). Clinical examination, haemogram, coagulogram, markers of inflammation and endothelial dysfunction, were studied at three time points during ascent and descent. The diagnosis of thrombosis was confirmed radiologically in all cases where a thrombotic event was suspected clinically. Subjects developing thrombosis at HA were labelled as Index Cases (ICs) and compared to a nested cohort of the healthy subjects (comparison group,(CG)) matched for altitude of stay.

FINDINGS: Twelve and three subjects, developed venous (incidence: 5,926/10⁵ person-years) and arterial (incidence: 1,482/10⁵ person-years) thrombosis at HA, respectively. The ICs had enhanced coagulation (FVIIa: p<0.001; FXa: p<0.001) and decreased levels of natural anticoagulants (thrombomodulin, p=0.016; tissue factor pathway inhibitor [TFPI]: p<0.001) and a trend to dampened fibrinolysis (tissue plasminogen activator tPA; p=0.078) compared to CG. ICs also exhibited statistically significant increase in the levels of endothelial dysfunction and inflammation markers (vascular cell adhesion molecule-1[VCAM-1], intercellular adhesion molecule-1 [ICAM-1], vascular endothelial growth factor receptor 3 [VEGFR-3], P-Selectin, CD40 ligand, soluble C-reactive protein and myeloperoxidase: p<0.001).

INTERPRETATION: The incidence of thrombosis in healthy subjects at HA was higher than that reported in literature at near sea-level. This was associated with inflammation, endothelial dysfunction, a prothrombotic state and dampened fibrinolysis.

FUNDING: Research grants from the Armed Forces Medical Research Committee, Office of the Director General of Armed Forces Medical Services (DGAFMS) & Defence Research and Development Organization (DRDO), Ministry of Defence, India.

PMID:37384264 | PMC:PMC10306047 | DOI:10.1016/j.lansea.2022.05.005

Risk Manag Healthc Policy. 2023 Jun 22;16:1131-1143. doi: 10.2147/RMHP.S406491. eCollection 2023.

ABSTRACT

PURPOSE: The present study assessed the awareness of the public about Biju Swasthya Kalyan Yojana (BSKY), which is a flagship public-funded health insurance scheme of the Government of Odisha. The study also identified its determinants and examined utilisation of the scheme among households in Khordha district of Odisha.

MATERIALS AND METHODS: Primary data were collected from randomly chosen 150 households using a pretested structured questionnaire from Balipatana block of Khordha district, Odisha. Descriptive statistics and binomial logistic regression were used to substantiate the objectives.

RESULTS: The study found that even though 56.70% of the sample households had heard about BSKY, procedure-specific awareness was low. State government organised BSKY health insurance camp was found to be a major source of knowledge among the sample. The regression model had an R² of 0.414. The Chi² value showed that the model with predictor variables was a good fit. Caste, gender, economic category, health insurance, and awareness about insurance were significant determinants of BSKY awareness. A majority (79.30%) of the sample had the scheme card with them. However, only 12.60% of the cardholders used the card and only 10.67% received benefits. Mean out-of-pocket expenditure (OOPE) faced by the beneficiaries is Rs. 15743.59. Among the beneficiaries, 53.80% financed the OOPE from their savings, 38.50% by borrowing, and 7.70% financed the OOPE by both means.

CONCLUSION: The study found that even though majority of people had heard about BSKY, they were not aware of its nature, features, and operational procedures. The trend of low benefit received and higher OOPE among the scheme beneficiaries hampers the economic health of the poor. Finally, the study highlighted the need to increase the magnitude of scheme coverage and administrative efficiency.

PMID:37384257 | PMC:PMC10293795 | DOI:10.2147/RMHP.S406491

Front Cell Dev Biol. 2023 Jun 13;11:1198148. doi: 10.3389/fcell.2023.1198148. eCollection 2023.

ABSTRACT

Introduction: The developing epigenome changes rapidly, potentially making it more sensitive to toxicant exposures. DNA modifications, including methylation and hydroxymethylation, are important parts of the epigenome that may be affected by environmental exposures. However, most studies do not differentiate between these two DNA modifications, possibly masking significant effects. Methods: To investigate the relationship between DNA hydroxymethylation and developmental exposure to common contaminants, a collaborative, NIEHS-sponsored consortium, TaRGET II, initiated longitudinal mouse studies of developmental exposure to human-relevant levels of the phthalate plasticizer di(2-ethylhexyl) phthalate (DEHP), and the metal lead (Pb). Exposures to 25 mg DEHP/kg of food (approximately 5 mg DEHP/kg body weight) or 32 ppm Pb-acetate in drinking water were administered to nulliparous adult female mice. Exposure began 2 weeks before breeding and continued throughout pregnancy and lactation, until offspring were 21 days old. At 5 months, perinatally exposed offspring blood and cortex tissue were collected, for a total of 25 male mice and 17 female mice (n = 5-7 per tissue and exposure). DNA was extracted and hydroxymethylation was measured using hydroxymethylated DNA immunoprecipitation sequencing (hMeDIP-seq). Differential peak and pathway analysis was conducted comparing across exposure groups, tissue types, and animal sex, using an FDR cutoff of 0.15. Results: DEHP-exposed females had two genomic regions with lower hydroxymethylation in blood and no differences in cortex hydroxymethylation. For DEHP-exposed males, ten regions in blood (six higher and four lower) and 246 regions (242 higher and four lower) and four pathways in cortex were identified. Pb-exposed females had no statistically significant differences in blood or cortex hydroxymethylation compared to controls. Pb-exposed males, however, had 385 regions (all higher) and six pathways altered in cortex, but no differential hydroxymethylation was identified in blood. Discussion: Overall, perinatal exposure to human-relevant levels of two common toxicants showed differences in adult DNA hydroxymethylation that was specific to sex, exposure type, and tissue, but male cortex was most susceptible to hydroxymethylation differences by exposure. Future assessments should focus on understanding if these findings indicate potential biomarkers of exposure or are related to functional long-term health effects.

PMID:37384255 | PMC:PMC10294071 | DOI:10.3389/fcell.2023.1198148

Res Pract Thromb Haemost. 2023 May 24;7(4):100194. doi: 10.1016/j.rpth.2023.100194. eCollection 2023 May.

ABSTRACT

BACKGROUND: Inherited protein S deficiency is a thrombophilic risk factor associated with venous thromboembolism. However, there is not much data on the impact of mutation position on thrombotic risk.

OBJECTIVES: The aim of this study was to evaluate the risk of thrombosis due to mutations located in the sex hormone-binding globulin (SHBG)-like region as opposed to the rest of the protein.

METHODS: Genetic analysis of PROS1 was performed in 76 patients with suspected inherited protein S deficiency, and the effect of missense mutations present in the SHBG region on thrombosis risk was analyzed by statistical methods.

RESULTS: We found 30 unique mutations (13 of them novel), of which 17 were missense mutations, in 70 patients. Patients with missense mutations were then divided into 2 groups: the “SHBG-region” mutation group (27 patients) and the “non-SHBG” group (24 patients). The multivariable binary logistic regression analysis showed that mutation position in the SHBG region of protein S is an independent risk factor for thrombosis in deficient patients (OR, 5.17; 95% CI, 1.29-20.65; P = .02). The patients with a mutation in the SHBG-like region also developed a thrombotic event at a younger age compared to the “non-SHBG” group in the Kaplan-Meier analysis (median thrombosis-free survival of 33 vs 47 years, respectively; P = .018).

CONCLUSION: Our findings show that a missense mutation located in the SHBG-like region may contribute to higher thrombotic risk rather than a missense mutation located elsewhere in the protein. However, as our cohort was relatively small, these findings should be taken with this limitation.

PMID:37384225 | PMC:PMC10293767 | DOI:10.1016/j.rpth.2023.100194

SAGE Open Med. 2023 Jun 25;11:20503121231178047. doi: 10.1177/20503121231178047. eCollection 2023.

ABSTRACT

OBJECTIVE: Most multiple sclerosis patients have urological complications such as lower urinary tract symptoms. This study was conducted to evaluate the prevalence of these symptoms and whether they result in a urological evaluation.

METHODS: A cross-sectional study of 517 multiple sclerosis patients at Tehran’s referral multiple sclerosis center and neurology clinics between 2018 and 2022 was performed. Data were collected through interviews after patients completed informed consent forms. Urological examinations, including urine analysis and ultrasonography, were evaluated as final assessments. The data were analyzed using descriptive and inferential statistical tests in Statistical Package for Social Science.

RESULTS: Among all participants, the prevalence of lower urinary tract symptoms was 73% (n = 384), with urgency (44.8% n = 232) being the most common symptom. The prevalence of intermittency was significantly higher among women (p = 0.004). There was no gender-significant difference in terms of the prevalence of other symptoms (p > 0.050). Lower urinary tract symptoms were significantly correlated with age, clinical course, disease duration, and disability (p < 0.001). Additionally, 37.3% and 18.7% of patients with lower urinary tract symptoms, as well as 17.9% and 37.5% of patients with multiple sclerosis attacks, respectively, had undergone urine analysis and ultrasonography.

CONCLUSION: Multiple sclerosis patients rarely undergo urological evaluations during the course of their disease. Proper assessment is essential as these symptoms are among the most detrimental manifestations of this disease.

PMID:37384196 | PMC:PMC10293526 | DOI:10.1177/20503121231178047

Front Psychol. 2023 Jun 13;14:1140959. doi: 10.3389/fpsyg.2023.1140959. eCollection 2023.

ABSTRACT

Based on previous literature, the present study examines the effects of background music on English reading comprehension using eye tracking techniques. All the participants, whose first language was Chinese, were selected from a foreign language college and all of them were sophomores who majored in English. The experiment in this study was a 2 (music tempo: fast and slow) × 2 (text difficulty: difficult and easy) × 2 (background music preference: high and low) mixed design. Both musical tempo and English reading passage were within-subjects factors, and the level of music listening preference was a between-subjects factor. The results showed that the main effect of the music tempo was statistically significant, which indicated that participants read texts more quickly in the fast-tempo music condition than in the slow-tempo music condition. Furthermore, the main effect of the text difficulty was statistically significant. Additionally, the interaction between the text difficulty and music tempo was statistically significant. The music tempo had a greater effect on easy texts than on difficult texts. The results of this study reveal that it is beneficial for people who have a stronger preference for music listening to conduct English reading tasks with fast-tempo music. It is detrimental for people who have little preference for background music listening to complete difficult English reading tasks with slow-tempo music.

PMID:37384187 | PMC:PMC10294666 | DOI:10.3389/fpsyg.2023.1140959

PEC Innov. 2023 May 26;2:100170. doi: 10.1016/j.pecinn.2023.100170. eCollection 2023 Dec.

ABSTRACT

OBJECTIVE: This article details the development of an interdisciplinary graduate medical education (GME) narrative curriculum.

METHODS: Descriptive statistics were conducted for the narrative session surveys. Two separate qualitative analyses were conducted. First, content and thematic analyses of the open-ended questions in the survey using NVIVO software occurred. Second, an inductive analysis of the participants’ 54 stories was performed to identify unique themes not related to the prompt topics.

RESULTS: Quantitative survey results demonstrated that 84% of learners’ felt the session benefited their personal or professional sense of wellbeing and resilience, 90% of learners believed the sessions aided in their ability to listen more effectively, and 86% of learners could apply what they practiced or witnessed. Qualitative analysis of survey data showed learners focused on patient care and listening. Thematic analysis of participants’ narratives revealed strong feelings and emotions, struggles with time management, increase in self- and other-awareness, and challenges managing job-life balance.

CONCLUSION: The longitudinal interdisciplinary Write-Read-Reflect narrative exchange curriculum is cost-effective, sustainable, and demonstrably valuable to learners and their program directors across multiple disciplines.

INNOVATION: The program was designed for 4 graduate programs’ learners to simultaneously experience a narrative exchange model to improve patient-provider communication, support professional resilience, and deepen relationship-centered care skills.

PMID:37384161 | PMC:PMC10294085 | DOI:10.1016/j.pecinn.2023.100170

J Paediatr Child Health. 2023 Jun 29. doi: 10.1111/jpc.16462. Online ahead of print.

ABSTRACT

AIMS: The aim of this study was to characterise and compare the biopsychosocial characteristics of children admitted with failure to thrive (FTT), subdivided into those with underlying medical complexities (categorised as organic FTT – OFTT) and those with none (categorised as non-organic FTT – NOFTT), with a focus on the medical, nutritional, feeding skills and psychosocial domains.

METHODS: A retrospective review of medical records was conducted in children admitted with FTT from January 2010 to December 2020. Descriptive statistics were used for data analysis.

RESULTS: A total of 353 children were included, with the mean age of presentation 0.82 ± 2.05 years (OFTT 1.16 ± 2.50 years, NOFTT 0.49 ± 1.41 years, P = 0.002). Approximately, half of the children were classified as having OFTT. These children had lower birth weights, were more likely to have a history of intrauterine growth restriction and had longer hospital stays. The NOFTT group had significantly more abnormal feeding strategies identified in their caregivers, whereas the OFTT group had more delayed feeding skills and oral aversion. There was no significant difference in psychosocial domains, with both groups having a comparably high risk of abuse and neglect.

CONCLUSIONS: The classification of FTT as non-organic or organic based purely on psychosocial parameters did not reflect the complex nature of FTT within our local population. These groups had different medical variables, and caregiver feeding strategies. A multidisciplinary team approach is recommended for the assessment and intervention for children with FTT to address these domains and the complex interactions between them.

PMID:37382081 | DOI:10.1111/jpc.16462

Sarcoidosis Vasc Diffuse Lung Dis. 2023 Jun 29;40(2):e2023022. doi: 10.36141/svdld.v40i2.14017.

ABSTRACT

BACKGROUND: In Primary Health Care (PHC) many interstitial lung disease (ILD) cases may remain at diagnostic delay, due to their challenging presentation and the limited experience of general practitioners (GPs) in recognizing their early symptoms.

OBJECTIVE: We have designed a feasibility study to investigate early ILD case-finding competency between PHC and tertiary care.

METHODS: A cross-sectional prospective case-finding study was launched at two private health care centers of Heraklion, Crete, Greece, during nine months (2021-2022). After clinical assessment by GP, PHC attenders, who agreed to participate in the study, were referred to the Respiratory Medicine Department, University Hospital of Heraklion, Crete, underwent Lung Ultrasound (LUS) and those with an overall suspicion for ILDs underwent high resolution computed tomography (HRCT) scan. Descriptive statistics and chi-square tests were used. Multiple Poisson regression analysis was performed to explain positive LUS and HRCT decision with selected variables.

RESULTS: One hundred and nine patients out of 183 were finally included (54.1% females; mean age 61, SD: 8.3 years). Thirty-five (32.1%) were current smokers. Overall, two out of ten cases were assessed to need HRCT due to a moderate or high suspicion (19.3%; 95%CI 12.7, 27.4). However, in those who had dyspnea in relation to counterparts, a significantly higher percentage of patients with LUS findings (57.9% vs. 34.0%, p=0.013) was found, as in those who had crackles (100.0% vs. 44.2%, p= 0.005). Detected possible ILD provisional labelling cases were 6, and most importantly, 5 of those cases were considered highly suspicious for further evaluation based on LUS findings.

CONCLUSIONS: This is a feasibility study exploring potentials by combining data of medical history, basic auscultation skills, as crackles detection, and inexpensive and radiation-free imaging technique, such as LUS. Cases of ILD labeling may be hidden within PHC, sometimes, much before any clinical manifestation.

PMID:37382071 | DOI:10.36141/svdld.v40i2.14017