Tag: statistics

PLoS One. 2023 Mar 14;18(3):e0280921. doi: 10.1371/journal.pone.0280921. eCollection 2023.

ABSTRACT

INTRODUCTION: Medical students should act as a model for the community in terms of compliance with preventive practices toward COVID-19. The aim of this study was to assess adherence to preventive behaviors related to COVID-19 among medical students and to identify its associated factors.

POPULATION AND METHODS: We conducted a cross-sectional survey in October 2020 in the faculty of medicine of Monastir. We included a representative sample of medical students during registration days for the 2020-2021 academic year. The data were collected through a self-administered anonymous questionnaire. Eleven items related to preventive practices against COVID-19 were assessed (respiratory hygiene practices (Six Item), hand hygiene practices (Three Items) and social distancing (two items)). Items were evaluated using a Likert scale of five points (from 0: (Never) to 4: (Always)). The score obtained from the sum of these items allowed to classify students into two categories: “Good compliance” if the score was ≥ 80% and “Poor compliance” if the score was less than 80%. Scores were compared according to the study population characteristics. Multivariate analysis was used to identify associated factors with good practices. The threshold of statistical significance was set at p < 0.05.

RESULTS: We included 678 medical students. The average age was 21.76 (SD = 1.89 years) with a sex ratio of 0.40. The protection measures most respected by the participants were related to the respiratory hygiene: correct coverage of the nose and mouth with the mask (80%), wearing masks regardless of the presence of symptoms (73.3%) and coverage of the mouth during coughing or sneezing (76.6%). Adherence to hand hygiene measures ranged from 51.4% to 66.3%. The least respected measures were related to social distancing: distancing of at least one meter from others (31.2%) and avoiding crowded places (42.5%). An overall score ≥ 80% was obtained among 61.5% of students. Referring to multivariate analysis, variables that positively affected the overall score of preventive measures related to COVID-19 were the female sex and living alone, with Beta coefficients of 3.82 and 1.37 respectively. The perceived level of stress, E-cigarette and Chicha consumption negatively affected the score with Beta coefficients of (-0.13), (-5.11) and (-2.33) respectively.

CONCLUSION: The level of adherence to good practice among medical students was overall moderate. Awareness programs would be needed in this population, especially for men and those who smoke and vape.

PMID:36917588 | DOI:10.1371/journal.pone.0280921

PLoS One. 2023 Mar 14;18(3):e0281663. doi: 10.1371/journal.pone.0281663. eCollection 2023.

ABSTRACT

This study aims to assess the influence of internal and external factors on the Efficiency of banks in Pakistan using the Data Envelopment Analysis Approach (DEA). Bank’s Efficiency is measured through DEA Model using input and output variables. The input variable includes the number of employees, number of branches, administration expenses, non-interest expenses, and loan loss provisions. In contrast, the output variable consists of net interest income, net commissions, and total other income. This study considers the internal determinants of the bank’s Efficiency as corporate governance, enterprise risk management, ownership structure (state, foreign, and domestic ultimate owned banks), return on equity, financial leverage, and the size of the bank. The external determinants of the bank’s Efficiency include banking structure and macroeconomic conditions. The study has used data from seventeen commercial banks over the period of 2011 to 2020. The study used the Data Envelopment Analysis Approach (DEA) and Logit and Probit Regression Model to evaluate research hypotheses. The Logit model results show that corporate governance, ultimate global ownership, and return on equity have a statistically significant and positive impact on the bank’s Efficiency. Enterprise risk management and financial leverage adversely affect the bank’s Efficiency. Better corporate governance can help banks to control the risk and cost of capital and enhancement the effectiveness of capital. Similarly, better risk management of banks can lead to better operational and strategic decisions in the competitive banking environment.

PMID:36917587 | DOI:10.1371/journal.pone.0281663

PLoS One. 2023 Mar 14;18(3):e0279624. doi: 10.1371/journal.pone.0279624. eCollection 2023.

ABSTRACT

BACKGROUND: Insomnia is a prevalent sleep disorder that affects people all over the world. Creating suitable interventions will require a better understanding of the magnitude and determinants of insomnia. This study aimed to assess the prevalence and associated factors of insomnia symptoms among residents of Mettu town during the pandemic lockdown.

METHODOLOGY: A community-based cross-sectional study was conducted among residents of Mettu town from October 1st to October 15th, 2020. Residents who lived in Mettu town at least for six months were included. To determine the prevalence and determinants of insomnia symptoms, both descriptive and inferential analyses were used. The chi-squared test of association and logistic regression was used to identify predictors of insomnia symptoms among residents of Mettu town. We used SPSS version 25 for all statistical analyses.

PRINCIPAL FINDINGS: The prevalence of depressive symptoms among residents of Mettu town was 52.6%. According to results of multivariable binary logistic regression, being female [AOR = 3.677, 95%CI: 2.124-6.365], being aged between 19 and 40 [AOR = 13.261, 95%CI: 6.953-25.291], being aged above 41 [AOR = 2.627, 95%CI: 1.120-6.159], smoking [AOR = 15.539, 95%CI: 7.961-30.329], satisfaction with information available [AOR = 0.310, 95%CI: 0.168-0.570], fear Corona Virus Disease 2019 (COVID-19), [AOR = 2.171, 95%CI: 1.262-3.733], feeling alienated from others [AOR = 3.288, 95%CI: 1.897-5.699], having somatic symptoms [AOR = 2.298, 95% CI: 1.360-3.884], having depressive symptoms [AOR = 1.841, 95% CI: 1.073-3.160], and experiencing psychological distress [AOR = 1.962, 95% CI: 1.173-3.281] were significantly associated with insomnia symptoms.

CONCLUSION: In this study, the prevalence of insomnia symptoms was found to be high among residents of Mettu town. Being female, being aged between 19 and 40, being aged above 41 years, smoking, fear of Corona Virus Disease 2019, feeling alienated from others, having somatic symptoms, having depressive symptoms, and experiencing psychological distress were all associated with an increased risk of developing insomnia symptoms while being satisfied with the information available decreased the risk of insomnia symptoms among residents of Mettu town. Interventions should be put in place to promote healthy sleep among residents of Mettu town.

PMID:36917577 | DOI:10.1371/journal.pone.0279624

Equine Vet J. 2023 Mar 14. doi: 10.1111/evj.13934. Online ahead of print.

ABSTRACT

BACKGROUND: Equestrian eventing is a dangerous Olympic sport, with 16 rider and 69 horse fatalities at competition in the last 10 years. Despite this, there is limited research that aims to improve safety within the sport.

OBJECTIVES: The purpose of this study was to identify risk factors for horse falls, which are the leading cause of rider fatality within the sport.

STUDY DESIGN: Retrospective cohort study.

METHODS: Competition data between January 2005 and December 2015 were analysed. Descriptive statistics followed by univariable logistic regression to identify risk factors for inclusion in a multivariable logistic regression model were conducted. Models were constructed stepwise using a bi-directional process and assessed using the Akaike Information Criterion. A total of 749 534 cross-country starts were analysed for association with the risk of horse falls.

RESULTS: Sixteen risk factors were identified including: higher event levels, higher dressage penalties and higher number of days since horses’ last start. For example, horse and rider combinations competing at BE100 (OR 1.64, CI 1.37-1.96, p < 0.001), Novice (OR 3.58, CI 3.03-4.24, p < 0.001), Intermediate (OR 8.00, CI 6.54-9.78, p < 0.001), Advanced (OR 12.49, CI 9.42-16.57, p < 0.001) and International (OR 4.63, CI 3.50-6.12, p < 0.001) all had a higher risk of having a horse fall in comparison to combinations competing at BE90 level. Furthermore, for every additional 10 dressage penalties awarded to a horse and rider combination, there was a higher risk of a horse fall (OR 1.20, CI 1.12-1.28, p < 0.001).

MAIN LIMITATIONS: The study is not geographically comprehensive (UK only) and does not include any information on training activity of horses and riders.

CONCLUSIONS: This is the largest-scale study ever conducted on horse falls during eventing competition. Study results can be utilised by sport governing bodies to inform policy which has the potential to reduce the risk of injury and fatality to sport participants. This article is protected by copyright. All rights reserved.

PMID:36917550 | DOI:10.1111/evj.13934

JMIR Res Protoc. 2023 Mar 14;12:e41040. doi: 10.2196/41040.

ABSTRACT

BACKGROUND: Digital transformation is impacting health care delivery. Great market dynamism is bringing opportunities and concerns alike into public discussion. Digital health apps are a vibrant segment where regulation is emerging, with Germany paving the way with its DiGA (Digitale Gesundheitsanwendungen, in German, meaning digital health apps) program. Simultaneously, mental ill-health constitutes a global health concern, and prevalence is expected to worsen due to the COVID-19 pandemic and its containment measures. Portugal and its National Health System may be a useful testbed for digital health interventions.

OBJECTIVE: The paper outlines the protocol for a research project on the attitudes of physicians and potential users toward digital mental health apps to improve access to care, patient outcomes, and reduce the burden of disease of mental ill-health.

METHODS: Web surveys will be conducted to acquire data from the main stakeholders (physicians and the academic community). Data analysis will replicate the statistical analysis performed in the studies from Dahlhausen and Borghouts to derive conclusions regarding the relative acceptance and likelihood of successful implementation of digital mental health apps in Portugal.

RESULTS: The findings of the proposed studies will elicit important information on how physicians and individuals perceive digital mental health app interventions to improve access to care, patient outcomes, and reduce the burden of disease of mental ill-health. Data collection ran between September 26 and November 6, 2022, for the first study and September 20 and October 20, 2022, for the second study. We obtained 160 responses to the first study’s survey and 539 answers to the second study’s survey. Data analysis is concluded, and both studies’ results are expected to be published in 2023.

CONCLUSIONS: The results of the studies projected in this research protocol will have implications for researchers and academia, industry, and policy makers concerning the adoption and implementation of digital health mental apps and associated interventions.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/41040.

PMID:36917172 | DOI:10.2196/41040

Brief Bioinform. 2023 Mar 14:bbad092. doi: 10.1093/bib/bbad092. Online ahead of print.

ABSTRACT

Metagenomic sequencing (mNGS) is a powerful diagnostic tool to detect causative pathogens in clinical microbiological testing owing to its unbiasedness and substantially reduced costs. Rapid and accurate classification of metagenomic sequences is a critical procedure for pathogen identification in dry-lab step of mNGS test. However, clinical practices of the testing technology are hampered by the challenge of classifying sequences within a clinically relevant timeframe. Here, we present GPMeta, a novel GPU-accelerated approach to ultrarapid pathogen identification from complex mNGS data, allowing users to bypass this limitation. Using mock microbial community datasets and public real metagenomic sequencing datasets from clinical samples, we show that GPMeta has not only higher accuracy but also significantly higher speed than existing state-of-the-art tools such as Bowtie2, Bwa, Kraken2 and Centrifuge. Furthermore, GPMeta offers GPMetaC clustering algorithm, a statistical model for clustering and rescoring ambiguous alignments to improve the discrimination of highly homologous sequences from microbial genomes with average nucleotide identity >95%. GPMetaC exhibits higher precision and recall rate than others. GPMeta underlines its key role in the development of the mNGS test in infectious diseases that require rapid turnaround times. Further study will discern how to best and easily integrate GPMeta into routine clinical practices. GPMeta is freely accessible to non-commercial users at https://github.com/Bgi-LUSH/GPMeta.

PMID:36917170 | DOI:10.1093/bib/bbad092

JMIR Public Health Surveill. 2023 Mar 14;9:e44274. doi: 10.2196/44274.

ABSTRACT

BACKGROUND: Cognitive and gait speed decline are common conditions in older adults and are often associated with future adverse consequences. Although an association between cognitive function and gait speed has been demonstrated, its temporal sequence remains unclear, especially in older Chinese adults. Clarifying this could help identify interventions to improve public health in older adults.

OBJECTIVE: This study aims to examine the longitudinal reciprocal association between gait speed and cognitive function and the possible temporal sequence of changes in both factors in a national longitudinal cohort.

METHODS: Data were derived from 2 waves (2011 baseline and 2015 follow-up) of the China Health and Retirement Longitudinal Study (CHARLS). Participants 60 years or older, without dementia or Parkinson disease at baseline, and with completed data on gait speed and cognition at both baseline and follow-up were included. Usual gait speed was measured over two 2.5-m walks. Mental intactness and episodic memory were used to assess global cognitive function. Cross-lagged panel models and linear mixed-effects models were used to examine the association between cognition and gait speed over time. Standardized coefficients were reported.

RESULTS: A total of 3009 participants (mean age 66.4 years, SD 5.4 years; 1422/3009, 47.26%, female participants) were eligible for inclusion in our analyses. Cross-lagged panel analyses revealed that after accounting for baseline gait speed, cognition, and potential confounders, baseline global cognition (β=.117, 95% CI 0.082-0.152; P<.001), mental intactness (β=.082, 95% CI 0.047-0.118; P<.001), and episodic memory (β=.102, 95% CI 0.067-0.137; P<.001) were associated with subsequent gait speed. Simultaneously, baseline gait speed was also associated with subsequent global cognition (β=.056, 95% CI 0.024-0.087; P=.001), mental intactness (β=.039, 95% CI 0.008-0.069; P=.01), and episodic memory (β=.057, 95% CI 0.023-0.092; P=.001). The comparison of standardized cross-lagged coefficients suggested that the effect size of baseline global cognition on subsequent gait speed was significantly larger than the reverse effect (χ₁²=6.50, P for difference=.01). However, the effects of both mental intactness and episodic memory on subsequent gait speed were not significantly stronger than those of the reverse pathway (χ₁²=3.33, P for difference=.07 and χ₁²=3.21, P for difference=.07). Linear mixed-effects analyses further supported these bidirectional relationships, revealing that lower baseline cognitive scores predicted steeper declines in gait speed trajectory, and slower baseline gait speed predicted more declines in cognitive trajectory over time.

CONCLUSIONS: There is a longitudinal bidirectional association between usual gait speed and both global cognitive function and specific domains of mental intactness and episodic memory among Chinese older adults. Baseline global cognition is likely to have a stronger association with subsequent gait speed than the reverse pathway. This interlinkage is noteworthy and may have implications for public health. Maintaining normal cognitive function may be an important interventional strategy for mitigating age-related gait speed reduction.

PMID:36917163 | DOI:10.2196/44274

Int J Surg. 2023 Mar 15. doi: 10.1097/JS9.0000000000000321. Online ahead of print.

ABSTRACT

OBJECTIVE: comparison of the perioperative outcomes of laparoscopic retroperitoneal lymph node dissection (L-RPLND) and open retroperitoneal lymph node dissection (O-RPLND) for low-stage (stage I/II) testicular germ cell tumors.

METHODS: We performed a systematic review and cumulative meta-analysis of the primary outcomes of interest according to PRISMA criteria, and the quality assessment of the included studies followed the AMSTAR guidelines. Four databases were searched, including Embase, PubMed, Cochrane Library, and Web of Science. The search period was from the creation of each database to October 2022. The statistical analysis software uses Stata17.

RESULTS: There were nine studies involving 579 patients. Compared with O-RPLND, L-RPLND was associated with shorter length of stay (WMD=-3.99, 95% CI [-4.80, -3.19], P<0.05), less estimated blood loss (WMD=-0.95, 95% CI [-1.35, -0.54], P<0.05), shorter time to oral intake after surgery (WMD=-0.77, 95% CI [-1.50, -0.03], P<0.05), and lower overall complications (OR=0.58, 95% CI [0.38, 0.87], P<0.05). Subgroup analysis found that the complication rate of Clavien-Dindo grade II was lower in L-RPLND (OR=0.24, 95% CI [0.11, 0.55], P<0.05). Interestingly, there was no statistically significant difference between the two groups in terms of operation time, lymph node yields, and recurrence rate during follow-up.

CONCLUSION: Laparoscopic retroperitoneal lymph node dissection is superior to open retroperitoneal lymph node dissection and is worthy of clinical promotion.

PMID:36917132 | DOI:10.1097/JS9.0000000000000321

Int J Surg. 2023 Mar 15. doi: 10.1097/JS9.0000000000000202. Online ahead of print.

ABSTRACT

BACKGROUND: The SARS-CoV-2 pandemic is estimated to have claimed more than 6 million lives globally since it started in 2019. Germany was exposed to two waves of COVID-19 during 2020, one starting in April and the other in October. To ensure sufficient capacity for COVID-19 patients in intensive care units, elective medical procedures were postponed. The fraction of major abdominal cancer resections affected by these measures remains unknown, and the most affected patient cohort has yet to be identified.

METHODS: This is a register-based, retrospective, nationwide cohort-study of anonymized “diagnosis related groups” (DRG) billing data provided by the Federal Statistical Office in Germany. Cases were identified using diagnostic and procedural codes for major cancer resections. Population-adjusted cancer resection rates as primary endpoint were compared at baseline (2012-2019) to those in 2020.

RESULTS: A change in resection rates for all analyzed entities (esophageal, gastric, liver, pancreatic, colon, rectum, and lung cancer) was observed from baseline to 2020. Total monthly oncological resections dropped by 7.4% (8.7% normalized to the annual German population, P=0.011). Changes ranged from +3.7% for pancreatic resections (P=0.277) to -19.4% for rectal resections (P<0.001). Reductions were higher during lockdown periods. During the first lockdown period (April thru June), the overall drop was 14.3% (8.58 per 100,000 vs 7.35 per 100,000, P<0.001). There was no catch-up effect during summer months except for pancreatic cancer resections. In the second lockdown period, there was an overall drop of 17.3%. In subgroup analyses, the elderly were most affected by the reduction in resection rates. There was a significant negative correlation between regional SARS-CoV-2-incidences and resections rates. This correlation was strongest for rectal cancer resections (spearman r: -0.425, P<0.001).

CONCLUSIONS: The pandemic lockdowns had a major impact on oncological surgical caseload in Germany in 2020. The elderly were most affected by the reduction. There was a clear correlation between SARS-CoV-2-incidences regionally and the reduction of surgical resection rates. In future pandemic circumstances, oncological surgery has to be prioritized with an extra focus on the most vulnerable patients.

PMID:36917131 | DOI:10.1097/JS9.0000000000000202

J Craniofac Surg. 2023 Mar 13. doi: 10.1097/SCS.0000000000009229. Online ahead of print.

ABSTRACT

BACKGROUND: Chin augmentation (CA) is important treatment modality for microgenia. The use of implantable alloplastic biomaterials in CA grows in popularity, and there is no verifiable documentation of patients’ satisfaction about CA with Medpor (CAWM) exists in the literature, this study examined effectiveness of CAWM by analyzing patient satisfaction.

METHODS: Patients had undergone CAWM were followed up postoperatively. Occurrence of complications was collected, patients’ satisfactions with chin shape and surgical decision were analyzed using FACE-Q scales, the reliability of operation was studied through analyzing the statistics, and the influences of sex and follow-up time on satisfaction were compared.

RESULTS: One hundred ten patients who had undergone CAWM received FACE-Q scales and 64 valid questionnaires were collected. 61 (95.3%) showed high satisfaction with chin shape after CAWM (Cronbach α coefficients were all above 0.8), the median values of satisfaction of chin shape and decision making were 85 (67, 100) and 100 (75,100), respectively. The median chin satisfactions of females and males were 87 (67, 100), 79 (61,100). The median chin satisfactions of patients had surgery before 2 years ago and within 2 years were 81 (67, 100), 87 (64,100), respectively. During the follow-up, among 110, 1 (0.91%) developed graft-related infection and 1 (0.91%) developed an allergic reaction, 1 (0.91%) underwent prosthesis removal because dissatisfaction with chin shape.

CONCLUSIONS: Chin augmentation with prothesis is a safe and efficacious way to improve microgenia. Medpor is the desired implant material with less infection, displacement and bone absorption, which is worthy of promotion and further study in CA surgery.

PMID:36917098 | DOI:10.1097/SCS.0000000000009229