Tag: statistics

PLoS One. 2023 Mar 23;18(3):e0282634. doi: 10.1371/journal.pone.0282634. eCollection 2023.

ABSTRACT

INTRODUCTION: 3D Non-Contact surface scanning (3DSS) is used in both biomechanical and clinical studies to capture accurate 3D images of the human torso, and to better understand the shape and posture of the spine-both healthy and pathological. This study sought to determine the efficacy and accuracy of using 3DSS of the posterior torso, to determine the curvature of the spinal column in the lateral lying position.

METHODS: A cohort of 50 healthy adults underwent 3DSS and Magnetic Resonance Imaging (MRI) to correlate the contours of the external spine surface with the internal spinal column. The correlation analysis was composed of two phases: (1) MRI vertebral points vs MRI external spine surface markers; and (2) MRI external spine surface markers vs 3DSS external spine surface markers. The first phase compared the profiles of fiducial markers (vitamin capsules) adhered to the skin surface over the spinous processes against the coordinates of the spinous processes-assessing the linear distance between the profiles, and similarity of curvature, in the sagittal and coronal planes. The second phase compared 3DSS external spine surface markers with the MRI external spine surface markers in both planes, with further qualitative assessment for postural changes.

RESULTS: The distance between the MRI vertebral points and MRI external spine surface markers showed strong statistically significant correlation with BMI in both sagittal and coronal planes. Kolmogorov-Smirnov (KS) tests showed similar no significant difference in curvature, k, in almost all participants on both planes. In the second phase, the coronal 3DSS external spine surface profiles were statistically different to the MRI external spine surface markers in 44% of participants. Qualitative assessment showed postural changes between MRI and 3DSS measurements in these participants.

CONCLUSION: These study findings demonstrate the utility and accuracy of using anatomical landmarks overlaid on the spinous processes, to identify the position of the spinal bones using 3DSS. Using this method, it will be possible to predict the internal spinal curvature from surface topography, provided that the thickness of the overlaying subcutaneous adipose layer is considered, thus enabling postural analysis of spinal shape and curvature to be carried out in biomechanical and clinical studies without the need for radiographic imaging.

PMID:36952526 | DOI:10.1371/journal.pone.0282634

PLoS One. 2023 Mar 23;18(3):e0283462. doi: 10.1371/journal.pone.0283462. eCollection 2023.

ABSTRACT

BACKGROUND: The COVID-19 pandemic has brought significant changes worldwide, and due to the strict “Social Distancing Plan” including school closures, Korean adolescents have experienced unprecedented changes in their lives. Considering the peer effect on adolescents’ health behavior impacted due to the changes brought about by the pandemic, it would be interesting to explore differences in substance use in Korean adolescents. This study examines how these risk behaviors among Korean adolescents have changed before and during the COVID-19 pandemic.

METHODS: Korea Youth Risk Behavior Web-based Survey of 87,532 adolescents was used to collect the data for the period 2019, 2020, and 2021. The KYRBWS is conducted by a national institution which uses a stratified two-stage cluster sampling, and the data is statistically reliable and representative of the population. The Cochran-Armitage and Chi-squared test for linear and non-linear time trends, respectively, were calculated to assess the difference across the period (2019, 2020, 2021). Also, the odds ratios (ORs) with 95% CIs for current smoking status and current alcohol use status among 2020 and 2021 participants were compared with those of the 2019 participants using multiple logistic regression analysis.

RESULTS: The degree of current smoking status was lower in 2020 and 2021 participants than in the 2019 participants (2020: OR = 0.66, 95% CI = 0.61-0.71; 2021: OR = 0.66, 95% CI = 0.61-0.71). On the same token, current alcohol use status was also lower in the participants during the pandemic than those before the pandemic (2020: OR = 0.70, 95% CI = 0.66-0.73; 2021: OR = 0.70, 95% CI = 0.66-0.73).

CONCLUSION: This study found that alcohol and tobacco use were reduced among Korean adolescents during the COVID-19 pandemic. Despite the decrease, future research on the potential effects of the COVID-19 pandemic on adolescents is warranted.

PMID:36952498 | DOI:10.1371/journal.pone.0283462

PLoS One. 2023 Mar 23;18(3):e0283146. doi: 10.1371/journal.pone.0283146. eCollection 2023.

ABSTRACT

INTRODUCTION: Heart failure is a growing public health concern around the world. People with heart failure have a high symptom burden, such as depression, which affects health-related quality of life (HRQoL). The objective of this systematic review and meta-analysis was to estimate the pooled prevalence of depression and evaluate its association with HRQoL among people with heart failure in low- and middle-income countries (LMICs).

METHODS: This systematic review was conducted in accordance with the JBI methodology. Electronic databases such as MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, Scopus and JBI EBP were searched to identify relevant studies published from January 2012 to August 2022. The methodological quality of each article was assessed using relevant JBI critical appraisal instruments. A random-effects model was employed to estimate the pooled prevalence of depression. Heterogeneity across the studies was investigated using Cochrane’s Q test and I2 statistic. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines 2020 were followed for reporting the results. All statistical analyses were performed using STATA version 17 software.

RESULTS: After screening, a total of 21 eligible articles with 5074 participants with heart failure were included in this review. The pooled prevalence of depression among people with heart failure in LMICs was 51.5% (95% CI = 39.7, 63.3%, I2 = 99.00%). Subgroup analysis revealed, the highest prevalence in studies whose participants were in-patients, and from the Middle East and North Africa, and studies utilizing Becks Depression Inventory (BDI). Depression was positively associated with HRQoL.

CONCLUSION: This review revealed that almost half of all people with heart failure in low- and middle-income countries have comorbid depression. People with heart failure and depressive symptoms had poor HRQoL. Therefore, early screening of depression is critical for improving HRQoL in this population. Systematic review registration: PROSPERO CRD42022361759.

PMID:36952483 | DOI:10.1371/journal.pone.0283146

PLoS One. 2023 Mar 23;18(3):e0283156. doi: 10.1371/journal.pone.0283156. eCollection 2023.

ABSTRACT

BACKGROUND: Primary healthcare (PHC) systems attain improved health outcomes and fairness and are affordable. However, the proportion of PHC spending to Total Current Health Expenditure in Kenya reduced from 63.4% in 2016/17 to 53.9% in 2020/21 while external funding reduced from 28.3% (Ksh 69.4 billion) to 23.9% (Ksh 68.2 billion) over the same period. This reduction in PHC spending negatively affects PHC performance and the overall health system goals.

METHODS: We conducted a cost-benefit analysis and computed costs against the economic benefits of a PHC scale-up. Activity-Based Costing (ABC) on the provider perspective was employed to estimate the incremental costs. The OneHealth Tool was used to estimate the health impact of operationalizing PHC over five years. Finally, we quantified Return on Investment (ROI) by estimating monetized DALYs based on a constant value per statistical life year (VSLY) derived from a VSL estimate.

RESULTS: The total projected cost of PHC interventions in the Kenya was Ksh 1.65 trillion (USD 15,581.91 billion). Human resource was the main cost driver accounting for 75% of the total cost. PHC investments avert 64,430,316 Disability Adjusted Life-Years (DALYs) and generate cost savings of Ksh. 21.5 trillion (USD 204.4 Billion) over five years. Shifting services from high-level facilities to PHC facilities generates Ksh 198.2 billion (USD 1.9 billion) and yields a benefit-cost ratio of 16:1 in 5 years. Thus, every $1 invested in PHC interventions saves up to $16 in spending on conditions like stunting, NCDs, anaemia, TB, Malaria, and maternal and child health morbidity.

CONCLUSIONS: Evidence of the economic benefits of continued prioritization of funding for PHC can strengthen the advocacy argument for increased domestic and external financing of PHC in Kenya. A well-resourced and functional PHC system translates to substantial health benefits with positive economic benefits. Therefore, governments and stakeholders should increase investments in PHC to accelerate economic growth.

PMID:36952482 | DOI:10.1371/journal.pone.0283156

PLoS One. 2023 Mar 23;18(3):e0280248. doi: 10.1371/journal.pone.0280248. eCollection 2023.

ABSTRACT

BACKGROUND: Socioeconomic status (SES) is an important determinant of screen time (ST) in children and adolescents, however, the association between SES and ST is not fully understood in China. This study aimed to investigate the association between SES and ST (operationalized as meeting the ST guidelines; no more than 2 hours per day) in Chinese children and adolescents.

METHODS: Cross-sectional data of 2,955 Chinese children and adolescents aged 8 to 17(53.4% girls) were used. SES was measured using indicators of parental education and perceived family wealth. ST was assessed with detailed items from the Health Behaviour School-aged Children survey questionnaires. Descriptive statistics and a Chi-square test were used to report the sample characteristics and analyse ST differences across different sociodemographic groups. A binary logistic regression was then applied to analyse the association of SES indicators with ST in children and adolescents.

RESULTS: Overall, 25.3% of children and adolescents met the ST guidelines. Children and adolescents with higher parental education levels were 1.84 [95% CI 1.31-2.57; father] and 1.42 [95% CI 1.02-1.98; mother] times more likely to meet the ST guidelines than those with lower parental education levels. Associations between SES and ST varied across sex and grade groups. Moreover, the associations of SES with ST on weekdays and weekends were different.

CONCLUSIONS: This study demonstrated the association between SES and ST in children and adolescents, highlighting the importance of targeting children and adolescents with low SES levels as an intervention priority. Based on our findings, specific interventions can be tailored to effectively reduce ST. Future studies are encouraged to use longitudinal or interventional designs to further determine the association between SES and ST.

PMID:36952470 | DOI:10.1371/journal.pone.0280248

PLoS One. 2023 Mar 23;18(3):e0283177. doi: 10.1371/journal.pone.0283177. eCollection 2023.

ABSTRACT

BACKGROUND: Children of incarcerated parents run a high risk for poor health and marginalisation across development where positive parenting comprises an essential protective factor. The For Our Children’s Sake (FOCS) intervention is delivered with incarcerated parents in Sweden to support parenting and healthy child development. This study aimed to explore the effects of the FOCS intervention on relationship quality between parent and child, parent criminal attitude and interest in treatment, while investigating intervention fidelity.

METHODS: The non-randomised non-blinded pragmatic controlled study was carried out during 2019-2020 in 15 prisons with 91 parents throughout Sweden. Group allocation was based on the set operation planning at each prison. Prisons delivering FOCS during the study period were recruited to the intervention group, whereas prisons delivering FOCS later were recruited to the control group. Outcomes were measured through parent-report at baseline September-December 2019 (T0), after intervention (T1) in January-April 2020, and at three-months follow-up in April-July in 2020 (T2). The primary outcome was relationship quality between incarcerated parent and child and secondary outcomes were criminal attitude, interest in other treatment programmes, and child-parent contact. Fidelity to intervention delivery was monitored through objectively rated audio recorded sessions by researchers, and by group-leader-reported logs. Group differences on outcome over time and at each time point were explored using mixed-model regression with repeated measures with an intention-to-treat approach and per protocol.

RESULTS: The intention-to-treat analysis showed favourable intervention effects over time for relationship quality, explained by a higher intervention group score at T2. An intervention effect was found for parental interest in other prison-delivered treatments at T2. The analysis per protocol found similar but stronger effects on the relationship quality and an additional intervention effect over time for criminal attitude, also explained by a significant group difference at T2. The effect on treatment interest did not reach statistical significance in the analysis per protocol. Group leaders reported that all sessions had been performed and the objective ratings of fidelity rendered overall acceptable delivery of the intervention.

CONCLUSIONS: The FOCS intervention had beneficial effects on relationship quality, and outcomes related to criminality which suggests that a parenting intervention for incarcerated parents has the potential to influence both parenting outcomes and outcomes related to a criminal lifestyle. Future studies should investigate intervention effectiveness on long-term outcomes related to both child health and parental recidivism. Further development of intervention components is suggested with the hypothesis to increase intervention effectiveness.

TRIAL REGISTRATION: ClinicalTrials.gov: No. NCT04101799, prospectively registered on September 24, 2019, Identifier: https://clinicaltrials.gov/ct2/show/NCT04101799, The authors confirm that all ongoing and related trials for this intervention are registered.

PMID:36952468 | DOI:10.1371/journal.pone.0283177

PLoS One. 2023 Mar 23;18(3):e0281788. doi: 10.1371/journal.pone.0281788. eCollection 2023.

ABSTRACT

The vulnerability of statistical learning has been demonstrated in reading difficulties in both the visual and acoustic modalities. We examined segmentation abilities of Hungarian speaking adolescents with different levels of reading fluency in the acoustic verbal and visual nonverbal domains. We applied online target detection tasks, where the extent of learning is reflected in differences between reaction times to predictable versus unpredictable targets. Explicit judgments of well-formedness were also elicited in an offline two-alternative forced choice (2AFC) task. Learning was evident in both the acoustic verbal and visual nonverbal tasks, both in online and offline measures, but learning effects were larger both in online and offline tasks in the verbal acoustic condition. We haven’t found evidence for a significant relationship between statistical learning and reading fluency in adolescents in either modality. Together with earlier findings, these results suggest that the relationship between reading and statistical learning is dependent on the domain, modality and nature of the statistical learning task, on the reading task, on the age of participants, and on the specific language. The online target detection task is a promising tool which can be adapted to a wider set of tasks to further explore the contribution of statistical learning to reading acquisition in participants from different populations.

PMID:36952465 | DOI:10.1371/journal.pone.0281788

PLoS One. 2023 Mar 23;18(3):e0283454. doi: 10.1371/journal.pone.0283454. eCollection 2023.

ABSTRACT

INTRODUCTION: Throughout recent years the demand for prehospital emergency care has increased significantly. Non-traumatic chest pain is one of the most frequent complaints. Our aim was to investigate the trend in frequency of the most urgent ambulance patients with chest pain, subsequent acute myocardial infarction (AMI) diagnoses, and 48-hour and 30-day mortality of both groups.

METHODS: Population-based historic cohort study in the North Denmark Region during 2012-2018 including chest pain patients transported to hospital by highest urgency level ambulance following a 1-1-2 emergency call. Primary diagnoses (ICD-10) were retrieved from the regional Patient Administrative System, and descriptive statistics (distribution, frequency) performed. We evaluated time trends using linear regression, and mortality (48 hours and 30 days) was assessed by the Kaplan Meier estimator.

RESULTS: We included 18,971 chest pain patients, 33.9% (n = 6,430) were diagnosed with”Diseases of the circulatory system” followed by the non-specific R- (n = 5,288, 27.8%) and Z-diagnoses (n = 3,634; 19.2%). AMI was diagnosed in 1,967 patients (10.4%), most were non-ST-elevation AMI (39.7%). Frequency of chest pain patients and AMI increased 255 and 22 patients per year respectively, whereas the AMI proportion remained statistically stable, with a tendency towards a decrease in the last years. Mortality at 48 hours and day 30 in chest pain patients was 0.7% (95% CI 0.5% to 0.8%) and 2.4% (95% CI 2.1% to 2.6%).

CONCLUSIONS: The frequency of chest pain patients brought to hospital during 2012-2018 increased. One-tenth were diagnosed with AMI, and the proportion of AMI patients was stable. Almost 1 in of 4 high urgency level ambulances was sent to chest pain patients. Only 1 of 10 patients with chest pain had AMI, and overall mortality was low. Thus, monitoring the number of chest pain patients and AMI diagnoses should be considered to evaluate ambulance utilisation and triage.

PMID:36952460 | DOI:10.1371/journal.pone.0283454

PLoS One. 2023 Mar 23;18(3):e0282962. doi: 10.1371/journal.pone.0282962. eCollection 2023.

ABSTRACT

BACKGROUND: Diabetes is one of the biggest worldwide health emergencies of the 21st century. A major goal in the management of diabetes is to prevent diabetic complications that occur as a result of poor glycemic control. Identification of factors contributing to poor glycemic control is key to institute suitable interventions for glycemic control and prevention of chronic complications.

METHODS: A hospital-based cross-sectional study was conducted among 305 adult type 2 diabetic patients at public hospitals in Hadiya zone from March 1-30, 2019. The study participants were selected by systematic sampling technique. Data were collected using a pretested structured questionnaire and patient chart review; anthropometric and blood pressure measurements were taken. Multivariable logistic regression analysis was used to identify factors associated with poor glycemic control. Adjusted odds ratios (AOR) with respective 95% Confidence Interval (CI) and p < 0.05 were used to set statistically significant variables.

RESULTS: Out of 305 diabetic patients, 222 (72.8%) were found to have poor glycemic control. Longer duration of diabetes (5-10 years) [AOR = 2.24, 95% CI: 1.17-4.27], lack of regular follow-up [AOR = 2.89, 95% CI: 1.08-7.71], low treatment adherence [AOR = 4.12, 95% CI: 1.20-8.70], use of other alternative treatments [AOR = 3.58, 95% CI: 1.24-10.36], unsatisfactory patient physician relationship [AOR = 2.27, 95% CI: 1.27-4.04], and insufficient physical activity [AOR = 4.14, 95% CI: 2.07-8.28] were found to be independent predictors of poor glycemic control. Diabetes Mellitus (DM) complications were slightly higher among participants with poor glycemic control (39.2%), duration of DM 10 and above years (41.9%), low medication adherence (48.5%), taking oral anti-diabetics (54.3%), and DM patients having unsatisfactory patient provider relationship (72.4%).

CONCLUSION: A significant proportion of diabetic patients had poor glycemic control and DM complications. Therefore, appropriate interventions are required to maintain optimal glycemic control and prevent the development of life-threatening complications among DM patients.

PMID:36952453 | DOI:10.1371/journal.pone.0282962

JMIR Res Protoc. 2023 Mar 23;12:e43537. doi: 10.2196/43537.

ABSTRACT

BACKGROUND: Journal articles describing randomized controlled trials (RCTs) and systematic reviews with meta-analysis of RCTs are not optimally reported and often miss crucial details. This poor reporting makes assessing these studies’ risk of bias or reproducing their results difficult. However, the reporting quality of diet- and nutrition-related RCTs and meta-analyses has not been explored.

OBJECTIVE: We aimed to assess the reporting completeness and identify the main reporting limitations of diet- and nutrition-related RCTs and meta-analyses of RCTs, estimate the frequency of reproducible research practices among these RCTs, and estimate the frequency of distorted presentation or spin among these meta-analyses.

METHODS: Two independent meta-research studies will be conducted using articles published in PubMed-indexed journals. The first will include a sample of diet- and nutrition-related RCTs; the second will include a sample of systematic reviews with meta-analysis of diet- and nutrition-related RCTs. A validated search strategy will be used to identify RCTs of nutritional interventions and an adapted strategy to identify meta-analyses in PubMed. We will search for RCTs and meta-analyses indexed in 1 calendar year and randomly select 100 RCTs (June 2021 to June 2022) and 100 meta-analyses (July 2021 to July 2022). Two reviewers will independently screen the titles and abstracts of records yielded by the searches, then read the full texts to confirm their eligibility. The general features of these published RCTs and meta-analyses will be extracted into a research electronic data capture database (REDCap; Vanderbilt University). The completeness of reporting of each RCT will be assessed using the items in the CONSORT (Consolidated Standards of Reporting Trials), its extensions, and the TIDieR (Template for Intervention Description and Replication) statements. Information about practices that promote research transparency and reproducibility, such as the publication of protocols and statistical analysis plans will be collected. There will be an assessment of the completeness of reporting of each meta-analysis using the items in the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement and collection of information about spin in the abstracts and full-texts. The results will be presented as descriptive statistics in diagrams or tables. These 2 meta-research studies are registered in the Open Science Framework.

RESULTS: The literature search for the first meta-research retrieved 20,030 records and 2182 were potentially eligible. The literature search for the second meta-research retrieved 10,918 records and 850 were potentially eligible. Among them, random samples of 100 RCTs and 100 meta-analyses were selected for data extraction. Data extraction is currently in progress, and completion is expected by the beginning of 2023.

CONCLUSIONS: Our meta-research studies will summarize the main limitation on reporting completeness of nutrition- or diet-related RCTs and meta-analyses and provide comprehensive information regarding the particularities in the reporting of intervention studies in the nutrition field.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/43537.

PMID:36951931 | DOI:10.2196/43537