Tag: statistics

BMC Ophthalmol. 2023 Jan 3;23(1):5. doi: 10.1186/s12886-022-02758-4.

ABSTRACT

BACKGROUND: To evaluate corneal topography and densitometry features in patients with polycystic ovary syndrome (PCOS) and compare them with healthy individuals.

METHODS: 53 eyes of 53 female patients diagnosed with PCOS and 53 eyes of 53 age-matched female volunteers were analyzed in the study. In addition to the detailed ophthalmological and gynecological examination, anterior segment analysis was performed using Pentacam. A complete analysis of aberrometric, keratometric, topometric, and, densitometric values between the groups was performed, and the results were outlined.

RESULTS: According to the results, although Kmax-front, Kmean-front, ISV, IVA, IHA, BAD_D and PI-Avg values were slightly higher in PCOS group along with a slight thinning in the thinnest location, there was no statistically significant difference between the groups. Moreover, correlation analysis between PCOS clinical parameters and keratometric/topometric/aberrometric data were found to be almost normal. Yet, when Pentacam tomography maps of all cases are examined in detail, mild ectatic changes were observed in 5 cases in PCOS group. Furthermore, a significant increase in thickness across all densitometry values except anterior (10-12 mm), central (10-12 mm), and total (10-12 mm) was found in PCOS group.

CONCLUSIONS: Our study showed that an intensification of corneal densitometry values ​​and various changes in keratometry data implying ectasia can be observed in patients with PCOS. Prospective studies with larger patient series are needed to reveal any potential relationship between PCOS and corneal abnormalities.

PMID:36597084 | DOI:10.1186/s12886-022-02758-4

BMC Pediatr. 2023 Jan 4;23(1):8. doi: 10.1186/s12887-022-03826-w.

ABSTRACT

BACKGROUND: Celiac disease (CD) is an autoimmune disease caused by gluten intake. Traditionally CD was believed to be a disease of the gut, although a wide range of extra-intestinal manifestations (EIM) was recognized. The exact prevalence of EIM and the associated risk factors have not been well studied.

AIM: We aimed to assess the prevalence of EIM in children with CD and their association with human leukocyte antigen (HLA) typing, and pathological and laboratory indices.

METHOD: We conducted a cross-sectional study on children and adolescents with a definite diagnosis of CD. They were followed in the main Celiac Clinic of Southern Iran.

RESULTS: We included 204 children who were visited between 2012 and 2017. Nearly 85% of them were positive for HLA-DQ2 and 40.6% for HLA-DQ8. The most prevalent intestinal complaints reported were abdominal pain (42.6%) and chronic constipation (19.1%). Failure-to-thrive (32.7%), iron deficiency anemia (25%), short stature (20.5%), and eczema (18.6%) were the most common EIMs. However, failure-to-thrive and short stature were presented at significantly younger ages, whereas those patients with concomitant type 1 diabetes mellitus (DM) were significantly older. We also found significant relationships between autoimmune thyroid disease and HLA-DQ5, and the presence of headaches with HLA-DQ7. The prevalence of HLA types of DQ2, DQ8, DQ6, and DQ7 significantly varied among different Marsh groups. Patients who were positive for HLA-DQ8, were significantly older, taller, and weightier. No significant association was found between HLA types and any of the gastrointestinal symptoms, anti-tTG and compliance to gluten free diet. Moreover, there were no statistically significant differences detected between the presence of each individual EIM, the level of IgA anti-tTG, sex, and Marsh typing.

CONCLUSION: This study highlights the presence of EIM in CD and their associated factors. We show the potential role of HLA typing in some EIMs, which may shed light for future studies.

PMID:36597078 | DOI:10.1186/s12887-022-03826-w

BMC Public Health. 2023 Jan 4;23(1):16. doi: 10.1186/s12889-022-14845-8.

ABSTRACT

BACKGROUND: Health risk behaviour is rife among school learners in the Western Cape province. This paper assesses risk and protective factors related to health risk behaviours among high school learners.

METHOD: Longitudinal data were sourced from 2950, 2675 and 2230 at Time 0, Time 1 and Time 2 among grade 8 learners aged 13-18 years between 2012 and 2013. Health risk behaviours were assessed on alcohol consumption, smoking cannabis in the past six months, and ever having sexual intercourse. The sociodemographic variables examined were age, sex, residence, socioeconomic status (SES), family structure and population group. Contextual variables studied were the feeling of learners about the intervention program, participation in religious activities, paid casual work and school sports. Descriptive statistics, bivariate associations and binary logistic analyses predicting health risk behaviours were carried out using generalized linear mixed models after restructuring the data collected at different time points.

RESULT: Health risk behaviours increased consistently for alcohol consumption (25.7-42.7%), smoking cannabis (10.4-22.1%) and (22.3-36.0%) engaging in sexual intercourse. Increasing age emerged as a risk factor for all the health risk behaviours: alcohol consumption [OR:1.3 (1.2-1.4), p < 0.001]; smoking cannabis [OR:1.3 (1.2-1.4), p < 0.001] and had sex [OR:1.5 (1.4-1.7), p < 0.001]. Participation in paid casual work also predicted health risk behaviour: alcohol use [OR:1.5 (1.2-1.8), p < 0.001]; smoking cannabis [OR:1.3 (1.0-1.7), p < 0.05] and sex [OR:1.4 (1.1-1.7), p < 0.01]. High SES and feelings about the EPEP programme enhanced alcohol consumption and smoking cannabis. Smoking cannabis was augmented by residing in an urban area. Participation in school sports was associated with increased alcohol consumption and engaging in sexual intercourse. Participation in religious activities was protected against alcohol consumption [OR:0.7 (0.53-0.83), p < 0.001]; and sex [OR: 0.5 (0.4-0.7), p < 0.001]. Being a female and belonging to a coloured population group diminished engaging in sexual intercourse, and the family structure of both parents attenuated involvement in smoking cannabis.

CONCLUSION: The findings of the study on risks and protective factors on health risk behaviours mirror those of school-based programmes in developing countries. Learners who participated in paid work and school sports are at risk of adverse health outcomes. Furthermore, participation in religious practices and family structure roles in attenuating health risk behaviours should be integrated and considered in the school-based intervention programme.

PMID:36597075 | DOI:10.1186/s12889-022-14845-8

BMC Public Health. 2023 Jan 3;23(1):7. doi: 10.1186/s12889-022-14914-y.

ABSTRACT

BACKGROUND: Socioeconomic deprivation (SED) is known to influence cardiovascular health. However, studies analyzing the relationship between deprivation and circulatory system diseases (CSD) in Central and Eastern Europe are limited. This study aimed to assess the relationship between SED and mortality due to CSD at a population level in 66 sub-regions of Poland.

METHODS: The 2010-2014 data regarding mortality and SED components were obtained from the Central Statistical Office. An area-based SED index was calculated based on the higher education rates, employment structure, wages, unemployment, and poverty. The dynamics of changes in mortality due to CSD was expressed by the number of deaths prevented or postponed (DPP) in terciles of the SED index. The associations between the mortality from CSD and SED index were analyzed using multivariate Poisson regression models and generalized estimating equations.

RESULTS: Among men, the percentage of DPP in 2014 was 13.1% for CSD, 23.4% for ischemic heart disease (IHD), and 21.4% for cerebrovascular diseases (CeVD). In the case of women, the proportion of DPP was 12.8, 25.6, and 21.6%, respectively. More deprived sub-regions experienced a greater decrease in CSD-related mortality than less deprived sub-regions. The disparity in mortality reduction between more deprived and less deprived sub-regions was even more pronounced for women. After adjusting for smoking prevalence, average BMI, population density, and changes in mortality over time, it was found that the SED index over the 2010-2014 time period was significantly associated with CSD- and IHD-related mortality for men (respectively 5.3 and 19.5% expected mortality increase per 1-unit increase of SED index), and with IHD- and CeVD-related mortality for women (respectively 30.3 and 23.0% expected mortality increase per 1-unit increase of SED index).

CONCLUSIONS: Significant differences in mortality changes due to CSD in Poland could be observed in relation to socioeconomic deprivation, resulting in reduced health inequalities. To reduce CSD mortality, more comprehensive preventive measures, including approaches addressing the socioeconomic factors, mainly poverty, education and employment, are needed, particularly in less urbanized areas.

PMID:36597073 | DOI:10.1186/s12889-022-14914-y

BMC Public Health. 2023 Jan 3;23(1):9. doi: 10.1186/s12889-022-14823-0.

ABSTRACT

BACKGROUND: Risky sexual behavior is a public health challenge that significantly affects young people’s health and well-being in Sweden and throughout the world. Moreover, poor mental health, anxiety and depression among adolescents and young adults have increased in recent years. However, although hypothesized, the associations between general mental health and risky sexual behavior among young adults are less established. Thus, this study aimed to examine the association between self-rated mental health and risky sexual behavior among young adults in southern Sweden.

METHODS: Population-based, cross-sectional survey data from 2968 participants aged 18-30 years old residing in southern Sweden was used (response rate 42%). The survey included questions on sexual behavior, alcohol habits, sociodemographic background, and mental health. Logistic regression was used to examine the associations between mental health, depression, anxiety, and risky sexual behavior, stratified by sex (gender). Indicators for risky sexual behavior included not using a condom, non-condom use with casual partner, and multiple (≥2) sexual partners during the last year.

RESULTS: Generally, male participants rated their depression and anxiety levels considerably lower than their female counterparts. Poor mental health, high depression, and high anxiety scores (levels) were significantly associated with having multiple sexual partners among among female participants; adjusted odds ratios (aOR) was 1.3 (95% CI 1.01 to 1.71). However, findings among males were not statistically significant. Furthermore, overall results indicated that higher depression and anxiety scores were associated with 1.4 and 1.6 higher odds, respectively, of not using condom with a casual partner in the most recent sexual encounter. Similarly, higher anxiety scores were associated with non-condom use in the latest sexual encounter, aOR 1.4 (1.1-1.7), but no significant gender-specific associations were found.

CONCLUSION: The associations found between poor mental health factors and multiple sex partners among females warrant consideration in future public health interventions. Further research to increase the understanding of the causal mechanisms that link mental health factors and risky sexual behavior, especially multiple sex partners, among young adult females is needed to support evidence-based interventions.

PMID:36597068 | DOI:10.1186/s12889-022-14823-0

BMC Health Serv Res. 2023 Jan 3;23(1):5. doi: 10.1186/s12913-022-08973-5.

ABSTRACT

BACKGROUND: While interprofessional collaboration (IPC) is widely considered a key element of comprehensive patient treatment, evidence focusing on its impact on patient-reported outcomes (PROs) is inconclusive. The aim of this study was to investigate the association between employee-rated IPC and PROs in a clinical inpatient setting.

METHODS: We conducted a secondary data analysis of the entire patient and employee reported data collected by the Picker Institute Germany in cross-sectional surveys between 2003 and 2016. Individual patient data from departments within hospitals was matched with employee survey data from within 2 years of treatment at the department-level. Items assessing employee-rated IPC (independent variables) were included in Principal Component Analysis (PCA). All questions assessing PROs (overall satisfaction, less discomforts, complications, treatment success, willingness to recommend) served as main dependent variables in ordered logistic regression analyses. Results were adjusted for multiple hypothesis testing as well as patients’ and employees’ gender, age, and education.

RESULTS: The data set resulted in 6154 patients from 19 hospitals respective 103 unique departments. The PCA revealed three principal components (department-specific IPC, interprofessional organization, and overall IPC), explaining 67% of the total variance. The KMO measure of sampling adequacy was .830 and Bartlett’s test of sphericity highly significant (p < 0.001). An increase of 1 SD in department-specific IPC was associated with a statistically significant chance of a higher (i.e., better) PRO-rating about complications after discharge (OR 1.07, 95% CI 1.00-1.13, p = 0.029). However, no further associations were found. Exploratory analyses revealed positive coefficients of department-specific IPC on all PROs for patients which were treated in surgical or internal medicine departments, whereas results were ambiguous for pediatric patients.

CONCLUSIONS: The association between department-level IPC and patient-level PROs remains – as documented in previous literature – unclear and results are of marginal effect sizes. Future studies should keep in mind the different types of IPC, their specific characteristics and possible effect mechanisms.

TRIAL REGISTRATION: Study registration: Open Science Framework (DOI https://doi.org/10.17605/OSF.IO/2NYAX ); Date of registration: 09 November 2021.

PMID:36597063 | DOI:10.1186/s12913-022-08973-5

BMC Pediatr. 2023 Jan 4;23(1):5. doi: 10.1186/s12887-022-03807-z.

ABSTRACT

INTRODUCTION: Since adolescent with obesity is closely linked with the incidence of cardiovascular disease, it is important to identify the factors that increase the prevalence of adolescent with obesity and prevent it early. This study aimed to examine which of the demographic and lifestyle factors including sitting hours per week for purposes other than study had the greatest influence on Korean adolescents with obesity during the coronavirus disease 2019 (COVID-19) pandemic.

METHODS: We used the Korean Youth Risk Behavior Web-based Survey (KYRBWS) data. The primary outcome was the relationship between sitting hours and obesity during and after the COVID-19 pandemic. Multiple logistic regression analysis was performed to examine which of the demographic and lifestyle factors including sitting hours per week for purposes other than study had the greatest influence on Korean adolescents’ obesity status.

RESULTS: The prevalence of obesity was significantly higher during the COVID-19 than before the COVID-19 (OR, 1.268, CI:1.232-1.305). There was a significant increase in the OR for sitting hours per week for purposes other than study (OR, 1.021, 95% CI, 1.019-1.024). Compared to low household income, the OR decreased for middle (OR = 0.798, 95% CI:0.77, 0.826) and high-income household students (OR, 0.833, 95% CI: 0.803-0.865).

DISCUSSION/CONCLUSION: The results of this study confirmed the relationship between sit-ting hours and obesity in adolescents during the pandemic. To prevent adolescent with obesity, further studies are needed to focus on the importance of promoting health policy in adolescents to avoid the continuous rising of its prevalence and needed to understand whether the increase in obesity rates during the pandemic is a temporary trend.

PMID:36597058 | DOI:10.1186/s12887-022-03807-z

BMC Cancer. 2023 Jan 3;23(1):5. doi: 10.1186/s12885-022-10479-6.

ABSTRACT

BACKGROUND: It has been reported that inflammatory and nutritional markers are related to prognosis in numerous malignancies. The present study analyzed the significance of these markers’ alterations during neoadjuvant chemotherapy in the long-term outcomes in patients with advanced gastric cancer.

METHODS: A retrospective review was performed of 437 advanced gastric cancer patients who underwent a neoadjuvant chemotherapy (NACT) regimen followed by surgical treatment. Inflammatory and nutritional markers measured from the blood samples collected from the patients before the first neoadjuvant chemotherapy and after the last neoadjuvant chemotherapy were used for analysis. Statistical analysis, including Mann-Whitney U or chi-square tests, the Kaplan-Meier method and Cox multivariate analysis, were performed to analyze the predictive value of these markers for overall survival outcomes (OS).

RESULTS: Most biomarkers, including lymphocyte, leucocyte, neutrophil, monocyte, platelet, LMR, PLR, SII, CRP, CAR, hemoglobulin and albumin levels, changed during NACT (P < 0.05). After separately grouping the patients based on the normal range of hematologic indexes and the change rate (α) of systemic inflammatory and nutritional markers by the cutoff value derived from X-tile (P < 0.05), we found that differentiation, TRG, pre-NACT BMI, pre-NACT platelet counts, post-NACT lymphocyte counts, the change in lymphocyte counts, change in platelet counts and LMR(α), PLR(α), SII(α), and CAR(α) were associated with OS. Multivariate analysis revealed that PLR (α) > – 19% was correlated with a 3.193-fold (95% CI: 2.194-4.649) higher risk of death (P < 0.001) than others.

CONCLUSION: NACT could significantly change several inflammatory and nutritional markers in the perioperative period; the platelet counts before NACT, and the change in lymphocytes during NACT truly correlated with long-term outcomes among patients with advanced gastric cancer. The systemic inflammatory marker PLR may be a reliable marker for the prediction of prognosis.

PMID:36597055 | DOI:10.1186/s12885-022-10479-6

BMC Psychiatry. 2023 Jan 3;23(1):5. doi: 10.1186/s12888-022-04506-w.

ABSTRACT

BACKGROUND: Cognitive reserve is a modifiable factor that could prevent cognitive decline in patients with cancer. The Cognitive Reserve Assessment Scale in Health (CRASH) is an instrument used to assess cognitive reserve. This study aims to develop and examine the psychometric properties of the Chinese version of the CRASH for patients with cancer.

METHODS: A cross-sectional survey was conducted with 167 cancer patients from four wards of two hospitals in China. Thirty-one patients were re-assessed to examine the test-retest reliability. Four translators and three reviewers developed the Chinese version of the scale. We assessed its structural validity, concurrent validity, internal consistency, test-retest reliability, measurement error, and floor/ceiling effects.

RESULTS: Confirmatory factor analysis showed a good model fit with the four-factor structure of the original CRASH. The CRASH scores were statistically significantly associated with neuropsychological test scores, indicating sufficient concurrent validity. The internal consistency was acceptable, except for leisure activities, with standardized Cronbach’s alphas (0.64-0.94) and standardized Omega (0.66-0.95). There was excellent test-retest reliability, with a high intraclass correlation coefficient (0.914-0.993) of total scores and scores for each domain. The measurement error was acceptable, and no floor or ceiling effects were observed.

CONCLUSIONS: The Chinese version of the CRASH is a valid and reliable instrument to assess cognitive reserve in patients with cancer. Moreover, cognitive reserve measured by the CRASH was associated with low cognitive performance in cancer patients.

PMID:36597052 | DOI:10.1186/s12888-022-04506-w

BMC Pediatr. 2023 Jan 4;23(1):7. doi: 10.1186/s12887-022-03823-z.

ABSTRACT

BACKGROUND: Left-to-right shunt congenital heart disease is more likely to induce recurrent respiratory infections in the patients which exacerbate pulmonary hypertension and thereby impairs cardiac function. It is urgent to explore a non-invasive and accurate diagnostic method that can show the cardiac anatomy and associated malformations in clinical research.

OBJECTIVE: To determine the diagnostic value of peripheral mucin domain protein-3 (Tim-3), N-terminal pro-brain natriuretic peptide (NT proBNP), sestrin2 testing in patients with the left-to-right shunt congenital heart disease and heart failure.

METHODS: Fifty-two neonates with with left to right shunt congenital heart disease and 30 healthy neonates were enrolled. Blood samples were collected within 24 h of admission from newborns for determining the content of TiM-3, NT proBNP, and Sestrin2. Analyzing the ROC curve provided insight into the diagnostic accuracy. Both a Spearman’s rank correlation test and a logistic regression analysis were carried out.

RESULTS: TiM-3, NT proBNP, and Sestrin2 levels in peripheral blood were statistically different in the three groups (P < 0.05). There were significant differences in LVEF and LVFS among the three groups (P < 0.05). When used to diagnose heart failure in conjunction with left-to-right shunt congenital heart disease, TiM-3, NT proBNP, and Sestrin2 exhibited sensitivity of 58.3, 58.3, and 83.3%, respectively, and specificity of 85.0, 72.5, and 70.0%. ROC curve analysis showed that the AUCs of Tim-3, NT proBNP, and sestrin2 in predicting the outcome of left-to-right shunted congenital heart disease combined with heart failure were 0.744 (95% CI, 0.580 to 0.908), 0.608 (95% CI, 0.359 to 0.857), respectively 0.744 (95% CI 0.592 to 0.896).

CONCLUSION: Tim-3, NT proBNP, and sestrin2 can accurately differentiate heart failure from non-combined heart failure from left-to-right shunt congenital heart disease.

PMID:36597051 | DOI:10.1186/s12887-022-03823-z