Tag: statistics

J Public Health Dent. 2024 May 8. doi: 10.1111/jphd.12623. Online ahead of print.

ABSTRACT

OBJECTIVES: This pilot study examined the association between food insecurity and edentulism among older adults in Washington State.

METHODS: This study focused on adults aged 50 years and older, who were recruited through seven community-based organizations in Washington State. The exposure variable was food security level (high, marginal, and low/very low food security) assessed using the 10-item U.S. Adult Food Security Survey. The outcome was edentulism, defined as having zero natural teeth. Confounder-adjusted odds ratios (OR) and 95% confidence intervals (CIs) were generated using binary logistic regression models (α = 0.05).

RESULTS: Of the 216 participants, 28.7% (n = 62) had low/very low food security and 7.9% (n = 17) had zero teeth. Older adults with low or very low food security had greater odds of being edentulous compared to those with marginal or high food security, although the difference was not statistically significant (OR: 1.39; 95% CI: 0.46, 4.20; p = 0.56).

CONCLUSIONS: Future research should explore food insecurity-focused interventions aimed at preventing edentulism in older adults in a broader effort to address oral health inequities.

PMID:38716566 | DOI:10.1111/jphd.12623

J Assoc Physicians India. 2023 Oct;71(10):19-30. doi: 10.59556/japi.71.0374.

ABSTRACT

Background: The management of non-diarrheal illnesses requires careful attention to maintaining the proper balance of fluids, electrolytes, and energy (FEE). Nevertheless, there is a limited amount of information accessible regarding the utilization of oral FEE formulations in the treatment of these conditions. Objective: The objective of this study was to assess and contrast the levels of knowledge, attitude, and practices (KAP) among various medical specialties in India when it comes to addressing FEE imbalances in non-diarrheal illnesses through the use of oral FEE formulations, as well as to examine how these approaches influence perceived patient outcomes. We also present a subgroup analysis of KAP in healthcare personnels (HCPs) whose practices include 25% or more diabetic or geriatric patients. Materials and methods: A cross-sectional online assessment was created and conducted among physicians (n = 494) representing different medical specialties in India, which include general practitioners (GPs) (n = 128), MD physicians (n = 121), gynecologists (n = 122), and pediatricians (n = 123). Results: A total of 494 physicians across specialties, including GPs, MDs (MD internal medicine physicians), obstetrics and gynecologists (OB-GYN), and pediatricians, participated in the online assessment from September to October 2021. Knowledge scores were moderate across specialties, and there was no significant difference in knowledge level across specialties. More pediatricians and GPs than other HCPs consider FEE deficit to have a high impact on recovery. Further, pediatrician prescribers consider FEE management to be of high importance compared to other specialties. A significantly higher percentage of pediatricians assess all their patients (100%) for hydration levels, and significantly more gynecologists spend >5 minutes providing hydration advice to their patients. Among all specialties, MD and gynecologist prescribers are more likely to recommend oral FEE for patient recovery. HCPs with diabetes practices agree slightly more than HCPs with geriatric practices that oral FEE management recommendations facilitate the speed of the recovery process from non-diarrheal illnesses in their patients. However, only approximately 30% of them recommend FEE to 70% of their eligible patients, of which approximately 70% of these HCPs give formal (written/electronic) prescriptions of ready-to-drink (RTD) fluids to their patients. Conclusion: Enhancing the understanding of physicians across diverse specialties in India regarding oral FEE management and formulating recommendations for the utilization of oral FEE formulations in non-diarrheal conditions could lead to better outcomes. While knowledge and awareness of oral FEE management are similar across specialties, their practice behaviors vary. Additional research into this disparity and the assessment of the clinical advantages of oral FEE formulations in non-diarrheal illnesses among various specialties should be conducted. How to cite this article: Sathe P, Chakravarty P, Tesado C, et al. Comparing the Knowledge, Attitude, and Practices on Oral Fluids, Electrolytes, and Energy Management in Non-diarrheal Illnesses across Different Physician Specialties in India. J Assoc Physicians India 2023;71(10):19-30.

PMID:38716520 | DOI:10.59556/japi.71.0374

J Assoc Physicians India. 2023 Oct;71(10):14-18. doi: 10.59556/japi.71.0363.

ABSTRACT

Introduction: Acute myocardial infarction (AMI) stands as one of the most catastrophic occurrences in the progression of coronary artery disease. Measuring QT dispersion (QTd) is a fairly straightforward and noninvasive technique for predicting mortality in patients at high risk following a myocardial infarction (MI). Objective: To measure the QT, corrected QT interval (QTc), QTd, and corrected QT dispersion (QTcd) intervals before and after thrombolysis in patients with AMI and to determine prognostic implications of QTd in AMI. Materials and methods: This was a before and after comparison study conducted in the intensive care unit (ICU) of a tertiary care center in Central India. It was carried out in patients with AMI [ST-elevation myocardial infarction (STEMI)] who underwent thrombolysis in ICU. A total of 160 participants were enrolled over the time period of 24 months using the convenience sampling technique. Results: The most prevalent (68 patients) risk factor among MI patients was hypertension (HTN). QT parameters such as QT, QTd, and QTcd showed significant statistical variation of p-value < 0.0001 when compared at admission and after thrombolysis. No significant difference (p > 0.05) in QT parameters at admission (QTd, QTc, and QTcd) between anterior and inferior wall MI, except for QT interval (p = 0.0010). Among the 33 patients who experienced arrhythmia, ventricular tachycardia was the most prevalent arrhythmia in 22 patients (13.75%). There was a significant statistical correlation between the arrhythmic event and the outcome of the patient (p < 0.0001). Patients who died had higher QT parameter values at admission, and these remained on the higher side even after thrombolysis, whereas those who got discharged had lower QT parameter values at admission, and their values decreased after thrombolysis. Conclusion: Successful thrombolysis significantly decreases the QTd and thereby the arrhythmogenic potential, and thus can also be used as a reliable predictor of arrhythmia in patients of MI. How to cite this article: M A, Khandait H, Guralwar C, et al. A Study on QT Dispersion before and after Thrombolysis in Acute Myocardial Infarction and its Prognostic Implications: A before and after Comparison Study. J Assoc Physicians India 2023;71(10):14-18.

PMID:38716519 | DOI:10.59556/japi.71.0363

Acta Oncol. 2024 May 8;63:313-321. doi: 10.2340/1651-226X.2024.22139.

ABSTRACT

BACKGROUND: A significant proportion of patients with incurable cancer receive systemic anticancer therapy (SACT) within their last 30 days of life (DOL). The treatment has questionable benefit, nevertheless is considered a quality indicator of end-of-life (EOL) care. This retrospective cohort study aims to investigate the rates and potential predictors of SACT and factors associated with SACT within the last 30 DOL. The study also evaluates the scope of Eastern Cooperative Oncology Group (ECOG) performance status and the modified Glasgow prognostic score (mGPS) as decision-making tools for oncologists.

PATIENTS AND MATERIAL: This review of medical records included 383 patients with non-curable cancer who died between July 2018 and December 2019. Descriptive statistics with Chi-squared tests and regression analysis were used to identify factors associated with SACT within the last 30 DOL.

RESULTS: Fifty-seven (15%) patients received SACT within the last 30 DOL. SACT within 30 last DOL was associated with shorter time from diagnosis until death (median 234 days vs. 482, p = 0.008) and ECOG score < 3 30 days prior to death (p = 0.001). Patients receiving SACT during the last 30 DOL were more likely to be hospitalised and die in hospital. ECOG and mGPS score were stated at start last line of treatment only in 139 (51%) and 135 (49%) respectively.

INTERPRETATION: Those with short time since diagnosis tended to receive SACT more frequently the last 30 DOL. The use of mGPS as a decision-making tool is modest, and there is lack in documentation of performance status.

PMID:38716486 | DOI:10.2340/1651-226X.2024.22139

Acta Oncol. 2024 May 7;63:303-312. doi: 10.2340/1651-226X.2024.35232.

ABSTRACT

BACKGROUND AND PURPOSE: Stage at cancer diagnosis is an important predictor of cancer survival. TNM stage is constructed for anatomic solid cancer diagnoses from tumor size (T), nodal spread (N) and distant metastasis (M) and categorized in groups 0-I, II, II and IV. TNM stage is imperative in cancer diagnosis, management and control, and of high value in cancer surveillance, for example, monitoring of stage distributions. This study yields an overview of TNM availability and trends in stage distribution in the Nordic countries for future use in monitoring and epidemiologic studies.

MATERIAL AND METHODS: TNM information was acquired from the cancer registries in Denmark, Norway, Sweden, and Iceland during 2004-2016 for 26 cancer sites in the three former countries and four in Iceland. We studied availability, comparability, and distribution of TNM stage in three periods: 2004-2008, 2009-2013, and 2014-2016, applying a previously validated algorithm of ‘N0M0 for NXMX’. For cancers of colon, rectum, lung, breast, and kidney, we examined TNM stage-specific 1-year relative survival to evaluate the quality in registration of TNM between countries.

RESULTS: Denmark, Sweden, and Iceland exhibited available TNM stage proportions of 75-95% while proportions were lower in Norway. Proportions increased in Sweden over time but decreased in Denmark. One-year relative survival differed substantially more between TNM stages than between countries emphasizing that TNM stage is an important predictor for survival and that stage recording is performed similarly in the Nordic countries.

INTERPRETATION: Assessment and registration of TNM stage is an imperative tool in evaluations of trends in cancer survival between the Nordic countries.

PMID:38716485 | DOI:10.2340/1651-226X.2024.35232

Acta Oncol. 2024 May 7;63:294-302. doi: 10.2340/1651-226X.2024.27731.

ABSTRACT

BACKGROUND: Survival of children with cancer has markedly improved over recent decades, largely due to intensified treatment regimes. The intensive treatment may, however, result in fatal complications. In this retrospective cohort study, we assessed temporal variation in the incidence of treatment-related death and associated risk factors among children diagnosed with cancer in Denmark during 2001-2021.

METHOD: Among all children diagnosed with first incident cancer before age 15 years recorded in the Danish Childhood Cancer Register (n = 3,255), we estimated cumulative incidence of treatment-related death (death in the absence of progressive cancer) within 5 years from diagnosis using Aalen-Johansen estimators and assessed associated risk factors using Cox regression.

RESULTS: Among all 3,255 children with cancer, 93 (20% of all 459 deaths) died from treatment. Of these treatment-related deaths, 39 (42%) occurred within 3 months of diagnosis. The 5-year cumulative incidences of treatment-related death were 3.3% during 2001-2010 and 2.5% during 2011-2021 (p = 0.20). During 2011-2021, treatment-related deaths accounted for more than half of all deaths among children with haematological cancers. Risk factors varied according to cancer group and included female sex, age below 1 year at diagnosis, disease relapse, stem cell transplantation, central nervous system involvement, and metastasis at diagnosis.

INTERPRETATION: Despite increasing treatment intensities, the incidence of treatment-related death has remained stable during the past 20 years in Denmark. Still, clinical attention is warranted to prevent treatment-related deaths, particularly among children with haematological cancers. Patient characteristics associated with increased treatment-related death risk support patient-specific treatment approaches to avoid these fatalities.

PMID:38716484 | DOI:10.2340/1651-226X.2024.27731

Research (Wash D C). 2024 Apr 29;7:0368. doi: 10.34133/research.0368. eCollection 2024.

ABSTRACT

Complex diseases do not always follow gradual progressions. Instead, they may experience sudden shifts known as critical states or tipping points, where a marked qualitative change occurs. Detecting such a pivotal transition or pre-deterioration state holds paramount importance due to its association with severe disease deterioration. Nevertheless, the task of pinpointing the pre-deterioration state for complex diseases remains an obstacle, especially in scenarios involving high-dimensional data with limited samples, where conventional statistical methods frequently prove inadequate. In this study, we introduce an innovative quantitative approach termed sample-specific causality network entropy (SCNE), which infers a sample-specific causality network for each individual and effectively quantifies the dynamic alterations in causal relations among molecules, thereby capturing critical points or pre-deterioration states of complex diseases. We substantiated the accuracy and efficacy of our approach via numerical simulations and by examining various real-world datasets, including single-cell data of epithelial cell deterioration (EPCD) in colorectal cancer, influenza infection data, and three different tumor cases from The Cancer Genome Atlas (TCGA) repositories. Compared to other existing six single-sample methods, our proposed approach exhibits superior performance in identifying critical signals or pre-deterioration states. Additionally, the efficacy of computational findings is underscored by analyzing the functionality of signaling biomarkers.

PMID:38716473 | PMC:PMC11075703 | DOI:10.34133/research.0368

Acta Ortop Bras. 2024 May 6;32(spe1):e273366. doi: 10.1590/1413-785220243201e273366. eCollection 2024.

ABSTRACT

OBJECTIVE: to determine the surgical indications for glenoid bone grafting associated with better postoperative ranges of motion.

METHODS: This systematic review was conducted according to PRISMA. The included studies were subdivided according to the criteria used to indicate glenoid bone graft surgery: group for radiological indications only (Group R), group for radiological indications associated with clinical indications (Group R + C), and group for arthroscopic indications (Group A). The extracted and evaluated data were the range of motion of the shoulder.

RESULTS: in the electronic search conducted in October 2022, 1567 articles were selected. After applying the inclusion criteria, 14 articles were selected for the systematic review. Regarding the ranges of motion, group A had the highest number of statistically positive results together with group R. Group A showed positive results in elevation parameters, loss of lateral rotation in adduction, and medial rotation in abduction. Group R showed positive results in lateral rotation in adduction and loss of lateral rotation in adduction. On the other hand, Group R + C was the one that presented the highest number of statistically negative results, in the following parameters: elevation, lateral rotation in abduction, loss of lateral rotation in adduction, and medial rotation in abduction.

CONCLUSION: the subgroups presented variable results in the evaluated parameters; however, the groups with arthroscopic and radiological indications showed the highest number of positive results, with the latter group showing the best results regarding lateral rotation. Level of Evidence II, Systematic Reviews.

PMID:38716462 | PMC:PMC11073535 | DOI:10.1590/1413-785220243201e273366

Niger Med J. 2022 May 13;62(5):267-272. doi: 10.60787/NMJ-62-5-53. eCollection 2021 Sep-Oct.

ABSTRACT

BACKGROUND: Massive obstetric haemorrhage is still a prime cause of maternal mortality and morbidity. Remarkable efficacy of off-label use of Recombinant Activated Factor VII (rFVIIa) has been reported in cases of postpartum haemorrhage (PPH) refractory to conventional measures. This study aims to determine the clinical efficacy of rFVIIa for patients with massive obstetric haemorrhage.

METHODOLOGY: This was a retrospective cross-sectional comparative study of patients with PPH who received rFVIIa during their treatment at the Department of Obstetrics and Gynaecology from November 2009 to April 2018. The data was collected by chart review on a specified form. The age, parity, cause of bleeding, primary treatment measures followed by rFVIIa treatment were recorded. Time since bleeding to administration of rFVIIa was also recorded. The response of rFVIIa in terms of required transfusion volume, need for ICU/ventilator support, fertility preservation and maternal outcome were also compared and analyzed.

RESULTS: In this study, mean age of patients was 33 ±4 years and uterine atony was the most frequent (>50%) cause of Post-partum Haemorrhage (PPH). Out of 12 patients, 50% received injection rFVIIa who within 6 hours were labelled as early group while 50% received it after 6 hours were labelled as late group. Statistically significant difference was observed in terms of fertility preservation, transfusion requirement and duration of ICU/ hospital stay in early and late groups. Although improved maternal outcome was noted following early rFVIIa administration, but it was not found statistically significant between the two groups.

CONCLUSION: Massive PPH not responding to conventional measures can be managed with early administration of rFVIIa which is an effective haemostatic agent.

KEY MESSAGE: Massive PPH not responding to conventional measures can be managed with rFVIIa which also has a significant role in preserving fertility if used before hysterectomy.

PMID:38716439 | PMC:PMC11073838 | DOI:10.60787/NMJ-62-5-53

Diabetes Obes Metab. 2024 May 7. doi: 10.1111/dom.15644. Online ahead of print.

ABSTRACT

AIM: To assess the efficacy and safety of dulaglutide 1.5 mg versus dulaglutide 0.75 mg in Japanese participants with type 2 diabetes (T2D).

MATERIALS AND METHODS: A Phase 3, multicentre, randomized, double-blind, parallel-group study was conducted in Japanese participants aged ≥20 years, with T2D for ≥6 months and inadequate glycaemic control, while on a single oral antihyperglycaemic medication (NCT04809220). The primary objective was to evaluate superiority of dulaglutide 1.5 mg versus dulaglutide 0.75 mg measured by mean change in glycated haemoglobin (HbA1c) from baseline to 26 weeks. Other efficacy and safety endpoints were evaluated at 26 and 52 weeks. All statistical analyses were conducted using the intention-to-treat population.

RESULTS: Overall, 591 participants were randomized to once-weekly dulaglutide 1.5 mg or 0.75 mg. At Week 26, dulaglutide 1.5 mg was superior to dulaglutide 0.75 mg in HbA1c reduction from baseline (least squares mean [LSM] difference -0.29% [95% confidence interval {CI} -0.43, -0.14]). At Week 52, the dulaglutide 1.5-mg arm had a significantly greater proportion of participants who achieved HbA1c <7.0% (46.3% vs. 38.5%; p = 0.03) and showed significantly greater reduction in fasting serum glucose (LSM difference -9.4 mg/dL [95% CI -14.4, -4.3]; p < 0.001) versus the dulaglutide 0.75-mg arm. No statistically significant change in body weight was observed in either treatment arm. Overall, 442 participants (75.4%) experienced treatment emergent adverse events (TEAEs). Constipation (11.3%), diarrhoea (9.6%) and pyrexia (9.0%) were the most commonly reported TEAEs.

CONCLUSIONS: Dulaglutide 1.5 mg once weekly demonstrated superior glycaemic control versus dulaglutide 0.75 mg once weekly, with comparable safety and tolerability, in Japanese people with T2D.

PMID:38715179 | DOI:10.1111/dom.15644