Tag: statistics

medRxiv [Preprint]. 2025 Jan 15:2025.01.15.25320592. doi: 10.1101/2025.01.15.25320592.

ABSTRACT

PURPOSE: Poor quality prostate MRI images, especially ADC maps, can lead to missed lesions and unnecessary repeat scans. To address this issue, we aimed to develop an automated method to predict ADC map quality from T2 images acquired earlier in the scanning process.

MATERIALS AND METHODS: A paired multi-site image corpus of T2-weighted images and ADC maps was constructed from 486 patients imaged in-house and at 62 external clinics. A senior radiologist assigned 1-3 quality ratings to each image set, later converted to a binary “non-diagnostic” or “diagnostic” scale. A deep learning model and a rectal cross-sectional area measurement approach were developed to predict ADC image quality from T2 images. Model performance was evaluated retrospectively by accuracy, sensitivity, negative and positive predictive value, and AUC.

RESULTS: No single acquisition parameter in the metadata was statistically associated with image quality for either T2 or ADC maps. Quality scores of the same modality showed low correlation across sites (r∼0.2). In the challenging task of predicting ADC quality from prior T2 images, our model achieved performance comparable to current single-site models directly using ADC maps, with 83% sensitivity and 90% negative predictive value. The model showed stronger performance on in-house data (94±2% accuracy) despite being trained exclusively on multicenter external data. Rectal cross-sectional area on T2 images provided an interpretable quality metric (AUC 0.65).

CONCLUSION: The probability of low quality, uninterpretable ADC maps can be inferred early in the imaging process by neural network approach, allowing corrective action to be employed.

PMID:40568662 | PMC:PMC12191087 | DOI:10.1101/2025.01.15.25320592

medRxiv [Preprint]. 2025 May 23:2025.05.22.25328175. doi: 10.1101/2025.05.22.25328175.

ABSTRACT

BACKGROUND: Recent genome-wide association studies (GWAS) for Alzheimer’s Disease and related dementias (ADRD) have increased statistical power via larger analysis datasets from biobanks by 1) including non-age-matched controls and prevalent cases, and/or 2) including individuals who report a family history of ADRD as proxy cases. However, these methods have the potential to increase noise and distort genetic associations which are important for genomic-informed prevention and treatment of ADRD. Here, we sought to understand how the effect sizes of genetic associations in ADRD could be sensitive to these methodological choices, using APOE genotypes as an example.

METHODS: Participants in the All of Us Research Program over the age of 49 at enrollment (n=258,693) were assigned one of four categories: incident ADRD (developed after enrollment in All of Us ), prevalent ADRD (present on enrollment), proxy ADRD (participant noted a family history of ADRD), and control (no history or diagnosis of ADRD). Dementia diagnoses were determined using available Electronic Health Records (EHR) and APOE genotype was determined using whole-genome sequencing. Effect sizes for the associations between APOE risk alleles and ADRD diagnoses were compared using polychotomous logistic regression.

RESULTS: The mean age of the cohort was 67±10 years, and it was 58% female; 63% clustered predominantly with European genetic reference populations. Among the participants, 3,107 (1.2%) had prevalent ADRD, 301 (0.1%) had incident ADRD, and 19,910 (7.7%) reported a family history of ADRD (proxy ADRD). Both prevalent and proxy ADRD had attenuated associations with APOE genotype compared to incident ADRD. The adjusted generalized ratio (95% CI) (AGR) for incident ADRD for APOE ε4 heterozygotes was 2.95 (2.31-3.74) compared to 2.10 (1.96-2.24) and 1.42 (1.32-1.55) for proxy and prevalent ADRD, respectively. For APOE ε4 homozygotes, the effect sizes were even more different. Furthermore, APOE association effect sizes increased when restricting the control (no ADRD) group to older age brackets.

CONCLUSIONS: Our study highlights how genetic associations with ADRD can be sensitive to how cases are defined in biobanks like All of Us , with effect sizes downwardly biased when using prevalent or by-proxy cases compared to incident cases.

PMID:40568661 | PMC:PMC12191090 | DOI:10.1101/2025.05.22.25328175

Rwanda J Med Health Sci. 2023 Nov 30;6(3):389-397. doi: 10.4314/rjmhs.v6i3.12. eCollection 2023 Nov.

ABSTRACT

BACKGROUND: Exposure to polluted air is a significant cause of negative health effects. Air quality is crucial in hospital environments as patients and healthcare workers spend more time in such settings for treatment where they experience prolonged and repetitive exposure; however, comprehensive studies on air quality in hospital environments in Rwanda are scarce.

OBJECTIVE: This study aimed to determine the indoor and outdoor air quality concentration levels in selected hospitals and investigate potential sources of air pollution.

METHODS: This descriptive cross-sectional study was conducted in two public and two private hospitals in Kigali that were randomly selected using a simple random sampling technique. Real-time particulate matter (PM), PM_2.5 and PM₁₀ were measured using calibrated Purple Air PA-II sensors. An observation checklist was used to identify potential sources of air pollution. One way ANOVA and t-tests were performed.

RESULTS: Air quality levels in selected hospitals exceeded acceptable limits. The daily average indoor PM_2.5 concentration ranged from 23.52 µg/m³ to 121.60 µg/m³, and the PM₁₀ levels varied from 25.98 µg/m³ to 131.17 µg/m³. In all hospitals, the difference in average indoor and outdoor PM_2.5 and PM₁₀ concentrations were not statistically significant.

CONCLUSION: All recorded concentrations exceeded the WHO air quality guidelines. The study calls for strategies to improve air quality in hospitals.

PMID:40568653 | PMC:PMC12110502 | DOI:10.4314/rjmhs.v6i3.12

Rwanda J Med Health Sci. 2023 Nov 30;6(3):303-314. doi: 10.4314/rjmhs.v6i3.4. eCollection 2023 Nov.

ABSTRACT

BACKGROUND: Over the past decade, the magnitude and intensity of reported natural and humanmade disasters have been rising globally with substantial mortality and long-term morbidity.

OBJECTIVES: To assess the health care providers’ knowledge, attitude and practices towards disaster and emergency preparedness at Ligula Regional Referral Hospital in Mtwara, Tanzania.

METHODS: A descriptive and analytical cross-sectional study was conducted among 94 health care providers; and a stratified sampling technique was employed to recruit the participants. Bivariate and multivariable regression analyses were performed using IBM SPSS Statistics for Windows version 25.0 (IBM Corp, Armonk, NY, USA) to determine the association between independent and dependent variables. A P < 0.05 was considered statistically significant.

RESULTS: More than half 50 (53.2%) and more than three-quarters 75 (79.8%) of the participants had adequate knowledge and positive attitude towards disaster and emergency preparedness respectively. Younger participants aged 20-29 years had 5.252 (95% CI 1.313-21.016) times higher odds of having adequate knowledge of disaster and emergency preparedness than the older groups.

CONCLUSIONS: More disaster and emergency preparedness training programs and clinical simulations are needed to enhance the competencies of health care providers in handling disastrous events efficiently.

PMID:40568652 | PMC:PMC12110494 | DOI:10.4314/rjmhs.v6i3.4

Rwanda J Med Health Sci. 2023 Nov 30;6(3):346-354. doi: 10.4314/rjmhs.v6i3.8. eCollection 2023 Nov.

ABSTRACT

BACKGROUND: Ultrasound imaging has been shown to improve maternal health outcomes through timely diagnosis of pregnancy problems. Despite ultrasound being vital for women’s management in pregnancy, studies have reported low awareness among African women.

OBJECTIVE: To evaluate the knowledge and expectations of pregnant women in Harare about prenatal ultrasound.

METHODS: A cross-sectional survey of 385 pregnant women was done at the ultrasound department of a private maternity hospital in Harare, Zimbabwe. Statistical Package for Social Sciences (SPSS) 27.0 and Windows Excel were used to analyse the data.

RESULTS: The majority of women (85.4%) concurred that ultrasound scans are important during pregnancy, but most (79.3%) were not aware that congenital abnormalities can be detected through ultrasound. Despite low overall knowledge of congenital abnormalities, 80.2% of women were familiar with Down’s syndrome, and this knowledge tended to increase with higher education levels, although not statistically significant (linear-by-linear association = 0.057). The primary expectation of ultrasound scans among pregnant women was to confirm the expected delivery date, and gender determination, with the least expectation being a diagnosis of congenital abnormalities.

CONCLUSION: Knowledge levels were lower in our setting relative to other similar studies, and hence this underscores the need for further public education.

PMID:40568646 | PMC:PMC12110497 | DOI:10.4314/rjmhs.v6i3.8

Rwanda J Med Health Sci. 2023 Nov 30;6(3):290-302. doi: 10.4314/rjmhs.v6i3.3. eCollection 2023 Nov.

ABSTRACT

BACKGROUND: Poorly controlled postoperative pain remains a significant challenge. Music is a safe, inexpensive, non-invasive intervention that can be used in managing pain in surgical patients.

OBJECTIVES: To evaluate effectiveness of music intervention as an adjuvant therapy in attenuating postoperative pain among patients with tibia/fibula fractures.

METHODOLOGY: A cross-sectional pre-test, post-test intervention study design was utilized to conduct a study involving 20 tibia-fibula patients, divided equally into intervention and control groups. Self-selected music was administered for 20 minutes to the intervention group once on day-3 after surgery. Data was collected using a demographic questionnaire and Visual Analogue Scale (VAS). Data was analyzed using SPSS software version 29.0. Descriptive statistics analyzed continuous and categorical data. T-test compared means of physiologic parameters and pain levels in pre-and post-intervention. ANCOVA established the relationship between music and post-intervention pain levels.

FINDINGS: Use of music alongside conventional therapy significantly reduced pain in the intervention group than in the control group (P = 0.014). Music had no statistically significant impact on the physiological parameters.

CONCLUSION: Music therapy is effective as an adjuvant therapy for pain management and can therefore reduce the use of analgesics among surgical patients.

PMID:40568645 | PMC:PMC12110506 | DOI:10.4314/rjmhs.v6i3.3

Rwanda J Med Health Sci. 2023 Nov 30;6(3):315-325. doi: 10.4314/rjmhs.v6i3.5. eCollection 2023 Nov.

ABSTRACT

BACKGROUND: In pregnancy, women experience physiological changes which could increase the risk of insulin resistance, and metabolic syndrome later in life. This study assessed the risk of future metabolic syndrome among pregnant women with either glycosuria or proteinuria at different gestational ages.

METHODS: Eight-Six participants were recruited from health facilities in South-west, Nigeria and they were in three categories: those with glycosuria (n = 32), proteinuria (n = 27), and control (n = 27), based on urinalysis result. Data were analyzed using IBM SPSS Statistics for Windows version 25.0 (IBM Corp, Armonk, NY, USA). Groups were compared using one way ANOVA. Association between the variables was determined using Pearson correlation. Linear regression analysis was performed to predict the risk of future metabolic syndrome.

RESULTS: Participants with glycosuria, proteinuria and control were 29.19 (SD 6.04), 27.15 (SD 4.37) and 25.74 (SD 4.67) years respectively. Glycosuria group had higher (P = 0.01) triglycerides, HOMA-IR, and a-positive association (P = 0.001) between, FBG and HBA1C. Linear regression analysis predicted future risk of metabolic syndrome (P< 0.05) for those with glycosuria and proteinuria respectively with their plasma insulin values.

CONCLUSION: Healthy volunteers with glycosuria and proteinuria are at greater risk of developing metabolic syndrome.

PMID:40568643 | PMC:PMC12110505 | DOI:10.4314/rjmhs.v6i3.5

J Nutr Sci. 2025 Jun 10;14:e38. doi: 10.1017/jns.2025.23. eCollection 2025.

ABSTRACT

Phase Angle (PhA) has emerged as an important parameter to monitor body composition, fluid status, muscle integrity, and physical performance among athletes. However, limited information exists regarding the associations between PhA and dietary intake, especially in athletes. This study aimed to identify the dietary intake components associated with PhA in athletes. This cross-sectional observational study was carried out with 153 athletes across 17 sports. Body composition was assessed by tetrapolar multifrequency BIA, and dietary intake by 24-hour dietary recalls administered on non-consecutive days. Reported foods and supplements were categorised into different groups (i.e. cereals, vegetables, fruits, beans and nuts, meat and eggs, dairy products, oils, and sugars), with portions established based on the food’s total energy content. Fat-free mass and fat-free mass index were higher in male compared to female athletes, potentially influencing PhA (6.6º vs 5.5º; P < 0.01). Multiple linear regression analysis indicated that protein intake was a significant predictor of PhA in athletes. This association remained significant even after adjustments for sex, age, and fat-free mass (R² = 0.48, β = 0.27, P = 0.02). The positive correlation observed between dietary protein and PhA reinforces the need for adequate daily protein intake to enhance PhA in athletes. Further studies investigating the effect of diet-induced changes in PhA within the athletic population are necessary.

PMID:40568622 | PMC:PMC12187483 | DOI:10.1017/jns.2025.23

J Nutr Sci. 2025 Jun 4;14:e41. doi: 10.1017/jns.2025.24. eCollection 2025.

ABSTRACT

Ultra-processed foods (UPFs) have negative health consequences. Food insecurity and Supplemental Nutrition Assistance Program (SNAP) are associated with higher UPF intake in U.S. adults, but this has not been examined in U.S. adolescents. This study assesses associations between food security status and SNAP participation with UPF intake in 3,067 adolescents aged 12-19 years with household incomes at or below 300% of the federal poverty line from the 2007-2016 National Health and Nutrition Examination Survey. UPF is defined using the Nova classification and measured as a percentage of daily total energy intake (TEI). High food security, marginal food security, or food insecurity status was determined through the U.S. Department of Agriculture’s eighteen-item Household Food Security Survey. SNAP participation was deemed affirmative if the household reported receiving SNAP benefits in the last year. Multivariable linear regressions that controlled for TEI and sociodemographic covariates and accounted for the complex survey design examined associations between food insecurity and SNAP participation with UPF intake. In the sample, the prevalence of marginal food security was 15.9%, the prevalence of food insecurity was 33.8%, and the prevalence of SNAP participation was 36.5%. After multivariate adjustment, there were no significant differences in UPF intake by food security status. Adolescents participating in SNAP consumed 2.7% higher UPF intake (95% CI: 0.1%, 5.2%, p = 0.04) compared to adolescents not participating in SNAP. Among lower-income U.S. adolescents, SNAP participation but not food security status was associated with higher UPF intake. Programs and policies promoting the intake of more healthful, minimally processed foods should be strengthened.

PMID:40568620 | PMC:PMC12187485 | DOI:10.1017/jns.2025.24

J Nutr Sci. 2025 Jun 16;14:e43. doi: 10.1017/jns.2025.10013. eCollection 2025.

ABSTRACT

Interest in probiotics and prebiotics in sports nutrition is growing, but research on Jordanian athletes remains limited. While gut microbiota influences athletic performance, little is known about athletes’ understanding and use of probiotic- and prebiotic-rich foods in this region. This exploratory study investigates the knowledge, dietary habits, and correlations with gastrointestinal (GI) problems among Jordanian athletes to inform future research and interventions. The study provides insights into how awareness and consumption of gut-supportive foods can impact GI health, offering broader nutritional implications for global dietary strategies for athletes. A standardised questionnaire was administered to 324 athletes (ages 18-22) to assess knowledge, dietary practices, and GI symptoms. Descriptive statistics summarised the data, and chi-square tests examined associations among knowledge, diet, and GI symptoms (p < 0.05). Knowledge and diet were scored based on correct responses and reported intake of gut-supporting foods. Results showed that 55.9% of athletes were familiar with probiotics and 32.1% with prebiotics. The majority reported low consumption of probiotic- and prebiotic-rich foods, with 72.2% scoring low on diet intake. Although 60.5% seldom consumed fast food, overall intake of gut-supportive foods was limited. No statistically significant associations were found, but a weak positive trend between dietary habits and GI symptoms was observed, suggesting diet may have a modest influence on GI health. Living arrangements influenced both dietary choices and GI symptoms. This study highlights the need for targeted nutrition education to improve awareness and intake of probiotics and prebiotics, potentially supporting GI health and enhancing athletic performance.

PMID:40568619 | PMC:PMC12187486 | DOI:10.1017/jns.2025.10013