International Journal of Statistics in Medical Research

A Double Truncated Binomial Model to Assess Psychiatric Health through Brief Psychiatric Rating Scale: When is Intervention Useful?

Alka Sabharwal, Babita Goyal, Vinit Singh — Thu, 11 Jan 2024 00:00:00 +0000

A double truncated binomial distribution model with ‘u’ classes truncated on left and ‘v’ classes truncated on right is introduced. Its characteristics, namely, generating functions; and the measures of skewness and kurtosis have been obtained. The unknown parameter has been estimated using the method of maximum likelihood and the method of moments. The confidence interval of the estimate has been obtained through Fisher’s information matrix.

The model is applied on cross sectional data obtained through Brief Psychiatric Rating Scale (BPRS) administered on a group of school going adolescent students; and the above-mentioned characteristics have been evaluated. An expert, on the basis of the BPRS score values, suggested an intervention program. The BPRS scores of the students who could be administered the intervention program lied in a range (which was above the lowest and below the highest possible values) suggested by the expert. Whereas the complete data suggested the average number of problem areas is four (which was not in consonance with the observations given by the expert), the double truncated model suggested the number of such areas as five which was consistent with the observations made by the expert. This establishes the usefulness of double truncated models in such scenarios.

Analysis of Wide Modified Rankin Score Dataset using Markov Chain Monte Carlo Simulation

Thu, 18 Jan 2024 00:00:00 +0000

Brain hemorrhage and strokes are serious medical conditions that can have devastating effects on a person's overall well-being and are influenced by several factors. We often encounter such scenarios specially in medical field where a single variable is associated with several other features. Visualizing such datasets with a higher number of features poses a challenge due to their complexity. Additionally, the presence of a strong correlation structure among the features makes it hard to determine the impactful variables with the usual statistical procedure. The present paper deals with analysing real life wide Modified Rankin Score dataset within a Bayesian framework using a logistic regression model by employing Markov chain Monte Carlo simulation. Latterly, multiple covariates in the model are subject to testing against zero in order to simplify the model by utilizing a model comparison tool based on Bayes Information Criterion.

Triglyceridemic Waist Phenotypes as Risk Factors for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Fiorella E. Zuzunaga-Montoya, Víctor Juan Vera-Ponce — Mon, 19 Feb 2024 00:00:00 +0000

Introduction: Triglyceride waist phenotypes, which combine high triglyceride levels and central obesity, have recently emerged as an area of interest in metabolic disease research.

Objective: To conduct a systematic review (SR) with meta-analysis to determine if triglyceride waist phenotypes are a risk factor for T2DM.

Materials: SR with meta-analysis of cohort studies. The search was conducted in four databases: PubMed/Medline, Scopus, Web of Science, and EMBASE. Participants were classified into four groups, based on triglyceride level and waist circumference (WC): 1) Normal WC and normalConduct triglyceride level (NWNT); 2) Normal WC and high triglyceride level (NWHT), 3) Altered WC and normal triglyceride level (EWNT) and 4) Altered WC and high triglyceride level (EWHT). For the meta-analysis, only studies whose measure of association were presented as Hazard ratio (HR) along with 95% confidence intervals (CI95%) were used.

Results: Compared to people with NWHT, a statistically significant association was found for those with NWHT (HR: 2.65; CI95% 1.77–3.95), EWNT (HR: 2.54; CI95% 2.05–3.16) and EWHT (HR: 4.41; CI95% 2.82–6.89).

Conclusions: There is a clear association between triglyceride waist phenotypes and diabetes, according to this SR and meta-analysis. Although central obesity and high triglyceride levels are associated with a higher risk of the aforementioned disease, their combination appears to pose an even greater risk. Therefore, in the clinical setting, it is important to consider this when assessing the risk of diabetes.

Adaptive Elastic Net on High-Dimensional Sparse Data with Multicollinearity: Application to Lipomatous Tumor Classification

Narumol Sudjai, Monthira Duangsaphon, Chandhanarat Chandhanayingyong — Fri, 29 Mar 2024 00:00:00 +0000

Predictive models can experience instabilities because of the combination of high-dimensional sparse data and multicollinearity problems. The adaptive Least Absolute Shrinkage and Selection Operator (adaptive Lasso) and adaptive elastic net were developed using the adaptive weight on penalty term. These adaptive weights are related to the power order of the estimators. Therefore, we concentrate on the power of adaptive weight on these penalty functions. This study purposed to compare the performances of the power of the adaptive Lasso and adaptive elastic net methods under high-dimensional sparse data with multicollinearity. Moreover, we compared the performances of the ridge, Lasso, elastic net, adaptive Lasso, and adaptive elastic net in terms of the mean of the predicted mean squared error (MPMSE) for the simulation study and the classification accuracy for a real-data application. The results of the simulation and the real-data application showed that the square root of the adaptive elastic net performed best on high-dimensional sparse data with multicollinearity.

The Impact of the Risk Perception of COVID-19 PANDEMIC on College Students' Occupational Anxiety: The Moderating Effect of Career Adaptability

Jinhui Ning, Shi Yin, Ruonan Tang — Tue, 21 May 2024 00:00:00 +0000

In order to understand the changes in college students' risk perception and occupational emotion under major public health events and to explore the influencing factors of college graduates' employment guidance, 578 college students were surveyed by questionnaire to explore the impact of the risk perception of COVID-19 pandemic on college students' occupational anxiety and its internal mechanisms, and to analyze the mediating role of psychological resilience in the impact and the moderating role of career adaptability. The results showed that: (1) there is a significant positive correlation between the risk perception of COVID-19 pandemic and occupational anxiety; there is a significant negative correlation between risk perception and psychological resilience; there is a significant negative correlation between the psychological resilience and occupational anxiety. (2) Psychological resilience plays a mediating role between risk perception and occupational anxiety. (3) Career adaptability plays a negative moderating role between the risk perception of COVID-19 pandemic and occupational anxiety. These results showed that the risk perception of COVID-19 pandemic not only directly aggravates college students' occupational anxiety, but also indirectly affects occupational anxiety through psychological resilience; Career adaptability significantly alleviats the incremental effect of the risk perception of COVID-19 pandemic on college students' occupational anxiety. This paper has positive enlightenment on how to improve the employability of college students and alleviate their employment anxiety during major public health events.

Competing Risks Model to Evaluate Dropout Dynamics Among the Type 1 Diabetes Patients Registered with the Changing Diabetes in Children (CDiC) Program

Noora Al-Shanfari, Ronald Wesonga, Amadou Sarr, M. Mazharul Islam — Tue, 04 Jun 2024 00:00:00 +0000

Understanding the survival dynamics of registered patients on a disease control program is a vital issue for the success of program objectives. Dropout of registered patients from such a program is a critical issue, hindering the effectiveness of the program. This study aimed to identify the risk factors of dropout of patients who were registered on the Changing Diabetes in Children (CDiC) program, taking a case of Uganda. Survival analysis was done by integrating competing risk of factors associated with attrition from the CDiC program. The data for the study was obtained from patients with type 1 diabetes mellitus (T1DM) registered during 2009-2018 at health units with specialized pediatric diabetes clinics from various regions in Uganda. The study considered follow-up data of 1132 children with T1DM. Our analysis revealed that the Body Mass Index (BMI) significantly influences dropout time, with patients classified as underweight showing higher hazards than those with normal BMI. Moreover, when considering competing risks, dropout hazards increased. Comparing the Cox model with the Fine and Gray model shows the latter exhibiting a smaller AIC value, which indicates its superiority in the time-to-dropout analysis. Thus, utilizing methods that integrate competing risks for CDiC dropout analysis is preferable and recommended for related studies. These findings provide actionable insights for enhancing CDiC program efficacy.

Automatic Diagnosis of Lung Diseases (Pneumonia, Cancer) with given Reliabilities on the Basis of an Irradiation Images of Patients

K.J. Kachiashvili, J.K. Kachiashvili, V.V. Kvaratskhelia — Mon, 10 Jun 2024 00:00:00 +0000

The article proposes algorithms for the automatic diagnosis of human lung diseases pneumonia and cancer, based on images obtained by radiation irradiation, which allow us to make decisions with the necessary reliability, that is, to restrict the probabilities of making possible errors to a pre-planned level. Since the information obtained from the observation is random, Wald’s sequential analysis method and Constrained Bayesian Method (CBM) of statistical hypothesis testing are used for making a decision, which allow us to restrict both types of possible errors. Both methods have been investigated using statistical simulation and real data, which fully confirmed the correctness of theoretical reasoning and the ability to make decisions with the required reliability using artificial intelligence. The advantage of CBM compared to Wald’s method is shown, which is expressed in the relative scarcity of observation results needed to make a decision with the same reliability. The possibility of implementing the proposed method in modern computerized X-ray equipment due to its simplicity and promptness of decision-making is also shown.

Support of Characteristics, Physical Environmental and Psychological On Quality Of Life Of Patients With DM Type II

Mon, 15 Jul 2024 00:00:00 +0000

Background: Diabetes mellitus is one of the diseases that ranks high in the list of non-communicable diseases in Indonesia. Factors that can affect quality of life such as physical environment and psychological.

Objective: This study aims to examine the relationship between characteristic, physical environment and psychological on quality of life of type II diabetes mellitus patients at the Barombong Public Health Center, Makkasar City.

Methodology: This study is a quantitative research with an analytical observational approach using a cross-sectional design. The population size in this study is 578 individuals, sample calculation using the WHO formula yielded a sample size of 385 individuals with predefined exclusion an inclusion criteria. The sampling technique employed is simple random sampling (SRS), and the hypothesis test used is chi-square.

Results: Bivariate statistical analysis shows that there is a relationship between quality of life and age (p=0,000), duration of illness (p=0,000), temperature (p=0,000), noise (p=0,000), positive feelings (p=0,000), thinking, learning, and concentration (p=0,000), self-esteem (p=0,000), while variables that are not associated with quality of life are gender (p=0,111), marital status (p=0,228) and social support (p=0,645). Based on logistic regression analysis, it was found that the factors that most influence quality of life are duration of illness (p=0,000) and positive feelings (p=0,000).

Conclusion: Length of suffering and positive feelings are the most dominant variables associated with quality of life with a probability level of 99.8%.

Body Mass Index and Metabolic Phenotypes in Breast Cancer Risk: A Meta-Analysis and Systematic Review

Thu, 01 Aug 2024 00:00:00 +0000

Introduction: Numerous studies have established that obesity, often assessed through body mass index (BMI), is one of the most significant risk factors for the development of breast cancer (BC). However, not all individuals with obesity have the same risk of developing BC and vice versa.

Objective: To determine the association between metabolic states and the risk of BC.

Materials: AS systematic review (SR) with a meta-analysis of cohort studies was conducted. The search was performed in four databases: PubMed/Medline, SCOPUS, Web of Science, and EMBASE. Metabolic states were classified as Metabolically Healthy Normal Weight (MHNW), Metabolically Unhealthy Normal Weight (MUNW), Metabolically Healthy Obesity (MHO), and Metabolically Unhealthy Obesity (MUO). Association measures were presented as hazard ratios (HR) with their 95% confidence intervals (CI95%).

Results: A total of four studies were evaluated. The meta-analysis found a statistically significant association between the development of BC and the MHO state (HR: 1.14; CI95% 1.02, 1.28) and MUO state (HR: 1.37; CI95% 1.16, 1.62) compared to individuals with MHNW. No association was found with the MUNW state.

Conclusions: The findings suggest that obesity, as determined by BMI, is significantly associated with an increased risk of BC, regardless of metabolic state. Additionally, metabolically unhealthy states, especially in obese individuals, appear to increase the risk of BC. Proposed mechanisms include systemic inflammation, metabolic dysfunction, and altered hormone production. These results have important public health implications, emphasizing the need for prevention strategies focused on obesity management and awareness of its associated BC risks.

Development of New Methods and Materials for the Restoration of Tooth Pulp

Thu, 01 Aug 2024 00:00:00 +0000

Nowadays, the latest treatment technologies are actively developing in dental practice, namely for the restoration of tooth pulp.

Aim: to evaluate the advantages of using modern materials in the treatment of tooth pulps.

Materials and Methods: We examined 33 patients with pulp diseases: 18 women (54.5%) and 15 men (45.5%) with an average age of (33.2±2.3) years. 18 patients (group I) had conservative treatment; 15 patients (group II) got pulp restoration using Biodentin.

Results: In 33 (100 %) patients of both groups, inflammation of tooth pulps was found; in 5 of 18 (27.8 %) patients of group I and 6 of 15 (40.0 %) patients of group II, the presence of fibrous pulpitis without signs of periodontitis was determined, in patients of group II, 4 of 15 (26.7 %) - acute diffuse pulpitis. Streptococci with α-haemolytic activity, staphylococci and fungi of the genus Candida albicans were detected in the plaque. In 93.3% of patients, both clinical and overall success was achieved with Biodentin, and the frequency of isolation of microorganisms of the genus Streptococcus spp. with α-haemolytic activity and Candida albicans decreased.

Conclusions: Effective pulp restoration, inflammatory process reduction, and conditionally pathogenic microflora suppression were found in patients treated with Biodentin.

Body Mass Index as a Risk Factor for Diffuse Large B-Cell Lymphoma: A Systematic Review and Meta-Analysis

Thu, 01 Aug 2024 00:00:00 +0000

Introduction: Given the increasing prevalence of obesity, as measured by the Body Mass Index (BMI), and the significant impact of Diffuse Large B-cell lymphoma (DLBCL) on global health, it is crucial to update our understanding of the relationship between BMI and DLBCL.

Objective: to carry out a systematic review (SR) with meta-analysis to determine the association between DLBCL and BMI

Methods: This study is a systematic review and meta-analysis following the PRISMA guidelines. It searched PubMed/Medline, SCOPUS, Web of Science, and EMBASE. The inclusion criteria were primary observational studies involving adults with DLBCL confirmed by biopsy. Exclusions were non-peer-reviewed materials and studies without inferential statistics. The findings of the study are presented as association measures such as relative risks (RR), accompanied by their corresponding 95% confidence intervals (95% CI).

Results: From 451 articles, 13 met the criteria for inclusion. The included studies, conducted between 2002 and 2013 in various countries, showed varied follow-up periods and sample sizes. The meta-analysis revealed that individuals with high BMI have a 1.31 times higher risk of developing DLBCL than those with lower BMI (RR: 1.31; 95% CI 1.07, 1.61). The heterogeneity among studies was moderate.

Conclusions: The study confirms an association between higher BMI and the increased risk of developing DLBCL. This finding underscores the need to explore further how obesity, chronic inflammation, and the development and progression of DLBCL are interconnected. Understanding this area could significantly reduce DLBCL incidence and improve patient outcomes.

Compliance with the NATO Standards in the Field of Psychological Assistance for the Servicemen with Post-Traumatic Stress Disorder

Tue, 13 Aug 2024 00:00:00 +0000

The increasing number of the servicemen with post-traumatic stress disorder (PTSD) as a result of the war raises the problem of providing them with psychological assistance among the top priorities at the national level. The aim of the study is to identify the effectiveness of using NATO standards in the system of psychological assistance to the servicemen with PTSD.

Methods: The study employed the Mississippi Scale, Impact of Event Scale (IES-R), Hospital Anxiety and Depression Scale (HADS). The statistics were processed using descriptive statistics, analysis of variance, Student’s t-test for independent samples.

Results: The study showed that 20.28% of the servicemen had a high level of PTSD. They have pronounced symptoms of intrusion, avoidance, hyperarousal, high anxiety, and depression. It was established that the use of NATO standards of psychological assistance to the servicemen with PTSD is reliably effective in reducing symptoms of intrusion (t=2.53, p≤0.01), avoidance (t=3.22, p≤0.01), excitability (t =4.18, p≤0.01), anxiety (t=4.56, p≤0.01), and depression (t=3.87, p≤0.01).Conclusions. The problem of the occurrence of PTSD and symptoms of the disorder among the servicemen participating in military operations was confirmed. It was proved that the use of NATO standards in the training and psychological assistance to service men is effective in reducing the PTSD level and its symptoms.

Prospects: The obtained results are significant for military psychologists who work directly with the servicemen in warfare and can use the obtained data for early intervention to prevent the occurrence of PTSD.

Assessment of the Awareness and Oral Hygiene Practices among Patients with Gum and Periodontal Diseases

Tue, 13 Aug 2024 00:00:00 +0000

The level of awareness and practice of hygiene of the average person with periodontal and periodontal tissue diseases remains low and needs to be strengthened by receiving constant information, monitoring and some training from the dentist. The aim of the research is to assess awareness and practice of oral hygiene in patients with gum and periodontal diseases.

Methods: 140 people were divided into two groups: I - control group (CG), relatively healthy individuals (n=40), II - patients with gum and periodontal diseases (n=100), who were interviewed, determined the Simplified Oral Health Index (OHI-S) and periodontal index at the first visit to the dentist and 6 months later.

Results: Correct responses too ralhy giene questions differed significantly between groups, with the highest meanin group I and the lowest in group II. There was no statistically significant difference between the groups in termsof frequency of brushing, duration, care products, or brushing techniques. Ingroup I, the OHI-S index corresponded to a satisfactory state of hygiene (1.53 ± 0.08) compared to the control group (0.17 ± 0.01) (Table 4), while the period on talindex corresponded to the presence of gingivitis (0.81 ± 0.03) compared to the control group (0.21 ± 0.09).

Conclusions: The importance of careful attention to oral hygiene, the use of various means to reduce inflammation and bleeding gums, and the reduction of dental plaque are important parameters in the prevention of gum and periodontal diseases.

Prospects: Further study of awareness and oral hygiene practice with therapy in patients who have gum and periodontal diseases is required.

A Study on the Effects of Biodiversity and Conservation Efforts on Community Health in the Sunderban Area of Eastern India

Haimanti Goswami, Sagar Debnath, Soumen Mukherjee, Swarnava Biswas — Fri, 23 Aug 2024 00:00:00 +0000

The Sunderbans, located at the southernmost tip of the Bay of Bengal, is a UNESCO World Heritage site renowned for its mangrove extent encompassing tidal rivers, mudflats, and islands. As the home of the Royal Bengal Tiger and countless humans, it represents the ecological centre of Eastern India. The primary objective of this study is to analyse community participation in Sunderbans conservation strategies. We are in a position to identify the primary catalysts and inhibitors of such community engagement by understanding the correlation between active conservation participation and health outcomes. The essence of the study emphasises the community's awareness of environmental factors that affect the health. Our ultimate objective is to design a framework that clarifies the connections between conservation and health initiatives in areas of high biodiversity. Using a mixed-methods approach, quantitative biodiversity metrics were derived using species richness, evenness, and Simpson's Diversity Index, and health data were gathered using standardised community health surveys that focused on disease prevalence, nutrition status, and sanitation practises. Twenty sites with differing degrees of community-based conservation activities provided the data. Using sophisticated statistical methods, such as multivariate regression analyses and non-metric multidimensional scaling, patterns and correlations between biodiversity and health indicators were identified. Preliminary results indicated a correlation between biodiversity metrics and specific health indicators. There was a 16.8% decrease in waterborne maladies and a 12.1% increase in nutritional diversity among community members in areas with greater biodiversity. Additionally, areas with robust community-based conservation activities demonstrated a 19.8% increase in biodiversity and community health metrics in comparison to areas with minimal to no conservation activities. Our findings highlight the necessity of merging conservation and health agendas, arguing for an integrative strategy in biodiverse regions. It is in the best interest of global stakeholders to recognise and exploit such potential in comparable ecologies.

Influence of Stress Factors on the Development of Post-Traumatic Stress Disorder in Children: Risk Factors

Anatolii Kuzmenko, Svitlana Makarenko — Mon, 09 Sep 2024 00:00:00 +0000

In the current conditions of the ongoing war in Ukraine, which began in February 2022, Ukrainian children might develop post-traumatic stress disorder (PTSD) due to stress factors caused by the conflict between Ukraine and Russian-backed separatist forces, along with the Russian military. In particular, the relationship between reduced emotional intelligence and the development of post-traumatic stress disorder in children has become more relevant. This study aimed to assess structural and cognitive changes in children with PTSD and their relationship to depression, anxiety, and event segmentation.

The study methods included clinical interviews (CAPS-CA-5 scale), neuropsychological tests (short-term and long-term memory tests), self-assessment questionnaires (standardised CDI, RCADS and SCAS-Child scales), and a single-shotMRI. The results showed that patients with post-traumatic stress disorder had reduced hippocampal volume (p=0.018) and the volume of cingulate cortex isthmus (p=0.026). Diffusion in the cerebellum-hippocampal tract was reduced (p=0.014). The level of depression was positively correlated with hippocampal volume (r=0.32, p=0.021) and anxiety with the volume of cingulate cortex isthmus (r=0.26, p=0.048).

These results emphasise the importance of the relationship between structural changes and levels of depression and anxiety in patients with PTSD.

Prospects for further research are based on the study of the long-term effects of psychotherapeutic interventions aimed at improving cognitive function in patients with posttraumatic stress disorder.

The Relationship between Traumatic Experiences, the Prevalence of Social Anxiety and Insecure Attachment among University Students

Aishwenee A.P. Arijina, Wu Wenzhong, Lu Jingyi, Ooi Boon Keat — Mon, 09 Sep 2024 00:00:00 +0000

University students face unique challenges and are considered a vulnerable population, making it crucial to understand the impact of trauma on their mental health. This study aimed to investigate the associations between traumatic experiences, the prevalence of social anxiety, and insecure attachment among MSU students. The present study adopted a quantitative research approach using the Trauma Screening Questionnaire (TSQ), the DSM-5 Severity Rating of Social Anxiety Disorder (SAD-D), moreover, for the purpose of assessing PTSD, the Vulnerable Attachment Styles Questionnaire (VASQ), Social Anxiety Disorder Severity, and Insecure Attachment, respectively. A total of 406 respondents participated in the research. Through descriptive analysis, data were collected using three different assessments, revealing that 67% of the students were identified as having a high risk of post-traumatic stress disorder (PTSD), while 6.9% experienced severe social anxiety, which was relatively low compared to the total number. Additionally, 87% of the students displayed a high level of insecure attachment. In order to test the research hypotheses, Pearson correlation analysis, linear regression analysis and path analysis were conducted in this study. The study's findings demonstrated that there was a significant correlation between traumatic experiences and insecure attachment and a non-significant correlation between traumatic experiences and social anxiety. Additionally, traumatic experiences had a significant positive effect on insecure attachment but did not significantly affect social anxiety. Lastly, traumatic experiences did not significantly affect insecure attachment through social anxiety or traumatic experiences through social anxiety.

The Chronic Progressive Repeated Measures (CPRM) Model for Clinical Trials Comparing Change Over Time in Quantitative Trait Outcomes

Yu Zhao, Steven D. Edland — Mon, 09 Sep 2024 00:00:00 +0000

Repeated measures analysis is a common analysis plan for clinical trials comparing change over time in quantitative trait outcomes in treatment versus control. Mixed model for repeated measures (MMRM) assuming an unstructured covariance of repeated measures is the default statistical analysis plan, with alternative covariance structures specified in the event that the MMRM model with unstructured covariance does not converge. We here describe a parsimonious covariance structure for repeated measures analysis that is specifically appropriate for longitudinal repeated measures of chronic progressive conditions. This model has the parsimonious features of the mixed effects model with random slopes and intercepts, but without restricting the repeated measure means to be linear with time. We demonstrate with data from completed trials that this pattern of longitudinal trajectories spreading apart over time is typical of Alzheimer’s disease. We further demonstrate that alternative covariance structures typically specified in statistical analysis plans using MMRM perform poorly for chronic progressive conditions, with the compound symmetry model being anticonservative, and the autoregressive model being poorly powered. Finally, we derive power calculation formulas for the chronic progressive repeated measures model that have the advantage of being independent of the design of the pilot studies informing the power calculations. When data follow the pattern of a chronic progressive condition. These power formulas are also appropriate for sizing clinical trials using MMRM analysis with unstructured covariance of repeated measures.