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1.
Eur. j. psychiatry ; 38(2): [100234], Apr.-Jun. 2024.
Artigo em Inglês | IBECS | ID: ibc-231862

RESUMO

Background and objectives Almost half of the individuals with a first-episode of psychosis who initially meet criteria for acute and transient psychotic disorder (ATPD) will have had a diagnostic revision during their follow-up, mostly toward schizophrenia. This study aimed to determine the proportion of diagnostic transitions to schizophrenia and other long-lasting non-affective psychoses in patients with first-episode ATPD, and to examine the validity of the existing predictors for diagnostic shift in this population. Methods We designed a prospective two-year follow-up study for subjects with first-episode ATPD. A multivariate logistic regression analysis was performed to identify independent variables associated with diagnostic transition to persistent non-affective psychoses. This prediction model was built by selecting variables on the basis of clinical knowledge. Results Sixty-eight patients with a first-episode ATPD completed the study and a diagnostic revision was necessary in 30 subjects at the end of follow-up, of whom 46.7% transited to long-lasting non-affective psychotic disorders. Poor premorbid adjustment and the presence of schizophreniform symptoms at onset of psychosis were the only variables independently significantly associated with diagnostic transition to persistent non-affective psychoses. Conclusion Our findings would enable early identification of those inidividuals with ATPD at most risk for developing long-lasting non-affective psychotic disorders, and who therefore should be targeted for intensive preventive interventions. (AU)


Assuntos
Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Valor Preditivo dos Testes , Previsões , Esquizofrenia/prevenção & controle , Transtornos Psicóticos/prevenção & controle , Espanha , Análise Multivariada , Modelos Logísticos
2.
Sci Rep ; 14(1): 7750, 2024 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-38565930

RESUMO

Hydroxychloroquine (HCQ) use is indicated for patients with systemic lupus erythematosus (SLE). Nevertheless, reports discussing the reasons for not prescribing HCQ are limited. We identified the factors that interfere with HCQ use in patients with SLE. This observational, single-center study included data from 265 patients with SLE in 2019. The patients were categorized into groups with and without a history of HCQ use. Between these groups, clinical characteristics were compared using univariate analysis and logistic regression models. Among the 265 patients, 133 (50.2%) had a history of HCQ use. Univariate analysis identified older age; longer disease duration; lower prednisolone dose, clinical SLE disease activity index 2000, and estimated glomerular filtration rate; higher C3 level; and lower anti-double-stranded DNA antibody concentration as HCQ non-use-related variables. Logistic regression models identified a positive association between HCQ non-use and longer disease duration (odds ratio [OR] 1.08), prednisolone dose ≤ 7.5 mg/day (OR 4.03), C3 level ≥ 73 mg/dL (OR 2.15), and attending physician having graduated > 10 years prior (OR 3.19). In conclusion, a longer disease duration, lower prednisolone dose, higher C3 level, and longer time since attending physicians' graduation correlated with HCQ non-use. Physicians and patients should be educated to facilitate HCQ use despite these factors.


Assuntos
Antirreumáticos , Lúpus Eritematoso Sistêmico , Humanos , Hidroxicloroquina/uso terapêutico , Antirreumáticos/efeitos adversos , Lúpus Eritematoso Sistêmico/complicações , Prednisolona/uso terapêutico , Modelos Logísticos
3.
PLoS One ; 19(4): e0297904, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38598456

RESUMO

More than 60% of suicides globally are estimated to take place in low- and middle-income nations. Prior research on suicide has indicated that over 50% of those who die by suicide do so on their first attempt. Nevertheless, there is a dearth of knowledge on the attributes of individuals who die on their first attempt and the factors that can predict mortality on the first attempt in these regions. The objective of this study was to create an individual-level risk-prediction model for mortality on the first suicide attempt. We analyzed records of individuals' first suicide attempts that occurred between May 1, 2017, and April 30, 2018, from the national suicide surveillance system, which includes all of the provinces of Thailand. Subsequently, a risk-prediction model for mortality on the first suicide attempt was constructed utilizing multivariable logistic regression and presented through a web-based application. The model's performance was assessed by calculating the area under the receiver operating curve (AUC), as well as measuring its sensitivity, specificity, and accuracy. Out of the 3,324 individuals who made their first suicide attempt, 50.5% of them died as a result of that effort. Nine out of the 21 potential predictors demonstrated the greatest predictive capability. These included male sex, age over 50 years old, unemployment, having a depressive disorder, having a psychotic illness, experiencing interpersonal problems such as being aggressively criticized or desiring plentiful attention, having suicidal intent, and displaying suicidal warning signals. The model demonstrated a good predictive capability, with an AUC of 0.902, a sensitivity of 84.65%, a specificity of 82.66%, and an accuracy of 83.63%. The implementation of this predictive model can assist physicians in conducting comprehensive evaluations of suicide risk in clinical settings and devising treatment plans for preventive intervention.


Assuntos
Ideação Suicida , Tentativa de Suicídio , Humanos , Masculino , Pessoa de Meia-Idade , Tailândia/epidemiologia , Fatores de Risco , Modelos Logísticos
4.
ScientificWorldJournal ; 2024: 7281288, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38586235

RESUMO

The Lebanese population has faced numerous stressors due to multiple crises in the past four years. This study aims to measure the perceived stress of the Lebanese population, identify the coping mechanisms being used, and determine whether they are associated with their stress levels. A cross-sectional study of 205 individuals randomly selected from Beirut was conducted. Frequency distribution, descriptive analysis, and multivariable cumulative logit models were used to determine the associations between coping mechanisms and perceived stress. Our results indicated that 95.4% of our population had moderate to high perceived stress levels. Problem-focused coping was the most adopted mechanism and was associated with a statistically significant lower stress level, whereas avoidant coping was associated with a statistically significant higher stress level. Our study can pave the way for raising awareness on the importance of managing stress with adaptive coping mechanisms.


Assuntos
Adaptação Psicológica , Estresse Psicológico , Adulto , Humanos , Estudos Transversais , 60670 , Modelos Logísticos
5.
World J Urol ; 42(1): 219, 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38587631

RESUMO

BACKGROUND: The aim of the study was to explore the association of serum soluble klotho with kidney stone disease (KSD) in the general population over the age of 40 years in the United States. METHODS: We integrated the data in National Health and Nutrition Examination Survey from 2007 to 2016 years. The relationship between serum soluble α­klotho and prevalence of KSD was analyzed by constructing weighted multivariable logistic regression model, restricted cubic spline (RCS) curve, and subgroup analyses. RESULTS: In the study, a total of 13,722 individuals were included in our study. A U-shaped association between serum soluble klotho and the risk of KSD was shown by the RCS curve (P value for nonlinear < 0.05). In the full adjusted model, compared with the lowest quartile of serum soluble α­klotho, the adjusted odd ratios (95% confidence intervals) for KSD across the quartiles were (0.999 (0.859, 1.164), 1.005 (0.858, 1.176), and 1.061 (0.911, 1.235)). Subgroup analyses also showed that the U-shaped association of serum soluble α­klotho with KSD was found among subjects who were age < 60 years, female or male, with or without hypertension, and BMI ≥ 30 kg/m2. CONCLUSIONS: Our findings suggested that serum klotho levels had a U-shaped correlation with risk of KSD. When the Klotho level is at 818.66 pg/mL, prevalence of KSD is lowest. Therefore, maintaining a certain level of serum soluble α­klotho could prevent the occurrence of KSD.


Assuntos
Hipertensão , Cálculos Renais , Humanos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Estudos Transversais , Inquéritos Nutricionais , Cálculos Renais/epidemiologia , Modelos Logísticos
6.
Turk Kardiyol Dern Ars ; 52(3): 199-207, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38573088

RESUMO

OBJECTIVE: The homogeneous distribution of physicians is important for ensuring patients' access to health services. To encourage physicians to work in underserved areas, policymakers create incentives. Understanding physicians' employment preferences is essential when developing these incentive packages. This study aims to quantitatively reveal the preferences of cardiologists in Türkiye using a discrete choice experiment (DCE). METHODS: A DCE questionnaire was distributed electronically to all cardiologists in Türkiye. It included 14 different pairs of hypothetical job offers based on seven parameters likely to influence their employment preferences. The data were analyzed using a conditional logit model. The coefficients (CEs) of conditional logistic regression and the willingness-to-accept (WTA) values were calculated. RESULTS: The analysis included 278 cardiologists. It revealed that the most influential parameter was location (CE: 2.86). To move to an undesirable location, the average participant would require an earnings increase of at least 123.3% relative to the average potential earnings of a cardiologist. Other parameters included availability of suitable facilities (CE: 1.07, WTA: 46.3%), harmony with co-workers (CE: 0.92, WTA: 39.61%), working conditions (CE: 0.68, WTA: 29.26%), and the number of night shifts (CE: 0.61, WTA: 26.34%). CONCLUSION: 'Location' emerged as the most important factor in the employment preferences of cardiologists in Türkiye. However, several other monetary and non-monetary factors were also influential, suggesting that policymakers should adopt a holistic approach when developing incentives for cardiologists.


Assuntos
Cardiologistas , Médicos , Humanos , Turquia , Emprego , Modelos Logísticos
7.
PeerJ ; 12: e17128, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38562994

RESUMO

Background: Interaction identification is important in epidemiological studies and can be detected by including a product term in the model. However, as Rothman noted, a product term in exponential models may be regarded as multiplicative rather than additive to better reflect biological interactions. Currently, the additive interaction is largely measured by the relative excess risk due to interaction (RERI), the attributable proportion due to interaction (AP), and the synergy index (S), and confidence intervals are developed via frequentist approaches. However, few studies have focused on the same issue from a Bayesian perspective. The present study aims to provide a Bayesian view of the estimation and credible intervals of the additive interaction measures. Methods: Bayesian logistic regression was employed, and estimates and credible intervals were calculated from posterior samples of the RERI, AP and S. Since Bayesian inference depends only on posterior samples, it is very easy to apply this method to preventive factors. The validity of the proposed method was verified by comparing the Bayesian method with the delta and bootstrap approaches in simulation studies with example data. Results: In all the simulation studies, the Bayesian estimates were very close to the corresponding true values. Due to the skewness of the interaction measures, compared with the confidence intervals of the delta method, the credible intervals of the Bayesian approach were more balanced and matched the nominal 95% level. Compared with the bootstrap method, the Bayesian method appeared to be a competitive alternative and fared better when small sample sizes were used. Conclusions: The proposed Bayesian method is a competitive alternative to other methods. This approach can assist epidemiologists in detecting additive-scale interactions.


Assuntos
Teorema de Bayes , Simulação por Computador , Modelos Logísticos , Estudos Epidemiológicos , Tamanho da Amostra
9.
World J Gastroenterol ; 30(10): 1368-1376, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38596494

RESUMO

BACKGROUND: Colorectal cancer (CRC) is a global health concern, with advanced-stage diagnoses contributing to poor prognoses. The efficacy of CRC screening has been well-established; nevertheless, a significant proportion of patients remain unscreened, with > 70% of cases diagnosed outside screening. Although identifying specific subgroups for whom CRC screening should be particularly recommended is crucial owing to limited resources, the association between the diagnostic routes and identification of these subgroups has been less appreciated. In the Japanese cancer registry, the diagnostic routes for groups discovered outside of screening are primarily categorized into those with comorbidities found during hospital visits and those with CRC-related symptoms. AIM: To clarify the stage at CRC diagnosis based on diagnostic routes. METHODS: We conducted a retrospective observational study using a cancer registry of patients with CRC between January 2016 and December 2019 at two hospitals. The diagnostic routes were primarily classified into three groups: Cancer screening, follow-up, and symptomatic. The early-stage was defined as Stages 0 or I. Multivariate and univariate logistic regressions were exploited to determine the odds of early-stage diagnosis in the symptomatic and cancer screening groups, referencing the follow-up group. The adjusted covariates were age, sex, and tumor location. RESULTS: Of the 2083 patients, 715 (34.4%), 1064 (51.1%), and 304 (14.6%) belonged to the follow-up, symptomatic, and cancer screening groups, respectively. Among the 2083 patients, CRCs diagnosed at an early stage were 57.3% (410 of 715), 23.9% (254 of 1064), and 59.5% (181 of 304) in the follow-up, symptomatic, and cancer screening groups, respectively. The symptomatic group exhibited a lower likelihood of early-stage diagnosis than the follow-up group [P < 0.001, adjusted odds ratio (aOR), 0.23; 95% confidence interval (95%CI): 0.19-0.29]. The likelihood of diagnosis at an early stage was similar between the follow-up and cancer screening groups (P = 0.493, aOR for early-stage diagnosis in the cancer screening group vs follow-up group = 1.11; 95%CI = 0.82-1.49). CONCLUSION: CRCs detected during hospital visits for comorbidities were diagnosed earlier, similar to cancer screening. CRC screening should be recommended, particularly for patients without periodical hospital visits for comorbidities.


Assuntos
Colonoscopia , Neoplasias Colorretais , Humanos , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/patologia , Estudos Retrospectivos , Modelos Logísticos , Detecção Precoce de Câncer
10.
Scand J Rheumatol ; 53(3): 199-206, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38607692

RESUMO

OBJECTIVE: To investigate sickness benefits following delivery in mothers with systemic lupus erythematosus (SLE) and mothers without SLE. METHOD: SLE and non-SLE mothers, matched by age and month of delivery, with a singleton liveborn (2004-2008), were identified from the Swedish Lupus Linkage cohort. Work loss (sum of sick leave and disability pension) was studied from 1 year prenatally to 3 years postpartum. Adjusted logistic regression models of covariates associated with > 30 days of work loss in the first and second years postpartum were estimated in SLE mothers. RESULTS: Among 130 SLE mothers and 440 non-SLE mothers, SLE mothers were more likely to have work loss from the prenatal year (42% vs 16%) to 3 years postpartum (49% vs 15%). In SLE mothers, work loss was on average 61 ± 112 days (mean ± sd) in the prenatal year and 38 ± 83 days in the first year postpartum, which increased to 71 ± 114 days in the third year postpartum. Having > 30 days of sick leave in the year of delivery [odds ratio (OR) 4.4, 95% confidence interval (CI) 1.5-12.9] and ≤ 12 years of education (OR 2.6, 95% CI 1.1-6.0) were associated with work loss in the first year postpartum. No covariates were associated with work loss in the second year postpartum. CONCLUSION: SLE mothers more often had work loss in the prenatal year to 3 years postpartum compared to non-SLE mothers. Lower education and sick leave in the year of delivery were associated with a higher odds of work loss in the first year postpartum in SLE.


Assuntos
Lúpus Eritematoso Sistêmico , Licença Médica , Gravidez , Humanos , Feminino , Escolaridade , Modelos Logísticos , Lúpus Eritematoso Sistêmico/epidemiologia , Pensões
11.
Eur J Med Res ; 29(1): 229, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38610037

RESUMO

BACKGROUND: Depression is the common mental disease after stroke. Our objective was to investigate the correlation of Life's Essential 8 (LE8), the recently updated evaluation of cardiovascular health, with the occurrence of post-stroke depression (PSD) and all-cause mortality among United States (US) adults. METHODS: Participants with stroke were chosen from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. The relationship between LE8 and the risk of PSD was assessed through weighted multiple logistic models. A restricted cubic spline was employed for the examination of correlations. To demonstrate the stability of the results, sensitivity analysis and subgroup analysis were carried out. Furthermore, Cox regression models were used for the correlation between LE8 and all-cause mortality. RESULTS: In this study, a total of 1071 participants were included for analysis. It was observed that LE8 score and PSD risk shared an inverse relationship in per 10 points increase [OR = 0.62 (0.52-0.74, P < 0.001)] in logistic regression models. The analysis of restricted cubic spline demonstrated approximately a noticeable inverse linear association between LE8 score and PSD risk. Sensitivity analysis verified the stability of the findings. Moreover, no statistically significant interactions were identified in subgroup analysis. A reverse association between LE8 score and all-cause mortality was also observed with a 10-point increase [HR = 0.85 (0.78-0.94, P < 0.001)] in cox regression models. CONCLUSIONS: A negative correlation was discovered between LE8 score and PSD and all-cause mortality risk among US adults. We need to conduct large-scale prospective studies to further validate our results.


Assuntos
Depressão , Acidente Vascular Cerebral , Adulto , Humanos , Inquéritos Nutricionais , Estudos Prospectivos , Acidente Vascular Cerebral/complicações , Modelos Logísticos
12.
Lupus Sci Med ; 11(1)2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38589223

RESUMO

OBJECTIVE: To develop an improved score for prediction of severe infection in patients with systemic lupus erythematosus (SLE), namely, the SLE Severe Infection Score-Revised (SLESIS-R) and to validate it in a large multicentre lupus cohort. METHODS: We used data from the prospective phase of RELESSER (RELESSER-PROS), the SLE register of the Spanish Society of Rheumatology. A multivariable logistic model was constructed taking into account the variables already forming the SLESIS score, plus all other potential predictors identified in a literature review. Performance was analysed using the C-statistic and the area under the receiver operating characteristic curve (AUROC). Internal validation was carried out using a 100-sample bootstrapping procedure. ORs were transformed into score items, and the AUROC was used to determine performance. RESULTS: A total of 1459 patients who had completed 1 year of follow-up were included in the development cohort (mean age, 49±13 years; 90% women). Twenty-five (1.7%) had experienced ≥1 severe infection. According to the adjusted multivariate model, severe infection could be predicted from four variables: age (years) ≥60, previous SLE-related hospitalisation, previous serious infection and glucocorticoid dose. A score was built from the best model, taking values from 0 to 17. The AUROC was 0.861 (0.777-0.946). The cut-off chosen was ≥6, which exhibited an accuracy of 85.9% and a positive likelihood ratio of 5.48. CONCLUSIONS: SLESIS-R is an accurate and feasible instrument for predicting infections in patients with SLE. SLESIS-R could help to make informed decisions on the use of immunosuppressants and the implementation of preventive measures.


Assuntos
Lúpus Eritematoso Sistêmico , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Masculino , Lúpus Eritematoso Sistêmico/complicações , Estudos Prospectivos , Imunossupressores , Modelos Logísticos
13.
Nutrients ; 16(7)2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38612995

RESUMO

Given the importance and continued interest in finding a simple, accessible, and universal measure which reflects both general and abdominal adiposity, this study tested for an association of the ratio of WC decile to BMI decile (WC-d/BMI-d) with all-cause mortality. Individuals aged 18-79 years who had participated in the National Health and Nutrition Examination Survey (NHANES) during the years 2007 to 2018 were included in the analysis. WC and BMI deciles were defined separately for males and females, while WC-d/BMI-d was calculated for each individual. The association of WC-d/BMI-d with mortality was assessed using logistic models for the total study population, and then again after stratification by sex, ethnicity, morbidity level, and BMI categories. Positive associations between WC-d/BMI-d and mortality were demonstrated for the total study population (adjusted OR = 1.545, 95%CI: 1.369-1.722) and within different sub-groups, including the population with a normal BMI level (adjusted OR = 1.32, 95%CI: 1.13-1.50). WC-d/BMI-d increased with age, with ~40 years representing a critical time point when WC-d surpasses BMI-d, with a sharper incline for males as compared to females. WC-d/BMI-d was significantly associated with all-cause mortality amongst NHANES American adults; thus, measurements of WC and its integration with BMI in this metric should be considered in clinical practice.


Assuntos
Etnicidade , Adulto , Feminino , Masculino , Humanos , Índice de Massa Corporal , Circunferência da Cintura , Inquéritos Nutricionais , Modelos Logísticos
14.
PLoS One ; 19(4): e0301091, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38573936

RESUMO

This study investigates the factors influencing specialization in artificial intelligence (AI) technology, a critical element of national competitiveness. We utilized a revealed comparative advantage matrix to evaluate technological specialization across countries and employed a three-way fixed-effect panel logit model to examine the relationship between AI specialization and its determinants. The results indicate that the development of AI technology is strongly contingent on a nation's pre-existing technological capabilities, which significantly affect AI specialization in emerging domains. Additionally, this study reveals that scientific knowledge has a positive impact on technological specialization, highlighting the necessity of integrating scientific advancements with technological sectors. Although complex technologies positively influence AI specialization, their effect is less pronounced than that of scientific knowledge. This suggests that in rapidly advancing fields, such as AI, incorporating new scientific knowledge into related industries may be more advantageous than simply advancing existing technologies to outpace competitors. This insight points nations toward enhancing AI competitiveness in new areas, emphasizing the vital importance of both scientific and technological capabilities, and the integration of novel AI knowledge with established sectors. This research offers critical guidance for policymakers in less technologically and economically developed countries, as these nations may not have the technological infrastructure required to foster AI specialization through increased technical complexity.


Assuntos
Inteligência Artificial , Indústrias , Conhecimento , Modelos Logísticos , Tecnologia
15.
PLoS One ; 19(4): e0290111, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38578819

RESUMO

BACKGROUND: Undernutrition and anemia are significant public health issues among under-5 children, with potential long-term consequences for growth, development, and overall health. Thus, this study aims to conduct a bivariate binary logistic regression model by accounting for the possible dependency of childhood undernutrition and anemia. METHODS: The data came from the DHS program's measurement. A total of 3,206 under-five children were involved in this study. A single composite index measure was calculated for stunting, wasting, and underweight using principal component analysis. A bivariate binary logistic regression model is used to assess the association between undernutrition and anemia given the effect of other predictors. RESULTS: Among 3,206 under-five children considered in this study, 1482 (46.2%) and 658 (20.5%) children were agonized by anemia and undernutrition, respectively. In bivariate binary logistic regression model; Urban children [AOR = 0.751, 96% CI: 0.573-0.984; AOR = 0.663, 95% CI: 0.456-0.995] and anemic mothers [AOR = 1.160, 95% CI: 1.104-1.218; AOR = 1.663, 95% CI: 1.242-2.225] were significantly associated with both childhood anemia and undernutrition, respectively. Improved water sources [AOR = 0.681, 95% CI: 0.446-0.996], average-sized children [AOR = 0.567, 95% CI: 0.462-0.696], and diarrhea [AOR = 1.134, 95% CI: 1.120-2.792] were significantly associated with childhood anemia. Large-sized children [AOR = 0.882, 95% CI: 0.791-0.853] and those with fever [AOR = 1.152, 95% CI: 1.312-2.981] were significantly associated with under-five children's undernutrition. CONCLUSION: The prevalence of both undernutrition and anemia among under-five-year-old children was high in Rwanda. The following determinants are statistically associated with both childhood undernutrition and anemia: place of residence; source of drinking water; maternal anemia; being a twin; birth size of children; diarrhea; fever; and child age. Anemia and nutritional deficiencies must be treated concurrently under one program, with evidence-based policies aimed at vulnerable populations.


Assuntos
Anemia , Desnutrição , Criança , Feminino , Humanos , Lactente , Modelos Logísticos , Ruanda/epidemiologia , Desnutrição/complicações , Desnutrição/epidemiologia , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/complicações , Habitação , Anemia/epidemiologia , Anemia/complicações , Prevalência , Diarreia/epidemiologia , Diarreia/complicações , Etiópia/epidemiologia
16.
Clin Nutr ESPEN ; 60: 195-202, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38479910

RESUMO

BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers and is currently the third leading cause of cancer-related deaths worldwide. This study aimed to evaluate whether the dietary approach to stop hypertension (DASH) and Mediterranean (MED) diets are associated with CRC in Iranian adults. METHODS: This hospital-based case-control study was conducted on 71 cases and 142 controls (40-75 years old) in three general hospitals in Tehran, Iran. The dietary intakes of individuals were collected through face-to-face interviews using a semi-quantitative food frequency questionnaire (FFQ) that included 125 food items. The DASH and MED diet scores were calculated according to food items based on guidelines. Two logistic regression models were applied to evaluate the association between DASH and MED score adherence. RESULTS: After adjusting for confounding factors, a negative association between DASH diet adherence and CRC risk was observed in the second and last tertile compared to the first tertile (T) (T2: odds ratio (OR) = 0.33; 95% confidence interval (CI): 0.14-0.77 - T3: OR = 0.09; 95% CI: 0.03-0.27). There was no significant association between the MED diet and the risk of CRC. CONCLUSIONS: In conclusion, the current study's findings presented that adherence to a DASH diet could reduce the odds of CRC.


Assuntos
Neoplasias Colorretais , Dieta Mediterrânea , Hipertensão , Adulto , Humanos , Pessoa de Meia-Idade , Idoso , Estudos de Casos e Controles , Irã (Geográfico)/epidemiologia , Hipertensão/prevenção & controle , Hipertensão/complicações , Modelos Logísticos , Neoplasias Colorretais/prevenção & controle
17.
PLoS One ; 19(3): e0300403, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38512905

RESUMO

Functional difficulty in children is a crucial public health problem still undervalued in developing countries. This study explored the socio-demographic factors and anthropometry associated with children's functional difficulty in Bangladesh. Data for 2-4-year-old children, obtained from Multiple Indicator Cluster Survey 2019, were used in this study. The mixed-effects logistic regression model was used to analyse the data. Children whose mothers had functional difficulty were found to be 2.75 times more likely to have functional difficulty than children whose mothers had no functional difficulty (95% CI 1.63-4.63). Male children were more likely to experience functional difficulty than female children (OR = 1.48). Furthermore, stunting was found to be significantly associated with functional difficulty (OR = 1.50). The study also revealed that division and mother's education, specifically, children with mothers having higher secondary + education, had significant association with the outcome variable. The findings provided a vital overview of child disability in a developing country.


Assuntos
Transtornos do Crescimento , Mães , Pré-Escolar , Feminino , Humanos , Masculino , Bangladesh/epidemiologia , Escolaridade , Transtornos do Crescimento/epidemiologia , Modelos Logísticos
18.
BMC Med Res Methodol ; 24(1): 72, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38509513

RESUMO

BACKGROUND: In the causal mediation analysis framework, several parametric regression-based approaches have been introduced in past years for decomposing the total effect of an exposure on a binary outcome into a direct effect and an indirect effect through a target mediator. In this context, a well-known strategy involves specifying a logistic model for the outcome and invoking the rare outcome assumption (ROA) to simplify estimation. Recently, exact estimators for natural direct and indirect effects have been introduced to circumvent the challenges prompted by the ROA. As for the approximate approaches relying on the ROA, these exact approaches cannot be used as is on case-control data where the sampling mechanism depends on the outcome. METHODS: Considering a continuous or a binary mediator, we empirically compare the approximate and exact approaches using simulated data under various case-control scenarios. An illustration of these approaches on case-control data is provided, where the natural mediation effects of long-term use of oral contraceptives on ovarian cancer, with lifetime number of ovulatory cycles as the mediator, are estimated. RESULTS: In the simulations, we found few differences between the performances of the approximate and exact approaches when the outcome was rare, both marginally and conditionally on variables. However, the performance of the approximate approaches degraded as the prevalence of the outcome increased in at least one stratum of variables. Differences in behavior were also observed among the approximate approaches. In the data analysis, all studied approaches were in agreement with respect to the natural direct and indirect effects estimates. CONCLUSIONS: In the case where a violation of the ROA applies or is expected, approximate mediation approaches should be avoided or used with caution, and exact estimators favored.


Assuntos
Análise de Mediação , Modelos Estatísticos , Humanos , Estudos de Casos e Controles , Modelos Logísticos , Causalidade
19.
Sci Rep ; 14(1): 6978, 2024 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-38521806

RESUMO

Synthetic data generation is being increasingly used as a privacy preserving approach for sharing health data. In addition to protecting privacy, it is important to ensure that generated data has high utility. A common way to assess utility is the ability of synthetic data to replicate results from the real data. Replicability has been defined using two criteria: (a) replicate the results of the analyses on real data, and (b) ensure valid population inferences from the synthetic data. A simulation study using three heterogeneous real-world datasets evaluated the replicability of logistic regression workloads. Eight replicability metrics were evaluated: decision agreement, estimate agreement, standardized difference, confidence interval overlap, bias, confidence interval coverage, statistical power, and precision (empirical SE). The analysis of synthetic data used a multiple imputation approach whereby up to 20 datasets were generated and the fitted logistic regression models were combined using combining rules for fully synthetic datasets. The effects of synthetic data amplification were evaluated, and two types of generative models were used: sequential synthesis using boosted decision trees and a generative adversarial network (GAN). Privacy risk was evaluated using a membership disclosure metric. For sequential synthesis, adjusted model parameters after combining at least ten synthetic datasets gave high decision and estimate agreement, low standardized difference, as well as high confidence interval overlap, low bias, the confidence interval had nominal coverage, and power close to the nominal level. Amplification had only a marginal benefit. Confidence interval coverage from a single synthetic dataset without applying combining rules were erroneous, and statistical power, as expected, was artificially inflated when amplification was used. Sequential synthesis performed considerably better than the GAN across multiple datasets. Membership disclosure risk was low for all datasets and models. For replicable results, the statistical analysis of fully synthetic data should be based on at least ten generated datasets of the same size as the original whose analyses results are combined. Analysis results from synthetic data without applying combining rules can be misleading. Replicability results are dependent on the type of generative model used, with our study suggesting that sequential synthesis has good replicability characteristics for common health research workloads.


Assuntos
Benchmarking , Revelação , Simulação por Computador , Modelos Logísticos , Processos Mentais
20.
Neural Netw ; 174: 106245, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38508046

RESUMO

Modeling and recognizing events in complex systems through machine learning techniques is a challenging task. Especially if the model is constrained to be explainable and interpretable, while ensuring high levels of accuracy. In this paper, we adopt a bilinear logistic regression model in which the parameters are trained in a data-driven fashion on a real-world dataset of power grid failure data. The bilinear white-box model - grounded on a specific neural architecture - has been proven effective in classifying faulty states with a performance comparable to several classifiers in technical literature. Additionally, the low computational complexity of the bilinear model, in terms of the number of free parameters, allows gaining insights into the fault phenomenon correlating the events that impact the power grid (exogenous causes) with its constitutive characteristics, thence eliciting the relational information hidden in the data. The proposed model is also able to estimate a vulnerability vector that can be associated, as a suitable characteristic "label", to power grid components, opening the way, as will be deeply demonstrated in the following, not only to predictive maintenance programs or condition monitoring tasks but also to risk assessment and scenario analyses in line with the explainable AI paradigm.


Assuntos
Sistemas Computacionais , Aprendizado de Máquina , Modelos Logísticos
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