Chi-square Test For Trend Research Articles

Stillbirth risk and smallness for gestational age according to Hadlock, INTERGROWTH-21st, WHO, and GROW fetal weight standards: analysis by maternal ethnicity and body mass index

Appropriate growth charts are essential for fetal surveillance, to confirm that growth is proceeding normally and to identify pregnancies that are at risk. Many stillbirths are avoidable through antenatal detection of the small-for-gestational-age fetus. In the absence of an international consensus on which growth chart to use, it is essential that clinical practice reflects outcome-based evidence. This study investigated the performance of 4 internationally used fetal weight standards and their ability to identify stillbirth risk in different ethnic and maternal size groups of a heterogeneous population. We analyzed routinely collected maternity data from more than 2.2 million pregnancies. Three population-based fetal weight standards (Hadlock, Intergrowth-21st, and World Health Organization) were compared with the customized GROW standard that was adjusted for maternal height, weight, parity, and ethnic origin. Small-for-gestational-age birthweight and stillbirth risk were determined for the 2 largest ethnic groups in our population (British European and South Asian), in 5 body mass index categories, and in 4 maternal size groups with normal body mass index (18.5-25.0 kg/m2). The differences in trend between stillbirth and small-for-gestational-age rates were assessed using the Clogg z test, and differences between stillbirths andbody mass index groups were assessed using the chi-square trend test. Stillbirth rates (per 1000) were higher in South Asian pregnancies (5.51) than British-European pregnancies (3.89) (P<.01) and increased in both groups with increasing body mass index (P<.01). Small-for-gestational-age rates were 2 to 3-fold higher for South Asian babies than British European babies according to the population-average standards (Hadlock: 26.2% vs 12.2%; Intergrowth-21st: 12.1% vs 4.9%; World Health Organization: 32.2% vs 16.0%) but were similar by the customized GROW standard (14.0% vs 13.6%). Despite the wide variation, each standard's small-for-gestation-age cases had increased stillbirth risk compared with non-small-for-gestation-age cases, with the magnitude of risk inversely proportional to the rate of cases defined as small for gestational age. All standards had similar stillbirth risk when the small-for-gestation-age rate was fixed at 10% by varying their respective thresholds for defining small for gestational age. When analyzed across body mass index subgroups, the small-for-gestation-age rate according to the GROW standard increased with increasing stillbirth rate, whereas small-for-gestation-age rates according to Hadlock, Intergrowth-21st, and World Health Organization fetal weight standards declined with increasing body mass index, showing a difference in trend (P<.01) to stillbirth rates across body mass index groups. In the normal body mass index subgroup, stillbirth rates showed little variation across maternal size groups; this trend was followed by GROW-based small-for-gestation-age rates, whereas small-for-gestation-age rates defined by each population-average standard declined with increasing maternal size. Comparisons between population-average and customized fetal growth charts require examination of how well each standard identifies pregnancies at risk of adverse outcomes within subgroups of any heterogeneous population. In both ethnic groups studied, increasing maternal body mass index was accompanied by increasing stillbirth risk, and this trend was reflected in more pregnancies being identified as small for gestational age only by the customized standard. In contrast, small-for-gestation-age rates fell according to each population-average standard, thereby hiding the increased stillbirth risk associated with high maternal body mass index.

Recent Trend in Artificial Intelligence-Assisted Biomedical Publishing: A Quantitative Bibliometric Analysis.

The rapid advancements in artificial intelligence (AI) technology in recent years have led to its integration into biomedical publishing. However, the extent to which AI has contributed to developing biomedical literature is unclear. This study aimed to identify trends in AI-generated content within peer-reviewed biomedical literature. We first tested the sensitivity and specificity of commercially available AI-detection software (Originality.AI, Collingwood, Ontario, Canada). Next, we conducted a MEDLINE (Medical Literature Analysis and Retrieval System Online) search to identify randomized controlled trials with available abstracts indexed between January 2020 and March 2023. We randomly selected 30 abstracts per quarter during this period and pasted the abstracts into the AI detection software to determine the probability of AI-generated content. The software yielded 100% sensitivity, 95% specificity, and excellent overall discriminatory ability with an area under the receiving operating curve of 97.6%. Among the 390 MEDLINE-indexed abstracts included in the analysis, the prevalence with a high probability (≥ 90%) of AI-generated text increased during the study period from 21.7% to 36.7% (p=0.01) based on a chi-square test for trend. The increasing prevalence of AI-generated text during the study period was also observed in various sensitivity analyses using AI probability thresholds ranging from 50% to 99% (all p≤0.01). The results of this study suggest that the prevalence of AI-assisted publishing in peer-reviewed journals has been increasing in recent years, even before the widespread adoption of ChatGPT (OpenAI, San Francisco, California, United States) and similar tools. The extent to which natural writing characteristics of the authors, utilization of common AI-powered applications, and introduction of AI elements during the post-acceptance publication phase influence AI detection scores warrants further study.

Benchmark dose estimation based on oxidative damage in Chinese workers exposed to benzene series compounds

This study evaluated the effects of BTEX exposure on oxidative stress; it analyzed the correlation between oxidative stress and peripheral blood counts and estimated the benchmark dose (BMD) of BTEX compounds. This study recruited 247 exposed workers and 256 controls; physical examination data were collected and serum oxidative stress levels were measured. Relationships between BTEX exposure and biomarkers were analyzed using Mann-Whitney U, generalized linear model, and chi-square trend tests. Environmental Protection Agency Benchmark Dose Software was used to calculate the BMD and lower confidence limit of the BMD (BMDL) for BTEX exposure. The total antioxidant capacity (T-AOC) correlated positively with peripheral blood counts, and negatively with the cumulative exposure dose. On using T-AOC as the outcome variable, the estimated BMD and BMDL for BTEX exposure were 3.57 mg/m3 and 2.20 mg/m3, respectively. Based on T-AOC, the calculated occupational exposure limit of BTEX was 0.055 mg/m3.

P005 Using novel remote electronic monitoring to measure and manage the Rheumatology Clinic backlog generated by COVID-19

Abstract Background/Aims During the COVID-19 pandemic we were unable to provide regular outpatient services for patients with chronic rheumatic diseases. A “backlog” of 6812 patients without an allocated follow-up appointment accrued by September 2021. We quantified this cohort and analysed attempts to deliver care remotely (using video, telephone, and electronic remote management forms (RMFs)). Methods We selected a 12-month “window” (May 2020-May 2021) and analysed the number of patients awaiting follow-up during this period. This was initially 3259 patients out of the total backlog 6812. We revisited the number of patients remaining in that cohort on four occasions between September 2021 and September 2022: at baseline, then at 1-, 2-, 6- and 12-month intervals. Each audit cycle was conducted using the same methodology. Alongside usual follow up pathways, (face to face, video or telephone), we implemented remote management forms (RMFs) for different disease groups which were designed by the department; they contained a triage questionnaire, including calculation of disease severity scores, and questions about medications. These were sent out by clinicians to some patients in lieu of a telephone, video or face to face appointments. Data from RMFs was stored in a secure database for clinician review. Data analysis performed in Microsoft Excel and R (version 4.2.1). Results The number of patients without allocated follow-up appointments reduced from 3259 to 326 between Sep-21 and Sep-22. This is a 90% reduction in the backlog over a 12-month period, with a 71% reduction achieved by 6 months. There was a significant, progressive reduction in the number of patients over time (p &amp;lt; 0.001 - Chi-square test for trend). Of the 1956 RMFs completed between Sep-21 - Mar-22, only 261 patients recorded a previous appointment date. 154/261 (59%) were completed by patients waiting in the “window” of May-20 - May-21. This indicates a preferential use of RMFs targeting backlog patients. Between 2-8% of the total backlog patients were managed using RMFs based on available data. Conclusion We have significantly reduced the size of our backlog of outpatient follow-up due to COVID-19 over a 12-month period. In-addition these results likely underestimate the effect of RMFs due to this dataset being incomplete. Remote management made a sizeable contribution to this reduction, meaning some of this reduction was achieved without face-to-face encounters. The use of 1956 forms over a 6-month period shows robust integration of our RMFs into outpatient services disrupted by COVID-19 and provides evidence for remote management as a useful tool in outpatient management, with relevance to areas such as Patient Initiated Follow Up pathways. Further work is needed to clarify where remote management is best deployed and which patient groups benefit most from this. Disclosure D. Kurzeja: None. A. Soni: None. J. Jackman: None. J. David: None. R. Luqmani: None.

The relationship between classroom environment and myopia

Objective: Based on a cohort and intervention study of the Eastern Chinese Student Surveillance, Cohort and Intervention Study (ES-SCI), this research aims to explore the correlation between monitor of the school environment and longitudinal data on myopia and provide evidence for the government myopia intervention strategy. Methods: This survey adopts the stratified cluster sampling method with the school as the unit. Students from grade 1 to grade 3 were selected according to the whole class to monitor the school environment in the classroom. Students will use the full-automatic computer optometer (TOPCON RM800) to conduct optometry from 2019 to 2021 under the condition of mydriasis to perform refractive eye examinations. Meantime eye axis length monitoring was also conducted. Cox proportional risk regression model was used to explore the relationship between school environmental monitoring and the occurrence and development of students' myopia. Results: From 2019 to 2021, 2 670 students from 77 classrooms participated in the observation study. The students' diopter after right/left eye mydriasis decreased in varying degrees (P<0.001), and the axial length of the right/left eye increased in various degrees (P<0.001). The weighted qualified rate of per capita area of primary school classrooms increased from 18.0% in 2019 to 26.0% in 2021, the weighted average illuminance pass rate of blackboard surface increased from 23.8% in 2019 to 26.4% in 2021, and the weighted average illuminance pass rate of classroom table decreased from 86.7% in 2019 to 77.5% in 2021. The trend chi-square test was significant (P<0.05). Cox proportional risk regression showed that after correcting for the grade, gender, parental myopia, diet, sleep, near work (sitting posture, working time, electronic mobile equipment, eye exercises), and outdoor activities, the per capita area of 1.36- m2 was the protective factor of eye axis length (HR=0.778, 95%CI: 0.659-0.918, P=0.003); The average reflection ratio of blackboard 0.15-0.19 was the protective factor of eye axis length (HR=0.685, 95%CI: 0.592-0.793, P<0.001); The average illumination of the blackboard 150-, 300-, 500- lx was the protective factor of the eye axis length (HR=0.456, 95%CI: 0.534-0.761, P<0.001; HR=0.794, 95%CI: 0.705-0.895, P<0.001; HR=0.690, 95%CI: 0.619-0.768, P<0.001). The blackboard evenness 0.40-0.59 was the risk factor of eye axis length (HR=1.528, 95%CI: 1.018-2.293, P=0.041), and the blackboard evenness 0.80- was the protection factor of eye axis length (HR=0.542, 95%CI: 0.404-0.726, P<0.001). The evenness of the desktop 0.40-0.59 was the protective factor of eye axis length (HR=0.820, 95%CI: 0.698-0.965, P=0.017). The average illuminance of 150-, 300-, 500- lx was the protective factor of a diopter (HR=0.638, 95%CI: 0.534-0.761, P<0.001; HR=0.911, 95%CI: 0.848-0.978, P=0.011; HR=0.750, 95%CI: 0.702-0.801, P<0.001). The average illumination of desktop 500- lx was a protective factor of a diopter (HR=0.855, 95%CI: 0.763-0.958, P=0.007). Conclusion: School environmental monitoring indicators, such as meeting per capita area standards, passing blackboard, and desk top-related indicators, all play protective effects on myopia development in students.

106 Reimbursement Trends in Neuroendovascular Interventions 2013-2022

INTRODUCTION: Neuroendovascular surgeries are increasingly important, particularly with the advent of thrombectomy as the gold standard in the management of large vessel stroke. METHODS: The Physician Fee Schedule Look-Up Tool was queried from 2013 to 2019 for all primary Current Procedural Terminology (CPT) codes identified by the American Medical Association as pertaining to endovascular procedures of the nervous system (61623, 61624, 61630, 61635, 61626, 61645, and 61650). The facility prices were averaged for each procedure and subsequently adjusted for inflation using the United States Bureau of Labor Statistics’ Consumer Price Index Inflation Calculator as adjusted to January of 2022. Statistical analyses, including data aggregation, exploratory analysis, and propensity adjustment, were performed using R, version 4.0.1 (The R Foundation, Vienna, Austria). The two-sided Mann-Kendall trend test, a non-parametric statistical test that assesses for monotonic trends in either an upward or downward trend, was utilized to assess for trends over time. Within each year analyzed, a Chi-squared test for trend in proportions was used. A significance level of 0.05 was used. RESULTS: Decreases in reimbursement were noted for all neuroendovascular procedures. This trend was statistically significant for temporary balloon occlusion, CPT61623 (2013:$677.04; 2022:586.96; p: 0.01), central nervous system transcatheter permanent occlusion or embolization, CPT61624 (2013:$1349.61; 2022:$1175.02; p: 0.02), non-central nervous system transcatheter permanent occlusion or embolization, CPT61626 (2013:$1040.86; 2019:$912.29; p: 0.002), stent placement, CPT61635 (2013:$1697.18; 2022:$1490.68; p: 0.05), and when viewed as aggregate procedures (2013:$1265.01; 2022:$1000.45; p &lt; 0.01). CONCLUSIONS: Inflation-adjusted reimbursement is decreasing for certain neuroendovascular procedures over time and for all neuroendovascular procedures when viewed as an aggregate group. This suggests a need for reevaluation of the market value and advocacy for neuroendovascular providers and procedures in the era of value/quality-based care.

The monocyte-to-high-density lipoprotein ratio is associated with the occurrence of atrial fibrillation among NAFLD patients: A propensity-matched analysis.

Accumulating evidence suggests that patients with nonalcoholic fatty liver disease (NAFLD) have a significantly high risk of incident atrial fibrillation (AF). Systemic inflammation, metabolic disorders and oxidative stress could be the potential mechanisms by which NAFLD drives AF. Monocyte-to- high-density lipoprotein ratio (MHR) has emerged as a novel biomarker of inflammation and oxidative stress that has not been studied in AF with NAFLD patients. We aimed to investigate the relationship between MHR and the risk of AF among NAFLD patients. A retrospective analysis was performed for the clinical data of the patients with NAFLD in the Second Hospital of Shanxi Medical University from January 2019 to October 2022, among whom 204 patients with AF were enrolled as NAFLD+AF group and 613 patients without AF were enrolled as NAFLD control, and 152 patients were selected from each group based on propensity score matching (PSM) at a ratio of 1:1 to balance the covariates between groups. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Logistic regression analysis was performed to identify the independent predictor for occurrence of AF among NAFLD patients. Trend chi-square test to analyze the prevalence of AF among MHR tertiles, and then the correlation between MHR and the risk of AF confirmed by restricted cubic splines (RCS). The receiver operating characteristic (ROC) curve analysis was used to determine the optimum MHR cutoff value to predict AF. Univariate analysis showed that AF patients had higher MHR than non-AF patients (P < 0.001). Meanwhile, compared with pure NAFLD patients, multivariate logistic regression analysis showed that MHR remained to be an independent risk factor for AF after adjusting for confounding risk factors (OR = 10.67, 95% CI 2.17-52.37, P = 0.004). TC、HDL-C were also independent risk factors for AF. Among them, TC and HDL-C are protective factors for AF. The trend chi-square test showed that the risk of AF increased with an increase in MHR (P < 0.05). However, the RCS showed a nonlinear and J-shaped relationship between MHR and the risk of AF (P for non-linearity = 0.023). The occurrence of AF increased with increasing MHR only when MHR > 0.44. The ROC curve showed that MHR combined with traditional risk factors can improve the ability to predict AF. MHR is an independently associated with incident AF in patients with NAFLD and show a certain predictive value.

Uptake of prevention of mother-to-child transmission cascade services in Burkina Faso between 2013 and 2020: are we on the right track?

BackgroundThe use of services to prevent mother-to-child transmission (PMTCT) of the human immunodeficiency virus (HIV) remains a serious challenge in sub-Saharan Africa. In the last decade, Burkina Faso has implemented numerous policies to increase the use of PMTCT services by pregnant women and their partners, as well as children. This study assesses trends in the uptake of PMTCT services in Burkina Faso from 2013 to 2020 in order to study the progress and gaps in achieving the national and international targets set for 2020.MethodsA repeated cross-sectional analysis was performed using data extracted from district health information software version 2. Percentages were computed for each PMTCT indicator and comparisons between the years were made using a chi-square test for trends with a significance threshold of 5%. Regions were not compared with each other.ResultsThe proportion of pregnant women who were tested and received their results significantly increased from 47.9% in 2013 to 84.6% in 2020 (p value < 0.001). Of the 13 regions in the country, only 1 region met the 95% national targets whereas, 6 regions met the 90% international targets for this indicator. The proportions of HIV-positive women receiving antiretroviral therapy (ART) increased from 90.8% in 2013 to 100% in 2020. In the same period, the proportion of exposed infants who received antiretroviral prophylaxis increased from 64.3% in 2013 to 86.8% in 2020. Only 3 regions reached the national and international targets for this indicator. A positive trend was also observed for the indicator related to screening at 2 months or later of exposed infants using Polymerase Chain Reaction (PCR) technic; with the rate rising from 7.4% in 2013 to 75.7% in 2020. However, for this indicator, the national and international targets were not achieved considering the national and regional settings. Concerning the women’s partners, the proportion of those who tested for HIV increased from 0.9% in 2013 to 4.5% in 2020, with only 1 region that fully met the national target of 10% in 2020. The prevalence of HIV in this particular group was 0.5% in 2020.ConclusionsPMTCT indicators show an increase from 2013 to 2020 but with a strong disparity between regions. National and international targets have not been achieved for any indicator; except for those related to women receiving ART. Strengthening strategies to effectively engage women and their partners on the use of PMTCT cascade services could help reduce mother-to-child transmission in Burkina Faso.

Comparison of alcohol consumption and tobacco use among Korean adolescents before and during the COVID-19 pandemic.

The COVID-19 pandemic has brought significant changes worldwide, and due to the strict "Social Distancing Plan" including school closures, Korean adolescents have experienced unprecedented changes in their lives. Considering the peer effect on adolescents' health behavior impacted due to the changes brought about by the pandemic, it would be interesting to explore differences in substance use in Korean adolescents. This study examines how these risk behaviors among Korean adolescents have changed before and during the COVID-19 pandemic. Korea Youth Risk Behavior Web-based Survey of 87,532 adolescents was used to collect the data for the period 2019, 2020, and 2021. The KYRBWS is conducted by a national institution which uses a stratified two-stage cluster sampling, and the data is statistically reliable and representative of the population. The Cochran-Armitage and Chi-squared test for linear and non-linear time trends, respectively, were calculated to assess the difference across the period (2019, 2020, 2021). Also, the odds ratios (ORs) with 95% CIs for current smoking status and current alcohol use status among 2020 and 2021 participants were compared with those of the 2019 participants using multiple logistic regression analysis. The degree of current smoking status was lower in 2020 and 2021 participants than in the 2019 participants (2020: OR = 0.66, 95% CI = 0.61-0.71; 2021: OR = 0.66, 95% CI = 0.61-0.71). On the same token, current alcohol use status was also lower in the participants during the pandemic than those before the pandemic (2020: OR = 0.70, 95% CI = 0.66-0.73; 2021: OR = 0.70, 95% CI = 0.66-0.73). This study found that alcohol and tobacco use were reduced among Korean adolescents during the COVID-19 pandemic. Despite the decrease, future research on the potential effects of the COVID-19 pandemic on adolescents is warranted.

The differences in drug resistance between drug-resistant tuberculosis patients with and without diabetes mellitus in northeast China: a retrospective study

BackgroundDiabetes mellitus (DM) and drug-resistant tuberculosis (DR-TB) are serious global public health problems. This study aimed to explore the differences in drug resistance between DR-TB patients with and without DM. Risk factors for developing multidrug-resistant tuberculosis (MDR-TB) were also investigated among DR-TB patients.MethodsThe patient’s basic demographic, clinical characteristics, and drug susceptibility testing (DST) data were collected from the Chinese Disease Control Information System. Descriptive statistics were used to estimate the frequency and proportion of included variables. Categorical variables were compared using the Chi-square test or Fisher’s exact test. Chi-square tests for trends were used to determine changes and trends in MDR-TB and pre-extensively drug-resistantTB (pre-XDR-TB) patterns over time. Univariate and multivariate logistic regression analysis was used to explore the risk factors of MDR-TB.ResultsCompared with DR-TB patients with DM, DR-TB patients without DM had significantly higher rates of mono-resistant streptomycin (SM) and any resistance to kanamycin (KM), but significantly lower rates of any resistance to protionamide (PTO) and mono-resistance to levofloxacin (LFX), and pre-XDR-TB (P<0.05). The proportion of resistance to other anti-TB drugs was not statistically different between the DR-TB with and without DM. Among DR-TB patients without and with DM, the proportion of patients with MDR-TB and pre-XDR-TB patterns showed a significant downward trend from 2016 to 2021 (P<0.05). Among DR-TB patients without DM, male, previously treated DR-TB cases, and immigration were risk factors for MDR-TB (P<0.05). In DR-TB patients with DM, a negative sputum smear is a risk factor for MDR-TB (P<0.05).ConclusionThere was no statistical difference in resistance patterns between DR-TB with and without DM, except in arbitrary resistance to PTO and KM, mono-resistant SM and LFX, and pre-XDR-TB. Great progress has been made in the prevention and control of MDR-TB and pre-XDR-TB. However, DR-TB patients with and without DM differ in their risk factors for developing MDR-TB.

Adjuvant treatment of surgically treated bone metastasis patients: association with hospital characteristics and trends over time.

Patients with metastatic disease of the bone (MDB) often require surgical stabilization; however, there is not widespread consensus on subsequent adjuvant management. This study aimed to characterize utilization of perioperative adjuvant treatment among MDB patients. We identified 9413 surgically treated MDB patients with primary (breast, kidney, lung, prostate, or multiple myeloma) cancer from Surveillance, Epidemiology, and End Results (SEER)-Medicare data. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for receipt of chemotherapy, radiation, and bisphosphonates, respectively, in the adjuvant setting (90days before or after surgery) by hospital characteristics-medical school affiliation, surgery volume, and Commission on Cancer (CoC) accreditation. Trends in treatment utilization by year of surgery were assessed via bar charts and Chi-square tests for trend. Patients surgically treated at major medical schools or high-volume facilities (compared to no medical school affiliation and low volume) had significantly higher odds of receiving radiation and chemotherapy, independent of patient and tumor characteristics (OR (95% CI); medical school: radiation 1.33 (1.19-1.49), chemotherapy 1.15 (1.02-1.30); and high volume: radiation 1.22 (1.11-1.34), chemotherapy 1.11 (1.02-1.22)). Patients surgically treated at CoC-accredited institutions, compared to non-accredited, had significantly higher odds of receiving radiation and bisphosphonates [radiation 1.24 (1.13-1.36); bisphosphonates 1.15 (1.04-1.28)]. Use of chemotherapy and bisphosphonates increased while radiation use declined over the study period from 1991 to 2014. Medical school affiliation, hospital volume, and CoC accreditation are associated with receipt of adjuvant treatment to prevent or manage pathologic fractures in MDB patients. Further investigation is needed to determine whether these associations reflect delivery of optimal care.

The Issue of Gender Bias Represented in Authorship in the Fields of Exercise and Rehabilitation: A 5-Year Research in Indexed Journals.

Despite progress made in recent decades, gender bias is still present in scientific publication authorship. The underrepresentation of women and overrepresentation of men has already been reported in the medical fields but little is known in the fields of exercise sciences and rehabilitation. This study examines trends in authorship by gender in this field in the last 5 years. All randomized controlled trials published in indexed journals from April 2017 to March 2022 through the widely inclusive Medline dataset using the MeSH term "exercise therapy" were collected, and the gender of the first and last authors was identified through names, pronouns and photographs. Year of publication, country of affiliation of the first author, and ranking of the journal were also collected. A chi-squared test for trends and logistic regression models were performed to analyze the odds of a woman being a first or last author. The analysis was performed on a total of 5259 articles. Overall, 47% had a woman as the first author and 33% had a woman as the last author, with a similar trend over five years. The trend in women's authorship varied by geographical area, with the higher representation of women authors in Oceania (first: 53.1%; last: 38.8%), North-Central America (first: 45.3%; last: 37.2%), and Europe (first: 47.2%; last: 33.3%). The logistic regression models (p < 0.001) indicated that women have lower odds of being authors in prominent authorship positions in higher-ranked journals. In conclusion, over the last five years, in the field of exercise and rehabilitation research, women and men are almost equally represented as first authors, in contrast with other medical areas. However, gender bias, unfavoring women, still exists, especially in the last authorship position, regardless of geographical area and journal ranking.

The changing composition of urinary calculi in Southern Thailand over the past 14 years

A worldwide increased incidence of urolithiasis has been observed over the past few decades. Insight into the composition of these stones can lead to enhanced medical treatment and outcomes. The objective of this study was to examine the distribution and chemical composition of urinary calculi in Southern Thailand over the past decade. An analysis was conducted on 2611 urinary calculi submitted to the Stone Analysis Laboratory, Songklanagarind Hospital, a single stone analysis laboratory in Southern Thailand. The analysis was performed from 2007 to 2020 using Fourier-transform infrared spectroscopy. The demographic results were described using descriptive statistical analyses, and the Chi-square test for trends was performed to identify changes in urinary calculi composition. The patients' demographic data revealed a male-to-female ratio of 2.2:1; the most common age group of affected men was 50-69 years, whereas the most common age group of affected women was 40-59 years. The most common components found in the calculi were uric acid (30.6%), mixed calcium oxalate with calcium phosphate (29.2%), and calcium oxalate (26.7%). We noted a trend of increasing uric acid calculi for 14 years (P = 0.00493), whereas the trend for the other major components was decreasing. The most common component of urinary calculi analyzed in Southern Thailand was uric acid, with a significant rising trend in proportion in the past decade; the trend of other major components, such as mixed calcium oxalate-calcium phosphate and calcium oxalate, decreased.

Cervical cancer risk levels among women aged 30-65 and factors affecting compliance with the national cervical cancer screening standards

Screening programs for early detection of cervical cancer are extremely important for better prognosis and long-term survival. This study was conducted to determine cervical cancer (CC) risk levels among women aged between 30-65 and the factors affecting having an HPV/Pap smear test that complies with national CC screening standards. A total of 1407 women in the 30-65 age group participated in this cross-sectional study. No sample selection procedure was conducted, and 1407 women who voluntarily agreed to participate in the study were included in the study group. Data were collected between January 2019 and March 2020. The questionnaire used in the study consisted of questions about women's sociodemographic characteristics, lifestyles, CC early diagnosis and screening behaviors, and the CC risk calculation model. Pearson chi-square test, chi-square test for trend, and logistic regression analysis were used in the study. The statistical significance level was accepted as p&lt; 0.05. In the study, 58.9% of the women reported that they had a test within one to three years, 67.5% of those who did not have the test stated they did not know that it was necessary, and 46.2% stated that they neglected it. The CC risk level of 83.6% of women was “below average”. The rate of having an HPV/PS test following the national CC screening standards was significantly higher in women who were in the 50-59 age group, smoked, had a childbirth experience, or did not regularly use a condom during sexual intercourse (p&lt;0.05). As the calculated CC risk level increased, testing behaviors decreased statistically significantly (p&lt;0.01). The time of the last screening test was more than five years in those with a calculated CC risk level of ≥average (p&lt;0.01). The CC risk level of the women in the study was below average. There was a significant relationship between HPV/PS testing behavior and age, smoking, having a childbirth experience, and condom use.

Automated coding and selection of causes of death in Peru: a descriptive study, 2016-2019.

It could be seen good performance of the software for the automatic selection of the underlying cause of death, increasing from 69.6% in 2016 to 78.8% in 2019. There was a correlation between this result and the use of online death certificates by physicians. Automatic coding and selection of causes of death improve productivity and timeliness of information, contributing to the quality of the country's information system. It is necessary to analyze the agreement between the medical terms in the software dictionaries used in South American countries in order to improve standardization and comparability of information on causes of death. to describe software performance in the automatic selection of the underlying cause of death in Peru, between 2016 and 2019. this was a descriptive study on the software performance in the automated selection of the underlying cause of death over the years (chi-square test for trend) and the correlation between the type of death certificate and software performance (correlation coefficient and coefficient of determination). a total of 446,217 death certificates were analyzed; the proportion of death certificates with the underlying cause of death increased from 69.6% in 2016 to 78.8% in 2019 (p-value < 0.001); it could be seen a direct linear correlation between electronic death certificates and software performance (correlation coefficient = 0.95; R2 = 0.89). the software showed good performance in the automatic selection of the underlying cause of death, with a significant increase between 2016 and 2019.

Sustained high HIV incidence among men who have sex with men in Jiangsu province, China: based on the limiting-antigen avidity EIA method and six consecutive surveys, 2016-2021.

The epidemic of HIV infection among men who have sex with men (MSM) is a major public health concern in some parts of China, but data on trends in HIV incidence are limited. This study aimed to examine the trends in HIV incidence and factors associated with recent HIV infection among MSM in Jiangsu province, China, based on the limiting-antigen avidity enzyme immunoassay (LAg-Avidity-EIA) method. Six consecutive surveys were implemented among MSM throughout Jiangsu province from 2016 to 2021. Participants were recruited in three ways. Socio-demographic and behavioral information were collected through face-to-face interviews. Venous blood samples were taken to test for HIV and syphilis. HIV incidence was estimated using the LAg-Avidity-EIA method. Chi-square trend tests were used to observe trends over the years. Multivariate regression analyses were used to identify factors associated with recent HIV infection. A total of 15,401 participants were enrolled in the study. The prevalence of HIV infection ranged from 8.0 to 9.8%, with no consistent rise or fall over the years (P = 0.189). HIV incidence ranged from 5.0 to 9.0%, and no uptrend or downtrend was shown (P = 0.418). MSM who lived locally for more than 2 years (aOR = 1.366, P = 0.019), had a lack of comprehensive HIV knowledge (aOR = 1.643, P = 0.031), had engaged in unprotected anal intercourse (UAI) in the past 6 months (aOR = 7.373, P < 0.001), had been tested for HIV within 12 months (aOR = 1.292, P = 0.035), and tested positive for syphilis (aOR = 2.840, P < 0.001) were likely to be recently infected with HIV. HIV incidence among MSM has remained at a high level in Jiangsu province. In China, health education, condom use, and HIV/syphilis testing should continue to be top priorities for HIV prevention among MSM to reduce HIV transmission.

Family Planning from a Male Perspective: Observations from a Community-Based Cross-sectional Study in Chennai, Tamil Nadu.

Traditionally, family planning has been considered in the context of maternal and child health, although men play a dominant role in all matters related to reproductive decision-making. This study is carried out to assess the attitude and participation in family planning among currently married males and identify factors influencing the acceptance of male contraception. A cross-sectional study was conducted in Chennai in October 2018, which included 180 currently married men by systematic random sampling of eligible couples in the field practice area of Sanjeevarayanpet Primary Health Center (UPHC). Data was collected through a self-administered questionnaire in the local language and analyzed using SPSS version 16. Absolute and relative frequencies were estimated for descriptive data while correlates were tested for statistical significance using Pearson or Trend Chi-square tests. Study participants considered two children (82%) and spacing of at least 2 years (95%) as ideal, with spousal communication regarding family planning considered essential by a two-thirds majority. Among the 117 men who reported ever using contraception as a couple, 69% had used a condom vs. 42% and 30% for female spacing methods and tubectomy, respectively. Vasectomy, with nil acceptors, was considered acceptable by only 21% of men. Education, per-capita income, and spousal communication were seen to positively influence male contraceptive use. While married men show considerable commitment to family planning decision-making and practice, the stigma and misconceptions surrounding vasectomy have become ever more prominent. There is a need for the community and the health care system to work together to promote gender equity in family planning.

ДИНАМИКА ГРУПП ЗДОРОВЬЯ ПО ИТОГАМ ДИСПАНСЕРИЗАЦИИ ДЕТЕЙ В ТРУДНОЙ ЖИЗНЕННОЙ СИТУАЦИИ

Evaluation of the effectiveness of medical care based on the results of medical examinations for orphans, children left without parental care, is an urgent area of work for pediatricians and healthcare organizers. The purpose of the study is to evaluate the effectiveness of clinical examination in terms of the health groups of children in a difficult life situation staying in stationary institutions in the Arkhangelsk region. Methods. Аn analytical observational cohort study was conducted, the rate of increase (loss) of indicators was assessed, the significance of a linear trend was determined using a chi-square test for a linear trend, and p was calculated using the Epi Info program. The study included children aged 0 to 17 years inclusive, who underwent a medical examination in 2016-2020. Results. Health group I decreased from 2.1 to 1.7%; II, from 41.3 to 38.9%; III, from 35.1 to 33.7%, IV - from 10.3 to 1.4%; increased from 11.2 to 24.3% of the V health group. The proportion of children with disabilities increased by 6%. Conclusion. The growth of an unfavorable health status in children shows the insufficient effectiveness of clinical examination, despite its annual conduct.

Acceptance of the COVID-19 vaccine booster dose and associated factors among the elderly in China based on the health belief model (HBM): A national cross-sectional study.

The reluctance of individuals to obtain solid vaccine-induced immunity represents a fundamental challenge to containing the spread of SARS-CoV-2, including its highly mutated variants. We aimed to assess vaccination acceptance and associated factors for the COVID-19 vaccine booster dose among elderly people (≥60 years old) in China, providing a theoretical and practical reference for universal vaccination policy. A national anonymous survey was conducted in mainland China from May 25 to June 8, 2022, using a stratified random sampling method. Individuals 60 years of age and above were the target population. A chi-squared test and Cochran-Armitage test for trend were used to compare and examine vaccine acceptance rates by characteristics. Via a backward stepwise method, multivariable logistic regression models were established to assess factors associated with booster dose acceptance. Two-sided P < 0.05 was considered statistically significant. Of 3,321 eligible participants, 82.8% (95% CI: 81.5-84.1%) were willing to receive COVID-19 vaccine booster shots. Concerns about contraindications (38.3%), vaccine safety (32.0%), and limited movement (28.0%) were the main reasons for vaccine hesitancy. Nearly one-third still believed that the booster dose was unnecessary after receiving the initial vaccination. Older adults with a low level of perceived barriers (aOR = 1.86, 95% CI, 1.03-3.38), a high level of perceived benefit (aOR = 2.31, 95% CI, 1.38-3.87), and higher cues to action (moderate, aOR = 2.22, 95% CI, 1.39-3.56; high, aOR = 5.46, 95% CI: 3.44-8.67) were more likely to accept the booster dose. Other major factors affecting the booster dose acceptance rate were occupation, time spent on social media, vaccination history, and a high knowledge score for COVID-19 and vaccines. In addition, for those over 70 years of age, rising awareness of susceptibility could be a better gateway for improving their willingness to get vaccinated. A total of 82.8% of recruited older adults were willing to receive the booster dose. Acceptance behaviors were closely related to occupation, time spent on social media, vaccination history, knowledge factors, perception of barriers, and benefit, as well as action cues. Targeted public health measures are a priority for improving the vaccination coverage of valid immunity among the elderly population, not only to prevent infection and poor prognosis caused by emerging variants but also to reduce the huge disease and economic burden caused by the long-term sequelae after SARS-CoV-2 infection.

Expression level and function analysis of serum miRNAs in workers with occupational exposure to benzene series

Benzene series are ubiquitous in industrial production and daily life, and can have an impact on health even at low concentrations. miRNAs have been proved to be a biomarker of a variety of diseases and carcinogens. The purpose of this study was to explore the distribution characteristics and biological function of miRNAs in subjects exposed to benzene series. In this study, serum miRNAs were measured in 247 occupationally exposed subjects and 256 controls. The relationship between cumulative exposure dose of benzene series and miRNAs was analyzed by Generalized linear model, Spearman's rank correlation, and chi-square test for trend. The function of MiRNAs target gene was analyzed by means of bioinformatics method. The results showed that the expressions of miR-181a-5p, 221-3p, 223-3p, and 342-3p were down-regulated, whilst the expression of miR-638 was up-regulated in the occupational exposure group. miR-181a-5p, 221-3p, 223-3p, 342-3p, and 638 showed dose-response relationship with benzene series, and were closely related to multiple tumor pathways. miR-181a-5p, 221-3p, 223-3p, 342-3p, and 638 may be involved in the carcinogenic process of benzene series, and can be used to evaluate the early biological effects and monitor the exposure level of benzene series. miRNAs are potential biomarkers of benzene series exposure.