Search Results (21)

Background: Prostate cancer is a major public health concern in Ghana, where most cases present late and mortality remains high. Community education is essential for improving awareness and early detection. Traditional health talks are widely used, but interactive approaches such as board games have received little evaluation. Aim: To compare the effectiveness of a Social Cognitive Theory–Socioecological Model-based literacy board game (S-S-LIBOG) with a traditional health talk in improving prostate cancer knowledge, attitudes, and perceptions. Methods: A quasi-experimental, two-arm interventional study was conducted in a semi-urban Ghanaian cohort. Participants (n = 197) were allocated to either the board game arm (n = 80) or the health talk arm (n = 61) after accounting for attrition. A structured questionnaire measured knowledge, attitudes, and perceptions (KAP) before and after intervention. Statistical analyses at 5% alpha level included chi-square tests, two-proportion Z-tests, Wilcoxon signed-rank tests, and multivariate logistic regression. Results: Among participants, 29.4% were female, 64.5% male, and 6.1% other genders. Tertiary education was reported by 81.7%, secondary 9.6%, postgraduate 5.6%, and primary 3.0%. Ethnicities: Ewe 41.6%, Akan 26.9%, Northern 13.7%, Ga 6.6%, Guan 1.5%, others 9.6%. Rural dwellers: 29.9%. LIBOG improved ‘good knowledge level’ from 35.0% at baseline to 60.0% post-intervention, compared to 35.0% to 62.3% by the Health Talk (HT). S-S-LIBOG also narrowed gender, education, and lifestyle disparities in KAP, with males showing higher odds of positive attitude (OR = 4.16, p = 0.004) and perception (OR = 2.79, p = 0.047), and rural residents having increased odds of good knowledge (OR = 4.39, p = 0.041) post—its intervention. HT similarly equalized disparities, except for perception, which remained linked to education. The significant improvements in knowledge were (LIBOG: z = 2.85, p = 0.004; HT: z = 3.10, p = 0.002). Even though health talks achieved higher overall knowledge gains, no statistically significant difference in overall effectiveness was observed between the two methods (Wilcoxon W = 102.0, p = 0.107). Acceptability of the board game was high, with over 80% of participants reporting satisfaction. Conclusions: The S-S-LIBOG board game was not inferior to the traditional health talk, showing particular strengths in enhancing attitudes and perceptions. Its interactive and culturally adapted design makes it a feasible adjunct to conventional health education methods. Future studies should examine long-term impacts and application in more diverse populations. This study was retrospectively registered by the Pan African Clinical Trial Registry on 10 October 2025; with the Trial Registration number PACTR202510512711680. Full article

Background: Prediabetes, a precursor state to type 2 diabetes mellitus (T2DM), is characterized by elevated glucose levels that are not yet in the diabetic range. It is often associated with comorbidities such as obesity, hypertension, and dyslipidemia, driven by unhealthy lifestyle factors. This study aims to assess the relationship between adherence to the Mediterranean diet and anthropometric measures, such as body mass index and waist circumference, in Arab adults with prediabetes, considering other lifestyle patterns, including smoking, socioeconomic status, and physical activity. Methods: We performed baseline data analysis among a sample of prediabetic participants of a clinical trial aimed at improving physical activity and healthy lifestyle behaviors. Patients were recruited from the Sheikh Jarrah Clalit Health Services clinic in East Jerusalem. Eligible participants were identified via medical record review and invited by their primary physician. After providing informed consent, participants completed interviewer-administered questionnaires covering sociodemographic data, physical activity, and dietary habits. Physical measurements, including height, weight, and waist circumference, were taken using standardized protocols. Adherence to the Mediterranean diet was assessed using the locally adapted Israeli Mediterranean Diet Adherence Screener (I-MEDAS). Results: A total of 172 prediabetic adults aged 40–69.9 years were recruited. The majority of participants exhibited high adherence to the Mediterranean diet, with 80.2% achieving a high adherence score. However, no significant associations were found between Mediterranean diet adherence and BMI or waist circumference. Active smokers were 70.6% less likely to adhere to the Mediterranean diet compared to nonsmokers, and participants with equal-to-average income had lower odds of adhering to the diet compared to those with below-average income. Conclusions: These findings underscore the need for tailored public health strategies that address local cultural, economic, and environmental factors influencing dietary habits. Improving adherence to the Mediterranean diet in this population will require a multifaceted approach, with further research needed to understand the complex relationship between diet, lifestyle, and chronic disease prevention. Full article

Background: Brucellosis is a major zoonotic infection that warrants treatment with antibiotic therapy. Current treatment recommendations include using either dual or triple therapy with antibiotics active against brucella species. This study aims to evaluate the effectiveness and safety of dual and triple antibiotic therapy for treating brucellosis. Methods: This is a retrospective cohort study for patients with confirmed Brucellosis infection from 2015 to 2024. The primary outcome was the achievement of a favorable response. Secondary outcomes were treatment failure, 90-day mortality, relapse of brucella infection, hospital re-admission, and adverse drug reactions (ADRs). Baseline characteristics were reported as means with standard deviations. All the statistical tests are shown as odds ratios (ORs) with 95% confidence intervals (CIs). Results: In total, 966 patients were screened and 287 met the inclusion criteria: 164 patients in the dual therapy group and 123 patients in the triple therapy group. Achievement of a favorable response was not statistically different between the dual therapy and triple therapy groups; 87.3% vs. 90.5%, OR 1.2 (0.48–3.02, p = 0.42). No patient died in either treatment group. Treatment failure, mean duration of hospitalization, brucella relapse, hospital re-admission, and the mean time to defervescence were not statistically different between dual and triple therapy groups. Adverse drug reactions were numerically higher in the triple therapy group. Conclusions: Dual therapy was equally effective for the treatment of patients with brucellosis compared to the triple therapy regimens. Although not statistically significant, there more ADRs in the triple therapy group compared to those receiving dual therapy. Thus, dual antibiotic therapy is efficacious, less costly, and associated with fewer ADRs compared to triple antibiotic therapy. Full article

Background: Insulin resistance (IR) is a condition that precedes the onset of type 2 diabetes mellitus (T2DM), which is regarded as an established risk factor for atherosclerosis (AS). Considering that the same metabolic changes as those caused by IR are evidenced to promote the development of AS, we investigated whether IR estimated by the homeostasis model assessment of IR (HOMA-IR) could predict the occurrence of preclinical AS. Methods: The study participants were divided into two groups based on the presence of IR diagnosed during the baseline hospitalization and defined as a HOMA-IR value equal to or higher than 2.5. After a follow-up period of at least four years, a total of 79 (n = 79) were prospectively assessed in terms of the presence of preclinical AS, determined by either an abnormally low ankle–brachial index (ABI) (ABI < 0.9) or an increased carotid intima media thickness (CIMT) (CIMT > 1 mm). Results: Using the multivariate logistic regression analysis, it was demonstrated that the HOMA-IR was associated with an abnormally low ABI (odds ratio: 1.609, 95% confidence interval (CI): [1.041–2.487], p = 0.032). The Cox regression model revealed that the HOMA-IR was a predictor of both an abnormal ABI (hazard ratio: 1.435, CI: [1.076–1.913], p = 0.014) and increased CIMT (hazard ratio: 1.419, CI: [1.033–1.948], p = 0.031), independently of age, sex, dyslipidemia, smoking, triglycerides (TG), low-density lipoproteins (LDL), high-density lipoproteins (HDL), and total cholesterol levels. Conclusions: IR, as estimated by the HOMA-IR, may be considered as a predictor of preclinical AS, independently of cardiovascular risk factors. Full article

Background: The incidence of cutaneous melanoma (CM) is increasing at an alarming rate in Canada and elsewhere around the world. Significant regional differences in CM incidence have been identified in Atlantic provinces. The goal of this study is to compare ultraviolet exposure, sun protective behaviours, level of worry and baseline CM knowledge in provinces with a high versus low incidence of CM as well, as between various demographic groups. Methods: A cross-sectional survey study was conducted in Atlantic provinces between July 2020 and August 2022. All participants aged ≥ 16 years with a completed survey were eligible. Survey responses were summarized using frequency counts, percentages, and means. Two-sided Z-tests for equality of proportions and logistic regression models were used to compare the survey results between geographic and demographic groups. Results: In total, 7861 participants were included (28.0% men; mean age 61.3 years; response rate 28%). Our results (gender- and age-adjusted odds ratio, 95% confidence interval) show that high-incidence provinces for CM (Prince Edward Island and Nova Scotia) had significantly more sunburns (OR 2.00, 1.72–2.31), total sun exposure (OR 2.05, 1.68–2.50), recreational sun exposure (OR 1.95, 1.61–2.35) and tans (OR 1.77, 1.53–2.05) than individuals in low-incidence provinces (Newfoundland and Labrador). However, individuals in high-incidence provinces displayed more protective behaviors: there were less tanning bed users (OR 0.82, 0.71–0.95), they checked their skin more frequently for new moles (OR 1.26, 1.06–1.51) and practiced more sun protection overall. Additional analyses are presented based on education, income, sexual orientation and gender. Discussion: These findings suggest that future efforts aimed at reducing the CM burden in Atlantic Canada should be tailored for target geographic and/or demographic groups. Limitations: the study participants are not representative of the population in Atlantic Canada due to recruitment strategies. Full article

(1) Background: Since the treatment of chronic total occlusion (CTO) with percutaneous coronary intervention (PCI) is associated with high procedural complexity, it has been suggested to use a multi-operator approach. This study was aimed at evaluating the procedural outcomes of single (SO) versus dual-operator (DO) CTO-PCI approaches. (2) Methods: This retrospective analysis included data from the Polish Registry of Invasive Cardiology Procedures (ORPKI), collected between January 2014 and December 2020. To compare the DO and SO approaches, propensity score matching was introduced with equalized baseline features. (3) Results: The DO approach was applied in 3604 (13%) out of 27,788 CTO-PCI cases. Patients undergoing DO CTO-PCI experienced puncture-site bleeding less often than the SO group (0.1% vs. 0.3%, p = 0.03). No differences were found in the technical success rate (successful revascularization with thrombolysis in myocardial infarction flow grade 2/3) of the SO (72.4%) versus the DO approach (71.2%). Moreover, the presence of either multi-vessel (MVD) or left main coronary artery disease (LMCA) (odds ratio (OR), 1.67 (95% confidence interval (CI), 1.20–2.32); p = 0.002), as well as lower annual and total operator volumes of PCI and CTO-PCI, could be noted as factors linked with the DO approach. (4) Conclusions: Due to the retrospective character, the findings of this study have to be considered only as hypothesis-generating. DO CTO-PCI was infrequent and was performed on patients who were more likely to have LMCA lesions or MVD. Operators collaboratively performing CTO-PCIs were more likely to have less experience. Puncture-site bleeding occurred less often in the dual-operator group; however, second-operator involvement had no impact on the technical success of the intervention. Full article

Neutrophil gelatinase-associated lipocalin (NGAL) is an inflammatory biomarker related to acute kidney injury (AKI). Including 1892 consecutive patients with ST-elevation myocardial infarction (STEMI), in which NGAL was measured in 1624 (86%) on admission and in a consecutive subgroup at 6–12 h (n = 163) and 12–24 h (n = 222) after admission, this study aimed to evaluate the prognostic value of NGAL in predicting AKI and mortality. Patients were stratified based on whether their admission NGAL plasma concentration was greater than or equal to/less than the median. The primary endpoint was a composite of the first occurrence of AKI or all-cause death within 30 days. AKI was classified by the maximal plasma creatinine increase from baseline during index admission as KDIGO1 (<200% increase) or KDIGO23 (≥200% increase) according to the Kidney Disease Improving Global Outcomes (KDIGO) system. Admission NGAL > the median was independently associated with a higher risk of severe AKI (KDIGO2-3) and 30-day all-cause mortality when adjusted for age, admission systolic blood pressure and high-sensitivity C-reactive protein, left-ventricular ejection fraction, known kidney dysfunction, and cardiogenic shock with an odds ratio (95% confidence interval) of 2.26 (1.18–4.51), p = 0.014. Finally, we observed increasing predictive values in a subgroup during the first day of hospitalization suggesting that assessment of NGAL should be delayed for optimal prognostic purposes. Full article

Elevated heart rate (HR) can be hypothesized to be involved in the pathways by which ambient air pollution, especially fine particulate matter (PM_2.5), causes cardiovascular morbidity and mortality. However, evidence concerning long-term PM_2.5 exposure and HR is still limited. Therefore, in this study, we assessed the associations of PM_2.5 with HR levels and tachycardia prevalence and explored potential modifiers of the associations. We used baseline data of 1,802,207 adults from the Kashgar Prospective Cohort Study (KPCS). PM_2.5 exposure was assessed based on satellite sensing data, meteorological factors, multi-resolution emission inventory, and measurements from ground-based surface monitors measurements. HR was measured using a calibrated electronic sphygmomanometer, and tachycardia was defined as resting heart rate (RHR) equal to or greater than 80 beats per minute. Linear regression and logistic regression models were employed to evaluate the associations of PM_2.5 levels with RHR levels and tachycardia prevalence, respectively. Stratified analyses by sex, age, ethnicity, smoking status, alcohol use, and physical activity were also performed. The mean (standard deviation) age of the study participants was 39.4 (15.5) years old. In the adjusted models, an interquartile range (8.8 µg/m³) increase in PM_2.5 levels was associated with 0.515 (95% confidence interval: 0.503–0.526) bpm increase in RHR levels and with 1.062-fold (95% confidence interval: 1.059–1.064) increase in the odds of tachycardia. The results were robust against several sensitivity analyses. In addition, we observed the above associations were stronger in participants that were men, of Uyghur ethnicity, smoking cigarettes, drinking alcohol, and having physical inactivity, compared to their counterparts. In summary, our findings indicate that long-term exposure to ambient PM_2.5 may be hazardously associated with HR, and women, Uyghur people, and those with unhealthy lifestyles may be more vulnerable to the hazardous effects. Full article

Staple food preference vary in populations, but evidence of its associations with obesity phenotypes are limited. Using baseline data (n = 105,840) of the Regional Ethnic Cohort Study in Northwest China, staple food preference was defined according to the intake frequency of rice and wheat. Overall and specifically abdominal fat accumulation were determined by excessive body fat percentage and waist circumference. Logistic regression and equal frequency substitution methods were used to evaluate the associations. We observed rice preference (consuming rice more frequently than wheat; 7.84% for men and 8.28% for women) was associated with a lower risk of excessive body fat (OR, 0.743; 95%CI, 0.669–0.826) and central obesity (OR, 0.886; 95%CI, 0.807–0.971) in men; and with lower risk of central obesity (OR, 0.898; 95%CI, 0.836–0.964) in women, compared with their wheat preference counterparties. Furthermore, similar but stronger inverse associations were observed in participants with normal body mass index. Wheat-to-rice (5 times/week) reallocations were associated with a 36.5% lower risk of normal-weight obesity in men and a 20.5% lower risk of normal-weight central obesity in women. Our data suggest that, compared with wheat, rice preference could be associated with lower odds ratios of certain obesity phenotypes in the Northwest Chinese population. Full article

The equal odds baseline model of creative scientific productivity proposes that the number of high-quality works depends linearly on the number of total works. In addition, the equal odds baseline implies that the percentage of high-quality works and total number of works are uncorrelated. The tilted funnel hypothesis proposes that the linear regression implied by the equal odds baseline is heteroscedastic with residual variance in the quality of work increasing as a function of quantity. The aim of the current research is to leverage Bayesian statistical modeling of the equal odds baseline. Previous work has examined the tilted funnel by means of frequentist quantile regression, but Bayesian quantile regression based on the asymmetric Laplace model allows for only one conditional quantile at a time. Hence, we propose additional Bayesian methods, including Poisson modeling to study conditional variance as a function of quantity. We use a classical small sample of eminent neurosurgeons, as well as the brms Bayesian R package, to accomplish this work. In addition, we provide open code and data to allow interested researchers to extend our work and utilize the proposed modeling alternatives. Full article

The STOP-Bang questionnaire is an easy-to-administer scoring model to screen and identify patients at high risk of obstructive sleep apnea (OSA). However, its diagnostic utility has never been tested with First Nation peoples. The objective was to determine the predictive parameters and the utility of the STOP-Bang questionnaire as an OSA screening tool in a First Nation community in Saskatchewan. The baseline survey of the First Nations Sleep Health Project (FNSHP) was completed between 2018 and 2019. Of the available 233 sleep apnea tests, 215 participants completed the STOP-Bang score questionnaire. A proportional odds ordinal logistic regression analysis was conducted using the total score of the STOP-Bang as the independent variable with equal weight given to each response. Predicted probabilities for each score at cut-off points of the Apnea Hypopnea Index (AHI) were calculated and plotted. To assess the performance of the STOP-Bang questionnaire, sensitivity, specificity, positive predictive values (PPVs), negative predictive values (NPVs), and area under the curve (AUC) were calculated. These data suggest that a STOP-Bang score ≥ 5 will allow healthcare professionals to identify individuals with an increased probability of moderate-to-severe OSA, with high specificity (93.7%) and NPV (91.8%). For the STOP-Bang score cut-off ≥ 3, the sensitivity was 53.1% for all OSA and 72.0% for moderate-to-severe OSA. For the STOP-Bang score cut-off ≥ 3, the specificity was 68.4% for all OSA and 62.6% for moderate-to-severe OSA. The STOP-Bang score was modestly superior to the symptom of loud snoring, or loud snoring plus obesity in this population. Analysis by sex suggested that a STOP-Bang score ≥ 5 was able to identify individuals with increased probability of moderate-to-severe OSA, for males with acceptable diagnostic test accuracy for detecting participants with OSA, but there was no diagnostic test accuracy for females. Full article

(1) Background: There is a high neonatal mortality rate in countries with low resources, especially sub-Saharan countries. There is no published data in Sudan on mothers’ knowledge and practice of essential newborn care. This study aimed to assess the maternal knowledge and practice of essential newborn care in Gadarif city, eastern Sudan. (2) Methods: A cross-sectional study was conducted in Gadarif city, eastern Sudan. Postnatal mothers (384) were recruited from postnatal and vaccination clinics. A structured questionnaire was used to collect the data. Mothers who responded to essential newborn care knowledge and practice items at a rate equal to 75% or above were classified as having good knowledge and practice. Logistic regression analysis was performed to identify the factors associated with essential newborn care knowledge and practice. (3) Results: In this study, 268 (66.4%) and 245 (63.8%) of the 384 participants had good knowledge and practice of essential newborn care, respectively. None of the investigated factors (age, residence, education, occupation, parity, antenatal care, and mode of delivery) was associated with knowledge and practice of essential newborn care with sociodemographic and obstetric factors. Mothers with poor knowledge were less likely to have good practices (adjusted odds ratios = 0.41; 95% CI (0.26–0.64)). The reported malpractices were giving dietary supplements to the babies (48.2%), mainly water (40.0%) and cow’s milk (43.2%), and putting substances on the umbilical cord (62.8%), with butter (92.1%) accounting for the majority. (4) Conclusion: In the present study, around two-thirds of the participants had good essential newborn care knowledge and practice. Poor knowledge was less likely to be associated with good newborn care practices. More research is needed to build baseline data for neonatal mortality reduction plans. Full article

Pancreatic cancer is the seventh leading cause of cancer death in both sexes. The aim of this study is to analyze baseline CT body composition using artificial intelligence to identify possible imaging predictors of survival. We retrospectively included 103 patients. First, the presence of surgical treatment and cut-off values for sarcopenia and obesity served as independent variates. Second, the presence of surgery, subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and skeletal muscle index (SMI) served as independent variates. Cox regression analysis was performed for 1-year, 2-year, and 3-year survival. Possible differences between patients undergoing surgical versus nonsurgical treatment were analyzed. Presence of surgery significantly predicted 1-year, 2-year, and 3-year survival (p = 0.01, <0.001, and <0.001, respectively). Across the follow-up periods of 1-year, 2-year, and 3-year survival, the presence of sarcopenia became an equally important predictor of survival (p = 0.25, 0.07, and <0.001, respectively). Additionally, increased VAT predicted 2-year and 3-year survival (p = 0.02 and 0.04, respectively). The impact of sarcopenia on 3-year survival was higher in the surgical treatment group (p = 0.02 and odds ratio = 2.57) compared with the nonsurgical treatment group (p = 0.04 and odds ratio = 1.92). Fittingly, a lower SMI significantly affected 3-year survival only in patients who underwent surgery (p = 0.02). Especially if surgery is performed, AI-derived sarcopenia and reduced muscle mass are unfavorable imaging predictors. Full article

The coronavirus virus disease 2019 (COVID-19) pandemic has impacted the global healthcare system. In Thailand, the first and most available vaccines were inactivated and viral vector vaccines. We reported the impact of those vaccines in preventing severe disease and death in kidney transplant recipients. This retrospective study comprised 45 kidney transplant recipients with COVID-19 infection, classified by vaccination status. Outcomes of interest were death, pneumonia, and allograft dysfunction. There were 23 patients in vaccinated group and 22 patients in unvaccinated group. All baseline characteristics were similar except mean age was older in vaccinated group, 55 vs. 48 years. Total 11 patients (24%) died (13% vaccinated vs. 36% unvaccinated RR, 0.56; 95% CI, 0.29–0.83; p = 0.03). Multivariate analysis showed that vaccination significantly decrease mortality (odds ratio, 0.54; 95% CI, 0.10–0.94; p = 0.03). Pneumonia developed equally in both groups (70%). There was a trend toward less oxygen requirement as well as ventilator requirement in vaccinated group. The rate of allograft dysfunction was similar (47%). Inactivated and viral vector COVID-19 vaccines have beneficial effect on mortality reduction in kidney transplant recipients. Even partial vaccination can exert some protection against death. However, full vaccination should be encouraged to achieve better prevention. Full article

Mixed evidence was published regarding the association of sodium, potassium and sodium-to-potassium ratio (Na/K ratio) with renal function impairment. This study was conducted to further explore the relationship between sodium, potassium, NA/K ratio and kidney function in the general adult Chinese population. We performed a cross-sectional analysis using the baseline data from the Action on Salt China (ASC) study. 5185 eligible general adult participants from the baseline investigation of the ASC study were included in this analysis. Sodium, potassium and albumin excretion were examined from 24-h urine collection. Albuminuria was defined as albumin excretion rate (AER) greater than or equal to 30 mg/24-h. Mixed linear regression models, adjusted for confounders, were fitted to analyze the association between sodium, potassium and Na/K ratio, and natural log transformed AER. Mixed effects logistic regression models were performed to analyze the odds ratio of albuminuria at each quintile of sodium, potassium and Na/K ratio. The mean age of the participants was 49.5 ± 12.8 years, and 48.2% were male. The proportion of albuminuria was 7.5%.The adjusted mixed linear models indicated that sodium and Na/K ratio was positively associated with natural log transformed AER (Sodium: β = 0.069, 95%CI [0.050, 0.087], p < 0.001; Na/K ratio: β = 0.026, 95%CI [0.012, 0.040], p < 0.001). Mixed effects logistic regression models showed that the odds of albuminuria significantly increased with the quintiles of sodium (p < 0.001) and Na/K ratio (p = 0.001). No significant association was found between potassium and the outcome indicators. Higher sodium intake and higher Na/K ratio are associated with early renal function impairment, while potassium intake was not associated with kidney function measured by albumin excretion. Full article