THE “FLU SEASONS” AND THE MISSING DATA: A MATCHED-PAIR ANALYSIS FOR THE PANDEMIC SEASON 2019_2020

The unit cell from the McNemar’s 2x2 Table denotes the week with col (1, 2) and the Public Health Region with Row (1, 2). We calculate the standard normal statistic (z) for A(H1), A(H3), Influenza B. Each one categorical unit is in fact a pair of matched-pair data within its own partial table. The Cochran-Mantel-Haenszel Test collapses these partial tables to summate these 2n observations in a 2x2 x n contingency table to yield the marginal counts of the McNemar’s test. The open data for Europe/Asia began this SARS-CoV2 pandemic, from week 3 to week 14, with the normal statistic (z) entering into an identical collapse mode. These all assumed the same “V” curve as the general collapse pattern and they rippled together without overlapping. During this period China applied mandatory lockdown and they mandated masks. We should strive to be more evidence-based so that we can convince more of the general public to accept the public health measures to survive.

Rivaroxaban is Comparable to Warfarin in Prevention of Thromboembolism in Patients with Non-Valvular Atrial Fibrillation with Valvular Heart Disease: A Systematic Review and Meta-analysis

Objectives: While the use of novel oral anticoagulants (NOACs) has been approved in the treatment of non-valvular atrial fibrillation (NVAF), we are lacking studies on individual NOACs in NVAF with valvular heart disease (VHD) including bio-prosthetic valve and valve repair. We aimed to determine the efficacy and safety of rivaroxaban compared to warfarin in prevention of thromboembolism in patients with NVAF with VHD. Methods: We searched PubMed, MEDLINE, and EMBASE including only RCTs and Cohort studies from inception till April 2021. Eligible studies compared rivaroxaban with warfarin in patients with NVAF with VHD. We excluded patients with valvular AF. We used Review Manager (version 5.4, Cochrane Collaboration, Oxford, UK) applying the Mantel-Haenszel test and followed PRISMA guidelines. Risk ratio (RR) and 95% confidence intervals (CIs) were estimated using a random-effects method and heterogeneity using I squared test. Results: We had total of 23136 participants in both groups. Our results showed stroke and systemic thromboembolism in 88 of 4258 (2.06%) patients in the rivaroxaban group compared to 351 of 18878 (1.85%) patients in the warfarin group (RR 0.76; 95% CI, 0.55, 1.06; heterogeneity I2 = 35%, P = 0.10), major bleeding in 247 of 4258 (5.8%) patients in the rivaroxaban group compared to 270 of 18879 (1.4%) patients in the warfarin group (HR 1.68; 95% CI, 0.59, 4.77; heterogeneity I2 = 97%) and intracranial hemorrhage in 24 out of 2583 (0.9%) patients in the rivaroxaban group compared to 35 of 2160 (1.6%) in warfarin group (HR 0.49; 95% CI, 0.16, 1.56; heterogeneity I2 = 70%). Conclusions: Our results show that rivaroxaban is comparable to warfarin in prevention of stroke and systemic thromboembolism in patients with NVAF with VHD. Rivaroxaban is also comparable to warfarin in bleeding risks in these patients.

Irregular menstrual cycles as a risk factor of type 2 diabetes mellitus in women of childbearing age

Background: Irregular menstrual cycles are a risk factor for developing type 2 diabetes mellitus (DM) in women. Objective: This study aimed to evaluate irregular menstrual cycles as a risk factor of type 2 DM in women of childbearing age with body fat percentage, waist-hip ratio, diet quality, and physical activity as confounding factors. Methods: This was a case-control study. Its subjects were subjects with type 2 diabetes mellitus (n=31) and subjects without any clinical evidence of abnormal glucose regulation (n=31) who attended Puskesmas (Community Health Centre) Rowosari, Tembalang, Semarang with over 30 years of age. Based on their menstrual cycles, they were divided into two groups: women with irregular menstrual cycles, and those with regular menstrual cycles. Cochran Mantel-Haenszel test was used to control their confounding factors. Results: There was an association between irregular menstrual cycles and type 2 DM (p<0.05) with a 7.2 greater risk on women of childbearing age (OR = 7.2, 95% CI=2.18-23.75). By the Cochran Mantel-Haenszel test, the association was still significant; women with over percentage of body fat and central obese with irregular menstrual cycle had 4,85 times and 4,37 times of sequentially greater risk on type 2 DM (OR = 4.85, 95% CI=0.98-23.95 vs OR = 4.37, 95% CI=0.93-20.51). Conclusion: The irregular menstrual cycles was a risk factor of type 2 DM, especially in obese women of childbearing age.

Hubungan Pola Makan Terhadap Kejadian Hipertensi di Wilayah Kerja Puskesmas Kebun Sikolos Kota Padang Panjang Tahun 2019

Hypertension is a non-communicable disease. This continues to increase from year to year, and can lead to various other chronic diseases. This study aims to analyze the effect of diet on hypertension in 2019. This type of research is an observational analytic study with a prospective cohort study design. The population in this study were all adults (26 - 45 years) at the Puskesmas Kebun Sikolos. By means of purposive random sampling, a sample of 110 respondents was selected. The data obtained were processed by computerization using the Chi-square test and the Mantel Haenszel test. Chi-square test results showed that there was a relationship between salt consumption (p = 0.004 and RR = 1.521), fat (p = 0.008 and RR = 1.464), fiber (p = 0.014 and RR = 2.047) and caffeine (p = 0.012 and RR = 1.438) against hypertension. The coat-Haenszel test results showed that age, gender, family history, physical activity, smoking habits, and obesity were confounding factors in the relationship between diet and hypertension. It can be concluded that the main factor that is closely related to hypertension is salt consumption. It is advisable to provide an understanding to the public about the risk of frequent salt consumption which causes hypertension to be very beneficial

Discrimination of Isointense Bitter Stimuli in a Beer Model System

Prior work suggests humans can differentiate between bitter stimuli in water. Here, we describe three experiments that test whether beer consumers can discriminate between different bitterants in beer. In Experiment 1 (n = 51), stimuli were intensity matched; Experiments 2 and 3 were a difference from control (DFC)/check-all-that-apply (CATA) test (n = 62), and an affective test (n = 81). All used a commercial non-alcoholic beer spiked with Isolone (a hop extract), quinine sulfate dihydrate, and sucrose octaacetate (SOA). In Experiment 1, participants rated intensities on general labeled magnitude scales (gLMS), which were analyzed via ANOVA. In Experiment 2, participants rated how different samples were from a reference of Isolone on a 7-point DFC scale, and endorsed 13 attributes in a CATA task. DFC data were analyzed via ANOVA with Dunnett’s test to compare differences relative to a blind reference, and CATA data were analyzed via Cochran’s Q test. In Experiment 3, liking was assessed on labeled affective magnitude scales, and samples were also ranked. Liking was analyzed via ANOVA and rankings were analyzed with a Cochran–Mantel–Haenszel test. Experiment 1 confirmed that samples were isointense. In Experiment 2, despite being isointense, both quinine (p = 0.04) and SOA (p = 0.03) were different from Isolone, but no significant effects were found for CATA descriptors (all p values > 0.16). In Experiment 3, neither liking (p = 0.16) or ranking (p = 0.49) differed. Collectively, these data confirm that individuals can discriminate perceptually distinct bitter stimuli in beer, as shown previously in water, but these differences cannot be described semantically, and they do not seem to influence hedonic assessments.

Energy and Nutrient Intakes of Rural Nigerian Schoolchildren: Relationship With Dietary Diversity

Background: Undernutrition among schoolchildren is a prevalent public health problem which may be due to inadequate energy and nutrient intakes associated with low dietary diversity. Objective: This study assessed dietary diversity scores (DDS), energy and nutrient intakes of schoolchildren (6-15 years), and risks factors of DDS and determined if energy and nutrient intakes were dependent on dietary diversity. Methods: The study involved a 2-stage random sampling of 90 schoolchildren. Dietary diversity and nutrient intake data were obtained through a 3-day weighed food intake. Analysis of variance, t test, and χ2 with Cochran-Mantel-Haenszel test were used to determine relationships among and between variables; P < .05 was reported as significant. Results: Few (22.2%) had high DDS with no significant difference ( P > .05) between age groups and sex. Children from male headed households were more likely to have medium DDS (odds ratio [OR] = 3.231; 95% confidence interval [CI] = 1.037-10.070) than those from female headed households ( P < .05). Low nutrient intakes were observed among 85.6% for niacin, 76.7% for calcium, 72.2% for riboflavin, 54.4% for protein, 32.2% for thiamine, and 15.6% for vitamin C. Among boys, prevalence of inadequate riboflavin intake was significantly ( P < .05) higher among 6- to 9-year-olds. Among girls, prevalence of inadequate vitamin A intake was significantly ( P < .01) higher among 10 to 15-year-olds. Children with adequate intakes of iron (OR = 0.744, 95% CI = 0.653-0.847) and thiamine (OR = 5.651, 95% CI = 1.214-26.310) were more likely to have high DDS. Conclusion: The schoolchildren had low energy and nutrient intakes. Iron and thiamine, intakes were dependent on DDS.

Trends in slipped capital femoral epiphysis: is the rate declining?

Purpose Slipped capital femoral epiphysis (SCFE) is an adolescent hip condition with a high risk of complication. The purpose of this study was to evaluate trends in treatment using a prospectively collected paediatric nationally representative database. Methods A total of 9034 patients undergoing treatment for idiopathic SCFE were selected by querying the Healthcare Cost and Utilization Project’s Kids’ Inpatient Database for the years 1997, 2000, 2003, 2006, 2009 and 2012. The selected patients were separated based on operative approach and these cohorts were analyzed based on temporal and categorical differences in operative approach, patient demographics and clinical characteristics. Univariate and multivariate analyses were used when appropriate and the Mantel-Haenszel test for trend was used in temporal analysis. Results Overall SCFE procedures have decreased 27.5% (p < 0.001). Closed procedures have decreased 28.5% (p < 0.001), while open procedures have decreased 44.8% (p < 0.001). Bilateral closed procedures have increased 7.2% (p < 0.001). The ratio of open to closed procedures decreased in patients aged nine to 12 years and increased in patients aged 13 to 16 years (p < 0.001). Conclusion Here we report age stratified trends in treatment for idiopathic SCFE using nationally representative data and show an overall decrease in admissions and procedures over time. Level of Evidence Level III, retrospective comparison study