Structural equation modelling for the effect of physical exercise on excessive daytime sleepiness.

OBJECTIVES: The present study aimed to examine the effect of physical exercise on excessive daytime sleepiness (EDS) which is a significant public health problem. STUDY DESIGN: This is a population-based cohort study. METHODS: We hypothesized that those who engage in regular exercise would have lower chances of dozing in the daytime and examined causal relationships between EDS and known risk factors for EDS using structural equation model (SEM). RESULTS: We found that causal relationships from both depression and sleep quality to EDS were relatively weaker in those who regularly engage in physical exercise, which resulted in lower chances of having EDS. CONCLUSION: Regular exercise may play a protective role in EDS prevention.

Association between interleukin-27 polymorphisms and pulmonary tuberculosis.

OBJECTIVE: To investigate the effect of interleukin (IL) 27 -964A/G, 2095T/G, 4603G/A and 4730T/C gene polymorphisms on the development of pulmonary tuberculosis (PTB), radiographic characteristics and severity. DESIGN: Differences in the allele and genotype distributions of the -964A/G, 2095T/G, 4603G/A and 4730T/C polymorphisms between 224 PTB patients and 233 healthy controls, between patients with single- and multi-lobe involvement, and between patients with and without cavitation, were investigated. Serum IL-27 concentration was measured using an enzyme-linked immunosorbent assay. RESULTS: There were no significant differences in the allele or genotype distributions between PTB patients and healthy controls. However, the -964A/A genotype was more prevalent in patients with single-lobe involvement than the -964A/G or -964G/G genotype in patients with multi-lobe involvement (50.0% vs. 31.3%, P = 0.01). There was no difference between patients with and without cavitation (P > 0.05). Serum median IL-27 concentration was significantly higher in patients with single-lobe involvement than in those with multi-lobe involvement (P = 0.03) and in those with -964A/A genotypes than in those with -964A/G or -964G/G genotypes (P = 0.02). CONCLUSIONS: In terms of serum IL-27 levels, the -964 A/A genotype may be associated with a protective role that prevents the intrapulmonary spread of PTB rather than its development.

Pooled preventable death rates in trauma patients : Meta analysis and systematic review since 1990.

PURPOSE: To estimate the pooled PDRs (preventable death rates) with articles being published since 1990, and compare the differences of PDRs over time and according to the evaluation approaches to determine preventable deaths. METHODS: Articles concerning preventable deaths of trauma patients published between 1990 and 2013 were systematically reviewed, and the pooled PDRs with 95 % confidence intervals were estimated using meta-analysis. It was also observed whether the PDRs differed over time and according to the evaluation approaches employed for determining preventable deaths. RESULTS: Twenty seven articles were identified through bibliographic searches using PUBMED with the keywords of 'preventable deaths', 'the cause of deaths' and 'trauma'. Mean ages of the trauma patients in the selected articles ranged from 32.9 to 58 years old and 72 % were male on average. The pooled PDR was estimated as 0.20 with 95 % CI (0.16, 0.25) with a p-value of 0.0001, and the differences of PDRs over time and according to the employed approaches were not statistically significant with p-values of 0.06 and 0.99, respectively. However, PDRs determined by statistical approaches alone showed greater dispersion in comparison with the 'panel review approach'. CONCLUSIONS: This article provided some insights about the trauma care system by computing the pooled estimate of PDRs over the past 23 years as an indicator. The pooled PDR was estimated as approximately 20 %, with no statistical significance of differences in PDRs over time or by the evaluation methods employed. That left us still room for improvement in trauma care system despite our efforts to reduce PDRs. In addition, when 'statistical approaches' are applied alone to estimate PDRs, we recommend that statistical methods should be applied with caution when the characteristics of trauma patients are heterogeneous. The optimal approach might be to combine both statistical and panel review approaches instead of employing a single approach.