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Nevin Manimala Statistics

Comparative effectiveness and safety of atorvastatin versus rosuvastatin among patients with ischemic stroke or transient ischemic attack: a national registry-based observational study

EClinicalMedicine. 2025 Jul 24;86:103381. doi: 10.1016/j.eclinm.2025.103381. eCollection 2025 Aug.

ABSTRACT

BACKGROUND: Atorvastatin and rosuvastatin are the most widely used statins in patients with ischemic stroke or transient ischemic attack (TIA). However, evidence on their effectiveness and safety during actual use is scarce. This study aims to compare the effectiveness and safety of initiating atorvastatin versus rosuvastatin among patients with ischemic stroke or TIA.

METHODS: This observational study was based on the Third China National Stroke Registry (CNSR-III), which recruited consecutive adult patients with ischemic stroke or TIA within 7 days from the onset of symptoms to enrollment from August 2015 to March 2018. This study identified 3322 adults aged ≥18 years who had a pre-stroke modified Rankin Scale (mRS) score of 0 and initiated atorvastatin or rosuvastatin on the day of onset. The primary outcome was the ideal outcome, as defined by a mRS score of 0, at 3 months. The secondary outcomes included the ideal outcome at discharge, at 6 months, and at 12 months, along with 12-month stroke recurrence, all-cause mortality, cardiovascular mortality, and major adverse cardiovascular events.

FINDINGS: A total of 3322 eligible patients were identified, with 2605 initiating atorvastatin and 717 initiating rosuvastatin. The proportion of patients achieving an ideal outcome, as defined by a modified Rankin Scale of 0, was 44.63% in rosuvastatin initiators, significantly higher than 41.46% in atorvastatin initiators, with a relative rate of 1.12 (95% confidence interval 1.03, 1.22). Also, a greater percentage of rosuvastatin initiators attained the ideal outcome at discharge and at 6 months, compared with atorvastatin initiators. Regarding other secondary outcomes, no statistically significant difference was observed.

INTERPRETATION: Compared with atorvastatin, rosuvastatin was associated with a potentially higher proportion of patients attaining a mRS score of 0 among patients with ischemic stroke or TIA who initiate atorvastatin or rosuvastatin, which was not yet sufficient to guide clinical practice. Further research is needed to validate these findings.

FUNDING: This work was supported by National Key Research and Development Program of China (2022YFC2502400, 2022YFC2502404), Beijing Natural Science Foundation Haidian original innovation joint fund (L222123), and Youth Innovation Fund of Beijing Neurosurgical Institute (2025 Reform and Development-Youth 15).

PMID:40747367 | PMC:PMC12311946 | DOI:10.1016/j.eclinm.2025.103381

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Epidemiology of dengue fever in Hajjah governorate, yemen, from 2020 to 2024

Sci Rep. 2025 Jul 31;15(1):27998. doi: 10.1038/s41598-025-12606-2.

ABSTRACT

The world faces ongoing challenges because the increasing number of dengue fever cases has become a major public health concern, with the potential for a pandemic resulting from a lack of attention and neglect. The Hajjah Governorate, located in subtropical regions, has not received any epidemiological studies on the prevalence of dengue fever. Therefore, we designed this study retrospectively to assess the prevalence of dengue fever in Hajjah Governorate over a five-year period (2020-2024). This retrospective study was based on secondary clinical data collected from the Hajjah Governorate Health and Environment Office database between 2020 and 2024. Furthermore, the data were obtained electronically, checked for their completeness and consistency, analyzed statistically, and presented in tables and figures. Of the 10,617 suspected dengue fever cases, 7,784 (73.3%) were classified as dengue fever according to the laboratory diagnosis (4,284; 40.3%) and clinical signs and symptoms (3,500; 33.0%). A higher proportion of DF cases was observed in males (6,994; 74.7%), the age group 5-14 years (1,632; 75.5%), in 2020 (3,756; 81.5%), and in autumn (3,625; 46.6%) and October (2,527; 32.5%). An overall incidence rate of dengue fever was reported at 28.1 cases per 10,000 individuals in Hajjah Governorate, with the highest in males (38.7), the age group of 15-29 years (40.0), in 2020 (16.3), and in Shars District (346.9). The rate of death related to dengue fever was 10 cases (0.13%), with the highest rates observed in males (0.13%), individuals under the age of 5 years (0.57%), and in 2023 (0.48%). The majority of patients experienced fever (99.97%), joint pain (99.1%), headache (98.8%), and muscle pain (73.3%). Additionally, 26 patients (0.03%) displayed symptoms of dengue hemorrhagic fever. These results indicate that the burden of dengue fever is increasing in the study area and poses a significant health challenge to Yemen in the near future if this complex health problem is not addressed. Furthermore, effective vector control, preventive education, targeted vaccination research, and epidemiological surveillance are imperative to address this complex health issue and to minimize its impact.

PMID:40745434 | DOI:10.1038/s41598-025-12606-2

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A multimodal dataset for understanding the impact of mobile phones on remote online virtual education

Sci Data. 2025 Jul 31;12(1):1332. doi: 10.1038/s41597-025-05681-7.

ABSTRACT

This work presents the IMPROVE dataset, a multimodal resource designed to evaluate the effects of mobile phone usage on learners during online education. It includes behavioral, biometric, physiological, and academic performance data collected from 120 learners divided into three groups with different levels of phone interaction, enabling the analysis of the impact of mobile phone usage and related phenomena such as nomophobia. A setup involving 16 synchronized sensors-including EEG, eye tracking, video cameras, smartwatches, and keystroke dynamics-was used to monitor learner activity during 30-minute sessions involving educational videos, document reading, and multiple-choice tests. Mobile phone usage events, including both controlled interventions and uncontrolled interactions, were labeled by supervisors and refined through a semi-supervised re-labeling process. Technical validation confirmed signal quality, and statistical analyses revealed biometric changes associated with phone usage. The dataset is publicly available for research through GitHub and Science Data Bank, with synchronized recordings from three platforms (edBB, edX, and LOGGE), provided in standard formats (.csv, .mp4, .wav, and .tsv), and accompanied by a detailed guide.

PMID:40745430 | DOI:10.1038/s41597-025-05681-7

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RpoB mutation patterns in Rifampicin-resistant tuberculosis: a Jiangxi Province study, 2021-2023

Sci Rep. 2025 Jul 31;15(1):27988. doi: 10.1038/s41598-025-11949-0.

ABSTRACT

Antimicrobial resistance in Mycobacterium tuberculosis (M.tb) strains presents a significant challenge to global tuberculosis (TB) control efforts. This study was conducted to explore the distribution and prevalence of mutations at various sites within the 81 bp Rifampicin (RIF) resistance-determining region (RRDR) of the rpoB gene in M.tb, as detected by the Xpert MTB/RIF assay. This retrospective analysis encompassed 9,867 non-repeating patients diagnosed with TB between 2021 and 2023. Cases with RR detected by the Xpert were included in further detailed analysis. The study utilized Chi-square tests or Fisher’s exact tests to identify statistically significant differences in demographic variables and the prevalence of rpoB gene mutations between RResistant TB (RR-TB) and non-RR-TB groups. Multiple logistic regression analysis was employed to examine the relationship between probe types and demographic variables, with a P-value of less than 0.05 considered statistically significant. Over the three-year study period, M. tb was identified in 2,927 cases, with 485 being RR-TB. While individuals aged ≥ 65 years constituted the largest absolute number of RR-TB cases, the highest relative risk was observed in children aged 5-14 years (OR = 2.68, 95% CI 1.16-6.22, P = 0.02) compared to the ≥ 65 reference group. probe E missing emerged as the predominant mutation site, particularly prevalent in pulmonary specimens and among individuals aged 55-64 years, with a statistically significant difference (P < 0.001). An upward trend in probe B mutations was also observed, reaching statistical significance (χ2 = 6.614, P = 0.037).This molecular epidemiological study has identified the mutation patterns within the rpoB gene that contribute to RR, as identified through the use of Xpert technology over a three-year span in Jiangxi Province. The insights gained are instrumental in informing individualized treatment regimens for RR-TB patients by correlating mutation locations with resistance levels (e.g., probe E mutations confer high-level resistance requiring second-line drugs, while probe B mutations like D435Y may confer low-level “disputed” resistance). This facilitates precision therapy, avoids unnecessary second-line treatments, and reduces transmission. Future advancements in technology, such as large-scale sequencing studies, could build upon these findings to further elucidate the genetic variations at play. Ultimately, these discoveries could be corroborated through rigorous in vitro and in vivo experimental research, reinforcing the foundation of our understanding and response to antimicrobial resistance in M.tb.

PMID:40745428 | DOI:10.1038/s41598-025-11949-0

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The Total Disc Replacement Osteolysis Grading Scale – a simple, reliable and quantifiable tool for assessing, managing and reporting osteolysis after cervical total disc replacement

Eur Spine J. 2025 Jul 31. doi: 10.1007/s00586-025-09128-w. Online ahead of print.

ABSTRACT

PURPOSE: Cervical Total Disc Replacement (CTDR) related periprosthetic osteolysis is inconsistently reported. The purpose of this study is to assess the previously published TDR Osteolysis Grading Scale, a quantitative classification system of CTDR-related osteolysis, and to assess its reliability and utility using Computer Tomography (CT) and X-ray imaging.

METHODS: Participants were assigned to Groups A (CT, 20 participants, 27 implants) and B (X-ray, 20 participants, 26 implants). Four blinded raters independently measured osteolytic cysts and both vertebral endplates, calculated the percentage of osteolysis and assigned osteolysis grades: Grade 0, no osteolysis; Grade 1, < 50% of 1 endplate; Grade 2, < 50% of both endplates; Grade 3, ≥ 50% of 1 endplate; Grade 4, ≥ 50% of both endplates. Inter-rater reliability and sensitivity were assessed using intraclass correlation coefficients (ICC), Fleiss’ and Cohen’s Kappa statistics and sensitivity testing.

RESULTS: Group A had good reliability for osteolytic cyst measurements (ICC = 0.78-0.79), poor reliability for endplate measurements (ICC = 0.41-0.45) and moderate reliability for osteolysis grades (κ-coefficient = 0.42). Group B had moderate reliability for osteolytic cyst (ICC = 0.55-0.57) and endplate measurements (ICC = 0.55-0.64) and fair reliability for osteolysis grades (κ-coefficient = 0.30). Reliability between reference grades and assigned grades was moderate for Group A (κ-coefficient = 0.46-0.60) and fair for Group B (κ-coefficient = 0.08-0.35). Sensitivity was greater for high grade osteolysis (grade 3 and 4) in Group A (0.80-1) than Group B (0.17-0.50).

CONCLUSION: The TDR Osteolysis Grading Scale demonstrated good reliability and sensitivity amongst raters with CT. Implementing this tool may aid in standardising osteolysis reporting, monitoring osteolysis progression and clinical decision-making.

PMID:40745412 | DOI:10.1007/s00586-025-09128-w

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Comparison of outcomes in autoimmune acquired factor XIII deficiency with and without underlying diseases: a systematic review

J Thromb Thrombolysis. 2025 Jul 31. doi: 10.1007/s11239-025-03148-5. Online ahead of print.

ABSTRACT

Autoimmune acquired factor XIII deficiency (AiF13D) is an exceptionally rare and serious bleeding disorder. This condition may occur idiopathically or in association with comorbidities, such as malignancies or autoimmune diseases. Data comparing these distinct etiological subgroups remain limited. Therefore, we conducted a systematic literature review of published case reports, case series, and cohort studies on AiF13D indexed in PubMed, Web of Science, and Scopus up to December 2023. We compared the clinical characteristics, treatment modalities, and outcomes between patients with AiF13D associated with underlying disorders and those with idiopathic AiF13D. Our analysis revealed a higher proportion of female patients in the AiF13D group with underlying diseases compared to the idiopathic group. Statistically significant differences were observed that patients with underlying diseases exhibited slightly higher inhibitor levels and a greater frequency of Grade III bleeding events. Furthermore, fewer AiF13D patients with underlying diseases received combination therapy (prednisone plus rituximab or cyclophosphamide) compared to the idiopathic group. Additionally, this group experienced higher rates of relapse and/or mortality. Collectively, these findings indicated that AiF13D patients with underlying diseases experience more severe bleeding manifestations and poorer outcomes. Consequently, clinicians managing concomitant conditions should maintain vigilance for potential AiF13D development. Regular monitoring of FXIII activity and inhibitor titers is essential, coupled with prompt initiation of anti-inhibitor therapy when indicated.

PMID:40745406 | DOI:10.1007/s11239-025-03148-5

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Graph theoretic and machine learning approaches in molecular property prediction of bladder cancer therapeutics

Sci Rep. 2025 Jul 31;15(1):28025. doi: 10.1038/s41598-025-14175-w.

ABSTRACT

This work introduces a hybrid computational approach in which degree-based topological descriptors are harnessed with the aid of advanced regression models and artificial neural networks (ANNs) to predict the crucial physicochemical properties of 17 drugs for the treatment of bladder cancer. Each molecule is assigned a molecular graph, from which a series of topological descriptors such as Zagreb indices, Randic index, Atom Bond Connectivity (ABC), and Symmetric Division Degree (SSD)are computed. These indices are used as input features by various regression models along with linear, cubic, and feedforward ANNs. The performance of the models is analyzed using metrics such as Mean Squared Error (MSE), Root Mean Squared Error (RMSE), Mean Absolute Error (MAE), and the coefficient of determination [Formula: see text]. ANNs showed the best predictive performance with the [Formula: see text] value achieving 0.99. Moreover, SHAP (SHapley Additive exPlanations) analysis was used to explain the contribution of each descriptor toward the models’ predictions. The findings validate the promise of the combination of graph-theoretic descriptors with the tools of machine learning to achieve solid and interpretable models of molecular property prediction, which hold the potential for drug discovery and optimization in oncologic applications.

PMID:40745380 | DOI:10.1038/s41598-025-14175-w

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Effects of a warm-up program on jump-landing pattern and lumbopelvic function in female basketball players with dynamic knee valgus

Sci Rep. 2025 Jul 31;15(1):27918. doi: 10.1038/s41598-025-13817-3.

ABSTRACT

Dynamic knee valgus (DKV), commonly observed during functional movements, is recognized as a key biomechanical factor contributing to the risk of anterior cruciate ligament (ACL) injury. Given its importance in injury prevention, this study aimed to investigate the effects of a warm-up program on jump-landing pattern and lumbopelvic function in female basketball players exhibiting dynamic knee valgus. The present study employed a quasi-experimental design. Thirty female basketball players with DKV were screened using the single-leg landing (SLL) test and subsequently randomized into control (n = 15) and experimental (n = 15) groups. The jump-landing test was utilized to assess the jump-landing pattern, whereas the forward step-down (FSD) test was implemented to evaluate lumbopelvic function. The experimental group participated in the STOP-X warm-up program over 8 weeks, whereas the control group continued with their traditional warm-up routine. Data were analyzed using a 2 × 2 repeated measures ANOVA, followed by Bonferroni post hoc tests, with statistical significance set at P < 0.05. All analyses were conducted using SPSS version 26. The results revealed significant differences in maximum flexion (F = 20.73; P = 0.001; effect size (ES) = 0.42, percentage change (PC) = ↑4.48%), initial valgus (F = 90.12; P = 0.001; ES = 0.76, PC = ↓32.56%), maximum valgus (F = 151.6; P = 0.001; ES = 0.84, PC = ↓52.86%), and FSD (F = 22.82; P = 0.001; ES = 0.44, PC = ↓51.45%) in the experimental group compared to the control group after following the STOP-X warm-up program. However, no significant impact was observed for the initial flexion (P = 0.49, ES = 0.01) variable. Implementing the warm-up injury prevention program significantly improves jump-landing pattern and optimizes lumbopelvic function. Therefore, it is recommended that coaches incorporate this program in place of traditional basketball warm-up routines. Such an approach may enhance athletic performance while reducing the risk of knee injuries associated with improper landing techniques.Trial registration No: IRCT20231230060574N1, (date of registration on 04/01/2024) registered in the Iranian Registry of Clinical Trials.

PMID:40745375 | DOI:10.1038/s41598-025-13817-3

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Country-level incidence of Alzheimer disease and related dementias is associated with increased omega-6-PUFA consumption

Commun Med (Lond). 2025 Jul 31;5(1):326. doi: 10.1038/s43856-025-01059-3.

ABSTRACT

BACKGROUND: Clinical and genetic studies have implicated lipid dysfunction in Alzheimer Disease (AD) pathogenesis. While the etiologic impact of lipid intake on individuals is receiving attention, the role of food systems in shaping community-level incidence remains uncharacterized.

METHODS: Mean country-level lipid intakes were compared to Age-Standardized Alzheimer-and-other-Dementia Incidence Rates (ASAIR) in 183 countries across all inhabited continents. Free-knot penalized spline regression and multivariable-adjusted linear regression, including a lag between intake and incidence, were used to assess the relationships between five lipid intakes and ASAIR. Validation was conducted using longitudinal within-country changes between 1990 and 2019.

RESULTS: Here we show that omega-6 Polyunsaturated-Fatty-Acid (omega-6) intake exhibits a positive linear relationship with ASAIR (multivariable-adjusted model: β = 2.44; 95%CI: 1.70, 3.19; p = 1.38 × 10-9). ASAIR also increases with saturated-fat, trans-fat, and dietary-cholesterol up to a threshold. The association between omega6-PUFA and ASAIR is confirmed using longitudinal intake changes. The scale of predicted benefits varies by country but, our results predict a 2 standard deviation decrease (-3.8% as a percent of daily energy intake) in omega-6 intake would reduce ASAIR by 8% in the US. This level of consumption has already been achieved in 20 countries. If our other findings are validated in future work, decreasing all four lipids could potentially yield large ASAIR reductions (in the US: a 35% decrease).

CONCLUSIONS: Higher levels of omega-6 consumption associate with increased ASAIR. Thus, decreasing omega-6 consumption on the country-level may have substantial benefits in reducing the burden of dementia.

PMID:40745374 | DOI:10.1038/s43856-025-01059-3

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The role of the ventral striatum in the relationship between impulsive decision-making and emotional self-regulation by cognitive reappraisal

Sci Rep. 2025 Jul 30;15(1):27830. doi: 10.1038/s41598-025-13599-8.

ABSTRACT

Delay discounting (DD), the preference for smaller, immediate rewards over larger, delayed ones, is a key measure of temporal impulsivity. While its link to behavioral self-regulation is well-studied, the relationship with emotional self-regulation is less understood. This study explored this relationship and its neuroanatomical mediators in the brain’s reward system. We administered the Emotion Regulation Questionnaire (ERQ) and a DD task to 155 young adult college students and collected structural MRI data. Our data revealed that greater use of cognitive reappraisal as an emotion regulation strategy was significantly associated with lower DD rates (i.e., reduced temporal impulsivity). No such relationship was found for expressive suppression. Furthermore, mediation analysis showed that higher cognitive reappraisal scores were associated with lower gray matter volume in the left ventral striatum, which in turn predicted lower DD. While the pattern of results is statistically consistent with full mediation, the cross-sectional nature of our data precludes causal inference. In conclusion, these results identify a novel neuroanatomical mechanism for temporal impulsivity. They suggest that cognitive reappraisal helps control impulsive choice and the process is mediated by the ventral striatum. This may provide a useful biomarker for developing interventions to improve self-control.

PMID:40745372 | DOI:10.1038/s41598-025-13599-8