Category: Statistics

Med Oral Patol Oral Cir Bucal. 2025 Aug 16:27059. doi: 10.4317/medoral.27059. Online ahead of print.

ABSTRACT

BACKGROUND: Oral Pathology (OP) is an important part of diagnosing and managing oral and maxillofacial diseases. Despite being recognized as a specialty in Brazil for over 50 years, significant gaps remain in the availability of specialists and training programs. Therefore, this study aims to map and analyze the training of specialists in OP in Brazil.

MATERIAL AND METHODS: A cross-sectional study was conducted using publicly available data from Brazilian governmental databases, including the Federal Council of Dentistry, the Brazilian Institute of Geography and Statistics, and the Ministry of Education. Variables analyzed included the number of OP specialists, their geographic distribution, training opportunities, and population coverage. Descriptive and comparative analyses were performed using Microsoft® Excel (version 2410) and Statistical Package for Social Sciences® (version 27.0).

RESULTS: In 2024, 424 active OP specialists were registered in Brazil, composed of 240 women and 184 men, representing only 0.3% of all dental specialists. The ratio of OP specialists to inhabitants was 1:478,964, with marked regional disparities. The Southeast had the highest density, while the North had the lowest, with some states lacking any OP specialists. Additionally, 12 active OP training programs were identified, primarily concentrated in the Southeast. Most programs were distance learning, limiting opportunities for practical training. Temporal analysis revealed a decline in OP specialist registrations over the past two decades, despite population growth.

CONCLUSIONS: Brazil faces challenges in OP training, including insufficient specialists, uneven regional distribution and limited hands-on training opportunities. The expansion of hybrid training models and the promotion of the OP specialty among dental students are vital to address these issues. Collaborative efforts between educational institutions, professional organizations, and the government are essential to strengthen the specialty and improve early diagnosis rates of oral cancer.

PMID:40818134 | DOI:10.4317/medoral.27059

Med Oral Patol Oral Cir Bucal. 2025 Aug 16:27222. doi: 10.4317/medoral.27222. Online ahead of print.

ABSTRACT

BACKGROUND: The study aimed to investigate the risk factors that could affect intraoperative blood loss in patients who underwent orthognathic surgery.

MATERIAL AND METHODS: The study included a retrospective analysis of 400 patients who underwent bimaxillary orthognathic surgery. Data on demographic, surgical, and hematological parameters affecting intraoperative blood loss were statistically analyzed.

RESULTS: The mean intraoperative blood loss of male patients was statistically higher than that of female patients (p ≤ 0.001). The mean blood loss was higher in patients aged 25 years and older than in patients aged 17-24 (p=0.004). Patient weight and duration of surgery were positively correlated with the amount of intraoperative bleeding (r = 0.280 and r = 0.371). Platelet (PLT) count negatively correlated with blood loss (r=-0.213). The MPV/PLT ratio and hemoglobin (HGB) levels were positively correlated with bleeding (r=0.208 and r=0.110).

CONCLUSIONS: In orthognathic surgeries, factors such as age, gender, body mass, and duration of surgery were found to be associated with intraoperative blood loss. Males, patients over 24, overweight patients, and prolonged surgical procedures are all significant risk factors for bleeding. In addition, high HGB levels, low platelet count, and low MPV/PLT ratios are also associated with an increased risk of blood loss.

PMID:40818130 | DOI:10.4317/medoral.27222

Med Oral Patol Oral Cir Bucal. 2025 Aug 16:27213. doi: 10.4317/medoral.27213. Online ahead of print.

ABSTRACT

BACKGROUND: After lower third molar surgery, suppurative infections can occur. They can spread into adjacent tissues, toward superficial mucosal or skin planes or toward deep facial and neck fascial spaces.

MATERIAL AND METHODS: The 2020 PRISMA guidelines for systematic reviews were followed. A literature search was conducted, without initial time limit, in the Medline database, via Pubmed (MEDLINE), and SCOPUS. For the analysis of statistical significance, the hypothesis test on the difference between means with unknown variances was used.

RESULTS: Eleven articles met the inclusion criteria. The total number of extractions taken from the articles included in the review is 7363, with a 5.35% total incidence of purulent infections. The incidence of purulent infections was found significantly higher in cases in which antibiotic prophylaxis was not performed.

CONCLUSIONS: Although lower third molar extraction is the most frequently performed oral surgical procedure, little has been written about post-operative purulent infections, in relation to risk factors, involved spaces, and performed therapies, so to be able to identify preventive and therapeutic behaviors based on scientific evidence. Antibiotic prophylaxis is the only variable which resulted in determining a significative statistical reduction in the incidence of purulent infection after lower third molar surgery.

PMID:40818128 | DOI:10.4317/medoral.27213

Diabet Med. 2025 Aug 16:e70126. doi: 10.1111/dme.70126. Online ahead of print.

ABSTRACT

AIMS: People with severe mental illness (SMI) are 2-3 times more likely to have diabetes than the general population. Little is known about the impact of living with diabetes for people with SMI. This study investigates psychosocial problems and diabetes self management for people with SMI and diabetes.

METHODS: We compared cross sectional survey data collected from 258 adults with diabetes and SMI in England with 500 adults with diabetes from the UK sample of the second Diabetes Attitudes, Wishes and Needs study (DAWN2). Effect size (ES) tests were used to quantify differences between the two samples adjusted for diabetes type, age, gender, treatment, treatment duration, diabetes complications and co-morbidities to achieve comparability of the two samples.

RESULTS: Compared to the DAWN2-UK sample, people with diabetes and SMI reported poorer quality of life (WHOQOL ES -0.3 (CI -0.5, -0.1), p < 0.001), mental well-being (ES -13.4 (CI -17.3, -9.5), p < 0.001) and increased diabetes distress (PAID5 ES 1.6 (CI 0.9,2.3), p < 0.001). While people with diabetes and SMI reported a negative impact from diabetes, their SMI had a greater impact on their lives than diabetes (mental illness impact profile 2.6 ± 1.1 vs. diabetes impact profile 3.4 ± 1.0, p < 0.001). People with SMI reported being less engaged in self management than the DAWN2-UK population (SDSCA-6; ES -0.4 (CI -0.7, -0.1), p = 0.01).

CONCLUSIONS: The psychosocial impact of diabetes is greater for people with SMI. To reduce inequalities in diabetes outcomes, people with SMI and diabetes require tailored support for diabetes management that considers the additional challenges associated with living with a severe mental illness.

PMID:40818112 | DOI:10.1111/dme.70126

J Diet Suppl. 2025 Aug 16:1-22. doi: 10.1080/19390211.2025.2547167. Online ahead of print.

ABSTRACT

women’s league. A randomized, double‑blind and placebo‑controlled crossover trial was conducted in 15 professional futsal female athletes. They received one daily capsule of DSM or placebo (750 mg) for 3 days as a preventive regimen, and an intense dynamic exercise protocol (concentric/eccentric actions) was applied to the lower limbs. Evaluations on the effects of DSM on athletic performance and DOMS‑related muscle soreness, blood oxidative stress, recovery of strength capacity, and postural balance were performed during a 48 h‑period. Although DSM had no greater effect than placebo on athletic performance, it presented trivial‑to‑moderate effects in other parameters without statistical significance, with the best effects including containing oxidative damage (through reduction in lipid peroxidation) (p = 0.3857, EF = 0.72) and muscle soreness upon climbing stairs (p = 0.7136, EF = 0.50) at the 48^th hour, and in preventing the reduction of muscle strength (p = 0.6784, EF = 0.61) and improving unipedal postural balance in contralateral leg (p = 0.7446, EF = 0.69) at the 24th hour. Althought not significant in the ANOVA, the flavonoid DSM seems effective for futsal athletes as a dietary supplement for some variables evaluated. These include preventing muscle soreness, oxidative stress, impairment of muscle strength, and postural balance postexercise, which is desirable to promote better results in sporting terms. Clinical trial registry number: NCT06125002.

PMID:40818103 | DOI:10.1080/19390211.2025.2547167

Hepatol Res. 2025 Aug 16. doi: 10.1111/hepr.70019. Online ahead of print.

ABSTRACT

BACKGROUND: Complete abstinence is the cornerstone of alcohol-related liver disease (ALD) management. However, many patients struggle to achieve or sustain abstinence, prompting growing interest in harm reduction strategies, particularly pharmacological interventions to reduce alcohol intake. Nalmefene, an opioid receptor modulator, has shown efficacy in reducing alcohol consumption among individuals with alcohol dependence. However, its effects on hepatic parameters in ALD have not been well studied in real-world settings.

OBJECTIVE: To evaluate the efficacy and safety of nalmefene in patients with ALD, focusing on changes in alcohol consumption, liver function, and hepatic reserve capacity.

METHODS: The present retrospective observational study included 21 patients with ALD who received nalmefene therapy at our institution between September 2019 and December 2023. Data on alcohol intake, liver function tests, hepatic reserve capacity, and alcohol use disorders identification test scores were collected at baseline and after 6 months of treatment. Adverse events were also recorded.

RESULTS: Within 1 month of initiating nalmefene, significant reductions in heavy drinking days and total alcohol consumption were observed. These reductions were accompanied by improvements in liver function parameters. However, no statistically significant changes in hepatic reserve capacity were noted. Most adverse events were mild to moderate (Grade 1 or 2), and no serious adverse events occurred.

CONCLUSION: Nalmefene appears to be a safe and effective pharmacological option for reducing alcohol intake and improving liver function in patients with ALD. These findings support its use as part of a harm reduction approach for those unable to achieve complete abstinence.

PMID:40818098 | DOI:10.1111/hepr.70019

Prostate. 2025 Aug 16. doi: 10.1002/pros.70034. Online ahead of print.

ABSTRACT

INTRODUCTION: Effective management of post-prostate cancer is hindered by the limitations of current prognostic tools in accurately assessing disease aggressiveness. Radical prostatectomy remains a standard treatment, but some patients develop biochemical recurrence and metastasis, underscoring the need for improved postsurgical prognostic tools.

METHODS: This investigation involved sequencing data derived from 38 matched prostate cancer patients who had undergone RP. Initial statistical analysis helped identify the most significant miRNAs, which were further subjected to unsupervised clustering and stepwise selection. A linear discriminant analysis (LDA) model was then trained and tested using a miRNA combination method to pinpoint biomarkers predictive of metastasis.

RESULTS: Out of 1123 miRNAs initially identified, 519 were selected as high-confidence candidates. Parametric analysis of these miRNAs discerned 41 that effectively distinguished between patients who developed metastasis postoperatively and those who did not. Utilizing LDA, this study harnessed 41 miRNAs in a combinatorial approach, identifying eight key miRNAs (hsa-miR-106b-3p, hsa-miR-769-5p, hsa-miR-182-5p, hsa-miR-194-5p, hsa-miR-345-5p, hsa-miR-183-3p, hsa-miR-200a-3p, hsa-miR-301a-3p) that collectively stratified the metastatic group from control with up to 91% accuracy. This model’s effectiveness was supported by a receiver operating characteristic analysis, demonstrating an area under the curve of 80% or higher for the best miRNA combinations. Notably, the performance of this eight-miRNA panel was consistent with CAPRA-based risk stratification.

CONCLUSION: Our study presents a miRNA-based machine learning model that distinguishes metastatic from non-metastatic prostate cancer patients following surgery. The panel’s alignment with CAPRA underscores its clinical relevance and highlights its potential for integration into future clinical frameworks.

PMID:40818090 | DOI:10.1002/pros.70034

Physiother Theory Pract. 2025 Aug 16:1-12. doi: 10.1080/09593985.2025.2547293. Online ahead of print.

ABSTRACT

BACKGROUND: Stroke-related balance impairments reduce independence, making accurate assessment vital for rehabilitation. However, research on the minimal clinically important difference for the Kansas University Standing Balance Scale (KUSBS) is limited.

OBJECTIVES: This study determined the minimal clinically important difference for the KUSBS based on reduced assistance in walking and daily living activities for inpatients with acute-to-subacute stroke.

METHODS: This retrospective study included 407 inpatients diagnosed with acute-to-subacute stroke who were referred to the rehabilitation department between 2016 and 2022. Clinical outcomes – including the Kansas University Standing Balance Scale (KUSBS), Berg Balance Scale (BBS), Functional Ambulation Category (FAC), and Modified Barthel Index (MBI) – were assessed at both admission and discharge. The minimal clinically important difference was determined using anchor-based methods, including receiver operating characteristic curve analysis.

RESULTS: The minimal clinically important difference for the KUSBS was 0.5 for both anchors; for the BBS, it ranged from 5.5 to 9.5. Subgroup analysis demonstrated statistical significance for patients requiring assistance with activities. Multivariate analysis indicated that functional improvements varied according to the initial functional levels.

CONCLUSION: The minimal clinically important difference for the KUSBS was 0.5 for patients requiring walking assistance and 1.5 for those needing maximal assistance with daily activities. Alternative balance assessment tools may be more suitable for patients who do not require assistance. Our study findings emphasize the importance of incorporating qualitative balance assessment tools, such as the KUSBS, alongside traditional quantitative measures, such as the BBS, to provide a more comprehensive evaluation of post-stroke balance function.

PMID:40818071 | DOI:10.1080/09593985.2025.2547293

J Evid Based Med. 2025 Aug 16:e70060. doi: 10.1111/jebm.70060. Online ahead of print.

ABSTRACT

AIM: Tongxinluo (TXL) capsule, a traditional Chinese medicine compound, has proven effective in acute myocardial infarction (AMI), but its cost-effectiveness is unclear.

METHODS: This economic evaluation utilized individual data from clinical trials to compare major adverse cardiac and cerebrovascular events (MACCEs) at 30 days and quality-adjusted life years (QALYs) at 1 year between an intervention group (TXL combined with conventional therapy) and the control group (placebo plus conventional therapy), from a healthcare perspective. A lifetime cost-utility analysis (CUA) was conducted using a Markov model, and sensitivity analyses were performed to evaluate the robustness of the results.

RESULTS: A total of 3777 patients (TXL: 1889; placebo: 1888) were included in the analysis. The 30-day total costs for the TXL and placebo groups were ¥38,561 ($5399) and ¥39,217 ($5490), respectively, showing no statistical difference. The 30-day MACCEs rates were 3.39% for the TXL group and 5.24% for the placebo group (p < 0.006), indicating TXL’s superiority in effectiveness at 30 days. Over a lifetime, the TXL group incurred higher total costs (¥97,108 [$13,595] vs. ¥92,033 [$12,885]) and gained more QALYs (6.70 vs. 6.30). The incremental cost-effectiveness ratio for TXL was ¥12,421/QALY ($1739), below the 1 Gross Domestic Product per capital threshold which was ¥89,358 ($12,510) in 2023 in China. Sensitivity analysis confirmed robust results, revealing that TXL was more likely to be accepted over the placebo when the willingness to pay exceeds ¥12,500 ($1739).

CONCLUSIONS: TXL is a cost-effective option compared to placebo in AMI.

PMID:40818069 | DOI:10.1111/jebm.70060

J Behav Addict. 2025 Aug 16. doi: 10.1556/2006.2025.00059. Online ahead of print.

ABSTRACT

BACKGROUND: Compulsive sexual behavior disorder (CSBD) is a mental health condition that has attracted significant research attention, especially following its inclusion in the eleventh revision of the International Classification of Diseases (ICD-11) by the World Health Organization. Despite this recognition, the field remains fragmented with ongoing debates about its classification and a lack of comprehensive cross-cultural research. In this study, bibliometrics was used to characterize the development status of CSBD over the past 25 years and to identify key research hotspots and future trends.

METHODS: This study collected data from the Web of Science Core Collection and analyzed the literature related to CSBD from 2000 to 2024. A total 2,261 publications were examined for their characteristics, including annual publication volume, countries/regions, institutions, authors, journals, references, and keywords. Several bibliometric and visualization tools (e.g., VOSviewer, CiteSpace, Scimago Graphica, and Pajek) were used to conduct the analysis of co-authorship, co-citation, co-occurrence and descriptive.

RESULTS: The analysis identified a consistent upward trend in research interest in CSBD, particularly after its inclusion in ICD-11. Co-occurrence analysis of 82 author keywords with frequencies of more than 12 resulted in 5 clusters: (1) competing conceptualizations of CSBD; (2) comorbidity of CSBD with other psychiatric disorders; (3) assessment, risk factors, and treatment; (4) gender differences and sexual health; (5) CSB caused by neurological diseases. Moreover, the findings of countries/regions analysis indicate that publications are mainly from Western, educated, industrialized, rich, and democratic (WEIRD) countries/regions, and collaborative networks mainly connect countries from the North America and Europe. Despite its growing recognition, the field still lacks interdisciplinary collaboration and comprehensive studies from non-WEIRD contexts, highlighting a need for broader, cross-cultural research.

CONCLUSIONS: This study comprehensively maps global research trends in CSBD, identifies critical knowledge gaps, and provides a foundation for future research. By synthesizing the current research status, it aims to guide researchers toward emerging topics and foster a more cohesive understanding of CSBD.

PMID:40818055 | DOI:10.1556/2006.2025.00059