Category: Statistics

Reprod Sci. 2025 Jun 19. doi: 10.1007/s43032-025-01908-5. Online ahead of print.

ABSTRACT

BACKGROUND: Infertility affects approximately 15% of reproductive-age couples, with polycystic ovary syndrome and poor ovarian reserve being major contributing factors. Metabolomic profiling of follicular fluid offers insights into the underlying metabolic disturbances associated with these infertility phenotypes. This study aims to identify metabolic biomarkers distinguishing PCOS, POR, and male factor infertility, which may facilitate improved diagnostic and therapeutic strategies.

METHODS: A total of 119 participants were categorized into three groups: PCOS (n = 39), POR (n = 40), and NOR (n = 40). Liquid chromatography-high-resolution mass spectrometry was used for untargeted metabolomic profiling. Metabolites were identified using HMDB, MassBank, and MoNA, while pathway analysis was performed using KEGG. Statistical analyses were conducted using R and Python, including one-way ANOVA, t-tests, and Mann-Whitney U tests, with False Discovery Rate correction applied.

RESULTS: Distinct metabolic alterations were observed among the groups. Trehalose-6-phosphate, taurocholate, and N,N-dimethylglycine emerged as the most significantly altered metabolites, showing strong discriminatory potential between PCOS and POR. PCOS patients exhibited reduced levels of taurocholate, mycalemide, and trehalose-6-phosphate, whereas NOR patients showed elevated levels of N,N-dimethylglycine and argininosuccinate. The POR group demonstrated increased levels of 1-methyl-2-pyrrolidone and haplopine, along with a broader metabolite distribution.

CONCLUSION: This study reveals phenotype-specific metabolic signatures in PCOS and POR, identifying taurocholate, mycalemide, and N,N-dimethylglycine as potential follicular biomarkers. These findings contribute to a deeper understanding of the metabolic basis of infertility and highlight the potential of follicular fluid metabolomics for precision medicine in reproductive health.

PMID:40537734 | DOI:10.1007/s43032-025-01908-5

Biol Futur. 2025 Jun 19. doi: 10.1007/s42977-025-00265-3. Online ahead of print.

ABSTRACT

To better understand the consequences of stress in realistic scenarios, police cadets were tasked with performing a police intervention under differing expectations. One group was led to anticipate a dangerous mission, while the other expected a routine event. In the field, however, both groups faced the same challenging situation. The warned group exhibited strong pre-intervention stress responses, which was minimal in the other group. By contrast, the unwarned group experienced a sudden surge in stress within the first minute of the intervention, as reality clashed with their expectations. A similar sudden stress response by the beginning of the intervention was missing from the warned group. A significant portion of cadets unlawfully attacked suspects, a behavior linked to intense stress displayed at the onset of the intervention. This emotional, illegitimate aggression was driven primarily by the noradrenergic stress response, with no indication of cortisol involvement. Traditional statistical methods (group comparisons, univariate, and multivariate regressions) suggested that psychological traits had little impact compared to acute stress effects. However, machine learning revealed that psychological characteristics-such as those assessed by the Reactive-Proactive Aggression Questionnaire, Buss-Perry Aggression Questionnaire, Big Five Personality Test, and Barratt Impulsiveness Scale-played a crucial role in conjunction with stress responses. Multivariate analyses yielded data similar to those obtained through machine learning, but only when the dependent variables were selected to match those identified as crucial by the latter. These findings highlight the power of machine learning in uncovering complex interactions that traditional methods might overlook.

PMID:40537691 | DOI:10.1007/s42977-025-00265-3

Spine Deform. 2025 Jun 19. doi: 10.1007/s43390-025-01133-9. Online ahead of print.

ABSTRACT

OBJECTIVES: The role of facet joint tropism (FJT) in degenerative spinal disorders such as disc herniation, spondylolisthesis, and lumbar canal stenosis is well-established. However, its association with adult spinal deformity (ASD) remains underexplored. Hence, we aim to study the correlation of FJT with spinopelvic parameters and lumbar paraspinal muscle morphology in ASD patients.

MATERIALS AND METHODS: We analysed 117 patients with ASD from 2021 to 2024. An absolute value difference (ΔFJA) of more than 10 degrees between the right- and left-facet joint angle (FJA) was defined as FJT. We considered patients with FJT at the apex vertebra as the FJT + group and with ASD but without FJT as the FJT- group.

RESULTS: The mean ΔFJAs between the FJT + (n = 45) and FJT- (n = 45) were 17.14 and 5.38, respectively. For Cobb angle (CA) > 40˚ (n = 13), 84.6% (n = 11) belonged to the FJT + group. For CA 10-19˚(n = 28), 78.6% (n = 22) belonged to the FJT- group. Of the radiological parameters, differences in CA (p = 0.012), pelvic incidence (PI) (p = 0.031), grades of vertebral body rotation (VBR) (p = 0.022), facet joint osteoarthritis grades (FJOA) (p = 0.040) and cross-sectional area (CSA) of concave multifidus muscle (MF) (p = 0.010) were statistically significant between both the groups. The CSA of MF was decreased on the concave side (2.45 cm²) compared to the convex side (3.70 cm²) and was negatively correlated with ΔFJA (R² = 0.642, p = 0.020). The ΔFJA had significant positive correlation with CA (R² = 0.550, p = 0.010), PI (R² = 0.624, p = 0.030), grades of VBR (R² = 0.610, p = 0.007), and grades of FJOA (R² = 0.780, p = 0.005).

CONCLUSIONS: Patients with ASD and FJT exhibited greater Cobb angle, higher PI, higher grades of FJOA and VBR, and lower CSA of concave MF. However, the role of facet joint tropism in adult spinal deformity-whether causal or compensatory-warrants validation through longitudinal, long-term studies.

LEVEL OF EVIDENCE: Level III.

PMID:40537686 | DOI:10.1007/s43390-025-01133-9

Lasers Med Sci. 2025 Jun 20;40(1):291. doi: 10.1007/s10103-025-04540-6.

ABSTRACT

Perioral aging manifests as fine lines, wrinkles, and structural changes, often requiring specialized treatment. Although laser systems are widely used in facial rejuvenation, few studies directly compare their efficacy in perioral rejuvenation. This study evaluates and compares the efficacy and safety of two laser systems-Erbium: glass laser and Nd: YAG combined with Er: YAG laser-for perioral rejuvenation. A prospective, comparative clinical trial was conducted with 36 female patients who sought perioral rejuvenation at a tertiary dermatology hospital. Participants were randomly assigned to either the erbium: glass group or the Nd: YAG combined with Er: YAG group, each receiving three treatment sessions at 4-week intervals. Efficacy was assessed through clinical wrinkle severity ratings, VisioFace^® imaging, and patient satisfaction scores. Safety was evaluated by monitoring adverse events. The mean ages in the erbium: glass and Nd: YAG combined with Er: YAG laser groups were 49.78 ± 6.59 and 46.72 ± 6.36 years, respectively, without significant difference (p > 0.05). All participants had Fitzpatrick skin types III- IV. Both treatment groups demonstrated significant improvements in supralabial lines and skin hyperpigmentation (p < 0.05). While erbium: glass was more effective in reducing supralabial lines, the difference between the two laser systems was not statistically significant. Conversely, improvement in corner lip wrinkles was statistically significant only in the Nd: YAG combined with Er: YAG laser group (p < 0.05). Erbium: glass showed significantly superior results in reducing pore count (p < 0.05). No significant difference was observed between the groups in terms of skin hyperpigmentation improvement. Both erbium: glass and Nd: YAG combined with Er: YAG laser are effective and safe options for perioral rejuvenation. Erbium: glass may be particularly suited for targeting superficial lines and pores, while Nd: YAG combined with Er: YAG laser appears more effective for treating deeper wrinkles. These findings support an individualized laser treatment selection approach based on specific skin concerns. Further studies with larger sample sizes and extended follow-up periods are recommended to confirm and expand on these results.

PMID:40537663 | DOI:10.1007/s10103-025-04540-6

JMIR Res Protoc. 2025 Jun 19;14:e66722. doi: 10.2196/66722.

ABSTRACT

BACKGROUND: Hypothermia in young infants presenting to the emergency department (ED) may indicate a serious bacterial infection (SBI) such as a urinary tract infection, bacteremia, or bacterial meningitis. Improved understanding of the epidemiology of SBI in infants with hypothermia and the development of prediction models can help avoid unnecessary invasive procedures and antimicrobial exposure.

OBJECTIVE: The aim of the study is to (1) describe the epidemiology of SBI and herpes simplex virus (HSV) among infants with hypothermia, (2) assess the role of biomarkers in predicting SBI, and (3) derive and internally validate a multivariable predictive model for SBI among infants with hypothermia.

METHODS: The study is being conducted through the Pediatric Emergency Medicine Collaborative Research Committee as a retrospective nested case-control study. We will include infants with hypothermia (rectal temperature<36.5 °C) presenting to 1 of 28 pediatric EDs in the United States between January 1, 2013, and December 31, 2022. Exclusion criteria will include (1) fever in the ED or prior to ED arrival, (2) transfer from another health care facility, (3) technology dependence, (4) trauma, (5) skin and soft tissue infections, and (6) presentation in cardiac arrest. The primary outcomes will be culture-confirmed SBI (objectives 1-3) and HSV-positivity (objective 1). The analytic approach for each objective will be (1) to use descriptive statistics to summarize the epidemiology of SBI and HSV and clinical outcomes, (2) to compare biomarker parameters of infants with and without SBI and determine optimal cutoff values using a receiver operator characteristic curve, and (3) to develop a multivariable predictive model using penalized mixed effects logistic regression within a 1:3 case-control sample among infants in the cohort who had a blood culture obtained.

RESULTS: Data collection for this study is ongoing, with a collection of data from 21 hospitals at the time of protocol submission. Of 16 sites evaluated in preliminary analysis (n=45,673), the median age is 25 (IQR 6-52) days, and 24,182 (52.9%) are male. In total, 340 (0.7%) infants have an SBI, of whom 103 had bacteremia or meningitis. Mortality occurred in 7 (2.1%; 95% CI 0.9%-4.3%).

CONCLUSIONS: We will use a consensus-based outcome measure for SBI with an established data acquisition pathway. We will use a multicenter sample from US children’s hospitals, using a consensus-based outcome measure for SBI and a case-control approach to evaluate outcomes to improve the management of young infants with hypothermia in the ED.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/66722.

PMID:40536806 | DOI:10.2196/66722

Omega (Westport). 2025 Jun 19:302228251353548. doi: 10.1177/00302228251353548. Online ahead of print.

ABSTRACT

Most patients dying in hospitals die outside of specialist palliative care, making healthcare professionals of all disciplines responsible for the care of the dying. This cross-sectional study assessed how burdened healthcare professionals on non-palliative care hospital wards are when caring for dying patients. Descriptive and inferential statistics (chi² and t tests) were used to analyze the data. N = 201 healthcare professionals on ten non-palliative care hospital wards participated in the survey (four general wards, six intensive care units). Intensive care unit staff reported a higher total burden related to care in the dying phase than general ward staff (d = 0.41; p = .005). “High demands of caring for dying patients”, “unexpected death”, and “special relationship with informal caregivers” were the most severe and prevalent burden factors in healthcare professionals. Results show specific burden factors that should be prioritized when implementing interventions to reduce burden in healthcare professionals.

PMID:40536794 | DOI:10.1177/00302228251353548

J Craniofac Surg. 2025 Jun 19. doi: 10.1097/SCS.0000000000011565. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to analyze the changes in trabecular bone architecture in the condylar neck and angulus regions of the mandible in patients who were treated with surgically assisted maxillary extension (SARME) using fractal analysis (FA) techniques.

METHODS: The study included 37 patients who underwent SARME operation for maxillary transversal deficiency in the Department of Oral, Maxillofacial and Maxillofacial Surgery. Fractal values (FV) were measured from the right and left condyle neck and angulus on panoramic radiographs before and 6 months after the operation.

RESULTS: As a result of the analysis, statistically significant changes were found in the bilateral condyle neck in pre and postoperative FV scores (P<0.05), whereas the changes in the angulus region were not statistically significant (P>0.05).

CONCLUSIONS: This study concludes that changing occlusion and masticatory forces after SARME surgery change the bone structure in the condyle region of the mandible, increase trabeculation and therefore FV.

PMID:40536787 | DOI:10.1097/SCS.0000000000011565

NEJM Evid. 2025 Jun 19:EVIDoa2500115. doi: 10.1056/EVIDoa2500115. Online ahead of print.

ABSTRACT

BACKGROUND: A predictive model for early-stage classic Hodgkin’s lymphoma (cHL) does not exist. Leveraging patient-level data from large clinical trials and registries, we developed and validated a model that we term the Early-Stage cHL International Prognostication Index (E-HIPI) to predict 2-year progression-free survival (PFS).

METHODS: We developed the model using the Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis (TRIPOD) guidelines in 3000 adults with newly diagnosed early-stage cHL from four international phase III clinical trials conducted from 1994 to 2011. External validation was performed in two cohorts, totaling 2360 treated patients from five international cHL registries (1996 to 2019). Two-year PFS was estimated using a Cox model with pretreatment variables selected using backward elimination. Internal validation corrected for overfitting. External validation assessed discrimination and calibration. The final model was also compared against European Organisation for Research and Treatment of Cancer (EORTC) favorable or unfavorable status.

RESULTS: The median age in the development cohort was 31.2 years; 77.4% had stage II disease. The estimated 2-year PFS was 93.7%. Final variables retained in the model were sex and continuous values of maximum tumor diameter (MTD), and levels of hemoglobin and albumin. The optimism-corrected C statistic in the development cohort was 0.63 (95% confidence interval, 0.60 to 0.69). Two-year PFS was lower in the validation cohorts 1 (90.3%) and 2 (91.6%). In validation cohort 1, the C statistic was 0.63 and the calibration slope was near 1, but overall calibration indicated underprediction, which improved on updating the intercept. The performance was similar in validation cohort 2. In addition, higher-risk E-HIPI scores were associated with worse outcomes in both the EORTC unfavorable and favorable subgroups. When included altogether in one Cox model, the E-HIPI was associated with PFS, whereas EORTC favorable or unfavorable status was not. Online risk calculators were developed (https://rtools.mayo.edu/holistic_ehipi/).

CONCLUSIONS: Utilizing objective, continuous, and readily available variables, we developed and validated a new prediction model for early-stage cHL. Male sex, lower hemoglobin or albumin levels, and higher MTDs were associated with worse PFS. (Funded by the National Cancer Institute; grant number, NCI R01 CA 262265-04.).

PMID:40536772 | DOI:10.1056/EVIDoa2500115

Ir J Med Sci. 2025 Jun 19. doi: 10.1007/s11845-025-03991-8. Online ahead of print.

ABSTRACT

BACKGROUND: Average screen time has increased drastically after the COVID-19 pandemic. It has raised concerns about the adverse effects, including the effect on BMI.

AIM: The present study is conducted to study the relationship between screen time and BMI among medical students at a medical institute in Lahore, Pakistan.

METHODS: For this cross-sectional study, a sample of 370 medical students and residents was obtained from a medical institute in Pakistan. An online survey to gather data about screen time activities, device usage, and BMI. Screen time was categorized into low (1-2 h/day), moderate (3-4 h/day), and high (5-6 h/day), while BMI score was calculated and categorized into under-weight, normal, overweight, and obese groups. Descriptive and inferential statistics including Spearman correlation analysis were applied using IBM SPSS 25.0.

RESULTS: Most participants fell into the normal BMI category (79%), with a smaller proportion classified as overweight (16%) or obese (5%). Most participants preferred using smartphones (92.1%). About 41% of participants had high screen time. There was a strong positive correlation between low screen time and normal BMI (r = 0.999). However, only 2.9% of the participants had low screen time. The link between higher screen time and obesity is observed especially in males, while females maintain a more stable normal weight, suggesting gender-based lifestyle or metabolic differences.

CONCLUSION: Screen time is significantly associated with BMI with a strong positive correlation as well. There is need to design educational programs to raise awareness about the safe use of devices and the amount of screen time.

PMID:40536737 | DOI:10.1007/s11845-025-03991-8

Ir J Med Sci. 2025 Jun 19. doi: 10.1007/s11845-025-03980-x. Online ahead of print.

ABSTRACT

BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterized by focal demyelinating lesions, axonal dysfunction/degeneration, and gliosis, which can lead to various clinical disabilities. Visual evoked potentials (VEP) is sensitive and repeatable techniques capable of monitoring significant short-term changes in neuroaxonal integrity and alterations in nerve conduction triggered by acute optic neuritis.

AIM: This study aims to evaluate whether VEP latency and amplitude could serve as subclinical predictors of clinical outcomes in MS patients over short-term follow-ups.

METHODS: This study was planned to include MS patients diagnosed according to the McDonald Criteria 18 who did not have any psychiatric, neurological, or ocular disorders that could interfere with the main purpose. The VEP test was performed for routine evaluation of demyelination or axonal damage.

RESULTS: A total of 83 patients were included in the study, with a mean age of 33.6 ± 9.3 years. Of all the patients, 54 were female (65.1%) and 29 were male (34.9%). Right pattern reversal visual evoked potential (PVEP) P100 (OR for PVEP1: 0.802, p = 0.001; OR for PVEP2: 0.879, p = 0.002) was statistically significant in showing right VEP abnormality at both baseline and at 6 months. Left VEP abnormalities were associated with left PVEP P100 at PVEP1 (OR: 0.852, p = 0.003) and left PVEP N75 at PVEP2 (OR: 0.935, p = 0.029).

CONCLUSION: VEPs have the potential to predict short-term subclinical stability or progression, making them valuable candidates for early treatment adjustments and evaluating future pharmacotherapy-supported remyelination.

PMID:40536736 | DOI:10.1007/s11845-025-03980-x