Category: Statistics

Inj Epidemiol. 2025 Jun 3;12(1):30. doi: 10.1186/s40621-025-00585-x.

ABSTRACT

OBJECTIVES: Extreme Risk Protection Orders (ERPOs) are civil court orders that temporarily prohibit firearm purchase and possession by someone (“respondent”) at imminent risk of harming themselves or others. Despite ERPOs being currently available in 21 states, DC, and U.S. V.I., little is known about the circumstances under which they are used across states.

METHODS: Using a standardized protocol, we abstracted ERPO petitions and associated court documents from 6 states to examine characteristics of respondents, documented risks of harm, and court outcomes. Included cases were filed through June 30, 2020, from 2013 (Connecticut) or from when the law went into effect (California: 2016; Colorado: 2020; Florida: 2018; Maryland: 2018; and Washington: 2016).

RESULTS: There were 6,634 ERPO petitions across included states. The median age of respondents was 40.0 years (SD: 16.4), and 10.8% were female. Almost half of petitions noted suicidal threats, plans, or ideation (43.9%) as the precipitating event, half noted interpersonal violence threats (50.8%), and one quarter (24.6%) noted threats to both self and others. Around one third (36.0%) noted unlawful or reckless firearm use. The majority of petitions (84.1%) indicated the respondent had current or recent access to a firearm. Most (77.5%) of the final orders (post-hearing) were granted. ERPO implementation varied across states, particularly with regard to how frequently they were used, for what type of threat, and by what type of petitioner.

CONCLUSIONS: This study examined ERPO law implementation in 6 states, highlighting differences and similarities. This comparison allows for a more nuanced understanding of variation in ERPO use, which can inform ERPO implementation and future studies of ERPOs’ effectiveness.

PMID:40462226 | DOI:10.1186/s40621-025-00585-x

Diabetol Metab Syndr. 2025 Jun 4;17(1):190. doi: 10.1186/s13098-025-01763-z.

ABSTRACT

OBJECTIVE: The relationship between metabolic syndrome (MetS) and venous thromboembolism (VTE) remains controversial. To clarify this, we conducted a two-step Mendelian randomization (MR) study to elucidate these independent causal associations and to investigate the potential mediating effects of circulating adipokines and coagulation factors.

METHODS: Two-sample MR was employed to explore the causal associations between MetS components and VTE and its subtypes, including pulmonary embolism (PE) and deep vein thrombosis (DVT). Multivariable MR (MVMR) assessed independent effects, while mediation analyses evaluated the mediating roles of adipokines and coagulation factors. The random-effects inverse-variance weighting was adopted as the primary method, and MR-Egger and weighted median methods were used as supplementary analyses. Cochran’s Q test was used to assess heterogeneity, and both the MR-Egger intercept test and Bayesian colocalization analysis were performed to detect horizontal pleiotropy.

RESULTS: In the two-sample MR analysis, we found that genetically predicted elevated systolic blood pressure (SBP) is associated with a reduced risk of VTE (OR = 0.99, p = 6.28e-06), PE (OR = 0.99, p = 4.97e-04), and DVT (OR = 0.98, p = 1.15e-08), while higher waist circumference (WC) increases the risk of VTE (OR = 1.65, p = 4.11e-10), PE (OR = 1.74, p = 1.99e-07), and DVT (OR = 1.76, p = 2.20e-08). MVMR analysis showed that both SBP and WC were independently associated with VTE, PE, and DVT. Further mediation analysis revealed that coagulation factor VIII (FVIII) mediated 18.97% of the effect of SBP on VTE, 12.95% on PE, and 14.14% on DVT. Leptin was found to mediate 50.69% of the effect of WC on VTE, 58.12% on PE, and 51.93% on DVT. These findings were replicated in independent samples. Sensitivity analyses excluded the possibility of horizontal pleiotropy and reverse causation.

CONCLUSION: Our MR analysis suggests that SBP among the components of MetS is negatively causally associated with VTE and its subtypes, while WC shows a positive causal association. Furthermore, FVIII and leptin play a key mediating role in these relationships. These findings illuminate the mechanisms linking metabolic factors to thrombotic risks, offering novel insights for targeted interventions.

PMID:40462212 | DOI:10.1186/s13098-025-01763-z

BMC Sports Sci Med Rehabil. 2025 Jun 3;17(1):139. doi: 10.1186/s13102-025-01180-9.

ABSTRACT

BACKGROUND: According to the evidence, female administrators are forced to fill both domestic and administrative tasks in their families and places of employment. They occasionally face demands from these roles that are out of their control. As a result, they experience fatigue and conflict from these demands. Based on these reasons, we studied the effects of an exercise-based counselling intervention on work-family conflict and occupational dysfunctional thinking in a sample of female educational administrators in light of these circumstances.

METHODS: A randomized control design was used, and a total of 86 school principals took part in the survey. Using scales to measure work-family conflict, participants were tested before and then tested twice (post-test and follow-up test) after completing an exercise-based counseling intervention. The intervention lasted for 14 weeks, with each session lasting one hour. Meanwhile, those in the comparison group were placed on a waitlist. The intervention aimed to enhance participants’ perceptions of work-family life. Univariate analysis, partial eta square analysis, and repeated measures analysis of variance were used to analyze the data that had been obtained.

RESULTS: The results showed that, among female administrators who had received the exercise-based counselling intervention, there had been a considerable improvement in a decrease in work-family conflict management. The results also suggest a statistically significant effect of time on work-family conflict among female administrators. The follow-up result reveals that the effectiveness of exercise-based counselling intervention was maintained over time in reducing work-family conflict.

CONCLUSION: The conclusion suggests that female administrators of schools exposed to exercise-based counselling intervention understand, perceive, and interpret conflicting work-family issues realistically, and that reduced work-family conflict.

TRIAL REGISTRATION: The study was registered retrospectively on 29/09/2024 123,702 with UMIN Clinical Registry UMIN000055666.

PMID:40462192 | DOI:10.1186/s13102-025-01180-9

BMC Sports Sci Med Rehabil. 2025 Jun 3;17(1):142. doi: 10.1186/s13102-025-01184-5.

ABSTRACT

BACKGROUND: As a type of game-based training (GBT), small-sided games (SSGs) are often compared with non-game-based training (NGBT) in team sports. However, there is still no consensus on the chronic effects between SSGs and NGBT, including high intensity interval training (HIIT) and traditional technical drills (TTD), on physical performance in basketball players.

OBJECTIVE: To systematically compare the chronic effects of SSGs versus NGBT on the physical fitness in basketball players through meta-analysis and to explore the moderator effects of training variables in SSGs.

METHODS: A systematic search was conducted in databases including PubMed, Scopus, Web of Science, EBSCO host, and CNKI, covering the period from inception until December 13, 2023, with last updated on April 14, 2025. The meta-analysis, sensitivity analysis, publication bias detection and subgroup analysis were mainly conducted by Review Manager 5.3. The methodological quality of the included studies was assessed by the PEDro scale and the NOS scale.

RESULTS: A total of 10 studies involving 253 subjects were included. The meta-analysis results indicated that: (1) No statistically significant differences were found between SSGs and NGBT for the improvement on aerobic and COD performance in basketball players (P > 0.05). And significantly higher enhancement of the lower limb explosive performance were found in SSGs compared with NGBT (SMD = 0.51, 95%CI: 0.20 to 0.82; P = 0.001). (2) Subgroup analysis revealed that SSGs programs favored a weekly training frequency ≥ 3 sessions (SMD = 0.60, 95%CI:0.08 to 1.13) in the improvement of aerobic performance and participants aged < 18 (SMD = 0.56, 95%CI:0.17 to 0.96) or training duration < 18.8 (SMD = 0.60, 95%CI:0.20 to 0.99) in the improvement of lower limb explosive performance. In addition, a higher enhancement of the lower limb explosive performance was found in SSGs versus TTD compared to SSGs versus HIIT (SMD = 0.78, 95%CI:0.33 to 1.22).

CONCLUSIONS: The evidence indicated that SSGs are as effective as NGBT for increasing aerobic and COD performance, and SSGs are more effective than NGBT for improving lower limb explosive performance in basketball players. Moreover, it is important to consider the influence of moderator variables such as weekly training frequency, age of participants and training duration when designing the SSGs programs. The findings provide consensus on the training effects of physical fitness between SSGs and NGBT, and offer directions for further research on optimal SSGs programs.

TRIAL REGISTRATION: This study was registered with PROSPERO (ID. CRD42023483633).

PMID:40462182 | DOI:10.1186/s13102-025-01184-5

Infect Dis Poverty. 2025 Jun 3;14(1):42. doi: 10.1186/s40249-025-01315-7.

ABSTRACT

BACKGROUND: Opisthorchiasis, caused by Opisthorchis viverrini, poses a significant health risk in northeastern Thailand, increasing the prevalence of cholangiocarcinoma. This study implemented a One Health integrated strategy, targeting human, animal, and environmental factors to reduce O. viverrini prevalence and transmission in an endemic region.

METHODS: The study was conducted from 2016 to 2022 in the Huay Luang Reservoir area, Udon Thani Province, Thailand and enrolled 5412 participants. Annual stool examinations were conducted and participants found to be infected with O. viverrini received anthelmintic treatments. Other intervention methods included health education, snail control, veterinary care, sanitation improvements, training of health volunteers, creating a learning center and liver fluke-free fish production. Annual data on prevalence, infection intensity, and reinfection rates were collected. Student’s t-test, one-way ANOVA, Chi-square test, or Fisher’s exact test were used to compare data across the study years, with statistical significance set at P < 0.05.

RESULTS: The One Health strategy significantly reduced O. viverrini prevalence in humans from 14.1% in 2016 to 0.9% in 2022, with O. viverrini-egg intensity decreasing from 76.9 to 25.5 eggs per gram (EPG) (P < 0.001). Reinfection rates decreased significantly from 17.4% in 2016 to 9.7% in 2022 following the implementation of the program (P = 0.003). Among reservoir hosts, infections in dogs and cats significantly decreased from 21.3% to 3.8% (P < 0.001). In cyprinoid fish, metacercarial prevalence significantly decreased from 21.9% to 2.2% (P < 0.001). Awareness of transmission routes rose from 45.1% to 82.6%, and raw fish consumption decreased from 52.4% to 12.3%. Biological control reduced Bithynia snail densities from 30 to under 5 snails/m², while sanitation interventions increased toilet use from 31.7% to 87.1%. A local fish-processing enterprise enhanced food safety and income. Health volunteers engaged 94% of households, and a learning center trained 250 individuals and hosted site visits.

CONCLUSIONS: The One Health strategy effectively and sustainably limited O. viverrini infections and reinfections, demonstrating the potential of One Health as a model for zoonotic parasite control in other endemic areas.

PMID:40462174 | DOI:10.1186/s40249-025-01315-7

Diabetol Metab Syndr. 2025 Jun 3;17(1):189. doi: 10.1186/s13098-025-01619-6.

ABSTRACT

OBJECTIVE: To systematically and statistically evaluate evidence from randomized controlled trials (RCTs) investigating the efficacy and safety of somatic stem cells in achieving glycemic control in type 1 and 2 diabetic patients.

METHODS: Bibliographic databases including PubMed, Scopus, Web of Science, and Cochrane Library were searched from the time of their establishment till January 2024. Obtained records were meticulously screened by title, abstract, and full text to include only RCTs seeking mesenchymal stem cells (MSCs) treatment for type 1 diabetes mellitus (T1DM) and 2 diabetes mellitus (T2DM). Included studies underwent quality assessment using the Cochrane risk of bias 2 tool (ROB2).

RESULTS: Thirteen studies were deemed eligible for meta-analysis, encompassing 507 patients (T1DM = 199, T2DM = 308). To measure treatment efficacy, the present meta-analysis was conducted on outcomes reported after 12 months following treatment. MSCs therapy group was associated with a significantly reduced glycosylated hemoglobin (HbA1c) compared to the control group, MD = -0.72; 95% CI: [-1.11 to -0.33], P = 0.0003, I² = 56%. Daily insulin requirement was lower in the MSCs group versus placebo, MD = -14.50; 95% CI: [-19.45 to -9.55], P < 0.00001, I² = 0%. Pooled fasting C-peptide levels were significantly higher in the MSCs group compared to placebo, MD = 0.24; 95% CI: [0.05 to 0.43], P = 0.01, I² = 93%. Postprandial blood glucose (PPBG) was observed to be significantly lower in the MSCs arm in contrast to placebo, MD = -11.32; 95% CI: [-16.46 to -6.17], P < 0.0001, I² = 17%. However, pooled analysis of fasting blood glucose (FBG) was not significantly different between both groups, MD = -6.22; 95% CI: [-24.23 to 11.79], P = 0.50, I² = 81% at the end of the 12-month follow-up.

CONCLUSION: Mesenchymal stem cell-derived therapy is an efficacious glycemia-lowering modality agent compared to conventional therapy in T1DM and T2DM patients. Albeit more sizeable and longer RCTs are warranted to further support and standardize their clinical use.

PMID:40462158 | DOI:10.1186/s13098-025-01619-6

Diabetol Metab Syndr. 2025 Jun 4;17(1):191. doi: 10.1186/s13098-025-01761-1.

ABSTRACT

BACKGROUND: The pathogenesis of metabolic syndrome (MetS) is strongly linked to dysbiosis in the gut microbiota. However, studies investigating the association between the dietary index of gut microbiota (DI-GM) and MetS are limited. As such, the present study aimed to examine the association between DI-GM and the prevalence of MetS, as well as long-term mortality among individuals in the United States.

METHODS: Data from 30,372 participants, obtained from the 2007 to 2018 cycle of the National Health and Nutrition Examination Survey, were analyzed. Associations between DI-GM scores and the prevalence of MetS and long-term mortality were examined using weighted logistic regression and Cox regression, respectively. Restricted cubic spline (RCS) and subgroup analyses were performed to further explore these relationships.

RESULTS: An inverse association was observed between DI-GM and the prevalence of MetS, with each 1-unit increase in DI-GM corresponding to an 8.2% decrease in MetS prevalence (odds ratio 0.918 [95% CI 0.896-0.941]). Among participants with MetS, a 1-unit increase in DI-GM was associated with reduced risk for cardiovascular mortality (hazard ratio 0.922 [95% CI 0.854-0.994]). RCS analysis revealed a significant linear inverse association between DI-GM scores and MetS prevalence and cardiovascular mortality among participants with MetS. Subgroup analyses suggested that race, income level, and smoking status may modify the association between DI-GM and MetS prevalence.

CONCLUSIONS: Findings revealed that higher DI-GM scores were significantly associated with a lower prevalence of MetS in the general population and a reduced risk for cardiovascular mortality among individuals diagnosed with MetS. Further longitudinal studies are needed to confirm these associations and explore the underlying biological mechanisms.

PMID:40462146 | DOI:10.1186/s13098-025-01761-1

Pilot Feasibility Stud. 2025 Jun 3;11(1):77. doi: 10.1186/s40814-025-01659-9.

ABSTRACT

BACKGROUND: Child maltreatment has severe and lasting consequences, and evidence-based interventions are essential for its prevention. However, few randomized controlled trials (RCTs) have been conducted within child welfare settings in Norway. Pilot trials play an important part in assessing the acceptability and feasibility of such interventions prior to full scale evaluations. This study evaluated the acceptability and feasibility of conducting a full-scale RCT of the Family Partner home-visiting intervention, designed to reduce the risk of child maltreatment.

METHODS: Families from three child welfare offices in Norway with at least one child under the age of 12 were invited to participate in this pilot trial. A two-arm randomized design was used, with participants allocated in a 1:1 ratio to either the intervention or control group (n = 45). The intervention group received the home-visiting Family Partner intervention, while the control group received treatment as usual. A qualitative process evaluation was conducted alongside the trial, comprising 29 interviews with Family Partners, caseworkers, participating families, and other stakeholders. Statistical and qualitative analyses evaluated participant acceptability, adherence, and retention.

RESULTS: Qualitative findings indicate a high level of acceptability for the Family Partner intervention across all stakeholder groups. Adherence was strong, with no participants withdrawing consent and only two opting out of subsequent surveys. However, participant retention declined over time, with survey response rates dropping at each time point and only 42% completing the final assessment.

CONCLUSIONS: This pilot trial provides preliminary evidence supporting the acceptability of the Family Partner intervention within child welfare services and highlights important considerations regarding the feasibility of conducting RCTs in this setting.

TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT04957394.

PMID:40462144 | DOI:10.1186/s40814-025-01659-9

Crit Care. 2025 Jun 3;29(1):225. doi: 10.1186/s13054-025-05482-9.

ABSTRACT

BACKGROUND: The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock (J-SSCG) 2020 aimed to standardize sepsis care in Japan. However, the extent of their impact on clinical practice remains uncertain.

METHODS: We conducted a nationwide retrospective cohort study using the Japanese Diagnosis Procedure Combination database between April 2018 and December 2021. Of the 118 clinical questions (CQs) in the J-SSCG 2020, we identified 26 recommendations to which adherence could be evaluated using patient-level data. We evaluated adherence trends before and after the guideline’s publication using interrupted time series analysis and quantified hospital-level variation using intraclass correlation coefficients.

RESULTS: A total of 213,099 patients with sepsis from 791 hospitals were included. Adherence rates varied widely across CQs (range: 0.5-98.7%). Recommendations “against” interventions generally showed high adherence, whereas those “for” interventions exhibited lower and more variable adherence. After guideline publication, adherence increased by < 3% points for most CQs. Interrupted time series analysis demonstrated no abrupt or substantial changes, and statistically significant trends were modest (< 2% annually). Among the 26 CQs, 14 were consistent with J-SSCG 2016 and 12 were newly introduced in 2020; both groups showed similarly limited changes in adherence. Adjusted intraclass correlation coefficients exceeded 10% for 22 CQs, indicating persistent between-hospital variation, which remained unchanged after the guideline’s release.

CONCLUSIONS: This nationwide study identified persistent evidence-practice gaps, minimal improvements in adherence after J-SSCG 2020, and substantial interhospital variation that remained unaltered. These findings underscore the challenges of implementing guidelines in practice and highlight the need to better understand contextual barriers to standardized sepsis care in Japan.

PMID:40462110 | DOI:10.1186/s13054-025-05482-9

BMC Public Health. 2025 Jun 3;25(1):2053. doi: 10.1186/s12889-025-23237-7.

ABSTRACT

BACKGROUND: The prevalence of high body mass index (BMI) has been increasing over the past three decades, resulting in significant public health challenges. This study aims to comprehensively analyze global, regional, and national trends in death and disability-adjusted life years (DALYs) attributable to high BMI from 1990 to 2021.

METHODS: We utilized data from the Global Burden of Disease study to estimate deaths and DALYs linked to high BMI across 204 countries and territories. Temporal trends were analyzed by sex, age group, region, and Socio-demographic index (SDI). Decomposition analyses were conducted to assess the impact of demographic factors on BMI-related disease burden. All estimates are presented with 95% uncertainty interval (UI) to quantify statistical uncertainty. The autoregressive integrated moving average model was employed to project future trends to 2036.

RESULTS: Globally, BMI-related deaths increased from 1.46 million (95% UI 0.72, 2.29) in 1990 to 3.71 million (95% UI 1.85, 5.66) in 2021. DALYs rose from 48 million (95% UI 21.2, 77.3) to 128.5 million (95% UI 56, 202.4) over the same period. Diabetes and kidney diseases have now overtaken cardiovascular diseases as the leading cause of DALYs, despite cardiovascular diseases remain the major contributor to BMI-related deaths. They accounted for 82.01% of deaths and 73.91% of DALYs. Among the four regions with the highest SDI, three showed a decline in BMI-related deaths and DALYs, except for high-income North America. In contrast, low-SDI regions continued to face escalating health burdens. Population aging was a primary driver of the increasing burden, which made up 49.43% of the increase in deaths and 47.03% in DALYs.

CONCLUSIONS: The increasing prevalence of high BMI has resulted in significant health burdens over the past three decades, with cardiovascular diseases, diabetes and kidney diseases being primary contributors. Low- and middle-income regions bear a larger share of the burden, while population aging exacerbates these challenges. Developing equitable and effective public health strategies is essential for addressing the growing obesity epidemic.

PMID:40462096 | DOI:10.1186/s12889-025-23237-7