Category: Statistics

J Nephrol. 2025 Jul 11. doi: 10.1007/s40620-025-02338-x. Online ahead of print.

ABSTRACT

BACKGROUND: Effective prediction of immunoglobulin A nephropathy (IgAN) progression is crucial for early intervention and management. We aimed to develop and validate distinct IgAN prediction models for clinical and research applications.

METHODS: We analyzed data from the Japanese Nationwide Retrospective Cohort Study in IgAN (n = 1174) gathered over 10 years. The models were developed and tested using data from general physicians in primary care, specialists in tertiary care hospitals, and researchers at academic research institutes. Three tailored prediction models (Primary Care, Tertiary Care, and Research Institute Models) were created to address the unique needs of different clinical environments. The primary outcome was a composite renal event defined as a 1.5-fold increase in serum creatinine level or progression to kidney failure. The predictive performance was assessed using C-statistics.

RESULTS: In the derivation cohort, the primary care model included predictors such as estimated glomerular filtration rate < 45 mL/min/1.73 m², proteinuria ≥ 0.5 g/day, and non-use of corticosteroids, achieving a C-statistic of 0.796 (95% confidence interval [CI] 0.686-0.895). The tertiary care model showed a C-statistic of 0.807 (95% CI 0.713-0.886), using predictors such as glomerular number and histological severity. The research institute model, incorporating 38 variables, demonstrated a C-statistic of 0.802 (95% CI 0.686-0.906).

CONCLUSIONS: The prediction models for primary and tertiary care settings provided effective tools for forecasting renal outcomes in IgAN patients and are competitive with more complex machine learning-based models used in research. These models can help guide clinical decisions in various healthcare settings.

PMID:40643794 | DOI:10.1007/s40620-025-02338-x

Int Ophthalmol. 2025 Jul 11;45(1):286. doi: 10.1007/s10792-025-03668-2.

ABSTRACT

AIM: To analyze the trend in Ahmed glaucoma valve (AGV) utilization in recent years and to assess its current clinical profile and surgical indications in glaucoma management.

METHODS: A retrospective observational study was conducted at a tertiary hospital within the Spanish National Health System, evaluating AGV surgeries performed from 2010 to 2022. To characterize current AGV use, a subset of 156 eyes that underwent surgery in the past five years was analyzed. Clinical variables, including age, gender, glaucoma type, intraocular pressure (IOP), IOP-lowering medications, and visual field status, were collected from patients aged ≥ 18 years. Temporal trends, surgical indications, and their evolution were examined.

RESULTS: A total of 519 AGV implantations were included. AGV utilization increased from 15.2% of all glaucoma surgeries in 2010 to 27.5% in 2019 but significantly declined thereafter, reaching 6.9% in 2022 (p = 0.001). Among the 156 eyes in the recent subset, 93 had refractory glaucoma, which showed the most pronounced decline in AGV procedures and the poorest surgical outcomes. Eyes with sulcus-placed or aphakic lenses, uveitis, or neovascular glaucoma experienced a less marked reduction in AGV implantation rates. These cases presented with higher baseline IOP but exhibited less glaucomatous damage and a better response to AGV implantation.

CONCLUSION: AGV implantation has significantly declined over the past five years, particularly in refractory glaucoma. This trend may be attributed to the increased adoption of subconjunctival bleb-forming surgeries and to the impact of the COVID-19 pandemic. Despite this overall decline, AGV continues to be primarily employed in cases of secondary glaucoma.

PMID:40643791 | DOI:10.1007/s10792-025-03668-2

APMIS. 2025 Jul;133(7):e70051. doi: 10.1111/apm.70051.

ABSTRACT

miR-143 and miR-145 have been reported as downregulated in colorectal cancer (CRC) compared to normal mucosa, with regulatory effects on proteins involved in carcinogenesis. These findings primarily derive from tissue homogenate analyses and experimental models. The present study employs in situ methodology to reassess miR-143 and miR-145 expression in CRC and their associations with validated protein targets within the native tumor microenvironment. Expression patterns of miR-143, miR-145, and eight previously experimentally validated target proteins were analyzed in clinical samples from 100 CRC patients using in situ hybridization, immunohistochemistry, and deep learning-based epithelial segmentation. Expression levels of miR-143 and miR-145 showed no significant difference between CRC and normal mucosa, though considerable inter-patient variability was observed. Among 11 examined miRNA-protein relationships, only four showed significant correlations, exhibiting positive associations that contrast with previously reported inverse relationships. Subgroup analyses revealed no statistically significant association between miRNA expression variability and examined clinicopathological parameters. These findings highlight the importance of in situ validation for results obtained from tissue homogenates and in vitro experiments. Additional research is warranted to determine the prognostic significance of miR-143 and miR-145 in clinical outcomes.

PMID:40642870 | DOI:10.1111/apm.70051

Aerosp Med Hum Perform. 2025 Apr;96(4):279-286. doi: 10.3357/AMHP.6530.2025.

ABSTRACT

INTRODUCTION: Warning information is mainly transmitted to pilots through visual and auditory forms in flight, with only a small portion transmitted through vibration. Poorly designed flight deck warnings have negative effects on pilot performance and safety. This study aimed to give insights into how different encoding forms of warnings act on pilot performance from a cognitive modeling perspective.

METHODS: Four encoding forms were designed using voice prompts and flashing messages. An Adaptive Control of Thought-Rational based model was built to simulate the perception process. Flight simulator tests were carried out with four types of warnings triggered randomly for comparison with simulation results and thereby performed model validation. Statistical tests were performed to examine the significant differences and effect sizes.

RESULTS: Both cognitive models (response time 0.82 ± 0.06 s with voice vs. 1.37 ± 0.09 s without voice in static forms; 1.35 ± 0.56 s with voice vs. 1.83 ± 0.32 s without voice in flashing forms) and subjects’ response time (1.42 ± 0.37 s with voice vs. 1.53 ± 0.42 s without voice in static forms; 1.43 ± 0.44 s with voice vs. 1.65 ± 0.43 s without voice in flashing forms) suggest the benefits of using voice prompts to improve performance, while flashing forms of warnings may impose an extra burden on cognition even though they bring the benefit of attracting attention.

DISCUSSION: By carrying out a joint analysis with cognitive modeling and flight simulator tests, this work shows that designers can make use of alternative sensory channels for achieving a timely transfer of attention, but with a risk of increasing cognitive load. Zhang X, Li C, Sun Y, Yan C. Cognitive response efficiency under varying audiovisual display modalities of flight deck warnings. Aerosp Med Hum Perform. 2025; 96(4):279-286.

PMID:40642852 | DOI:10.3357/AMHP.6530.2025

Aerosp Med Hum Perform. 2025 Apr;96(4):356-359. doi: 10.3357/AMHP.6590.2025.

ABSTRACT

INTRODUCTION: We previously published a model of how calcium from resorbing bone can enter and persist in the circulation with consequent precipitation in coronary arteries. The model was based on chronic inflammation as the source of continued bone resorption. We asked whether other forms of resorptive bone loss such as microgravity (disuse) might also be associated with bone calcium accumulation in coronary arteries.

METHODS: We analyzed a de-identified database provided by NASA consisting of 52 astronauts who had flown a space mission around two determinations of coronary artery calcium (CAC) scores at 5-yr intervals and bone density determinations in the year prior to and 10 d and 1 yr following a space mission.

RESULTS: We found that in 38.5% of the astronauts, their CAC scores changed between pre- and postflight, with 95% of the CAC scores increasing. These astronauts were significantly older than the 61.5% whose CAC scores did not change, although the mission length was not different between the groups. Both groups lost bone acutely but had partial recovery over the year postflight.

DISCUSSION: Due to lack of uniform sampling times, we could not correlate changes in CAC score with bone loss and would advocate for synchronous determinations of CAC and bone density pre- and postflight. Klein GL, Jupiter DC. Elevated coronary artery calcium scores in astronauts. Aerosp Med Hum Perform. 2025; 96(4):356-359.

PMID:40642848 | DOI:10.3357/AMHP.6590.2025

Telemed J E Health. 2025 Jul 11. doi: 10.1089/tmj.2024.0468. Online ahead of print.

ABSTRACT

Objective: The purpose of this study is to explore the prevalence of and factors associated with telehealth utilization in a medically underserved, ambulatory care diabetes population during COVID-19 pandemic. Methods: A retrospective chart review was conducted using electronic medical records from January 2020 to January 2021 at an ambulatory care diabetes clinic within an urban teaching hospital. Descriptive statistical analysis was conducted for all study variables. Simple and multiple logistic regression analyses were conducted to assess predictive factors of telehealth utilization during the COVID-19 pandemic. All statistical analysis was conducted using SPSS version 28 at an alpha level of 0.05. Results: A total of 325 patients were included in the study. The mean age of the study population was 58.2 ± 15.9 years, and the majority was female (67.6%) and Black/African American (92.6%). The average number of medications prescribed was 4.9 ± 2.6 medications, and the average A1C was 8.1% ± 2.4%. A high proportion of patients utilized telehealth (88.3%). Findings from the multivariable analysis showed that females were more likely to use telehealth compared to males, adjusting for other factors (OR_adjusted 2.14 (95% CI: 1.06-4.32). Ward, as a proxy for low income and high medically underserved status, was not a significant predictor of telehealth utilization (p = 0.89). Conclusion: Findings showed that telehealth was widely acceptable at the height of the COVID-19 pandemic even for participants who are low income and have high medically underserved status. Telehealth should continue to be championed as a viable option of care delivery for these vulnerable patients.

PMID:40642808 | DOI:10.1089/tmj.2024.0468

Quintessence Int. 2025 Jul 11;0(0):0. doi: 10.3290/j.qi.b6362487. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to investigate the causal relationship between metabolites and periodontitis using Mendelian randomization (MR) and validate findings through gingival crevicular fluid (GCF) metabolomic profiling.

METHODS AND MATERIALS: A two-sample MR analysis used genetic data from 486 metabolite Genome-Wide Association Study (GWAS) and periodontitis statistics, with IVW as the primary method, supported by MR-Egger, weighted median, and weighted mode. Sensitivity analyses included Cochran’s Q, MR-Egger, and MR-PRESSO tests. GCF metabolomics compared 5 periodontitis patients and 5 controls, identifying differential metabolites via t-tests and PLS-DA, with KEGG pathway enrichment.

RESULTS: MR analysis identified 17 metabolites causally linked to periodontitis, spanning amino acids, lipids, energy metabolism, and cofactors/vitamins. Protective metabolites included betaine (OR: 0.478, 95% CI:0.235-0.975), laurate (0.51, 0.267-0.974), and glycerol 3-phosphate (0.312, 0.105-0.926), while phenylalanine (39.651, 2.173-723.565), pelargonate (2.527, 1.059-6.03), and 3-methylhistidine (1.481, 1.074-2.042) increased risk. Sensitivity analyses confirmed minimal heterogeneity, no pleiotropy (except 4-acetamidobutanoate), and no reverse causation. GCF metabolomics revealed 75 upregulated and 245 downregulated metabolites, with pathway enrichment in lipid, amino acid, and vitamin metabolism. Notably, betaine-protective in MR analysis-was significantly reduced in periodontitis, aligning with its anti-inflammatory role.

CONCLUSION: This study indicates that some circulating metabolites (e.g., betaine) may protect against periodontitis. Integrating MR and GCF analyses, we identified key metabolic risk factors. Clinically, metabolites like betaine and glycerol 3-phosphate could serve as non-invasive early biomarkers, providing new avenues for personalized periodontitis prevention and treatment.

PMID:40642796 | DOI:10.3290/j.qi.b6362487

Euro Surveill. 2025 Jul;30(27). doi: 10.2807/1560-7917.ES.2025.30.27.2400748.

ABSTRACT

BACKGROUNDSurveillance of severe acute respiratory infections (SARI) using ICD-10 codes from electronic health records (EHR) lacks consensus on optimal case-defining codes.AIMWe determined codes that maximise sensitivity (Se) and positive predictive value (PPV) for SARI associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza virus and respiratory syncytial virus (RSV) in Denmark, Iceland, Malta, Norway and Spain.METHODSWe included hospitalisations from week 21/2021 to 39/2023, with ICD-10 diagnostic codes for respiratory disease (three-character codes J00-J99) or COVID-19 (U07.1, U07.2, country-specific codes for Denmark). We assessed Se and PPV of individual codes against laboratory results. Based on Se and PPV rank-sum, we selected the top 10 codes and combined them into 10 sets per pathogen. We identified sets that maximised the clinical utility index (CUI = Se × PPV), categorised as excellent (≥ 0.81), good (0.64-0.80), satisfactory (0.49-0.63) and poor (< 0.49).RESULTSWe assessed 395,163 hospitalisations for SARI-SARS-CoV-2, 313,418 for SARI-influenza and 192,936 for SARI-RSV, all tested. For SARI-SARS-CoV-2, code U07.1 (B34.2A, B97.2A for Denmark) had excellent utility in Denmark, Malta, Norway, Spain (≥ 0.82), and good utility in Iceland (0.79). For SARI-influenza, J09, J10 and J11 performed excellently in Denmark, Norway, Spain (≥ 0.83), satisfactorily in Malta (0.52), and poorly in Iceland (0.43). For SARI-RSV, J12, J20 and J21 achieved highest CUI but had poor utility (0.17-0.34).CONCLUSIONSCOVID-19- and influenza-specific three-character ICD-10 codes accurately identified SARI associated with SARS-CoV-2 and influenza virus. For SARI-RSV, four-character codes should be explored. We recommend context-specific assessments in countries adopting EHR-based surveillance.

PMID:40642769 | DOI:10.2807/1560-7917.ES.2025.30.27.2400748

Euro Surveill. 2025 Jul;30(27). doi: 10.2807/1560-7917.ES.2025.30.27.2400820.

ABSTRACT

BACKGROUNDDanish women vaccinated with the 4-valent human papillomavirus (HPV) vaccine (HPV types: 6/11/16/18) at age 14 in 2008 reached screening age in 2017, allowing assessment of long-term effects on prevalence, persistence and incidence of HPV infections.AIMTo examine the HPV status of cervical samples over time among women vaccinated as girls.METHODSBetween February 2017 and February 2024, residual material from cytology-analysed samples collected through the ‘Trial23’ study, part of the national screening programme, was tested for HPV16/18 and non-vaccine high-risk (HR) HPV types. Prevalence in first, second and third samples, and persistence and incidence between samples were calculated.RESULTSOver 7 years, 8,659 women provided at least one sample, 5,835 at least two and 2,461 at least three. In 7,800 vaccinated women, HPV16/18 prevalence was 0.4% (95% confidence interval (CI): 0.2-0.5), 0.3% (95% CI: 0.1-0.4) and 0.2% (95% CI: 0.0-0.4) in three consecutive samples. Prevalence of non-vaccine HR HPV was 32% (95% CI: 31-33), 28% (95% CI: 27-29) and 31% (95% CI: 29-33). Persistence of HPV16/18 and non-vaccine HPV among vaccinated women was 40% and 53%. In adjusted analyses comparing vaccinated vs unvaccinated women, incidence was significantly lower for HPV16/18 (adjusted relative risk (aRR) < 0.10) while incidence of non-vaccine HR HPV types was higher (aRR: 1.66; 95% CI: 1.12-2.45). No significant difference was observed for persistence.CONCLUSIONOur study provides real-world evidence of stable protection against HPV16/18 infections in women vaccinated as girls. Less intensive screening seems reasonable until women vaccinated with the 9-valent vaccine reach screening age, when screening should be reconsidered.

PMID:40642768 | DOI:10.2807/1560-7917.ES.2025.30.27.2400820

Cureus. 2025 Jun 10;17(6):e85708. doi: 10.7759/cureus.85708. eCollection 2025 Jun.

ABSTRACT

INTRODUCTION: Charcot foot is a debilitating complication of diabetes mellitus (DM), characterized by joint destruction, deformity, and instability due to neuropathy-induced microtrauma. Despite its severe impact on mobility and quality of life, Charcot foot remains underdiagnosed. This study aims to determine the prevalence of Charcot foot among diabetic patients at two major referral hospitals in Malaysia and identify associated risk factors.

METHODS: A cross-sectional study was conducted at the Integrated Diabetic Centers (IDCs) of Hospital Kulim and Hospital Raja Permaisuri Bainun (HRPB). Diabetic patients aged ≥18 years attending follow-ups at these centers were recruited via convenient sampling. Data collection included structured interviews, clinical examinations, laboratory investigations, and radiographic assessments. The diagnosis of Charcot foot was confirmed based on clinical findings, imaging, and laboratory parameters. Statistical analyses, including Fisher’s exact test, were conducted using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, New York, United States), with significance set at p<0.05.

RESULTS: A total of 675 diabetic patients were included, with a mean age of 56.1 years (SD±13.96). Men comprised 58.2% (n=393/675) of participants, while 41.8% (n=282/675) were women. The overall prevalence of Charcot foot among diabetic patients in this study was 1.8% (n=12/675). Gender was significantly associated with Charcot foot (p=0.005), with a higher prevalence among women (3.5%; n=10/282) than men (0.5%; n=2/393). The mean DM duration among Charcot foot patients was 19.67 years (SD±7.34), with 66.7% (n=8/12) having DM for 11-20 years. Poor glycemic control was prevalent, with a mean HbA1c of 9.21% (SD±1.87) and 75% (n=9/12) of Charcot foot patients having HbA1c ≥7%. Additionally, 50% (n=6/12) had a history of diabetic foot ulcers, and 16.7% (n=2/12) had undergone prior amputation.

CONCLUSION: Charcot foot is a significant but often underdiagnosed complication in diabetic patients, particularly in women and those with long-standing, poorly controlled DM. Early detection and multidisciplinary management are crucial to reducing morbidity. Future research should focus on longitudinal studies to assess disease progression and intervention effectiveness.

PMID:40642735 | PMC:PMC12244756 | DOI:10.7759/cureus.85708