Category: Statistics

Environ Monit Assess. 2025 Jul 5;197(8):866. doi: 10.1007/s10661-025-14324-8.

ABSTRACT

Droughts are one of the most severe natural hazards, and its occurrences are increasingly exacerbated due to climate change. While numerous studies have analyzed drought occurrences using multi-model ensembles (MME) developed considering uniform weights to general circulation models (GCMs), biases inherent in these models impeded the attainment of reliable predictions. Also, studies conducted were region specific and were limited to considering a specific socio-economic pathway (SSP). The inconsistency in findings drawn across different SSPs limits the applicability of these results to implement best management practices to combat drought effectively. In this study, Drought Prone Index (DPI) built on the mathematical framework of Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) has been proposed. This index represents the frequency and severity of the possible drought events considering near future (2024-2060) and far future (2061-2100). Further, to overcome the limitation of bias, a multi-criteria decision-making (MCDM) framework integrating CRiteria Importance Through Intercriteria Correlation (CRITIC) and analytical hierarchy process (AHP) methods has been proposed to create differential weighted multi-model ensemble. The proposed framework is demonstrated considering India as study area. Findings of our study indicate a significant increase in rainfall and temperature ranging between 100-440 mm, and 0.75-3.5 °C across different SSP scenarios. Alongside a decline in rainfall in certain regions of Northeast India and the Western Ghats is observed from the derived spatial maps created using the data of developed MME. Spatial variation of DPI computed at a district level indicates that though the frequency of drought occurrences in the near and far future periods does not substantially increase, the severity of droughts is found to be intense. Findings highlight that it is imperative to consider the influence of climate change while assessing the droughts. These findings can assist policymakers and stakeholders in prioritizing resource allocation and implementing targeted mitigation strategies.

PMID:40616693 | DOI:10.1007/s10661-025-14324-8

Clin Oral Investig. 2025 Jul 5;29(7):372. doi: 10.1007/s00784-025-06450-x.

ABSTRACT

OBJECTIVES: This study aimed to compare the clinical efficacy of a novel apical barrier technique (N-ABT) and a traditional apical barrier technique (T-ABT).

MATERIALS AND METHODS: A randomized controlled clinical trial was conducted. Forty-seven patients with 50 teeth meeting the inclusion criteria of large root canals and incompletely developed apical foramina were enrolled. Teeth were randomly assigned to either the N-ABT or T-ABT group in a 1:1 ratio and were followed for 24 months. N-ABT employed 3D printing technology to design personalized pluggers and to calculate the precise volume of barrier material, while T-ABT used a standard commercial plugger without volume control. Randomization was performed using a computer-generated sequence, and the study was conducted in a single-blind manner.

RESULTS: A total of 45 teeth completed the 24-month follow-up (22 in the N-ABT group and 23 in the T-ABT group), with no significant adverse events reported. All cases were considered clinically successful, defined by the absence of symptoms and a reduction in apical radiolucency. Success was further classified as healed (complete disappearance of apical radiolucency) or healing (reduction in apical radiolucency). At the 12-month follow-up, the N-ABT group showed a slightly higher healed rate (22.7% vs. 17.4% in the T-ABT group), and at the 24-month follow-up, a trend toward a higher healed rate was observed (68.2% vs. 47.8% in the T-ABT group), although the differences were not statistically significant. However, N-ABT significantly improved filling efficiency by reducing the number of obturation attempts from 1.41 ± 0.50 to 1 and the filling time from 99.31 ± 25.08 s to 38.78 ± 15.56 s. Additionally, N-ABT significantly increased the no overfilling rate from 8.7 to 40.9%.

CONCLUSIONS: N-ABT clinically improve clinical outcomes (> 20%) during the observation period, it also demonstrated enhanced filling quality and efficiency and reduced technical sensitivity.

CLINICAL RELEVANCE: The novel apical barrier technique demonstrated superior filling quality and efficiency compared to the traditional apical barrier technique, reduced technical sensitivity, and showed potential for future automated filling procedures, enhancing clinical applicability.

CLINICAL TRIAL REGISTRATION: This study was registered on www.chictr.org.cn (Identifier: ChiCTR2200058635;Trial title: Personalized Root Canal Barrier Technique Using 3D Printing Technology).

PMID:40616689 | DOI:10.1007/s00784-025-06450-x

J Orthop Traumatol. 2025 Jul 5;26(1):44. doi: 10.1186/s10195-025-00864-9.

ABSTRACT

BACKGROUND: Few studies have investigated the relationship between the chronicity of anterior cruciate ligament (ACL) tears and the incidence of ramp lesion subtypes. The purpose of this study was to evaluate the relationship between the chronicity of ACL tears and the new subtypes of ramp lesions for treatment selection.

METHODS: Between May 2015 and April 2023, 367 patients who underwent primary ACL reconstruction were evaluated. Meniscal repair was performed in cases where a ramp lesion was identified. According to the exclusion criteria, 96 patients who underwent repair of ramp lesion were divided into three groups (PR type: pure ramp lesion, RR type: red-red ramp lesion, and DL type: double longitudinal ramp lesion), and the groups were compared for chronicity of ACL tears and time from injury (TFI).

RESULTS: Of the 30 patients classified as having PR type lesions, 11 (36.7%) had chronic ACL tears. Likewise, of the 37 patients classified as having RR type lesions, 14 (37.8%) had chronic ACL tears. In contrast, among the 29 patients classified as having DL type lesions, 20 (69.0%) had chronic ACL tears, indicating a statistically significant difference (p < 0.05). This distinction was significant up to 12 months after injury.

CONCLUSIONS: Pure ramp lesions accounted for only 31% of all ramp lesions in ACL tears. In addition, chronic ACL tears are more frequently accompanied by double longitudinal tears than by red-red zone longitudinal tears or pure ramp lesions of the meniscus posterior horn.

STUDY DESIGN: case series, level of evidence IV.

PMID:40616683 | DOI:10.1186/s10195-025-00864-9

Environ Monit Assess. 2025 Jul 5;197(8):865. doi: 10.1007/s10661-025-14282-1.

ABSTRACT

Surface water pollution driven by land use practices and soil erosion remains a persistent challenge in tropical river basins of East Africa. Despite its socio-economic importance, the transboundary Sio Malaba Malakisi River Basin (SMMRB), shared by Kenya and Uganda, lacks comprehensive data on spatial and seasonal water quality dynamics. This study provides the first year-long baseline assessment of surface water quality in the SMMRB, using water samples collected from 12 monitoring sites across three distinct hydrological seasons: dry, short rainy, and long rainy. Twelve physicochemical parameters were analyzed following standardized protocols from the American Public Health Association (APHA), resulting in 854 data points. Multivariate statistical techniques: agglomerative hierarchical clustering, Wilk’s lambda analysis, and exploratory factor analysis (EFA), were used to identify patterns and key drivers of water quality variation. Three distinct spatial clusters, corresponding to the Sio, Malaba, and Malakisi sub-catchments, were identified, each exhibiting unique water quality profiles. Elevated concentrations of total phosphorus (TP), soluble reactive phosphorus (SRP), and total suspended solids (TSS) were observed, exceeding typical background levels for unpolluted rivers. Seasonal differences highlighted the role of sediment transport and dilution processes, particularly during the rainy seasons. These findings provide novel insights into nutrient transport and hydrogeomorphological influences in a tropical, data-scarce, transboundary basin. The results offer a scientific basis for setting up targeted monitoring stations and adaptive water management strategies. Future studies should assess long-term interactions between sediment and nutrients. Evaluating the effectiveness of soil and water conservation practices will also be important for improving water quality.

PMID:40616682 | DOI:10.1007/s10661-025-14282-1

Environ Monit Assess. 2025 Jul 5;197(8):868. doi: 10.1007/s10661-025-14310-0.

ABSTRACT

Precise source tracing and risk quantification of multi-source heavy metals (HMs) contamination in soil pose significant challenges for regional environmental management. This study proposed an innovative dynamic coupling model that combines a self-organizing map (SOM) and positive matrix factorization (PMF), overcoming the limitations of single models. The geo-accumulation index (I_geo) and the initial ecological risk index (RI) were integrated with human health risks to form a comprehensive evaluation chain of “pollution source-exposure pathway-risk contribution.” The results showed that the average concentrations of eight HMs in soil exceeded background levels, with Cd exhibiting the highest exceedance ratio (0.67 mg/kg, 4.17 × background value). Cd, Zn, and As are influenced by human activities, as evidenced by variation coefficients greater than 70%. The SOM-PMF model successfully identified five pollution sources and their respective contribution rates (contribution/main elements): agricultural sources (8.48%, As), traffic sources (30.24%, Pb, As, Cr), natural background sources (23.04%, Ni, Cu, Cr), industrial sources (18.34%, Cd, Pb, Zn), and smelting sources (19.91%, Mn). Ecological risk assessments have indicated that Cd represents the most significant environmental cumulative risk ( $\overline{I}$ _geo = 1.52) and potential ecological risk ( $\overline{\mathrm{RI}}$ _{microorganism} = 0.34). However, source-risk coupling analysis reveals that agricultural activities (47.3% of As) contribute 24% to the biological risk, with As replacing Cd as the priority element for control. Traffic sources are the primary contributors to health risks, with Pb and As being the main elements (with proportions of 65.18% and 45.52%, respectively), followed by agricultural sources primarily associated with As (47.3%). These sources contribute over 42% to both carcinogenic and non-carcinogenic risks. As was the major contributor to health risks in the study area, with carcinogenic and non-carcinogenic risks in children significantly higher than in adults (3.28 and 4.24 times, respectively). This study provides a scientific basis and technical support for the zonal management and collaborative control of multi-source soil HM pollution.

PMID:40616676 | DOI:10.1007/s10661-025-14310-0

Clin Oral Investig. 2025 Jul 5;29(7):373. doi: 10.1007/s00784-025-06455-6.

ABSTRACT

OBJECTIVES: The study aims to compare methods for 3D volumetric assessment of unilateral alveolar clefts using CBCT, evaluating their accuracy and analysing clinical applicability, and to provide recommendations for improved precision in treatment planning and scientific research.

MATERIALS AND METHODS: Two methods were used to assess the volumes of 20 patients with unilateral alveolar clefts. One was based on anterior nasal spine (ANS) and greater palatine foramen (GPF); while the other was based on ANS and posterior nasal spine (PNS), regarding the palatal plane (PP) as the reference plane. Reliability for the different outcome variables was analyzed with intra-class correlation (ICC) and by calculating a paired Student’s t tests and Pearson’s correlation coefficient.

RESULTS: The mean volume measured by the ANS&PNS based method (957.70 ± 174.25 mm³) was higher than the one measured by the combined method based on ANS&GPF (786.74 ± 146.10 mm³) with statistically significant difference (P < 0.001). The Pearson correlation coefficient between the groups showed good stability in the differences (r = 0.957, P < 0.001).

CONCLUSIONS: The volumetric assessment of alveolar clefts varies with the reference plane used. The method based on palatal plane offers relatively easier identification of landmarks, closely reflecting actual alveolar bone volume.

CLINICAL RELEVANCE: The refined method for alveolar cleft assessment could improve treatment planning for orthodontics and alveolar bone grafting in patients with UCLP, while also supporting research on alveolar cleft morphology and its developmental mechanisms.

PMID:40616672 | DOI:10.1007/s00784-025-06455-6

World J Urol. 2025 Jul 5;43(1):410. doi: 10.1007/s00345-025-05792-1.

ABSTRACT

OBJECTIVE: To assess the efficacy and safety of flexible ureteroscopic lithotripsy (f-URL) assisted by the tip-bendable suction ureteral access sheath (SUAS) and mini-percutaneous nephrolithotomy (mPCNL) for the treatment of simple lower calyx renal calculi.

METHODS: A prospective randomized controlled trial was conducted on 102 patients with simple lower calyx renal calculi (with a diameter of 1 ~ 3 cm) admitted to the Second Hospital of Tianjin Medical University from December 2023 to February 2025. The patients were randomly assigned to the SUAS f-URL group (n = 49) and the mPCNL group (n = 53). The primary endpoint of the study was the immediate stone-free rate (SFR), while the secondary endpoints included operative time, anesthesia time, visual analogue scale (VAS) pain score, estimated blood loss, complication rate, length of hospital stay, hospitalization cost, and the SFR at 30 days postoperatively.

RESULTS: The two groups had comparable baseline characteristics. The SUAS f-URL group demonstrated a similar immediate SFR compared to the mPCNL group (67.35% vs. 66.04%, p = 0.889). Compared to the mPCNL group, the SUAS f-URL group had a shorter anesthesia time (78.08 ± 29.79 vs. 94.62 ± 34.22 min, p = 0.011), a shorter postoperative hospital stay (3.00 [1.50, 3.00] vs. 3.00 [2.00, 5.50] days, p = 0.003), and lower overall costs (3171.21 ± 373.34 vs. 5056.69 ± 358.97 USD, p < 0.001). There were no statistically significant differences between the two groups in terms of postoperative complications, estimated blood loss, pain scores, or SFR at 30 days postoperatively.

CONCLUSION: Compared to mPCNL, SUAS f-URL achieved a similar SFR while offering advantages such as less anesthesia time, shorter hospitalization, and lower hospitalization costs. Moreover, it did not increase the incidence of perioperative complications such as infection and blood loss. Therefore, SUAS f-URL would be a viable alternative supported by preliminary evidence for the management of 10-30 mm simple lower calyceal renal calculi.

PMID:40616669 | DOI:10.1007/s00345-025-05792-1

Eur J Orthop Surg Traumatol. 2025 Jul 5;35(1):293. doi: 10.1007/s00590-025-04406-1.

ABSTRACT

PURPOSE: This study aims to analyse the short- and long-term survival rate of an all-polyethylene tibia UKR, and the relationship with implant thickness and patient demographics including sex, age, ASA, and BMI.

METHODS: This was a single centre, retrospective, observational study of 388 consecutive medial fixed bearing all-polyethylene tibia UKRs done by a single surgeon between 2007 and 2019. We analysed the survival rate at 2, 5, 7, and 10 years and any relationship with sex, BMI, ASA, and implant thickness.

RESULTS: Cumulative implant survivorship was 98.7% at 2 years, 96.4% at 5 years, 95.3% at 7 years, and 91.9% at 10 years. The majority of patients had a BMI between 30 and 34 and were ASA 2; however, neither of these factors were associated with implant survival. The 7-mm all-polyethylene tibial component was most commonly used, and again, there was no association with implant size and survival. The most common reason for revision was progression of arthritis in the remaining compartments (40% of all revisions). There were no revisions due to loosening of the tibial component, and only 1.7% of revisions were due to femoral component loosening.

CONCLUSION: Fixed bearing medial all-polyethylene tibia UKR shows excellent survivorship at 2, 5, 7, and 10 years. There is no significant association with survivorship and sex, age, BMI, ASA grade, or implant thickness.

PMID:40616661 | DOI:10.1007/s00590-025-04406-1

Ann Hematol. 2025 Jul 5. doi: 10.1007/s00277-025-06497-6. Online ahead of print.

ABSTRACT

This study aimed to investigate the feasibility and safety of low-dose radiotherapy (RT) (< 50 Gy) in patients with stage I/II Extranodal NK/T-cell lymphoma (ENKTCL). Clinical and treatment data from 158 stage I/II ENKTCL patients who received combined chemoradiotherapy at the First Affiliated Hospital of Zhengzhou University from 2020 to 2022 were retrospectively analyzed to compare locoregional control (LC) and survival outcomes between high-dose (≥ 50 Gy) and low-dose (< 50 Gy) RT groups. All patients achieved an objective response (OR) after treatment, with a median follow-up of 51 months. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 90.1% and 81.7% in the high-dose group (n = 130), compared to 84.0% and 68.2% in the low-dose group (n = 28), with no significant statistical differences between the two groups. Notably, no local recurrence was observed in the low-dose group (100% local control rate), and the incidence of grade ≥ 3 RT-related adverse events (AEs) was significantly lower in the low-dose group than in the high-dose group. Preliminary evidence suggests that for newly diagnosed stage I/II ENKTCL patients receiving combined chemoradiotherapy, low-dose radiotherapy may not compromise LC and survival outcomes while reducing the incidence of grade 3-4 adverse events, with 40-45 Gy appearing to be the optimal dose range within the examined parameters.

PMID:40616628 | DOI:10.1007/s00277-025-06497-6

Health Econ Rev. 2025 Jul 5;15(1):56. doi: 10.1186/s13561-025-00653-4.

ABSTRACT

BACKGROUND: The alignment of preferences between physicians and patients can cause variations in treatment decision-making, thereby affecting health outcomes. However, research on the differences in preferences between physicians and the general population is scarce. This study examines the risk and time preferences of physicians compared with those of the general population, exploring the influence of gender concordance on health outcomes and decision-making in healthcare.

METHODS: We conducted an online field experiment in October and November 2022 in Japan and analyzed the responses of 469 individuals, including physicians and the general population. The survey was stratified by age and gender to align with the demographics of physicians nationally. Participants’ preferences were measured across the health and monetary domains by using a modified multiple price list test format.

RESULTS: The findings revealed that physicians tended to be more risk-averse than the general population in the health and monetary domains, although no statistically significant differences were observed. Physicians were found to be statistically significantly future-oriented, particularly regarding their significant health or monetary gains. Furthermore, while the female general population was more risk-averse in both domains, a gender difference in the physician group was observed only in the monetary domain.

CONCLUSION: The results affirm that preference differences between physicians and the general population exist in Japan and clarify the unique preference traits of female physicians.

PMID:40616619 | DOI:10.1186/s13561-025-00653-4