Category: Statistics

Proc Inst Mech Eng H. 2025 Jul 7:9544119251348490. doi: 10.1177/09544119251348490. Online ahead of print.

ABSTRACT

Lower limb fragility fractures included a break in bone from the pelvis to the foot. Weight-bearing and walking stability stand as key performance indicators to quantify fracture restoration. Normally, progress in fracture rehabilitation is observed through clinical assessments and patients’ responses, and modern research also presents instrumented gait analysis. There exists a gap to statistically compute the regaining in patients’ weight-bearing ability and walking stability following fractures. This study introduces methods to advance the analysis of instrumented signals and evaluate walking stability in fracture-healing patients. The centre of pressure (CoP) signals were captured for four conditions: tibia/fibula/talus fracture near the ankle (AF), lower-leg shaft fracture (LF), calcaneus fractures (CF), and normal ankle (NA). The time derivative for CoP signals showed impulsive responses during the loading and unloading transitions which were then modelled and transformed to the frequency domain. The developed models were further analysed by applying Nyquist and Bode methods and margins of stability were calculated for the fractured and healthy subjects. Results showed a substantial decline (Kruskal-Wallis’s test, p < 0.001) in the intralimb stability of all three fractures. Also, there was a strong interlimb dependency (p < 0.001) observed between fractured and intact limbs applying Spearman’s correlation during double limb support periods. Overall, the calcaneus fracture (CF) exhibited minimum intralimb stability and increased interlimb dependency. These methods stand clinically important in monitoring patients’ rehabilitation and in decision-making about alternative treatment plans.

PMID:40621615 | DOI:10.1177/09544119251348490

Int J Gen Med. 2025 Jun 30;18:3569-3578. doi: 10.2147/IJGM.S526759. eCollection 2025.

ABSTRACT

AIM: To investigate the clinicopathological features and prognostic factors of intrahepatic and extrahepatic cholangiocarcinoma.

METHODS: Clinicopathological and follow-up data of 328 cholangiocarcinoma patients treated at Shanxi Cancer Hospital from November 7, 2016, to August 11, 2021, were retrospectively reviewed. All samples were tested for Fibroblast growth factor receptor 2 (FGFR2) fusion by FISH. The expression of the proliferative marker Ki67 in patients with intrahepatic cholangiocarcinomas (iCCA) was evaluated by immunohistochemistry. All patients were followed up from the date of surgery to the time of death or August 31, 2023. Pathological specimens from patients with recurrence were collected and FGFR2 was tested again.

RESULTS: The positivity rates for FGFR2 fusion in intrahepatic, perihilar, and distal cholangiocarcinomas were 15%, 2.73%, and 1.69%, respectively. The chi-square test showed that tumor diameter, perineural invasion, complications, and FGFR2 fusion were statistically significant. Immunohistochemistry showed that patients with low expression of Ki67 accounted for 30% of iCCA, low expression of Ki67 and FGFR2 fusion was statistically significant. Relapse specimens were collected from 13 patients, and FISH showed that the expression of FGFR2 was consistent with that of the primary lesion. Multivariate analysis showed that lymph node metastasis was an independent factor for the prognosis of cholangiocarcinoma (P<0.05).

CONCLUSION: CCA is an aggressive tumor with high mortality and low survival rates, especially for perihilar cholangiocarcinoma (pCCA). Therefore, it is necessary to understand the clinicopathological features and prognostic factors of iCCA, pCCA and distal cholangiocarcinoma (dCCA). In addition, lymph node status is likely to be an independent and important prognostic factor.

PMID:40621597 | PMC:PMC12227518 | DOI:10.2147/IJGM.S526759

J Oral Biol Craniofac Res. 2025 Sep-Oct;15(5):925-931. doi: 10.1016/j.jobcr.2025.06.010. Epub 2025 Jun 22.

ABSTRACT

INTRODUCTION: Innovative approaches to curriculum design and implementation are critical in meeting the needs of today’s students. The present study was undertaken to determine the perspective of students on the introduced module of ‘Digital Dentistry’ along with knowing their self -directed learning abilities.

METHODS: The present study was conducted in the Medical University after ethical approval was obtained. Forty volunteers from 3rd and 4th year undergraduates of “Bachelor of Dental Surgery” course were selected and consent form was obtained. A pre-validated questionnaire on self-directed learning (SDLI) was administered to the volunteers to know their SDL abilities. A pre-post-session questionnaire containing feedback questionnaires was prepared, validated and administered before the session. A pre designed module was applied on the volunteers by using SDL session. 2 h duration of First contact session followed by 2 weeks of intersession period, where student went through the shared online/offline study material and visit to the lab under faculty supervision. Outcome assessment was done with 30 MCQ based on the 3 chapters taught in the session. In Second contact session, debriefing by faculty was done and post-module questionnaire was administered. The responses obtained from SDLI, assessment questionnaires and pre-post-module questionnaires were further analyzed statistically.

RESULTS: Student’s SDLI score with median value of 77.325 represented a good score, with learning motivation scored highest in SDLI. The total score significantly improved post-intervention, with the mean score increasing from 28.83 (5.43) pre-intervention to 35.35 (4.36) post-intervention.

CONCLUSION: Significant improvement in knowledge, awareness and perceptions of digital dentistry was seen after the conduct of the session.

PMID:40621583 | PMC:PMC12226062 | DOI:10.1016/j.jobcr.2025.06.010

Front Psychiatry. 2025 Jun 20;16:1556046. doi: 10.3389/fpsyt.2025.1556046. eCollection 2025.

ABSTRACT

OBJECTIVE: This study aims to examine the effect of online verbal aggression on interpersonal trust and the chain-mediating role of core self-evaluation and emotional intelligence among college students.

METHOD: A questionnaire survey was conducted among 869 college students with experiences of online verbal aggression using the Cyber Verbal Bullying Scale, Interpersonal Trust Scale, Core Self-Evaluation Scale, and Emotional Intelligence Scale.

RESULTS: (1) After controlling other latent variables, it was found that online verbal aggression had a significant direct negative effect on college students’ interpersonal trust. (2) Core self-evaluation and emotional intelligence played significant mediating roles in the relationship between online verbal aggression and interpersonal trust, and their combined chain mediation effect was also statistically significant.

CONCLUSION: Victimization by online verbal aggression may lower core self-evaluation in college students, thereby impairing their emotional perception and regulation and ultimately reducing their interpersonal trust. Effective interventions should address self-evaluation, emotional intelligence, and interpersonal trust to mitigate the adverse effects of online verbal aggression on college students.

PMID:40621562 | PMC:PMC12226459 | DOI:10.3389/fpsyt.2025.1556046

Pak J Med Sci. 2025 Jun;41(6):1743-1748. doi: 10.12669/pjms.41.6.11856.

ABSTRACT

OBJECTIVE: To investigate clinical efficacy of novel biogenically fabricated titania nanoparticles enriched mouth wash in treating dentin sensitivity of patients.

METHODS: Tripple blinded randomized clinical trial was conducted at School of Dentistry Islamabad from 6^th June 2024 to 6^th December 2024 incorporating participants (n = 260) with Group-A (n = 130) and Group-B (n = 130). After attaining informed consent and randomization, Visual Analog Scoring system (VAS Value) was induced to check the Dentin hypersensitivity (DH) of the participants at baseline, after one month and three months follow up. Group-A was given Conventional Mouth wash and Group-B was given Novel-Nanoparticles (Nps) Mouth Wash for total three months to treat DH. The primary outcome was calculated as mean VAS Values for both Groups-A and B after one month and three months. Mann-Whitney-U Test was used for comparing DH between these two groups.

RESULTS: According to trial results, significant difference was obtained between Group -A that used Conventional Mouth wash and Group-B that used Novel- Nps Mouth wash after one month (p = 0.001) and three months (p = 0.002).

CONCLUSION: DH declination was more prominent in patients that used Novel- Nps Mouth wash with nanoparticles in comparison to participants that used Conventional Mouth wash without any nanoparticles. This concludes that inclusion of biogenically fabricated titania nanoparticles in clinical dentistry could be beneficial in resolving Dentin Hypersensitivity.

PMID:40621550 | PMC:PMC12223751 | DOI:10.12669/pjms.41.6.11856

Pak J Med Sci. 2025 Jun;41(6):1734-1742. doi: 10.12669/pjms.41.6.12187.

ABSTRACT

BACKGROUND & OBJECTIVE: Recent studies have showed a correlation between hyperglycemia and insulin resistance with adverse outcomes in multiple critical diseases, including sepsis. The triglyceride-glucose index (TyGi) is now recognized as a proxy indicator of insulin therapy resistance. We aimed to ascertain the connection between TyGi and the sepsis prevalence and clinical outcomes in patient’s post-abdominal surgery.

METHOD: Data for this retrospective cohort study was acquired from the Medical Information Mart for Intensive Care IV database from 2008 to 2019. Patients (≥18 years) who had elective major abdominal surgery were included. The primary outcome was the occurrence of sepsis following abdominal surgery. The connection between TyGi and sepsis incidence was investigated with multivariable Cox regression analysis.

RESULTS: One thousand eight hundred eighty-four patients were included in this study. The cumulative incidence of sepsis during hospitalization was 12.3%. The adjusted Cox regression model showed that raised TyGi levels were linked to a greater probability of sepsis incidence (Hazard’s ratio, 1.907; 95% CI, 1.327-2.739; p<0.001). Restricted Cubic Spline analysis demonstrated that TyGi possessed a strong and almost linear connection with the likelihood of postoperative sepsis. Subgroup analysis showed interaction effects in the subgroup with low high-density lipoprotein cholesterol (p for interaction=0.018). Furthermore, the incorporation of TyGi into the existing prediction model shows an enhancement in outcome prediction. The C-statistic elevated from 0.696 to 0.722, p<0.007. The continuous net reclassification improvement (NRI) was 0.203, p=0.005, and the integrated discrimination improvement (IDI) was 0.007, p<0.001.

CONCLUSION: Patients at increased risk of developing sepsis following abdominal surgery may be identified in clinical practice with TyGi.

PMID:40621548 | PMC:PMC12223748 | DOI:10.12669/pjms.41.6.12187

Pharmacoepidemiol Drug Saf. 2025 Jul;34(7):e70177. doi: 10.1002/pds.70177.

ABSTRACT

Multi-database distributed data networks for post-marketing surveillance of drug safety and effectiveness use two main approaches: common data models (CDMs) and common protocols. Networks such as the U.S. Sentinel System, the Observational Health Data Sciences and Informatics (OHDSI) network, and the Data Analysis and Real-World Interrogation Network in Europe (DARWIN-EU) use a CDM approach in which participating databases are translated into a standardized structure so that a single, common analytic program can be used. On the other hand, the common protocol approach involves applying a single common protocol to site-specific data maintained in their native format, with analytic programs tailored to each data source. Some networks, such as the Canadian Network for Observational Drug Effect Studies (CNODES) and the Asian Pharmacoepidemiology Network (AsPEN), use a variety of approaches for multi-database studies. Regardless of the approach, distributed networks support comprehensive pharmacoepidemiologic studies by leveraging large-scale health data. For example, utilization studies can uncover prescribing trends in different jurisdictions and the impact of policy changes on drug use, while safety and effectiveness studies benefit from large, diverse patient populations, leading to increased precision, representativeness, and potential early detection of safety threats. Challenges include varying coding practices and data heterogeneity, which complicate the standardization of evidence and the comparability and generalizability of findings. In this Core Concepts paper, we review the purpose and different types of distributed data networks in pharmacoepidemiology, discuss their advantages and disadvantages, and describe commonly faced challenges and opportunities in conducting research using multi-database networks.

PMID:40619597 | DOI:10.1002/pds.70177

J Dermatolog Treat. 2025 Dec;36(1):2526073. doi: 10.1080/09546634.2025.2526073. Epub 2025 Jul 6.

ABSTRACT

PURPOSE: Onychomycosis, in contrast to other routine superficial dermatophyte infections, is difficult to treat and poor outcomes are not unusual. Few guidelines for onychomycosis management have been published, and these vary considerably from region to region. To meet global antifungal stewardship (AFS) goals, there must be global management guidelines for clinicians to follow in their onychomycosis practice. We aimed to survey current practices for onychomycosis management across a variety of global regions and compare practices to published treatment guidelines, as well as to what degree the management practices may facilitate AFS practices.

MATERIALS AND METHODS: An informal literature review was performed to identify regional onychomycosis guidelines. An online survey of our colleagues was distributed to assess current onychomycosis management practices and challenges for comparison with associated regional guidelines. Guidelines and practices were reviewed for adherence to the general AFS principles.

RESULTS: Our review of current practices shows that, despite guidelines, identification of the infecting species is often not obtained, and treatment provision does not strictly follow existing guidelines. Lack of laboratory access prevents diagnosis and antifungal susceptibility testing that can help provide targeted treatments and resistance surveillance. Better diagnostic methods are needed as a component to improve management decisions, and provide the reliable monitoring required for effective AFS. Broader clinical testing is needed to address knowledge gaps in onychomycosis therapy. Meeting these challenges must be a priority as antifungal resistance is quickly becoming a worldwide problem.

CONCLUSIONS: As a reservoir for resistant strains, onychomycosis represents a significant future medical/economic burden. Future onychomycosis guidelines must address the challenge of resource limitations experienced by clinicians, as well as the challenge of balancing the need for AFS principles with the specific needs of onychomycosis therapy.

PMID:40619586 | DOI:10.1080/09546634.2025.2526073

Anat Sci Educ. 2025 Jul 6. doi: 10.1002/ase.70084. Online ahead of print.

ABSTRACT

Postmortem body donation (BD) plays a central role in medical education and scientific research. Sociocultural, religious, and legal factors can influence attitudes toward BD. In Italy, BD programs are in early development, and recent legislation (Law 10/2020) regulating body donation came into effect in 2021. Although international surveys have explored attitudes toward BD, data specific to the Italian context remain limited. This study provides initial insights into attitudes and willingness to donate among medical academics and students at an Italian university. A cross-sectional study was conducted between February and March 2023 using an online questionnaire. The survey collected data on attitudes, dissection experience, sociodemographic, and academic background. A multivariate logistic regression model was implemented to evaluate factors associated with willingness to donate. Of the 2273 individuals invited, 434 completed the questionnaire (19.4% response rate, 70% female, 88% students). Overall, 72.8% were willing to donate. Knowing organ donors was associated with higher willingness, whereas religious beliefs were negatively associated. Only 32% of participants were aware of the national law regulating BD. This study highlights the predominance of positive attitudes toward BD within a healthcare-oriented academic population and the significant influence of religion and personal experience. The limited awareness of Law 10/2020 underscores the need for targeted educational efforts, even within expert communities. These findings support future initiatives aimed at improving awareness, shaping national policy, and contributing to the global discourse on ethical and practical aspects of body donation.

PMID:40619569 | DOI:10.1002/ase.70084

J Prosthodont. 2025 Jul 6. doi: 10.1111/jopr.14097. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the impact of different complete-arch digital scanning techniques and prosthesis types on the passive fit of computer-aided design and computer-aided manufacturing (CAD-CAM) verification devices.

MATERIALS AND METHODS: Two different maxillary master casts with four multi-unit abutment (MUA) implant analogs (FP-1 and FP-3 prosthesis types) were used as the basis for fabricating verification devices through two impression techniques (OptiSplint and RevEX). Group 1 utilized digital scans of splinted scanbodies reinforced with a light-polymerizing acrylic resin and metal mesh on the FP-1 cast (OptiSplint technique), Group 2 employed the same impression technique as Group 1 on the FP-3 cast, Group 3 applied digital scans of reverse scanbodies connected to a passively fitting interim prosthesis on FP-1 cast (RevEX technique), and Group 4 used the same impression technique as Group 3 on FP-3 cast. A total of 40 milled verification devices were fabricated, with 10 devices allocated to each group. The misfit of verification devices was assessed using visual inspection, tactile sensation, and a one-screw test, with any disagreements between the two primary examiners resolved by a third evaluator. Agreement between the clinicians was assessed using Cohen’s kappa statistics and percent agreement. The percentage of misfits was calculated for each group and compared between groups using Fisher’s exact tests (α = 0.05).

RESULTS: The misfit analysis showed the lowest misfit (10%) in Group 1 (OptiSplint-FP1), followed by Groups 3 (RevEX-FP1) and 4 (RevEX-FP3) at 20%, and the highest (40%) in Group 2 (OptiSplint-FP3), with no significant differences between groups by Fisher’s exact tests (p > 0.05). Odds ratios indicated six times higher misfit odds for FP-3 than FP-1 with OptiSplint, no difference for FP-1 versus FP-3 with RevEX (odds ratio = 1.0), and lower odds with RevEX compared to OptiSplint under FP-3 conditions (odds ratio = 0.375). Inter-examiner agreement was strong, with 90% concordance and a Kappa statistic of 0.66, demonstrating substantial consistency.

CONCLUSION: OptiSplint is preferable for FP1 cases, whereas RevEX suits FP3 cases when intraoral-scanner-based extraoral workflows are used. Despite these recommendations, misfits occurred in every group, suggesting that a verification cast may be prudent when adopting these newer scanning approaches. Clinicians should consider fabricating an additional verification cast with splinted scanbodies or a clinically satisfactory interim implant prosthesis. This cast can confirm implant positions whenever modern scanbodies such as OptiSplint or RevEX are incorporated into the workflow.

PMID:40619568 | DOI:10.1111/jopr.14097