Category: Statistics

BMC Oral Health. 2025 Jun 2;25(1):880. doi: 10.1186/s12903-025-06320-8.

ABSTRACT

BACKGROUND: Tongue position plays a vital role in craniofacial development, influencing skeletal structure and dental alignment. This study aims to assess tongue position and investigate its relationship with various dentofacial skeletal patterns using a novel cephalometric analysis method.

METHODS: This cross-sectional study included 550 orthodontic patients (ages 6-50) with pre-treatment lateral cephalograms. Participants were divided into mixed dentition (6-11 years) and permanent dentition (12-50 years) groups and classified into three sagittal skeletal patterns (Class I, II, III) based on ANB angle and three vertical patterns (high, average, low angle) based on FMA angle. Statistical analyses were selected according to data distribution and variance. Correlation analysis included Spearman’s rank and partial correlation, the latter of which adjusted for age, FMA, and adenotonsillar hypertrophy.

RESULTS: In the mixed dentition group, tongue position showed no significant variation by vertical pattern. In the permanent group, patients with low angles had a lower tongue tip. Class III patients exhibited an anterior and inferior tongue tip, while Class II patients had a higher tongue tip in the permanent group, after controlling for adenotonsillar hypertrophy, age, and FMA.

CONCLUSIONS: This study introduces a simplified method for measuring tongue position. A superior tongue tip correlates with skeletal Class II malocclusion, while an anterior and inferior tongue tip and lower tongue position are linked to skeletal Class III malocclusion. A lower tongue tip is also associated with low angle skeletal patterns.

PMID:40457430 | DOI:10.1186/s12903-025-06320-8

Thromb J. 2025 Jun 2;23(1):56. doi: 10.1186/s12959-025-00745-5.

ABSTRACT

BACKGROUND: The elevated prevalence of venous thromboembolism (VTE) among individuals diagnosed with inflammatory bowel disease (IBD) necessitates thorough investigation. Analyzing the genetic association mechanisms between these conditions is essential for comprehending their concurrent manifestation.

METHODS: Using genome-wide association study (GWAS) datasets for IBD and VTE, we applied a comprehensive approach to explore the genetic connections between these two diseases. The analysis was conducted in four steps: first, we assessed the overall genetic correlation between IBD and VTE using linkage disequilibrium score regression and genetic covariance analysis; next, we analyzed specific chromosomal regions to understand the genetic characteristics in these areas; then, we used the conditional/conjunctional false discovery rate (cond/conjFDR) method to better identify and quantify the shared genetic loci that contribute to both diseases’ development.

RESULTS: The genome-wide analysis revealed a strong genetic correlation between IBD, especially ulcerative colitis (UC), and VTE, while the correlation between Crohn’s disease (CD) and VTE was weaker. A detailed regional analysis identified specific chromosomal areas with genetic links to both diseases. Using the conjFDR method, we confirmed the shared genetic components between these conditions and identified key genetic variants that influence the development of both diseases.

CONCLUSION: This study provides genetic-level statistical evidence into the comorbidity mechanisms of IBD and VTE from a genetic standpoint, thereby enhancing the understanding of the underlying genetic basis contributing to their concurrent occurrence.

PMID:40457427 | DOI:10.1186/s12959-025-00745-5

AIDS Res Ther. 2025 Jun 2;22(1):56. doi: 10.1186/s12981-025-00741-9.

ABSTRACT

BACKGROUND: Differentiated service delivery (DSD) models in resource-limited settings reduce strain on health services and improve clinical outcomes such as retention and viral suppression, but little is known about the impact of HIV DSD models on quality of life (QoL), which is essential for optimizing person-centered care. This study assessed the impact of DSD models on Quality of life, loss to follow-up (LTFU), and mortality among persons living with HIV (PLHIV) on Antiretroviral therapy (ART) over time at a large urban HIV clinic in Uganda.

METHODS: Records of 1,000 PLHIV enrolled in a 10-year cohort at the Infectious Diseases Institute (IDI) clinic in Kampala, Uganda were retrospectively analyzed. QoL was assessed using an adapted Medical Outcomes Study (MOS-HIV) tool. QoL scores, sustained annual viral suppression (< 200 copies/mL), all-cause mortality and LTFU (≥ 3 months of missed visits) were compared for PLHIV in three DSD models for ≥ 6 consecutive months-fast-track drug refill (FTDR), facility-based groups (FBG), and composite model combining these two-versus facility-based individual management (FBIM) or the standard of care (SOC). Inverse probability treatment weighting was applied for covariate comparability while robustness of results was checked using G-computation. Sustained viral suppression was compared using odds ratios; all-cause mortality and LTFU were compared using hazard ratios from the Cox proportional hazard regression model.

RESULTS: Of the 1,000 PLHIV, 980 had ≥ 1 follow-up and were included in the analysis. Median age was 45 years (IQR: 40-51), 62% were female, and 95% had a suppressed viral load at baseline. Baseline QoL was 90.1% in any DSD model vs. 89.2% in SOC. After eight years of follow-up, weighted mean QoL was higher in participants enrolled in DSD models than the SOC (90.4% vs. 89.1%; weighted mean ratio 3.66, 95% CI 2.10-6.37, p-value < 0.001); there were no statistical differences across DSD models. Participants in DSD models were more likely to have sustained viral suppression (weighted odds ratio 1.69, 95% CI 1.24-2.31), lower mortality (weighted hazard ratio 0.08, 95% CI 0.03-0.20) and lower LTFU rates (weighted hazard ratio 0.08, 95% CI 0.02-0.31).

CONCLUSION: DSD models were associated with modestly higher quality of life, better viral suppression, and lower mortality and LTFU compared to the standard of care. These findings support the broader adoption of DSD models in delivering ART across HIV programs to enhance the QoL and clinical outcomes among PLHIV.

PMID:40457424 | DOI:10.1186/s12981-025-00741-9

Orthop Surg. 2025 Jun 2. doi: 10.1111/os.70056. Online ahead of print.

ABSTRACT

BACKGROUND: Antibiotic-loaded cement (ALC) is often used to reduce the risk of surgical site infections (SSIs) in hip hemiarthroplasty; however, controversy exists regarding the use of dual antibiotic-loaded cement (DALC) and single antibiotic-loaded cement (SALC).

OBJECTIVE: This systematic review and meta-analysis compare the efficacy of DALC and SALC for hip hemiarthroplasty.

METHODS: For this systematic review, a search was undertaken in the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and ClinicalTrials.gov. Grey literature such as ProQuest Dissertations and Theses Global (PQDT) was also explored. The inclusion criteria comprised randomized controlled trials (RCTs) or comparative observational studies, and patients undergoing hip hemiarthroplasty with DALC or SALC. Newcastle-Ottawa Scale (NOS) and RoB 2.0 tools were used for risk of bias assessment in observational and RCTs, respectively. Review Manager (RevMan, version 5.4.1; The Cochrane Collaboration, Copenhagen, Denmark) was used for statistical analysis. The primary outcome was the incidence of deep SSIs.

RESULTS: A total of five articles, including 28,418 participants, met the inclusion criteria. Three of the included studies were retrospective studies, one quasi-randomized study, and one RCT. The primary outcome revealed that DALC was associated with a statistically significant reduction in deep SSIs compared to SALC (RR, 0.47; 95% CI, 0.29-0.76; p = 0.002; I² = 27%). Subgroup analysis based on the study design did not show a significant difference for deep SSIs (p = 0.29). The majority of the secondary outcomes, such as superficial SSIs, mortality, participants with ≥ 1 complication, or antibiotic use, did not show any significant difference. However, DALC significantly lowered the risk of any infection (RR, 0.55; 95% CI, 0.38-0.79; p = 0.001; I² = 27%).

CONCLUSION: In conclusion, DALC can significantly reduce the risk of SSIs and the overall rate of any infection in hip hemiarthroplasty. A limitation of this study is that RCTs were pooled with observational studies, which decreased the power of analysis. Therefore, further research, including large RCTs, is needed to validate these findings.

PMID:40457409 | DOI:10.1111/os.70056

BMC Health Serv Res. 2025 Jun 2;25(1):784. doi: 10.1186/s12913-025-12951-y.

ABSTRACT

INTRODUCTION: Males have substantial sexual and reproductive health (SRH) needs, but there is low utilization of these SRH services. We compared the utilization and ascertained factors associated with the utilization of sexual and reproductive health services among males in urban and rural areas of Anambra State, Nigeria.

METHODS: A community-based cross-sectional study was conducted in Anambra State. Using multistage sampling, 1147 respondents were surveyed via interviewer-administered, structured questionnaires. Data was collected on socio-demographic characteristics, utilization of, and factors associated with the utilization of SRH services. We compared differences in the utilization of SRH services among males using Z test. Simple binary logistic regression analysis was performed to obtain odds ratios and 95% confidence intervals of the crude associations between each predisposing, enabling, and need factor and the utilization of male SRH services. Factors that had a p-value of ≤ 0.05 in the bivariable analysis were included in a multivariable logistic regression analysis to ascertain the independent association between each factor and the utilization of SRH services while controlling for the other factors. The level of statistical significance was set at < 0.05.

RESULTS: The mean age of the respondents was 28.00 ± 9.35 years. There was a low level of utilization, with males in rural areas (35.6%) having a higher level of utilization than males in urban areas (27.0%). Rural location, older age, higher educational level, communication with sexual partner, access to SRH information, exposure to SRH information on mass media, access to health insurance, being sexually active, feeling susceptible to SRH diseases, and having a diagnosis of SRH disease in the last 12 months were positively associated with the utilization of male sexual and reproductive health services. Marital and employment status, number of children, number of sexual partners and recent sexual intercourse were negatively associated with the utilization of male sexual and reproductive health services.

CONCLUSION: There is suboptimal utilization of SRH services in Anambra State, Nigeria. Interventions targeting these identified factors could increase the utilization of male sexual and reproductive health services in such settings.

PMID:40457399 | DOI:10.1186/s12913-025-12951-y

Thyroid Res. 2025 Jun 3;18(1):23. doi: 10.1186/s13044-025-00239-6.

ABSTRACT

Micronutrients play a crucial role in several metabolic processes including thyroid hormone metabolism and functions. The current study aimed to assess the associations between thyroid hormone levels and micronutrient status in a cohort of adolescents Afghan refugees residing in a refugee camp in Pakistan. A randomised, community based, cross-sectional study design was employed to recruit 206 adolescent (both male and female) Afghan refugees aged 10-19 years. Sociodemographic data, anthropometric assessments and blood samples were collected using standard methods. Serum vitamins, minerals and thyroid hormones levels were assessed using ELISA, electrochemiluminescence and inductively coupled plasma mass spectrometry (ICP-MS) respectively. Overall results showed the median levels of T3 and TSH were significantly higher (p < 0.05) in younger adolescents (10-14 years) compared to 15-18 year olds while T4 was significantly higher in boys compared to girls. Correlational analysis between serum micronutrients status (vitamin D, vitamin B12, ferritin, folate, zinc, copper, selenium) and thyroid hormones revealed significant relationships in different age groups. Overall, vitamin D exhibited a statistically significant positive correlation with T4 (r = 0.279) in the combined, younger (r = 0.277) and older (r = 0.319) age groups. In contrast, a statistically significant but negative correlation was observed when zinc levels were compared with T3 (r=-0.288) in the older age group and with T4 (r=-0.195) in the younger age group. In conclusion, micronutrients status, especially vitamin D and zinc, have important implications for thyroid health and thereby require close monitoring in any thyroid deficiency related disorders in vulnerable population such as refugees.Clinical trial number: Not applicable.

PMID:40457391 | DOI:10.1186/s13044-025-00239-6

J Orthop Surg Res. 2025 Jun 3;20(1):559. doi: 10.1186/s13018-025-05972-0.

ABSTRACT

BACKGROUND: Femoral neck system (FNS) and cannulated screws combined with medial plate (CS with medial plate) both are commonly used internal fixation for femoral neck fractures in recent years. There is a debate that which is the better choice for young and middle-aged patients with femoral neck fractures. The objective of the study is to compare clinical effects of FNS and CS with medial plate on young and middle-aged patients with femoral neck fractures by a prospective multicenter randomized controlled trial for the first time.

METHODS: Patients between 18 and 65 years old with femoral neck fractures were allocated to FNS fixation and CS with medial plate fixation with 2 years follow-up. The primary outcomes included fracture bone union rate and Harris hip score. The secondary outcomes included Garden’s alignment index, surgical data, Barthel index, visual analogue scale (VAS), gait analysis and complications during follow-up. Statistical analysis was performed by multiple linear regression and logistics regression.

RESULTS: 165 patients in FNS group and 166 patients in CS with medial plate group were analyzed finally. There was no statistical difference in bone union rate, Garden’s alignment index, Barthel index, gait analysis between two groups. The FNS group had a higher Harris hip score at 3 months after operation (P < 0.05), lower surgical data including operation time, intraoperative blood loss and fluoroscopy frequency (P < 0.001) and lower VAS at 1 month after operation (P < 0.05) than that of CS with medial plate group, but no significant difference at 3, 6, 12, and 24 months. There was no statistical difference in the incidence of complications between groups, except the incidence of coxa vara, which is higher in FNS group (P < 0.05).

CONCLUSIONS: For young and middle-aged patients with femoral neck fractures, both FNS and CS combined with a medial plate are effective.

TRIAL REGISTRATION: ChiCTR2100042960, registered 1 February 2021, http://www.chictr.org.cn .

PMID:40457366 | DOI:10.1186/s13018-025-05972-0

BMC Public Health. 2025 Jun 2;25(1):2029. doi: 10.1186/s12889-025-23191-4.

ABSTRACT

BACKGROUND: Exposure to political violence, which pervades many parts of the Middle East and Northern African (MENA) region, is a key potential factor behind the rising rates of risky behaviors among youth, such as drug use, alcohol use, and sexual activity. Theory and empirical work on youth elsewhere suggests that individual characteristics, mental health, and youths’ future orientation play a role in such behaviors. It is possible that political violence impacts behavior in part through its effects on these factors, in particular mental health. However, very little is known about the determinants of youth risk behavior in the region. Understanding the determinants will help MENA countries to deal with emerging public health threats as well as risks to youth health and well-being resulting from engagement in risky behavior. We examined determinants of risky behavior among Palestinian youth in the West Bank and East Jerusalem.

METHODS: We employed structural equation modeling using a 2014 nationally representative data from the Palestinian Youth Health Risk Study to examine the factors associated with engagement of youth ages 18-24 (N = 1449) in risky behaviors.

RESULTS: Personal experience of political violence was the strongest direct predictor of engagement in interpersonal violence (β = 0.21, p = 0.00) and substance use (β = 0.21, p = 0.00). With respect to indirect effects, global distress mediates the impact of witnessing and vicariously experiencing violence on the three outcomes. However, no association was found between personally experiencing political violence and global distress. The study also identified several individual characteristics, such as religiosity, that may be protective against risky behavior. Females are less likely to engage in risky behavior than males, despite experiencing higher levels of global distress.

CONCLUSIONS: The study is the first to use population-based data to test the effects of exposure to political violence on key risky health behaviors of Palestinian youth, a population facing protracted conflict and hardship for which solutions remain elusive. The findings suggest the need for customized interventions to target male and female Palestinians at an early age to develop their coping skills in dealing with violence and distress.

TRIAL REGISTRATION: Not applicable.

PMID:40457364 | DOI:10.1186/s12889-025-23191-4

BMC Infect Dis. 2025 Jun 2;25(1):784. doi: 10.1186/s12879-025-11009-y.

ABSTRACT

BACKGROUND: Antiretroviral therapy (ART) and ART adherence are crucial for preventing HIV transmission and prolonging the lifespan of people living with HIV (PLWH). Serostatus disclosure is a significant factor influencing both ART initiation and ART adherence. However, studies evaluating the impact of disclosure on ART initiation and ART adherence in mainland China have yielded inconsistent findings. This systematic review and meta-analysis aim to examine the associations between disclosure and both ART initiation and adherence.

METHODS: We systematically reviewed English databases (MEDLINE, Embase, Web of Science and the Cochrane Library) and Chinese databases (CNKI, WanFang, CQVIP, and SinoMed) to identify literature on factors that influence ART initiation and ART adherence from inception to Sep 24, 2024. Microsoft Excel 2019 sheet was used for data extraction. The data extraction sheet included information on the author’s names, publication year of the study, study design, study population, sample size, definition of adherence to ART, and study quality score. The Joanna Briggs Institute (JBI) critical appraisal checklist for prevalence studies was employed to assess the quality of the selected articles. Data were analyzed using STATA 17.0, and a random effects model was utilized to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Sensitivity analyses were conducted through the sequential exclusion of studies. Publication bias was assessed using Begg’s test and Egger’s test.

RESULTS: Our search yielded 517 results, of which 21 were eligible and included in the final meta-analysis. The analysis found that PLWH who disclosed their HIV serostatus were 2.59 times more likely to initiate ART compared to those who did not disclose (OR = 2.59, 95%CI: 1.92-3.49). However, we found no statistically significant association between HIV serostatus disclosure and ART adherence (OR = 1.21, 95%CI: 0.89-1.65). Additionally, no significant associations were identified between HIV serostatus disclosure and ART adherence in any subgroup analyses based on the subjects of disclosure, participants, or adjusted effect estimates for confounding factors.

CONCLUSIONS: We found evidence that serostatus disclosure is likely to positively associated with ART initiation, but not with ART adherence. Encouraging serostatus disclosure among PLWH, while simultaneously increasing public awareness about HIV and fostering a supportive environment for disclosure, may enhance ART adherence.

PMID:40457351 | DOI:10.1186/s12879-025-11009-y

BMC Public Health. 2025 Jun 2;25(1):2032. doi: 10.1186/s12889-025-23036-0.

ABSTRACT

OBJECTIVE: To analyze the epidemiological profile of women who experienced physical violence before and during the coronavirus disease (COVID-19) pandemic from reports of corpus delicti performed at the Forensic Medical Institute, Curitiba, Paraná, Brazil.

MATERIALS AND METHODS: This study used a retrospective cross-sectional design and secondary data analysis of cases of injuries caused by physical violence against women between 2019 and 2021 contained in Forensic Medical Institute reports. Only records of physical violence examinations performed on women were eligible for inclusion. Reports that did not allow for the identification of the victim’s gender, as well as those referring to other physical violence that did not involve aggression, were excluded. Data were collected electronically. The variables analyzed were age, ethnicity, marital status, sex, and relationship with the aggressor. A bivariate analysis using Pearson’s chi-square test was conducted to assess associations between the outcome (year) and independent variables. For significant associations, pairwise comparisons of proportions were made using the Z-test, with Bonferroni correction applied to control for Type I errors. Variables with p-values ≤ 0.05 were considered significant. Statistical analyses were performed using SPSS version 25.0.

RESULTS: In total, 5033 reports of physical violence against women were included in the study. In 2020, a greater proportion of personal injury examinations were observed in white women than in 2019 and 2021 (p < 0.001). Single women are the most vulnerable to physical violence in 2020 and 2021 (p < 0.001). During the same years, assaults by men, partners, former partners, and family members were more prevalent than in 2019 (p < 0.001). The Women’s Police Station was the sought-after place for reporting cases.

CONCLUSION: Over the two pandemic years analyzed, a significant reduction in the number of physical violence examinations conducted at the Forensic Medical Institute was observed. Nevertheless, single women, particularly those subjected to male-perpetrated violence, including by partners, ex-partners, and relatives, sought forensic services with greater frequency compared to the pre-pandemic period. Furthermore, the Women’s Police Station was the most frequently utilized facility for reporting such incidents.

PMID:40457344 | DOI:10.1186/s12889-025-23036-0