Category: Statistics

J Family Med Prim Care. 2025 Apr;14(4):1486-1493. doi: 10.4103/jfmpc.jfmpc_1833_24. Epub 2025 Apr 25.

ABSTRACT

INTRODUCTION: Oral cancer, particularly oral squamous cell carcinoma (OSCC), is a significant global health issue, with India facing one of the highest incidence rates due to widespread tobacco and alcohol use. This study examines the impact of demographic factors, adverse habits, and socioeconomic status on the development and progression of OSCC among patients in Kolkata, India.

MATERIALS AND METHODS: A cross-sectional, observational study was conducted on 100 OSCC patients and 100 control subjects at a tertiary care centre in Kolkata over a year. Data were collected through structured questionnaires detailing demographic characteristics, adverse habits, socioeconomic status, and clinical presentations. Statistical analysis was performed using SYSTAT, with Student’s t-test, Chi-square tests, and one-way ANOVA used to assess associations between variables.

RESULTS: The mean age of OSCC patients was 53.5 years, and 65% were male. Tobacco and alcohol use were prevalent, with OSCC patients showing higher frequencies and longer durations of use compared to controls. Statistically significant associations were observed between OSCC diagnosis and both tobacco smoking and chewing habits (P < 0.05), as well as lower socioeconomic status. The mean presentation delay was 4.4 months, commonly due to initial consultations at non-specialized facilities and lack of awareness, with tongue lesions as the most frequent complaint site. Histopathologically, 57% of cases were poorly differentiated squamous cell carcinoma, often diagnosed at TNM Stage II.

CONCLUSION: This study highlights that demographic factors, adverse habits, and socioeconomic status significantly influence OSCC risk and severity in Indian patients. The findings underscore the critical need for early detection initiatives, particularly in lower socioeconomic groups, and suggest that reducing tobacco and alcohol use can mitigate OSCC risk. Equipping the primary care physicians with the knowledge of primary prevention and enhanced public awareness are recommended to reduce presentation delays and improve patient outcomes.

PMID:40396110 | PMC:PMC12088539 | DOI:10.4103/jfmpc.jfmpc_1833_24

J Family Med Prim Care. 2025 Apr;14(4):1194-1206. doi: 10.4103/jfmpc.jfmpc_1513_24. Epub 2025 Apr 25.

ABSTRACT

BACKGROUND: Coronavirus 2019 (COVID-19) is an infectious disease caused by a novel coronavirus, SARS-CoV-2. Acute kidney injury (AKI) affects approximately 20-40% of patients with COVID-19 admitted to the intensive care unit (ICU), and it is a complication that has been linked to increased morbidity and mortality. Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker of acute kidney injury.

METHODS: Articles were searched from databases such as PubMed, Google Scholar, and Cochrane Library till June 2023. Pooled sensitivity, specificity, area under the curve (AUC), diagnostic odds ratio (DOR), and summery receiver operating curve (SROC) were calculated with 95% confidence interval. I² statistics and Chi-square test were used to look for the heterogeneity in between studies. Meta-regression was conducted to look for the source of heterogeneity and GRADE analysis was performed to look for the certainty of evidence.

RESULTS: Altogether, eight studies were selected (4 serum/5 urine), out of which one study had both serum and urine NGAL data. The total sample size was 1,067 (349 serum/718 urine). For serum and urine NGAL, the pooled sensitivity was 0.79 (95% CI: 0.72-0.84) and 0.75 (95% CI: 0.68-0.80), pooled specificity was 0.87 (95% CI: 0.81-0.91) and 0.85 (95% CI: 0.77-0.91), DOR was 24 (95% CI: 14-43), and 17 (95% CI: 9-32) and AUC was 0.90 (95% CI: 0.87-0.92) and 0.80 (95% CI: 0.76-0.83), respectively.

CONCLUSION: Both serum and urine NGAL have favourable pooled sensitivity, specificity, DOR and AUC for the diagnosis of AKI in COVID-19 infection, however, with low certainty of evidence.

PMID:40396107 | PMC:PMC12088576 | DOI:10.4103/jfmpc.jfmpc_1513_24

J Dev Orig Health Dis. 2025 May 21;16:e21. doi: 10.1017/S2040174425000133.

ABSTRACT

Childbirth influences maternal and new-born’s future health, with the Epigenetic Impact of Childbirth (EPIIC) hypothesis proposing that labour stress affects foetal gene expression. This study explores how birth experiences relate to DNA methylation in infants, breastfeeding and mother-infant bonding. Data from the Avon Longitudinal Study of Parents and Children was used, including 14,541 pregnant women. The ARIES subset of 1,022 mother-child pairs provided DNA methylation profiles. Maternal birth experience (MBE) was evaluated, with mother-infant bonding and breastfeeding. Statistical analysis involved linear regression and epigenome-wide association study. Half of the mothers reported at least one negative childbirth event, with 7% experiencing three or more adverse events. Negative MBE correlated with shorter breastfeeding duration and weaker mother-infant bonding. No significant CpG associations with MBE were found. While positive MBE is linked to improved mother-infant bonding and breastfeeding, no significant changes in DNA methylation profiles were observed in the offspring. Further research is needed to understand MBE’s long-term impact on child health.

PMID:40394752 | DOI:10.1017/S2040174425000133

Se Pu. 2025 Jun;43(6):688-695. doi: 10.3724/SP.J.1123.2025.02005.

ABSTRACT

Crude oils are complex mixtures of thousands of organic compounds that differ significantly in relative molecular mass， volatility， content， and polarity. Traditional methods for analyzing crude oil often involve complicated steps， consume large amounts of organic solvents， and require long sample-preparation times. These limitations lead to inefficient and time-consuming analysis processes. Crude oil is commonly analyzed by gas chromatography-mass spectrometry （GC-MS）. However， this technique is incapable of effectively separating complex crude-oil components owing to its low resolution and peak capacity， resulting in overlapping peaks that can lead to inaccurate compound identification and quantification. These challenges highlight the need for advanced analytical techniques. Comprehensive two-dimensional gas chromatography （GC×GC） is a novel separation technique that has been widely used to analyze complex samples， such as food， environmental samples， natural products， and crude oil. GC×GC has several advantages over traditional GC. Firstly， it offers higher resolution and peak capacity， thereby improving separation efficiency. Secondly， its high separation power reduces the need for complex sample pretreatment. Thirdly， the ordered separation and “tile effect” in a GC×GC chromatogram facilitate easier compound identification and quantification in complex mixtures.In this study， we developed a gas purge microsyringe extraction （GPMSE） method for the rapid pretreatment of crude-oil samples. This method reduces sample processing time to only 10 min while minimizing organic solvent consumption. The chemical compositions of 45 crude oil samples were analyzed using GC×GC-time-of-flight mass spectrometry （GC×GC-TOFMS）， which helped to establish detailed chemical fingerprints for each sample. The GC×GC-TOFMS data were processed using multivariate statistical methods， including redundancy analysis （RDA） and Monte Carlo permutation testing， which identified 36 biomarkers that are strongly associated with the origin of the crude oil （p<0.05）. A classification model was constructed using a training set of 28 samples. Four single-source and 13 mixed-source samples were used to validate the model. The GPMSE-GC×GC-TOFMS method was demonstrated to be highly efficient and accurate. A discrimination accuracy of 97.8% was achieved during the identification of crude-oil sources. The developed method not only provides a powerful tool for tracing crude oil but also has broad applications potential， including for the detection of adulterated crude oil， tracking oil-spill sources， and monitoring oilfield development. This study offers several significant benefits. For example， it helps to address crude-oil trade fraud and supports national energy security. Additionally， it provides scientific support in relation to crude-oil quality control and risk assessment. The developed method is fast， reliable， and environmentally friendly； hence， it is expected to be a valuable tool for use in the oil industry. The GPMSE-GC×GC-TOFMS method is cost-effective and requires minimal solvent； consequently， it is an attractive option for reducing environmental impacts in laboratory and industrial settings. Furthermore， the high throughput and accuracy of the developed method make it suitable for large-scale analyses. In conclusion， this study demonstrated the effectiveness of combining GPMSE with GC×GC-TOFMS for analyzing crude oil； the ability of the method to identify biomarkers and classify crude-oil sources in a highly accurate manner represents a significant advancement in the field. Future studies are expected to further explore its applications in related areas， such as oil refining and environmental monitoring.

PMID:40394748 | DOI:10.3724/SP.J.1123.2025.02005

BMC Psychol. 2025 May 20;13(1):531. doi: 10.1186/s40359-025-02804-y.

ABSTRACT

BACKGROUND: This study responds to an important research gap around the impact of socioemotional variables and mental health on young emerging adults in the Spanish university context. Although previous research has explored these dynamics in international populations, there is limited knowledge about how these interactions manifest in the Mediterranean cultural model of transition to adulthood, characterised by distinctive socioeconomic and familial factors. This paper not only describes the prevalence of symptoms of psychological distress, but also identifies protective (social support and emotional clarity) and risk (substance use) variables, highlighting the need for specific interventions in Spanish universities.

METHODS: The sample included 727 students aged 18-29, who completed questionnaires on emerging adulthood, mental health (DASS-21), social support (MSPSS), emotional intelligence (TMMS-24), alcohol (AUDIT-C) and cannabis (CAST) use. This cross-sectional, correlational study used statistical analysis to explore gender differences and predictors of symptomatology.

RESULTS: The results show a high prevalence of symptoms of emotional distress, with more than 55% of students showing symptoms of depression, anxiety or stress. This indicates the presence of these symptoms but does not necessarily imply clinical significance or a formal diagnosis. Gender differences were observed: females showed higher levels of anxiety and stress, while males showed higher levels of alcohol and cannabis use. In addition, social support from friends and certain dimensions of emotional intelligence (emotional clarity and emotional repair) were inversely associated with symptomatology, suggesting a protective role.

CONCLUSIONS: This study provides valuable insights into the relationship between emerging adulthood and mental health problems, highlighting the need for interventions in universities that promote emotional well-being and addiction prevention. In addition, the findings highlight the need to promote the development of emotional skills and social support networks to mitigate symptoms such as anxiety, depression and stress.

PMID:40394725 | DOI:10.1186/s40359-025-02804-y

Neurol Res Pract. 2025 May 19;7(1):35. doi: 10.1186/s42466-025-00384-1.

ABSTRACT

BACKGROUND: Weaning from mechanical ventilation (MV) and tracheal cannula (TC) during neurological early rehabilitation (NER) is mostly successful. However, some patients leave NER with TC/MV, requiring home-based specialized intensive care nursing (HSICN). Data on medical and demographic characteristics and long-term outcomes of these patients are limited.

METHODS: A multicentric retrospective observational study across five German NER hospitals collected data from neurological patients with TC/MV at discharge. The study aimed to assess patients’ health status at NER discharge, and to identify predictors of post-discharge survival. Survival rates were analyzed using Kaplan-Meier estimates; further predictors of survival post-discharge were analyzed using Cox regression.

RESULTS: Among 312 patients, the one-year survival rate was 61.9%, decreasing to 38.1% after approximately 4 years. Older age, higher overall morbidity and discharge with MV were associated with an increased likelihood of death, while a longer stay in NER correlated with survival.

CONCLUSIONS: Patients requiring HSICN after discharge from NER have a high mortality rate. Identifying survival predictors may help to identify patients at risk, and thus could be integrated into the decision-making process for NER discharge. The high mortality post-discharge warrants an evaluation of the current post-hospital care model. Optimizing therapeutic care in the HSICN setting may have the potential to reduce mortality and neuro-disability, and enhance the quality of life in these neurologically severely affected patients.

TRIAL REGISTRATION: The trial OptiNIV – Retrospective study of post-hospital intensive care in neurological patients has been retrospectively registered in the German Clinical Trials Register (DRKS) since 28.10.2022 with the ID DRKS00030580.

PMID:40394723 | DOI:10.1186/s42466-025-00384-1

BMC Nutr. 2025 May 20;11(1):99. doi: 10.1186/s40795-025-01083-5.

ABSTRACT

BACKGROUND: Self-medication, as a self-care practice, increased dramatically during the COVID-19 pandemic. Among the most prevalent medications used for self-medication were vitamins and minerals. Accordingly, this study aimed to estimate the prevalence of self-medication with vitamins or minerals for preventing and treating COVID-19 and its related factors.

MATERIAL AND METHOD: A comprehensive search was performed in four electronic databases (PubMed, Web of Science, Scopus, and ProQuest), two preprint repositories (MedRxiv and SciELO), two grey literature sources (Google and Google Scholar), and the reference lists of eligible studies in January 2024. The search strategy was built on two core concepts: “self-medication” and “COVID-19”. No language, place, and time restrictions were applied. Risk of bias assessment tool was adapted from Hoy checklist. The protocol of this study was registered under the code CRD42023434567 in the open-access online database of the International Prospective Register of Systematic Reviews (PROSPERO). A random effect model was applied to estimate the pooled prevalence of self-medication. Statistical heterogeneity among the studies was assessed using both the I² statistic and the χ2 test. Moreover, subgroup analysis and meta-regression model were used to identify the potential sources of methodological heterogeneity of the studies. A two‑sided P-value < 0.05 was considered statistically significant.

RESULTS: Out of 1424 non-duplicate studies, 56 were included in the meta-analysis. Vitamin C, vitamin D, B complex, multivitamins, and zinc were most commonly used for self-medication. The pooled prevalence of self-medication with vitamins was 29% (95% CI: 22%,37%; I² = 99.62%), with minerals 15% (95% CI: 8%, 23%; I² = 99.68%), and the corresponding value for the concomitant use of minerals and vitamins was 34% (95% CI: 27%, 42%; I² = 98.72%). The subgroup analysis showed people who lived in the American continent practiced self-medication with vitamins less (Pooled prevalence: 12%, 95% CI: 8%,16%; I² = 91.39%), and self-medication with vitamins and minerals was most prevalent in Asia. Besides; according to I² values, the continents in which the studies were conducted could be the reason for the statistical heterogeneity.

CONCLUSION: The reported prevalence of self-medication with vitamins and minerals to prevent and treat COVID-19, especially in Asia, is concerning and needs more public health action. In addition, people should be educated about the possibility of poisoning with vitamins and minerals because awareness of the risks of supplements can reduce self-medication practices at present and even in future pandemics.

PMID:40394722 | DOI:10.1186/s40795-025-01083-5

J Pharm Health Care Sci. 2025 May 20;11(1):43. doi: 10.1186/s40780-025-00450-5.

ABSTRACT

INTRODUCTION: Pharmacists play essential roles in the use of antiepileptic drugs (AEDs), inadequate knowledge among community and hospital pharmacists regarding AEDs poses a significant challenge in ensuring optimal medication management and patient care.

OBJECTIVE: This study aimed to assess the knowledge of pharmacists about antiepileptic drugs in Sudan.

METHOD: This was a cross-sectional analytical study conducted in Atbara, Gadarif, Kassala, and Port Sudan, Sudan. Using stratified, convenience sampling technique. We collected data directly via a modified, validated English questionnaire from the 1st to the 30th of October 2024.

RESULTS: In total, 384 pharmacists were included. Among them, 300 (78.1%) were under 35 years of age, and the majority of participants were male 213 (55.5%), 157 (40.9%) had a basic bachelor’s degree, and 330 (85.9%) received specialized AEDs training. The overall median score of knowledge percentages among participants was 10, with an interquartile range of 30 {25- (-5)}. Only 25 participants (6.5%) demonstrated good knowledge, while a majority of 359 (93.5%) exhibited poor knowledge. There was a statistically significant correlation between years of experience (adjusted odds ratio (AOR) 0.437; 95% CI 0.224-0.855; p value 0.016) and training on AEDs (AOR 0.085; 95% CI 0.031-0.233; p value 0.001) with their level of good knowledge.

CONCLUSION: Our study revealed that the majority of pharmacists in Sudan had a poor level of knowledge about AEDs. The level of knowledge was associated with years of experience and training on AEDs. These results highlight the need for pharmacists to have more training and more exposure to epilepsy and its management.

PMID:40394718 | DOI:10.1186/s40780-025-00450-5

Neurol Res Pract. 2025 May 20;7(1):36. doi: 10.1186/s42466-025-00391-2.

ABSTRACT

BACKGROUND: Despite considerable previous research, to what degree white matter lesions (WML) may be epileptogenic remains unclear. Therefore, the decision of initiating treatment with antiseizure medication (ASM) can be challenging in patients with only WML on neuroimaging. In this prospective study we assessed whether the prevalence, localization or severity of WML impact the risk of seizure recurrence in patients aged 60 years or older after first-time seizures.

METHODS: Data was analyzed from 168 patients, aged ≥ 60 years-old who had experienced a previous unprovoked seizure and had either a potentially epileptogenic lesion or WML on neuroimaging. The frequency of seizure recurrence was documented after 6, 12, and 24 months. Pearson´s chi-square test of independence (categorical variables) and the independent Student´s t-test (continuous variables) were used to analyze intergroup differences. Binary logistic regressions were calculated to examine the influence of WML locations as a predictor of seizure recurrence. Kaplan-Meier survival analyses and log-rank statistics were performed to determine the cumulative recurrence rates between the groups.

RESULTS: Fifteen patients had only potentially epileptogenic lesions on neuroimaging (EPI) and 93 showed WML only (OWML). Sixty patients showed both of them on neuroimaging (EWML). Frontal and parieto-occipital were the predominant WML locations. Neither severity nor location of WML had a significant impact on recurrence rates. The two-year cumulative probability of becoming seizure-free was significantly lower in the EPI group compared to the EWML (χ² [1] = 4.425, p = 0.035) and the OWML group (χ² [1] = 13.094, p < 0.001). A significant association between interictal epileptiform discharges in EEG and seizure recurrence was found in OWML patients (p = 0.004).

CONCLUSION: We could not find any association between prevalence, severity or location of WML and seizure recurrence after first seizures in the elderly. Therefore, treatment with ASM should be started with caution in those patients. Our results show a trend of WML not having epileptogenic potential, but further studies are needed to get better evidence.

TRIAL REGISTRATION: ClinicalTrials.gov Protocol Registration and Results, NCT06836687, AZ 199/17, release: 03/19/2024 retrospectively registered. https://register.

CLINICALTRIALS: gov/prs/beta/studies/S000EBC700000025/recordSummary.

PMID:40394715 | DOI:10.1186/s42466-025-00391-2

Eur J Med Res. 2025 May 20;30(1):406. doi: 10.1186/s40001-025-02650-z.

ABSTRACT

BACKGROUND: Clinical research is based on the parameters at defined time points, such as admission, diagnosis or discharge, for the purpose of risk factor analysis in relation to outcome. However, these parameters are collected with greater frequency in clinical practice. The objective of this study was to demonstrate a correlation between the time course of closely monitored parameters, such as blood gases, ventilatory parameters or routine laboratory values, and the survival of patients with acute respiratory distress syndrome (ARDS) caused by pneumonia.

METHODS: This single-center, retrospective study included 274 ARDS patients with primary pneumonia requiring invasive mechanical ventilation. Patients were treated at a German university hospital between January 2014 and April 2021. Ethical approval was obtained from the local ethics committee (BO-EK-374072021). Longitudinal data on ventilatory and inflammatory parameters were collected during ICU stays. The analysis was conducted using descriptive statistics, cox regression and joint models. Joint modelling was used to integrate the progression of these parameters with survival outcomes, with the modelling of longitudinal data performed using quadratic B-splines.

RESULTS: The cohort included 274 patients, with an ICU mortality rate of 49.6%. Non-survivors were older (67 vs. 62 years, p < 0.001) and had higher SOFA scores at admission (10 vs. 8, p < 0.001). Differences in ventilatory parameters, including driving pressure and the PaO₂/FIO₂ ratio, as well as inflammatory markers such as procalcitonin, were observed between survivors and non-survivors during the ICU stay. The joint model analysis revealed a significant effect of the time course of parameters, such as positive end-expiratory pressure (PEEP), peak airway pressure (Ppeak), driving pressure, minute ventilation, tidal volume, C-reactive protein (CRP) and procalcitonin on mortality. The increase over time (slope-dependent association) for these parameters was strongly associated with mortality. For example, driving pressure was associated with mortality both by its current value (HR 1.16) and by its increase over time (HR 7.10). Similarly, tidal volume (HR 0.72 and 0.07), minute ventilation (HR 0.91 and 0.36), PEEP (HR 1.32 and 13.52), Ppeak (HR 1.20 and 3.28) and CRP (HR 1.14 and 4.25) showed a current value association and a strong slope-dependent association with mortality.

CONCLUSION: This study underscores the importance of analyzing the dynamics of clinical parameters rather than static values for ARDS management. The findings suggest that changes in routine clinical parameters over time provide valuable prognostic information and should be prioritized in risk assessment and therapeutic decision making.

PMID:40394713 | DOI:10.1186/s40001-025-02650-z