Category: Statistics

Cancer Control. 2025 Jan-Dec;32:10732748251390022. doi: 10.1177/10732748251390022. Epub 2025 Nov 1.

ABSTRACT

IntroductionThe burden of prostate cancer (PCa) is disproportionately concentrated in low- and middle-income countries (LMICs). Abiraterone and enzalutamide have improved survival rates and quality of life for men with PCa. However, cost constraints limit access to these medications due to limited insurance coverage and out-of-pocket payments. The survey assessed the current practices and opinions of Nigerian clinical oncologists and urologists regarding the use of low dose abiraterone and enzalutamide for the management of metastatic PCa.MethodsThis survey consisted of twenty multiple-choice questions, distributed via Google Forms to urologists and oncologists in Nigeria from August to November 2024. It examined current practices, awareness of effective dose reduction strategies, and opinions on their cost-effectiveness. The collected data were entered into Microsoft Excel, and responses were presented using tables and charts.ResultsA total of 104 respondents completed the survey. Among them, 37 (36%) reported that 61%-80% of their patients initially presented with advanced PCa. Additionally, 55 respondents (53%) were unaware of studies and guidelines regarding low-dose abiraterone. Furthermore, 66% of clinicians indicated that fewer than 20% of their patients could afford abiraterone, and 91 (87.5%) noted that few could afford enzalutamide. Moreover, 92 (89%) respondents believed that low-dose abiraterone would improve compliance, while 76% felt that reducing the enzalutamide dose would also enhance compliance and decrease patient costs. Sixty percent (58%) of respondents were willing to switch to low-dose abiraterone.ConclusionThe survey revealed limited awareness of landmark studies on dose-reduction strategies for abiraterone and enzalutamide. These strategies have the potential to enhance affordability and compliance in the management of advanced PCa in Nigeria.

PMID:41175049 | DOI:10.1177/10732748251390022

Int J Inj Contr Saf Promot. 2025 Nov 1:1-24. doi: 10.1080/17457300.2025.2572095. Online ahead of print.

ABSTRACT

Wearable systems for knee pathology detection and prosthetic control remain constrained by diagnostic limitations or rigid actuation. This study introduces an integrated two-phase framework combining non-invasive screening with adaptive prosthetic control. Phase 1 employs novel time-frequency features (Enhanced Mean Absolute Value/Enhanced Wavelength), achieving 94.7% abnormality detection accuracy via Extra Trees classifier, a + 3.16% improvement over conventional features, which is validated through 10-fold cross-validation and rigorous statistical testing (Friedman/Nemenyi, 95% confidence intervals). SHAP analysis yields clinician-interpretable thresholds (e.g. Semitendinosus EMAV > 0.3 mV). Phase 2 utilises multimodal fusion (EMG, FSR, IMU) to achieve 99.2% gait phase accuracy with XGBoost, enabling real-time health-adaptive prosthetic control that dynamically modulates: phase-transition timing (400 ms abnormal vs. 300 ms normal), EMG thresholds (0.15 mV vs. 0.10 mV), and motor gains (2.5× vs. 1.0×) based on pathology status. Validated in a LabVIEW-based control environment across variable terrains and speeds, this end-to-end diagnostics-to-control implementation delivers superior screening accuracy (>4.7% gain vs. deep learning) while enabling context-aware prosthetic adaptation, establishing a new paradigm for accessible musculoskeletal rehabilitation.

PMID:41175030 | DOI:10.1080/17457300.2025.2572095

Int J Methods Psychiatr Res. 2025 Dec;34(4):e70040. doi: 10.1002/mpr.70040.

ABSTRACT

OBJECTIVE: Estimate the psychometric properties of the interRAI Quality of Life for Mental Health and Addictions (interRAI QOL) instrument with users of Psychosocial Care Centers and participants of therapeutic groups in Primary Health Care, exploring age, gender, and service settings differences in quality of life.

METHOD: This quantitative study was conducted with 617 users from Psychosocial Care Centers and Primary Care services in two Brazilian states, Rio Grande do Sul and Rondônia. Data collection was carried out using the interRAI QOL. Confirmatory factor analysis and reliability assessment were performed using McDonald’s Omega index. Non-parametric tests, including Mann-Whitney and Kruskal-Wallis, were conducted to compare the Quality-of-Life dimensions among participants based on age, gender, and care unit.

RESULTS: The confirmatory factor analysis indicated a good fit for the hypothesized model (CFI = 0.97, RMSEA = 0.08). Reliability was adequate for all subscales according to McDonald’s Omega, ranging from 0.71 to 0.88. Gender differences were observed in the well-being and health dimensions, while all dimensions except support showed significant differences based on age group. The care unit location also revealed significant differences across all dimensions. Participants from Psychosocial Care Center Alcohol and Drugs and from Primary Health Care show better QOL profiles than in other settings and regions.

CONCLUSION: The interRAI QOL demonstrated adequate psychometric properties and proved to be a valuable new instrument for assessing quality of life among individuals receiving care in the psychosocial care network.

PMID:41175024 | DOI:10.1002/mpr.70040

Foot Ankle Spec. 2025 Nov 1:19386400251383440. doi: 10.1177/19386400251383440. Online ahead of print.

ABSTRACT

BackgroundThis study aims to analyze the effect of preoperative 5-factor modified frailty index (mFI-5) on 30-day complication, readmission, reoperation, and mortality rates following ankle fracture open reduction and internal fixation (ORIF).MethodsThe American College of Surgeons (ACS NSQIP) database was queried to identify 44 838 patients undergoing ankle fracture ORIF. Patients were stratified into groups based on preoperative mFI-5 scores.ResultsThe cohort was predominantly male (59.0%), and the mean age was 49.52 (range = 16-89) years. The mFI-5 score was statistically significantly predictive of any complication (P < .001), serious medical complication (P < .001), surgical site infection (P <.001), readmission (P <.001), reoperation (P <.001), mortality (P <.001), adverse discharge (P <.001), and increased hospital length of stay (LOS) (P <.001).ConclusionOur results indicate that mFI-5 score is a useful predictive measure for postoperative complications, adverse discharge, readmission, reoperation, mortality, and increased LOS in patients undergoing ankle fracture ORIF.Levels of Evidence:Level III, Retrospective cohort study.

PMID:41175018 | DOI:10.1177/19386400251383440

Ther Adv Respir Dis. 2025 Jan-Dec;19:17534666251390672. doi: 10.1177/17534666251390672. Epub 2025 Nov 1.

ABSTRACT

BACKGROUND: Interstitial lung disease (ILD) leads to progressive lung function decline and significant respiratory symptoms. Although antifibrotic agents preserve lung function and reduce mortality in ILD, their impact on health-related quality of life (HRQoL) remains unclear.

OBJECTIVES: We aimed to evaluate whether antifibrotic agents improve HRQoL and their effectiveness in treating HRQoL-related symptoms in patients with ILD.

DESIGN: Systematic review and meta-analysis.

DATA SOURCES AND METHODS: A literature search was conducted using MEDLINE, EMBASE, and the Cochrane Library from inception to August 25, 2025. The search included terms related to ILD, antifibrotic agents, and measures of HRQoL. HRQoL outcomes were assessed using the St. George’s Respiratory Questionnaire (SGRQ), including total and domain scores. Data were pooled using a random-effects model, with outcomes reported as mean differences (MD) or relative risks (RR) and heterogeneity evaluated using the I² statistic.

RESULTS: A total of 13 randomized controlled trials were included. Antifibrotic agents showed significant improvement in SGRQ scores, particularly in the symptom (MD: -2.59, 95% confidence interval [CI]: -4.56 to -0.61; I² = 32%) and activity (MD: -2.88, 95% CI: -4.82 to -0.94; I² = 34%) domains. Antifibrotics reduced the rate of cough (RR: 0.77, 95% CI: 0.64-0.94; I² = 0%) and dyspnea (RR: 0.71, 95% CI: 0.56 to 0.89; I² = 0%). However, fatigue was frequently observed in patients treated with antifibrotics (RR: 1.48, 95% CI: 1.20-1.83; I² = 0%) compared with the non-antifibrotic group. Most trials were judged to have low-to-moderate risk of bias, and the certainty of evidence was rated very low for total SGRQ scores but low to moderate for domain-specific outcomes and symptoms.

CONCLUSION: Antifibrotic agents may improve HRQoL and reduce dyspnea and cough in patients with ILD, but the certainty of evidence is low, and they may increase fatigue, requiring careful monitoring.Trial registration:The study protocol was registered in PROSPERO (CRD42023450917).

PMID:41174997 | DOI:10.1177/17534666251390672

Inquiry. 2025 Jan-Dec;62:469580251385397. doi: 10.1177/00469580251385397. Epub 2025 Nov 1.

ABSTRACT

Stroke is a leading cause of morbidity and disability, with limited data on in-hospital mortality from low-resource settings. This study aimed to identify predictors of in-hospital mortality among stroke patients at a tertiary care hospital in Nepal. A prospective cohort study was conducted among 120 stroke patients aged ≥ 18 years, enrolled between November 2023 and April 2024. The primary outcome was in-hospital mortality following admission. Data was analysed using SAS version 9.4. Kaplan-Meier survival analysis and Cox proportional hazards regression were employed to identify predictors of in-hospital mortality. A p-value < .05 was considered statistically significant. The cohort comprised 68.3% ischemic and 31.7% haemorrhagic strokes, with an overall in-hospital mortality rate of 9.0%. Multivariate analysis revealed that a Glasgow Coma (GCS) score < 8 (AHR: 12.36; 95% CI: 2.73-56.00), National Institutes of Health Stroke Scale (NIHSS) ≥12 (AHR: 14.75; 95% CI: 3.01-72.28), moderate to severe disability (mRS ≥ 3; AHR: 9.92; 95% CI: 1.10-89.24), hemiplegia (AHR: 6.70; 95% CI: 1.835-53.748), territorial infarcts (AHR: 26.33; 95% CI: 2.093-331.203), capsuloganglionic infarcts (AHR: 14.6; 95% CI: 1.819-160.877), presence of chronic obstructive pulmonary disease (COPD) (AHR: 2.48; 95% CI: 1.317-45.091), and alcohol use (AHR: 3.87; 95% CI: 1.014-18.478) were significant predictors of in-hospital mortality. Neurological impairment at admission, specific infarct locations, hemiplegia, COPD, and alcohol use are significant predictors of in-hospital mortality among stroke patients. These findings underscore the importance of early neurological assessment, systematic risk stratification, and targeted interventions to improve stroke outcomes in resource-constrained settings.

PMID:41174984 | DOI:10.1177/00469580251385397

Inquiry. 2025 Jan-Dec;62:469580251382395. doi: 10.1177/00469580251382395. Epub 2025 Nov 1.

ABSTRACT

Non-suicidal self-injury (NSSI) and suicidal ideation (SI) represent significant mental health challenges among university students. In low- and middle-income contexts like Bangladesh, there is limited understanding of how these behaviors differentially affect students with and without mental illness. This study addresses these gaps by investigating the prevalence and risk factors of NSSI and SI, with stratified analyses by mental illness status, to predict these behaviors. This cross-sectional study recruited 1401 university students between December 2024 and January 2025. Data was collected via a self-administered questionnaire assessing socio-demographics, and psychological factors. Traditional statistical analyses, including chi-square tests and logistic regression, were conducted in SPSS 27. The prevalence of NSSI and SI was 21.4% and 17.2%, respectively. Both NSSI and SI were more common among students with symptoms of depression or anxiety (mental illness) than those without. Multivariable analyses identified smoking, cyberbullying, and probable eating disorder as significant predictors of both NSSI and SI, with these associations persisting after stratification by mental illness status. Subgroup analyses showed that among students without mental illness, female gender, older age, smoking, cyberbullying, and eating disorder symptoms significantly predicted NSSI, while smoking, cyberbullying, eating disorder, and older age predicted SI. In students with mental illness, smoking and cyberbullying remained robust predictors of both NSSI and SI, while eating disorder was significantly associated with NSSI but not SI. The regression models explained 12.9% of the variance in NSSI and 16.6% in SI. The findings highlight the necessity to adopt interventions that address modifiable risk factors, with a strong emphasis on behavioral and mental health variables, to effectively reduce self-harming and suicidal behaviors in young adults.

PMID:41174978 | DOI:10.1177/00469580251382395

Int J Gynaecol Obstet. 2025 Nov 1. doi: 10.1002/ijgo.70634. Online ahead of print.

NO ABSTRACT

PMID:41174961 | DOI:10.1002/ijgo.70634

Pediatr Allergy Immunol. 2025 Nov;36(11):e70234. doi: 10.1111/pai.70234.

ABSTRACT

BACKGROUND: Patients with chronic granulomatous disease (CGD) can develop hemophagocytic lymphohistiocytosis (HLH), exacerbating mortality risk. Despite its clinical significance, data on HLH in CGD from international cohorts remain limited. This study aims to describe the occurrence of HLH in a cohort of patients with CGD, providing clinical insight into this association and emphasizing the need for early recognition and effective management.

METHODS: The records of 60 patients with CGD were reviewed. Those meeting the diagnostic criteria for HLH based on the HScore were included in the analysis. Both descriptive and inferential statistics were employed to evaluate the data.

RESULTS: Eleven patients (18.3%) fulfilled the HLH diagnostic criteria. The median interval between CGD genetic diagnosis and HLH onset was 36 months, with a median age at HLH diagnosis of 67 months. Infectious triggers were identified in eight cases, with Salmonella and Aspergillus species being the most common. One case involved an inflammatory trigger-multisystem inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection. Mortality was high: 72.7% of the patients with HLH died. No significant difference (p = .338) was observed between those who died after receiving only immunosuppressive therapy (n = 2) and those who received both intravenous immunoglobulin and immunosuppressive therapy (n = 6).

CONCLUSION: HLH in CGD is associated with a high mortality rate. Notably, MIS-C can present as an inflammatory trigger for HLH in this population. Careful evaluation of HLH parameters is recommended for all patients with CGD admitted with infection or inflammation to facilitate early diagnosis and guide management.

PMID:41174960 | DOI:10.1111/pai.70234

Int J Biostat. 2025 Nov 3. doi: 10.1515/ijb-2025-0011. Online ahead of print.

ABSTRACT

Competing risks models are survival models with several events of interest acting in competition and whose occurrence is only observed for the event that occurs first in time. This paper presents a Bayesian approach to these models in which the issue of model selection is treated in a special way by proposing generalizations of some of the Bayesian procedures used in univariate survival analysis. This research is motivated by a study on the survival of patients with heart failure undergoing cardiac resynchronization therapy, a procedure which involves the implant of a device to stabilize the heartbeat. Two different causes of death have been considered: cardiovascular and non-cardiovascular, and a set of baseline covariates are examined in order to better understand their relationship with both causes of death. Model selection, model checking, and model comparison procedures have been implemented and assessed. The posterior distribution of some relevant outputs such as the overall survival function, cumulative incidence functions, and transition probabilities have been computed and discussed.

PMID:41174955 | DOI:10.1515/ijb-2025-0011