Category: Statistics

Brain Behav. 2025 Jul;15(7):e70669. doi: 10.1002/brb3.70669.

ABSTRACT

BACKGROUND: Traumatic brain injury (TBI) and depression are major global health burdens, yet their bidirectional causal relationship remains unclear.

OBJECTIVE: To explore the causal relationship between depression and TBI, and to clarify whether depression is one of the potential risk factors for TBI and whether TBI is one of the pathogenic factors for depression.

METHODS: This bidirectional two-sample Mendelian randomization (MR) analysis investigated causal relationships between depression (n = 170,756) and TBI (n = 3193) using genome-wide association study (GWAS) summary statistics. Genetic instruments were selected as single nucleotide polymorphisms (SNPs) significantly associated with exposures (depression/TBI) and outcomes (TBI/depression) at genome-wide significance (P < 5 × 10⁻⁶). The inverse variance weighted (IVW) method under fixed-effects and multiplicative random-effects models served as the primary analytical approach, with Cochran’s Q test evaluating SNP heterogeneity. To address horizontal pleiotropy, MR-Egger regression and MR-PRESSO(MR Pleiotropy RESidual Sum and Outlier)outlier correction were applied. Sensitivity analyses included weighted median, penalized weighted median, maximum likelihood estimation, and leave-one-out validation to ensure robustness. All analyses were conducted using the TwoSampleMR package in R (v4.3.2), with effect estimates reported as odds ratios (OR) and 95% confidence intervals (CI).

RESULTS: MR analyses revealed bidirectional causal relationships between depression and TBI. In forward analyses, depression increased TBI risk across multiple IVW frameworks (fixed-effects IVW: OR = 1.137, 95% CI = 1.019-1.271, P = 0.022; multiplicative random-effects IVW: OR = 1.137, 95% CI = 1.014-1.277, P = 0.028), corroborated by maximum likelihood estimation (OR = 1.137, 95% CI = 1.017-1.274, P = 0.024). Reverse analyses demonstrated TBI’s causal effect on depression through IVW models (fixed-effects: OR = 1.083, 95% CI = 1.036-1.131, P < 0.001; multiplicative random-effects: OR = 1.083, 95% CI = 1.043-1.124,P < 0.001) and penalized weighted median methods (OR = 1.079, 95% CI = 1.018-1.145, P = 0.011). Robustness was confirmed by null heterogeneity (Cochran’s Q: forward P = 0.209, reverse P = 0.596) and absence of horizontal pleiotropy (MR-PRESSO: forward P = 0.218, reverse P = 0.672; MR-Egger intercepts: forward P = 0.661, reverse P = 0.874). All effect estimates remained stable in sensitivity analyses, supporting unconfounded causal inference.

CONCLUSION: Our MR analyses robustly demonstrate bidirectional causality: depression is a risk factor for TBI (OR = 1.137, 95% CI = 1.019-1.271), and TBI subsequently increases depression risk (OR = 1.083, 95% CI = 1.036-1.131), advocating integrated clinical monitoring.

PMID:40621715 | DOI:10.1002/brb3.70669

Med J Aust. 2025 Jul 7;223(1):46-53. doi: 10.5694/mja2.52698.

ABSTRACT

OBJECTIVES: To describe clinician-reported reasons for non-waitlisting of patients with kidney failure for deceased donor kidney transplantation, and to examine disparities affecting Aboriginal and Torres Strait Islander people.

DESIGN: Retrospective cross-sectional analysis of data from a national clinical quality registry.

PARTICIPANTS AND SETTING: Patients receiving dialysis in 26 Australian renal units as of 31 December 2020.

MAIN OUTCOME MEASURES: Rates of active waitlisting for kidney transplantation and clinician-reported reasons for non-waitlisting.

RESULTS: Thirty-six of 1832 Aboriginal and Torres Strait Islander people (2.0%) were actively waitlisted, compared with 512 of 6128 non-Indigenous people (8.4%). For Aboriginal and Torres Strait Islander patients aged < 65 years, 457 of 1204 (38%) were not waitlisted due to a permanent contraindication, 276 (23%) due to a temporary contraindication, and 232 (19%) due to incomplete work-up. Among those with a contraindication, cardiovascular disease was reported as the reason for about a quarter of people in both groups. Obesity was cited for 163 Aboriginal and Torres Strait Islander patients aged < 65 years (22%) and 30 Aboriginal and Torres Strait Islander patients aged ≥ 65 years (10%); in the non-Indigenous group, obesity was cited for 207 (26%) and 163 (9%) patients aged < 65 years and ≥ 65 years, respectively. Cancer was reported for 28 Aboriginal and Torres Strait Islander patients aged < 65 years (4%) and 86 non-Indigenous patients aged < 65 years (11%). Other reasons for non-waitlisting, reported as free text, included patient safety, smoking, age and mental health.

CONCLUSIONS: Aboriginal and Torres Strait Islander people experience inequities in waitlisting for kidney transplantation across multiple stages of a complex process. Addressing these barriers requires system-level reform and accountability to improve equity in transplantation access.

PMID:40621681 | DOI:10.5694/mja2.52698

Brain Behav. 2025 Jul;15(7):e70667. doi: 10.1002/brb3.70667.

ABSTRACT

OBJECTIVE: The purpose of this research was to ascertain how university students’ eating addiction was impacted by their early experiences, picky eating, and hedonic hunger.

METHODS: This descriptive cross-sectional study involved 681 university students and was carried out between April and June 2024. A sociodemographic characteristics information form, Childhood Positive and Negative Experiences Scale, Picky Eating Scale, Yale Food Addiction Scale, and Power of Food Scale were utilized to collect data. G^*Power 3.1, the SPSS 22 software, and the R programming language 4.1.3 were utilized in the study’s analysis.

RESULTS: Hierarchical regression analysis produced a significant and applicable model for this investigation (F(4,676) = 61.193, p = 0.001). A total of 26.6% (R² = 0.266) of the variance in the degree of eating addiction was explained by the levels of Picky Eating, Negative Childhood Experiences, Positive Childhood Experiences, and Power of Food Scales. When the t-test results for the regression coefficient’s significance were examined in the regression model, it was found that the level of “Eating Addiction” increased statistically in response to increases in the levels of Negative Childhood Experiences Scale (t = 7.699, p < 0.001), Picky Eating Scale (t = 6.625, p < 0.001), and Food Power Scale (t = 9.532, p < 0.001). Eating addiction was found to be unaffected by the degree of positive childhood experiences (p = -0.566). Hedonic hunger was found to be the most significant variable in predicting the eating addiction variable in the machine learning technique.

CONCLUSION: In our study, childhood experiences, picky eating status, and hedonic hunger status were found to affect eating addiction. Longitudinal studies on eating addiction in young people are recommended.

PMID:40621678 | DOI:10.1002/brb3.70667

J Esthet Restor Dent. 2025 Jul 7. doi: 10.1111/jerd.13506. Online ahead of print.

ABSTRACT

INTRODUCTION: Surgical correction and orthodontic intervention are considered the ideal approach for patients with chin deviation, yet many opt for non-surgical alternatives. This study aims to evaluate the acceptable range of occlusal plane cant in cases of chin deviation and assess the perception of different raters.

MATERIALS AND METHODS: A cross-sectional study was conducted at a tertiary care hospital, involving frontal photographs of adult male and female subjects. Two groups of raters were engaged to assess these modified photographs using a numeric rating scale. An Independent t-test was utilized to compare the perception between the two groups of raters, and for the comparison of esthetic scores related to occlusal plane cant toward and away from chin deviation, paired t-test was employed. A generalized linear model was utilized to compare the perception between the two group of raters, esthetic scores toward and away from chin deviation and to assess the factors associated with male and female facial attractiveness scores.

RESULTS: A statistically significant distinction was identified in the evaluation of facial esthetics between orthodontists and laypersons (p ≤ 0.05). Orthodontists showed increased sensitivity to mild facial asymmetries, with esthetic scores beginning to diverge at cant angles as low as 2°. Furthermore, a significant difference in esthetic scores was observed specifically at 4°, 6°, and 8° of occlusal cant away from chin deviation in both male and female subjects (p ≤ 0.05).

CONCLUSIONS: Orthodontists were more critical compared to laypersons in diagnosing minor asymmetries. Female gender received higher esthetic scores from laypersons compared to orthodontists. Both orthodontists and laypersons rated the cant away from chin deviation as more esthetically pleasing.

CLINICAL SIGNIFICANCE: These findings suggest that minor occlusal cant may be esthetically acceptable, potentially minimizing the need for major interventions while aiding clinicians in patient management.

PMID:40621674 | DOI:10.1111/jerd.13506

J Pediatr Gastroenterol Nutr. 2025 Jul 7. doi: 10.1002/jpn3.70136. Online ahead of print.

ABSTRACT

OBJECTIVES: Limited literature exists on non-clinically significant varices (nCSV) and progression in children with portal hypertension (PHT). This study investigates trends and associations in this cohort.

METHODS: This retrospective cohort study analysed 70 children with nCSV undergoing surveillance endoscopy between January 2012 and 2024. Laboratory parameters, prediction scores and fibroscan results were collected. Statistical analysis include Mann-Whitney U test, chi-squared test and receiver operating characteristic.

RESULTS: Ten children (14.3%) presented with portal vein thrombosis (PVT), 26 (37.1%) with non-biliary atresia chronic liver disease (CLD) and 34 (48.6%) with biliary atresia (BA). Twenty-five children (35.7%) had variceal progression, with median years until progression of 3 years recorded in PVT and CLD (PVT: 1-6 years, CLD: 2-8 years), and 2 years (1-10 years) in BA. Haemoglobin count (Hb) (area under the curve [AUC] = 0.943), risk score (AUC = 0.748), and spleen stiffness by fibroscan (SSM) (AUC = 1.00) revealed optimal accuracy in predicting progression in PVT, with similar findings in CLD (von Willebrand Factor score [vWFAg score]: AUC = 1.00, risk score: AUC = 0.767, SSM: AUC = 0.882). Suboptimal accuracy was seen in BA biomarkers.

CONCLUSIONS: Risk score is a reliable marker to monitor variceal progression in CLD and PVT. Interim noninvasive scores could be trialled along with surveillance OGD to validate results. Caution is advised extending endoscopy period for children with BA. Due to small subgroup sizes, larger cohort studies are needed to validate SSM and vWFAg score in children with nCSV.

PMID:40621668 | DOI:10.1002/jpn3.70136

Chronobiol Int. 2025 Jul 7:1-9. doi: 10.1080/07420528.2025.2524520. Online ahead of print.

ABSTRACT

The aim of this study was to examine the influence of the time-of-day on muscular strength, power and endurance performance in resistance-trained individuals. Fourteen resistance-trained males (age: 26.3 ± 6.7 years) underwent a randomized, counterbalanced cross-over trial. After a familiarization session, participants underwent two trials performing in the morning (9:00 h) and in the evening (18:00 h) a muscular strength and power assessment for bench press and back squat exercises at 25%, 50%, 75%, 90%, and 100% of one-repetition maximum (1RM). Then, muscular endurance was assessed for both exercises at 65%1RM, performing one set until failure. Once completed, isometric strength and vertical jump capacity (CMJ) tests were also performed. Only back squat exercise at 25% 1RM reported higher performance in the evening compared to the morning at mean velocity and mean and peak power (11-13%, p = 0.018-0.031, g = 1.91-2.20). Also, CMJ power was higher in the evening compared to the morning trial (2.5%, p = 0.002, g = 0.23). No statistical differences were found in the remaining loads, exercises or tests. In conclusion, circadian rhythm affects muscular strength and power performance at low (≤25% 1RM) but not moderate-to-higher loads in resistance-trained male participants, an effect observed in lower-body (e.g. back squat and vertical jump) but not in upper-body exercises (e.g. bench press).

PMID:40621663 | DOI:10.1080/07420528.2025.2524520

Epidemiol Psychiatr Sci. 2025 Jul 7;34:e37. doi: 10.1017/S2045796025100139.

ABSTRACT

AIMS: Understanding patterns and predictors of elevated psychological distress (EPD) among humanitarian migrants compared to the host population is critical for designing effective mental health interventions. However, existing research presents conflicting findings on the prevalence of EPD. This study examined EPD prevalence and associated factors in humanitarian migrants and Australian-born adults using large population-level datasets.

METHODS: Kessler 6 scores (range 6-30) were dichotomised, and scores above 19 were defined as EPD and indicative of probable serious mental illness. Comparative 1:2 matched analysis used humanitarian migrant data from the Building a New Life in Australia and Australian-born comparators from the National Health Survey. Each humanitarian migrant was matched by age, sex and location with two Australian-born residents. Modified Poisson regression identified predictors of EPD in both groups.

RESULTS: EPD was higher among humanitarian migrants (17.2%, 95% CI: 15.5, 18.9) compared to Australian-born (14.5%, 95% CI: 13.3, 15.6), with an adjusted relative risk (aRR) with 95% confidence intervals (1.16%, 95% CI: 1.11, 1.21) after adjusting for key factors. In both groups, females had a higher aRR than males, with similar effect sizes: 1.06 (95% CI: 1.04, 1.08) among Australian-born and 1.04 (95% CI: 1.02, 1.07) among humanitarian migrants. The impact of age on distress was more pronounced in Australian-born individuals: compared to the 65+ age group, the youngest group (18-24 years) had an aRR of 1.36 (95% CI: 1.28, 1.43) for Australian-born and 1.19 (95% CI: 1.12, 1.27) for humanitarian migrants. Compared to excellent health, poor and fair self-rated health condition had an aRR of 2.13 (95% CI: 2.03, 2.26) and 1.69 (95% CI: 1.61, 1.79), respectively, for humanitarian migrants and 1.94 (95% CI: 1.82, 2.05) and 1.48 (95% CI: 1.43, 1.56), respectively, for Australian born. Australian-born individuals in the lowest-income quintile had higher distress (aRR: 1.11 [95% CI: 1.06-1.15]) compared to the highest-income quintile, with no significant income effect for humanitarian migrants. In both groups, females with poorer self-rated health had higher aRRs than females reporting excellent health.

CONCLUSIONS: Although distress prevalence was higher in the humanitarian migrants, age and sex differences followed similar patterns in both groups. Income level was a factor in Australian-born adults but not in humanitarian migrants. Clinically, this highlights the need for culturally sensitive and group-specific mental health support. From a policy perspective, the use of matching methodology from large, separate datasets offers a valuable model for generating actionable insights, supporting the development of targeted and equitable mental health programmes.

PMID:40621658 | DOI:10.1017/S2045796025100139

Disaster Med Public Health Prep. 2025 Jul 7;19:e176. doi: 10.1017/dmp.2025.10106.

ABSTRACT

OBJECTIVES: On February 6, 2023, 7.7 and 7.6 magnitude earthquakes struck southeastern Türkiye, affecting 11 provinces and causing significant losses. This study aims to assess the mental health status of survivors in the twelfth month after the earthquake.

METHODS: A cross-sectional study was conducted using an online survey with the virtual snowball sampling method. The survey included sociodemographic data, previous traumas, earthquake-related experiences, and the Post-Earthquake Trauma Level Determining Scale (PETLDS) and Hospital Anxiety and Depression Scale.

RESULTS: The study included 2544 participants. The mean PETLDS score was 58.14±18.18, indicating that the participants were highly traumatized. Among them, 59.5% had high levels of post-traumatic symptoms, 44.2% had high anxiety, and 61% had high depression symptoms. 35.77% of participants displayed a co-occurrence of post-traumatic stress along with anxiety and depression. Female gender was the strongest predictor of high-level trauma and anxiety, while a history of psychiatric disorder was the strongest predictor of depression. Multiple logistic regression analysis indicated that symptoms were predicted by low income, low education level, smoking, comorbid chronic diseases, past traumatic experiences, the loss or injury of a loved one due to the earthquake, personal injury, temporary displacement, and damage to homes and workplaces.

CONCLUSIONS: The findings suggest that one year after the earthquake, mental health problems are prevalent among survivors, highlighting the need for urgent psychiatric interventions.

PMID:40621653 | DOI:10.1017/dmp.2025.10106

Disaster Med Public Health Prep. 2025 Jul 7;19:e179. doi: 10.1017/dmp.2025.10121.

ABSTRACT

Measles (rubeola) caused by measles virus is highly contagious and can be transmitted via respiratory droplets or can spread via sneezing or coughing of an infected person. In January 2025, two cases of measles associated with international travel seen in unvaccinated individuals of Harris County were reported by the Houston Health Department. This disease which was once declared eradicated from United States (US) in the year 2000, unfortunately has affected a total of 607 cases since January 2025, across the US, with highest number of cases recorded in Texas. Majority of the cases are witnessed in the paediatric population, especially the ones who are unvaccinated or have an uncertain vaccination history. Unfortunately, vaccine hesitancy is an important barrier in achieving measles eradication, and it is more imperative than ever to address this issue in a timely manner. There is an urgent need of virus containment measures to be taken by public health authorities to curb its spread, specifically by reinforcing the importance and safety of vaccinations, debunking myths and educating parents that the recommended two doses of vaccination not only serve as a safety net for their child but also for the community as a whole.

PMID:40621651 | DOI:10.1017/dmp.2025.10121

Clin Transl Med. 2025 Jul;15(7):e70386. doi: 10.1002/ctm2.70386.

NO ABSTRACT

PMID:40621643 | DOI:10.1002/ctm2.70386