Category: Statistics

J Behav Med. 2025 Jul 16. doi: 10.1007/s10865-025-00585-8. Online ahead of print.

ABSTRACT

Living with a chronic health condition (CHC) can negatively impact quality of life (QoL) through a complex interaction of mental health challenges, functional limitations, and disease management demands. Acceptance and Commitment Therapy (ACT) is a transdiagnostic approach that shows promise in addressing shared challenges across various CHCs by fostering psychological flexibility (PF). PF has been associated with improved QoL and functional outcomes and reduced psychological symptoms in individuals living with specific CHCs; yet its mediating role in these outcomes remains underexplored. This secondary analysis examined whether changes in PF mediated improvements in QoL, psychological symptoms, and functional impairment among individuals with various CHCs. Participants (n = 100) were randomized to a six-session self-guided, online ACT program or a waitlist control group. Outcomes were assessed at baseline, post-treatment, and four-week follow-up. Results revealed that increases in PF significantly mediated improvements in QoL, with indirect effects indicating that higher PF at post-treatment predicted better QoL at follow-up. The ACT group demonstrated significant reductions in functional impairment at follow-up compared to the waitlist group, though this effect was not mediated by changes in PF. Improvements in psychological symptoms were not statistically significant and were not mediated by PF. These findings suggest that ACT effectively enhances PF, which subsequently improves QoL in individuals with CHCs. This supports the transdiagnostic applicability of ACT for improving mental health and QoL across diverse chronic conditions. Future research should explore additional mechanisms underlying ACT’s effects and investigate ways to optimize its impact on functional and psychological outcomes within CHCs.

PMID:40668495 | DOI:10.1007/s10865-025-00585-8

Curr Med Sci. 2025 Jul 16. doi: 10.1007/s11596-025-00093-5. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to develop a prediction model to assess the risk of sepsis-induced coagulopathy (SIC) in sepsis patients.

METHODS: We conducted a retrospective study of septic patients admitted to the Intensive Care Units of Shandong Provincial Hospital (Central Campus and East Campus), and Shenxian People’s Hospital from January 2019 to September 2024. We used Kaplan-Meier analysis to assess survival outcomes. LASSO regression identified predictive variables, and logistic regression was employed to analyze risk factors for pre-SIC. A nomogram prediction model was developed via R software and evaluated via receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).

RESULTS: Among 309 patients, 236 were in the training set, and 73 were in the test set. The pre-SIC group had higher mortality (44.8% vs. 21.3%) and disseminated intravascular coagulation (DIC) incidence (56.3% vs. 29.1%) than the non-SIC group. LASSO regression identified lactate, coagulation index, creatinine, and SIC scores as predictors of pre-SIC. The nomogram model demonstrated good calibration, with an AUC of 0.766 in the development cohort and 0.776 in the validation cohort. DCA confirmed the model’s clinical utility.

CONCLUSION: SIC is associated with increased mortality, with pre-SIC further increasing the risk of death. The nomogram-based prediction model provides a reliable tool for early SIC identification, potentially improving sepsis management and outcomes.

PMID:40668489 | DOI:10.1007/s11596-025-00093-5

Qual Life Res. 2025 Jul 16. doi: 10.1007/s11136-025-04025-7. Online ahead of print.

ABSTRACT

PURPOSES: Children and adolescents with type 1 diabetes (T1D) experience persistent impacts on quality of life (QoL). While most previous studies have relied on cross-sectional designs, this prospective cohort study intended to: (1) assess longitudinal changes in patient-reported QoL over a three-year period; (2) identify distinct QoL trajectory subgroups; and (3) examine demographic, physiological, psychological, and clinical determinants associated with trajectory membership and multidimensional QoL outcomes.

METHODS: Two hundred children and adolescents with T1D from China were followed for three years in a longitudinal cohort study. QoL was measured using the Quality of Life Scale for Children and Adolescents (QLSCA) at baseline from June 2019 to May 2020, with follow-up visits at years 1, 2, and 3 thereafter. Trajectories of QoL and associations with determinants were identified via iterative estimations of group-based trajectory models and multivariable multinomial logistic regression, respectively. The specific impacts of the determinants on QoL were revealed using multiple linear regressions. Changes in QoL dimensions over time were examined using linear mixed models, while changes in determinants were analyzed using both linear mixed models and generalized estimating equations.

RESULTS: Four QoL trajectory groups were identified (N = 200): poor (19.5%), moderate (27.5%), improving (17.5%), and good (35.5%) QoL. Improved QoL was associated with higher paternal education, greater height, lower glycosylated hemoglobin (HbA1c), fewer hypoglycemic episodes, and reduced depression levels. Furthermore, the frequency of self-monitoring of blood glucose (SMBG), Self-Management of Type 1 Diabetes for Adolescents (SMOD-A) scores, and higher parental education were positively correlated with improvements in various QoL dimensions. In contrast, higher State-Trait Anxiety Inventory-Trait (STAI-T) and Children’s Depression Inventory (CDI) scores were negatively correlated with relationship between teacher and pupil, negative emotions, and other QoL aspects. Throughout the study, a significant increase in the use of continuous glucose monitoring (CGM) and insulin pumps was observed, along with improvements in SMBG and self-management ability. Notably, a reduction in the monthly frequency of hypoglycemic episodes and anxiety levels was also observed. Statistically significant improvements were found across several QoL dimensions, including companionship, self-esteem, physical feeling, activity opportunity, and physical activity ability, with the most pronounced improvement seen in physical activity ability.

CONCLUSION: This study identified the dynamic trajectories of QoL changes in a cohort of children and adolescents with T1D and screened potential determinants that enhance QoL. These insights are valuable for developing tailored, individualized diabetes management strategies aimed at improving long-term outcomes for T1D patients.

PMID:40668484 | DOI:10.1007/s11136-025-04025-7

Qual Life Res. 2025 Jul 16. doi: 10.1007/s11136-025-04019-5. Online ahead of print.

NO ABSTRACT

PMID:40668483 | DOI:10.1007/s11136-025-04019-5

Neurol Sci. 2025 Jul 16. doi: 10.1007/s10072-025-08349-7. Online ahead of print.

ABSTRACT

BACKGROUND: International trials suggested the efficacy of therapeutic window enlarged for mechanical thrombectomy (MT) in acute ischemic stroke (AIS). Real-life studies seem to confirm this opportunity. We aimed to evaluate the therapeutic window enlargement impact in an about 1.5 million residents region to determine if our drip-and-ship organization could ensure favorable clinical outcome and safety for patients treated more than 6 h after stroke onset.

METHODS: All AIS patients attending the Emergency Department of the only Marche region hub hospital who underwent MT were enrolled. We collected epidemiological, clinical and radiological variables. We used the National Institutes of Health Stroke Scale (NIHSS) to assess patients and calculated delta (NIHSS) as the difference between admission and discharge NIHSS scores. We examined patients undergoing MT with an onset-to-groin time (OGT) of less and greater than 6 h.

RESULTS: Delta (NIHSS) showed a statistically significant difference between patients who underwent MT within and after 6 h from symptom onset, with notable improvement in the first group. The overall prevalence of post-procedural intracranial bleeding did not significantly differ between the two groups (32.3% vs. 38.2%; p = 0.266). The risk of in-hospital deaths significantly increased among patients treated after 6 h.

CONCLUSIONS: Our results suggest satisfactory AIS outcomes even when treated several hours after the symptoms’ onset, despite a significant increase in the number of in-hospital deaths. However, the better results obtained with earlier IT and MT confirm the “golden hour” concept. Our findings show that our stroke organization provides a good clinical opportunity for patients treated within an extended therapeutic window.

PMID:40668465 | DOI:10.1007/s10072-025-08349-7

J Assoc Res Otolaryngol. 2025 Jul 16. doi: 10.1007/s10162-025-00998-x. Online ahead of print.

ABSTRACT

PURPOSE: Permanent hearing loss primarily results from the inability of the mammalian cochlea to replace lost inner ear hair cells. However, neonatal mice exhibit a unique capacity: isolated cochlear floor cells can efficiently proliferate in vitro and form organoids that harbor new hair cells and supporting cell populations. In this study, we isolated extracellular vesicles (EVs) from organoids and analyzed the miRNAs derived from them to identify gene regulatory elements that coordinate proliferation and regeneration.

METHOD: We utilized cochlear floor cells from postnatal day two mice and optimized the culture conditions to efficiently grow organoids that exhibit progenitor properties. Next, we isolated EVs from the culture media of organoids in their proliferative state. We analyzed miRNAs contained in these EVs to identify potential regulators that drive or modulate organoid cell proliferation. The miRNA sequencing data from organoid EVs were compared with miRNAs identified in EVs obtained from the culture supernatant of P2 mouse cochlear ducts.

RESULTS: We identified 184 miRNAs in organoid EVs and 176 miRNAs in cochlear duct EVs. A total of 122 miRNAs differed more than twofold between these groups, with 12 miRNAs (10 upregulated and 2 downregulated in organoid EVs) exhibiting statistically significant differences. The target genes of these twelve differentially expressed miRNAs are associated with pathways related to pluripotent stem cell regulation, cell proliferation, ear development, and cell fate modulation. This indicates that the miRNAs in organoid-derived EVs may impact processes associated with cell proliferation and the generation of inner ear cell types.

CONCLUSION: Our study comprehensively inventoried miRNAs contained in EVs released by growing inner ear organoids. Our differential miRNA expression analysis provides insight into regulatory mechanisms that promote cochlear floor cell proliferation and organoid formation, which could be leveraged in miRNA-based therapeutic approaches.

PMID:40668461 | DOI:10.1007/s10162-025-00998-x

Eur J Orthop Surg Traumatol. 2025 Jul 16;35(1):307. doi: 10.1007/s00590-025-04419-w.

ABSTRACT

BACKGROUND: Lateral epicondylitis (tennis elbow) is a common musculoskeletal condition characterized by lateral elbow pain and functional impairment. While both extracorporeal shockwave therapy (ESWT) and ultrasound therapy are frequently used interventions, their relative effectiveness remains uncertain. This systematic review and meta-analysis aimed to compare the efficacy of ESWT versus ultrasound therapy in improving pain and functional outcomes in patients with lateral epicondylitis through a systematic review and meta-analysis of randomized controlled trials (RCTs).

METHODS: Searches were conducted across databases including Scopus, Web of Science, PubMed, and Cochrane Central up until August 2024. We selected studies comparing ESWT and ultrasound for lateral epicondylitis. The primary outcome was pain intensity, assessed using the visual analog scale (VAS). The secondary outcome was functional status, evaluated using the patient-rated tennis elbow evaluation (PRTEE) score. The Cochrane Risk of Bias (ROB2) tool was used to assess evidence quality, and data analysis was performed using RevMan 5.4.

RESULTS: Nine RCTs involving 654 participants were included. ESWT demonstrated significantly greater pain reduction than ultrasound (MD = – 0.90, 95% CI [- 1.28, – 0.52], p < 0.0001). However, there was no statistically significant difference in functional outcomes as measured by PRTEE (MD = – 5.28, 95% CI [- 10.61, 0.04], p = 0.05). Substantial heterogeneity was noted for both outcomes.

CONCLUSION: ESWT appears more effective than ultrasound therapy in reducing pain in lateral epicondylitis. However, this superiority does not extend to functional improvement. Given the observed heterogeneity and borderline statistical significance in functional outcomes, further high-quality trials are warranted.

PMID:40668449 | DOI:10.1007/s00590-025-04419-w

Lasers Med Sci. 2025 Jul 16;40(1):318. doi: 10.1007/s10103-025-04569-7.

ABSTRACT

This systematic review aims to evaluate the efficacy of laser-based photobiomodulation therapy (PBMT) in reducing pain associated with dental injections. The review addresses the research question: “What is the effect of PBMT on pain levels during local anesthetic injections in dental patients compared to control interventions?”. A comprehensive search was conducted across PubMed, Scopus, Embase, Web of Science, and Cochrane Library databases. Studies included were prospective or retrospective clinical trials involving PBMT for pain control during dental injections. The quality of studies was assessed using the revised Cochrane Risk of Bias 2 tool. Data were extracted on patient demographics, laser parameters, and pain outcomes. A total of 14 studies were included in this systematic review, with 6 focusing on children and 8 on adults. In children, three studies indicated that PBMT effectively reduced pain, with a significant difference according to the Wong-Baker FACES Pain Rating Scale (WFPRS) but not on the Face, Legs, Activity, Cry, and Consolability (FLACC) scale. Conversely, three studies found no significant differences between PBMT and topical anesthesia. In adults, five studies demonstrated a pain-reducing effect of PBMT, though one study reported a statistically significant difference that did not achieve clinical significance. The meta-analysis revealed a statistically significant overall effect of PBMT on pain reduction in both children and adults (p < 0.05). This systematic review of the literature suggests that PBMT may help reduce discomfort associated with dental injections in both adults and children. Nonetheless, further investigation is warranted to arrive at a more definitive conclusion on this topic.

PMID:40668432 | DOI:10.1007/s10103-025-04569-7

Lab Chip. 2025 Jul 16. doi: 10.1039/d4lc01092b. Online ahead of print.

ABSTRACT

In this article, we study the height distribution of phoretically active microparticles exposed to external flow. Sedimented particles hover under light illumination and experience a stronger shear force proportional to the elevation height of the particle. Due to the natural variation in the phoretic activity of individual particles, their hovering heights also vary, resulting in an observed velocity distribution along the flow streamline. Furthermore, the hovering height results from a many-body problem of long-ranged phoretic effects of individual particles. Indeed, the mean velocity and its distribution depend on particle concentration: as the concentration increases, both the mean velocity and the width of the velocity distribution decrease, until a certain concentration is reached beyond which both remain constant. This results from overlapping chemical product gradient of an individual particle with its neighbors, basically decreasing with increasing concentration – and so the phoretic activity and hovering height. Besides, during the hovering we observe a localized dilution having an impact on the light-induced velocity changes of the microparticles.

PMID:40667569 | DOI:10.1039/d4lc01092b

JCO Oncol Adv. 2025 Jul 9;2(1):e2400101. doi: 10.1200/OA-24-00101. eCollection 2025.

ABSTRACT

PURPOSE: The vast majority of cervical cancer is preventable through human papillomavirus vaccination and screening with cytology or DNA testing. After decades of progress, recent cervical cancer trends in Western populations show a plateau or modest increase in incidence rates. Further investigation is required to understand the drivers of these emerging trends. In this study, we examined age-specific cervical cancer incidence rates in Canada from 1992 to 2022.

METHODS: Data were obtained from the Canadian Cancer Registry maintained by Statistics Canada, which included cancer cases, population counts, and incidence rates of cervical cancer by age and province for the period 1992 to 2022. Joinpoint regression analysis was used to estimate temporal incidence trends across age groups.

RESULTS: Cervical cancer incidence rates in Canada decreased among women age 25-34 years and those 65 years and older since 1992. Incidence rates among women age 35-44 years and 45-54 years have increased by 1.1% (95% CI, 0.5 to 2.5) and 1.6% (95% CI, -0.1 to 8.6) per year since 2001 and 2012, respectively. In 2022, the highest incidence rate of cervical cancer was among women age 35-44 years (18.1 per 100,000 women), which is comparable with rates in 1992.

CONCLUSION: Cervical cancer incidence rates have been increasing in recent years among women age 35-54 years. This cohort may be falling into a cancer prevention gap. Targeted public health interventions are warranted to address the rising incidence of cervical cancer among this cohort of Canadian women.

PMID:40667567 | PMC:PMC12258797 | DOI:10.1200/OA-24-00101