Category: Statistics

Front Health Serv. 2025 Nov 26;5:1466958. doi: 10.3389/frhs.2025.1466958. eCollection 2025.

ABSTRACT

INTRODUCTION: The Affordable Care Act (ACA) represents the most comprehensive U.S. health reform since Medicare and Medicaid. However, evidence on its impact on population health in the general U.S. population, particularly mental health, remains limited.

METHODS: We analyzed a nationally representative sample of non-elderly adults aged 18-64 from the Medical Expenditure Panel Survey (2007-2019). Outcomes included two health-related quality of life (HRQOL) measures derived from the SF-12 v2: physical component summary (PCS) and mental component summary (MCS) scores. Using conditional-mean and quantile-regression difference-in-differences models, we examined the effect of the ACA by comparing pre-post changes in PCS and MCS scores among non-elderly adults relative to counterfactuals from TRICARE beneficiaries not subject to ACA provisions.

RESULTS: Our conditional-mean DID estimates indicate that the ACA was associated with a 2.7% increase in PCS scores among non-elderly adults during 2011-2013. Although statistically insignificant, MCS scores exhibited increases of growing magnitude following the implementation of the major ACA major provisions in 2014. Notably, simultaneous-quantile DID estimates suggest that the increases in PCS and MCS scores attributable to the ACA were concentrated among individuals with relatively lower health levels, particularly those around the 30th to 60th percentiles of the score distributions.

DISCUSSION: Findings indicate that the ACA led to measurable gains in physical and mental health, particularly among relatively lower-middle levels of physical and mental health. Policymakers assessing the value of the ACA, or more generally debating the value of expanding access to health insurance in the population, should consider these positive gains in population health.

PMID:41384265 | PMC:PMC12689885 | DOI:10.3389/frhs.2025.1466958

Dent Res J (Isfahan). 2025 Nov 25;22:46. doi: 10.4103/drj.drj_428_24. eCollection 2025.

ABSTRACT

BACKGROUND: This study aimed to synthesize mesoporous zinc oxide nanoparticles (ZnO NPs) and evaluate their effect as dentin pretreatments on the microshear bond strength (μSBS) of a universal adhesive.

MATERIALS AND METHODS: This in vitro experimental study used 100 extracted human molars sectioned to expose mid-coronal dentin. Samples were divided into five groups (n = 20) based on pretreatment: no treatment, chlorhexidine (CHX), calcined mesoporous ZnO NPs, noncalcined mesoporous ZnO NPs, and ZnO NPs. Each group was subdivided into two subgroups (n = 10) based on the universal adhesive application mode: etch-and-rinse (E and R) or self-etch (SE). Pretreatments were applied for 1 min. Composite resin was bonded using a universal adhesive. After 24 h of storage in distilled water at 37°C, μSBS testing was performed. Statistical analysis included the Shapiro-Wilk test for normality, two-way analysis of variance with Tukey’s post hoc test, and t-tests, with significance set at P < 0.05.

RESULTS: The noncalcined mesoporous ZnO NP group showed the highest μSBS, followed by the ZnO NP group, with significant differences compared to other groups (P < 0.05). Lower μSBS values were observed in the calcined mesoporous ZnO NP, CHX, and untreated groups. The adhesive application mode had a significant effect only in the untreated and calcined mesoporous ZnO NP groups (P < 0.05), with SE yielding higher μSBS than E and R.

CONCLUSION: Noncalcined mesoporous ZnO NPs enhanced dentin bond strength more effectively than other pretreatments, including CHX, indicating their potential as a promising alternative in adhesive dentistry.

PMID:41384264 | PMC:PMC12694918 | DOI:10.4103/drj.drj_428_24

Dent Res J (Isfahan). 2025 Nov 25;22:43. doi: 10.4103/drj.drj_319_24. eCollection 2025.

ABSTRACT

BACKGROUND: Bone remodeling is essential for orthodontic tooth movement. Techniques such as micro-osteoperforation (MOP) and vibration have been introduced to accelerate treatment by stimulating biological responses.

MATERIALS AND METHODS: Randomized clinical trial study adult orthodontic patients who required bilateral extraction of maxillary first premolars were randomly assigned to two groups (n = 10) of intervention and control. Both groups received MOP at the onset of canine retraction. The intervention group also used a VPro5 vibrator for 28 days after the onset of canine retraction in addition to MOP. GCF samples were collected before the onset of orthodontic treatment (T0), right before canine retraction (T1), and after 24 h (T2), 7 days (T3), and 28 days (T4) by a paper point, and the GCF levels interleukin (IL)-1 B, receptor activator of nuclear factor kappa-B ligand (RANKL), C-C motif chemokine ligand (CCL) 2, and tumor necrosis factor-alpha (TNF)-α were measured. Data were analyzed using SPSS v25. Repeatedmeasures Analysis of Variance was employed to compare quantitative outcomes between groups and over time, with statistical significance set at P < 0.05.

RESULTS: The GCF level of the four inflammatory factors was not significantly different between the two groups at any time point (P > 0.05). The trend of change in GCF level of the four inflammatory factors was also the same in the two groups over time, such that the lowest level of all four markers was recorded at T0. The highest level of TNF-α was recorded at T2, and the highest level of RANKL, IL1-B, and CCL2 was recorded at T2 and T3.

CONCLUSION: It does not seem that combined MOP with vibration can increase the level of inflammatory factors in GCF.

PMID:41384263 | PMC:PMC12694923 | DOI:10.4103/drj.drj_319_24

Dent Res J (Isfahan). 2025 Nov 25;22:45. doi: 10.4103/drj.drj_225_25. eCollection 2025.

ABSTRACT

BACKGROUND: This study assessed the linear accuracy of three-dimensionally (3D)-printed mandibular models from cone-beam computed tomography (CBCT) scans with two voxel sizes.

MATERIALS AND METHODS: In this in vitro study, five dry human mandibles underwent CBCT with 0.2- and 0.3-mm voxel sizes. The images were converted to STL format, and the distances between (I) mental foramen (MF) and alveolar ridge crest, (II) MF and inferior border of the mandible (IBM), and (III) alveolar crest and IBM at the midline, as well as the (IV) left central incisor socket depth, (V) left second premolar buccolingual socket width, and (VI) right third molar buccolingual socket width were measured on the CBCT scans, 3D-printed models, and dry mandibles. Two observers recorded the measurements twice, 1 week apart. We analyzed the data using the intraclass correlation coefficient and Pearson’s correlation test. Statistical significance was set at P < 0.05.

RESULTS: Since the interobserver agreement was high, the mean data was used for the comparisons. The linear accuracy was high for MF-IBM, MF-alveolar crest, and alveolar crest-IBM distances, and second premolar and third molar buccolingual socket width. CBCT scans demonstrated reliable accuracy for left central incisor socket depth measurement, but a lack of significant correlation was found between the 3D-printing and gold-standard measurements of this variable.

CONCLUSION: The linear accuracy of CBCT scans taken with 0.3- and 0.2-mm voxel sizes was comparable, and they may be used for the fabrication of linearly accurate 3D-printed models of mandible. 3D-printed models demonstrated high precision in all measured parameters except socket depth.

PMID:41384259 | PMC:PMC12694914 | DOI:10.4103/drj.drj_225_25

Front Physiol. 2025 Nov 26;16:1661258. doi: 10.3389/fphys.2025.1661258. eCollection 2025.

ABSTRACT

INTRODUCTION: Snoring is a common symptom of Obstructive Sleep Apnea (OSA) and has also been associated with an elevated risk of cerebrovascular disease. However, existing snoring detection studies predominantly focus on individuals with Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS), with limited attention given to the specific acoustic characteristics of patients with concomitant cerebrovascular diseases. To address this gap, this paper proposes a snoring classification method integrating dynamic convolution and attention mechanisms, and explores the acoustic feature differences between patients with cerebrovascular stenosis and those without stenosis.

METHODS: First, we collected nocturnal snoring sounds from 31 patients diagnosed with OSAHS, including 16 patients with cerebrovascular stenosis, and extracted four types of acoustic features: Mel spectrogram, Mel-frequency cepstral coefficients (MFCCs), Constant Q Transform (CQT) spectrogram, and Chroma Energy Normalized Statistics (CENS). Then, based on the ConvNeXt backbone, we enhanced the network by incorporating the Alterable Kernel Convolution (AKConv) module, the Convolutional Block Attention Module (CBAM), and the Conv2Former module. We conducted experiments on snoring versus non-snoring classification and stenotic versus non-stenotic snoring classification, and validated the role of each module through ablation studies. Finally, the Mann-Whitney U test was applied to compare intergroup differences in low-frequency energy ratio, snoring frequency, and snoring event duration.

RESULTS: This method achieves the best performance on the Mel spectrogram, with a snoring classification accuracy of 90.24%, compared to 88.16% for the ConvNeXt baseline model. It also maintains superiority in classifying stenotic versus non-stenotic snoring. Ablation analysis indicates that all three modules contribute to performance improvements. Moreover, the Mann-Whitney U test revealed significant differences $\left(p<0.05\right)$ between the stenotic and non-stenotic groups in terms of low-frequency energy ratio and nocturnal snoring frequency, whereas snoring event duration showed no significant difference.

DISCUSSION: The proposed method demonstrates excellent performance in snoring classification and provides preliminary evidence for exploring acoustic features associated with cerebrovascular stenosis.

PMID:41384251 | PMC:PMC12689313 | DOI:10.3389/fphys.2025.1661258

Front Physiol. 2025 Nov 26;16:1708619. doi: 10.3389/fphys.2025.1708619. eCollection 2025.

ABSTRACT

BACKGROUND: Badminton is a high-intensity sport that demands explosive strength, dynamic balance, and agility. Plyometric training (PT) is crucial for enhancing these abilities, yet there is limited research comparing sand-based PT to hard-surface PT in badminton players.

OBJECTIVE: This study compared the effects of sand-based PT and hard-surface PT on lower-extremity explosive strength, dynamic balance, and agility in male badminton players.

METHODS: Twenty-eight male collegiate badminton players were randomly assigned to a sand-based PT group (n = 14) or a hard-surface PT group (n = 14). Both groups performed plyometric programs twice weekly for 8 weeks. Outcomes measurement before and after training included countermovement jump (CMJ) height, squat jump (SJ) height, drop jump (DJ) height, standing long jump (SLJ) distance, Y-balance test (YBT), hexagon jump test, and badminton-specific agility test (lateral agility test and four-corner agility test). We used two-way repeated measures analysis of variance (ANOVA) (time × group) with Bonferroni post hoc tests, and effect sizes were reported as partial eta squared ( ${\eta }_p^2$ ) or Cohen’s d (p < 0.05).

RESULTS: Statistical analysis revealed significant time main effects across multiple metrics: CMJ height (F = 81.26, p < 0.01, ${\eta }_p^2$ = 0.75), SJ height (F = 82.86, p < 0.01, ${\eta }_p^2$ = 0.76), DJ height (F = 54.58, p < 0.01, ${\eta }_p^2$ = 0.68, large effect), SLJ distance (F = 49.86, p < 0.01, ${\eta }_p^2$ = 0.66), dynamic balance ability (p < 0.01), and agility (p < 0.01), no significant between-group differences were found for any of the variables (p > 0.05). Additionally, a significant interaction effect between time and group was observed in the left leg to right (F = 4.76, p = 0.04).

CONCLUSION: This study indicates that both sand-based PT and hard-surface PT over 8 weeks significantly enhance explosive power, dynamic balance, and agility performance, with no significant differences between groups.

PMID:41384248 | PMC:PMC12689396 | DOI:10.3389/fphys.2025.1708619

Ther Adv Neurol Disord. 2025 Dec 9;18:17562864251396529. doi: 10.1177/17562864251396529. eCollection 2025.

ABSTRACT

BACKGROUND: Although migraine is the second most prevalent form of headache, its preventive treatment has some contraindications and complications. It has been postulated that lacosamide reacts with collapsin response mediator protein 2 and prevents its phosphorylation, inhibiting calcitonin gene-related peptide release in the trigeminal system, which might have a role in migraine management.

OBJECTIVE: Our study aimed mainly to evaluate the efficacy and safety of lacosamide as an alternative medication to topiramate for the prevention of migraine, especially in patients who had contraindications to topiramate and other approved antiseizure medications used for migraine prevention.

DESIGN: Our study included two parallel groups: the lacosamide and the topiramate groups.

METHODS: We recruited episodic migraine patients between the ages of 18 and 65; the lacosamide group received lacosamide 50 mg once daily for 1 week, then twice daily from the 8th day till the 90th day); while the topiramate group received topiramate 50 mg once daily for 1 week, then 50 mg twice daily from the 8th day till the 90th day.

RESULTS: There was not a statistically significant difference between the lacosamide and topiramate in the absolute change in monthly migraine days (MMD) at 90 days with p-value 0.34, there was no significant difference between lacosamide and topiramate groups regarding the percentage of patients with ⩾50% reduction in the baseline migraine days frequency in the last 4 weeks of the treatment period with a p-value 0.11. In total, 14.0 (4.7%) patients in the lacosamide group and 24.0 (8.0%) in the topiramate group stopped treatment prematurely due to intolerance to drug-related adverse effects, hazard ratio 2.83, 95% confidence interval (1.34-4.72), p-value 0.03.

CONCLUSION: In episodic migraine patients, the regular use of lacosamide 50 mg Bid for 3 months yielded reductions in the MMD, migraine days that required acute medications, and Headache Impact Test-6 score comparable to those achieved using topiramate 50 mg Bid. Lacosamide was more tolerable than topiramate in episodic migraine patients.

TRIAL REGISTRATION: Prospectively registered on clinicaltrials.gov, NCT06243692-January 29, 2024; https://clinicaltrials.gov/study/NCT06243692.

PMID:41384236 | PMC:PMC12690048 | DOI:10.1177/17562864251396529

J Abdom Wall Surg. 2025 Nov 26;4:15523. doi: 10.3389/jaws.2025.15523. eCollection 2025.

ABSTRACT

INTRODUCTION: Botulinum Toxin A is increasingly used as a preoperative adjunct in the management of complex abdominal wall hernias, particularly in those with wider defects and/or loss of domain. While its anatomical and surgical benefits have been documented, patient-reported outcomes remain underexplored.

METHODS: An international, retrospective, observational study was conducted using a structured, anonymised survey available in five languages (German, English, Polish, French, Spanish). The survey included nine closed-ended and one open-ended question assessing pain perception, mobility, respiratory, gastrointestinal, and urinary function, and changes in abdominal contour. It was distributed by medical teams and through patient support forums between 2024 and 2025. Patients included had received BTA injections 4-6 weeks prior to elective hernia surgery.

RESULTS: Seventy patients from multiple European centres completed the survey. Pain during injection was minimal in 71.5% of cases, with 85.7% reporting complete resolution of pain within 1-3 days. Most respondents (74.3%) experienced no breathing difficulties and only mild symptoms in 18.6%. Mobility remained unchanged in 80%, while 15.7% noted slight deterioration. Changes in urinary and bowel function were uncommon and mostly transient. Over half of patients reported visible changes in abdominal shape. No severe complications were identified.

CONCLUSION: This international patient survey suggests that BTA injections as preoperative preparation for complex hernias is well tolerated, with limited perceived side effects and functional disruption. These findings support its continued use and prompts further prospective data collection.

PMID:41384233 | PMC:PMC12689444 | DOI:10.3389/jaws.2025.15523

Cureus. 2025 Nov 9;17(11):e96428. doi: 10.7759/cureus.96428. eCollection 2025 Nov.

ABSTRACT

Background and aim Electroconvulsive therapy (ECT) has a well-established role in the management of patients who do not respond to psychopharmacological treatment. The therapeutic effect of ECT on major depressive disorder is widely investigated; the search for an ideal induction agent for ECT is an ongoing process. The present study was conducted to compare the effects of 3 mg/kg of intravenous thiopentone versus 0.2 mg/kg of intravenous etomidate on modified electroconvulsive therapy (MECT) in patients with major depressive disorder. Methods The present study was carried out as a double-blinded randomized study on 40 patients diagnosed with major depressive disorder. The study was approved by the institutional ethics committee, and written informed consent from each patient was obtained before the study. A total of 40 patients were divided into two groups of 20 each by block randomization. Group A patients (n = 20) received IV etomidate 0.2 mg/kg. Group B (n = 20) patients received IV thiopentone 3 mg/kg. After induction and muscle relaxation, electrical stimulus was applied, and the duration of seizure quality was measured using the cuff method. Results All statistical tests were done with IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York, United States). The average seizure duration was 54 seconds in group A (etomidate), and it was 42 seconds in group B (thiopentone). Etomidate showed longer seizure duration compared to thiopentone with a significant p-value of 0.001 using an independent-samples T-test. Conclusion Etomidate, as an induction agent for patients with major depressive disorder, showed good seizure quality compared to thiopentone.

PMID:41384213 | PMC:PMC12689468 | DOI:10.7759/cureus.96428

Cureus. 2025 Nov 10;17(11):e96492. doi: 10.7759/cureus.96492. eCollection 2025 Nov.

ABSTRACT

This systematic review and meta-analysis aim to synthesize the current evidence from randomized clinical trials (RCTs) comparing the anesthetic success of mental/incisive nerve block (MINB) versus inferior alveolar nerve block (IANB) in patients with symptomatic irreversible pulpitis affecting mandibular premolars. A thorough literature search was performed using databases such as PubMed, Web of Science, Science Direct, Cochrane Database, and Google Scholar. The search covered publications up to June 2025. The focused PICOTT question for this review was: “What is the anesthetic efficacy of mental/incisive nerve block compared to inferior alveolar nerve block in mandibular premolars with symptomatic irreversible pulpitis?”. The included studies were evaluated for quality using the ROB 2 tool for non-randomized designs, while the certainty of the evidence was assessed through the GRADE approach. A meta-analysis was performed using a random-effects model to address potential variability among studies. Three RCTs were included. Overall, the risk of bias was considered low to moderate using the ROB 2 tool. The GRADE assessment indicated that the certainty of evidence was rated as very low. The overall pooled analysis showed no statistically significant difference in success rates between the MINB and IANB techniques (OR = 1.25; 95% CI: 0.74 to 2.12; P = 0.40), with low heterogeneity (I² = 0%). Subgroup analysis by premolar type showed no significant differences between techniques for either first (OR = 1.03; 95% CI: 0.64-1.65; P = 0.90; I² = 0%) or second premolars (OR = 1.23; 95% CI: 0.76-1.98; P = 0.40; I² = 0%). In conclusion, the findings of this systematic review and meta-analysis indicate no clear difference in anesthetic efficacy between MINB and IANB techniques. However, most studies suggest that achieving adequate pulpal anesthesia requires the use of supplemental anesthesia.

PMID:41384210 | PMC:PMC12694680 | DOI:10.7759/cureus.96492