Category: Statistics

Contracept Reprod Med. 2025 Feb 5;10(1):10. doi: 10.1186/s40834-024-00328-1.

ABSTRACT

BACKGROUND: One of the Sustainable Development Goals (2030) focuses on reducing the total fertility rate. Reducing grand multiparity in Ethiopia remains a challenge. Understanding the underlying factors that contribute to this issue is crucial for explaining why grand multiparity remains prevalent despite various health interventions and socio-economic progress.

METHODS: A community-based cross-sectional study was conducted using data from the Ethiopian Demographic and Health Survey 2019. Multilevel multivariable logistic regression analysis was employed to model the hierarchical data. The final findings were presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI). A p-value < 0.05 was considered statistically significant.

RESULT: The trend analysis of grand multiparity in Ethiopia over 19 years shows no significant change (linear trend = 1.23, p = 0.27). The prevalence slightly decreased from 72% in the 2000 EDHS to 66.3% (95% CI: 65.7 – 66.96%) in the 2019 mini EDHS. Additionally, the highest prevalence of grand multiparity was observed among illiterate women (79.7%), those from poor households (54.8%), non-family planning users (77.5%), and residents of the Oromia (15.8%) and SNNPR (15.4%) regional states. Significant individual-level factors associated with grand multiparity include wealth index, marital status, maternal education, non-use of family planning, use of short-acting family planning, age at first birth < 18 years, and short birth intervals. At the community level, rural residency was significantly associated with grand multiparity.

CONCLUSION: This study emphasizes the need for targeted interventions to address the socio-economic and reproductive factors driving grand multiparity, especially in rural areas and among disadvantaged populations. To improve maternal and child health outcomes, we recommend that the government focus on lowering fertility rates through need-based family planning services and promoting the well-being of women of reproductive age.

PMID:39910588 | DOI:10.1186/s40834-024-00328-1

World J Surg Oncol. 2025 Feb 5;23(1):42. doi: 10.1186/s12957-025-03658-9.

ABSTRACT

BACKGROUND: Renal cell carcinoma (RCC) is a frequent and aggressive type of kidney cancer with limited therapeutic options. Although phosphatase and tensin homolog (PTEN) have been recognized as a potential tumor suppressor in all kinds of cancers, its function in RCC remains to be thoroughly elucidated.

OBJECTIVE: This article was recruited to examine the PTEN’s role in managing the PI3K/AKT pathway and its impact on the RCC cell proliferation and migration.

METHODS: This study collected renal cancer and adjacent non-cancerous tissue samples from our hospital. HK-2 and 786-O cells were used, with 786-O cells divided into control, vector, and oe-PTEN groups. PTEN and related protein levels were detected using RT-qPCR and Western blot. Statistical analyses were performed using the Mann-Whitney U test and Kruskal-Wallis H test. Cell viability and migration were assessed using the CCK-8 assay and wound healing assay. All analyses were conducted with SPSS 22.0 software, with statistical significance defined as p < 0.05.

RESULTS: RT-qPCR results showed that PTEN expression was significantly increased in RCC tumor tissues compared to normal tissues (p < 0.01). However, PTEN mRNA levels were significantly reduced in 786-O cells compared to HK-2 cells (p < 0.01). In 786-O cells with low PTEN expression, further induction of PTEN overexpression significantly inhibited PI3K/AKT signaling activity (p < 0.01), accompanied by decreased cell viability and migration ability. These results indicate that the expression pattern of PTEN in RCC is complex, but its overexpression can exert tumor-suppressive effects by inhibiting the PI3K/AKT signaling pathway.

CONCLUSION: Our findings demonstrate that PTEN overexpression in RCC cells leads to decreased PI3K/AKT signaling, decreasing cell viability and migration. This study highlights the critical role of PTEN in RCC progression and suggests potential therapeutic targets for intervention.

PMID:39910585 | DOI:10.1186/s12957-025-03658-9

J Exp Clin Cancer Res. 2025 Feb 5;44(1):40. doi: 10.1186/s13046-025-03306-w.

ABSTRACT

BACKGROUND: Despite the high response rate to PD-1 blockade therapy in metastatic melanoma (MM) patients, a significant proportion of patients do not respond. Identifying biomarkers to predict patient response is crucial, ideally through non-invasive methods such as liquid biopsy.

METHODS: Soluble forms of PD1, PD-L1, LAG-3, CTLA-4, CD4, CD73, and CD74 were quantified using ELISA assay in plasma of a cohort of 110 MM patients, at baseline, to investigate possible correlations with clinical outcomes. A clinical risk prediction model was applied and validated in pilot studies.

RESULTS: No biomarker showed statistically significant differences between responders and non-responders. However, high number of significant correlations were observed among certain biomarkers in non-responders. Through univariate and multivariate Cox analyses, we identified sPD-L1, sCTLA-4, sCD73, and sCD74 as independent biomarkers predicting progression-free survival and overall survival. According to ROC analysis we discovered that, except for sCD73, values of sPD-L1, sCTLA-4, and sCD74 lower than the cut-off predicted lower disease progression and reduced mortality. A comprehensive risk score for predicting progression-free survival was developed by incorporating the values ​​of the two identified independent factors, sCTLA-4 and sCD74, which significantly improved the accuracy of outcome prediction. Pilot validations highlighted the potential use of the risk score in treatment-naive individuals and long responders.

CONCLUSION: In summary, risk score based on circulating sCTLA-4 and sCD74 reflects the response to immune checkpoint inhibitor (ICI) therapy in MM patients. If confirmed, through further validation, these findings could assist in recommending therapy to patients likely to experience a long-lasting response.

PMID:39910579 | DOI:10.1186/s13046-025-03306-w

BMC Public Health. 2025 Feb 5;25(1):466. doi: 10.1186/s12889-025-21638-2.

ABSTRACT

BACKGROUND: Non-communicable diseases burden is rising globally; women are disproportionately affected by both non-communicable diseases burden and lack of access to health care. Research on the relationship between access to health care and non-communicable diseases control are limited. We aimed to assess the relationship between women’s access to health care and three non-communicable diseases control.

METHODS: A cross-sectional study was conducted on 420 women diagnosed with diabetes mellitus, hypertension and/or Asthma. Access to health care was assessed through pretested validated Arabic version of access 31 questionnaire. The control status of diabetes mellitus, hypertension, and asthma was assessed according to the American Diabetes Association HbA1c targets, World Health Organization Guidelines, and the Global Initiative for Asthma control assessment tool, respectively. The associations were assessed using univariate and multivariate logistic regression analysis.

RESULTS: (83%) of the participants had poor access to health care, of those, (39.0%) achieved non-communicable diseases control, while (16.9%) participants had good access to health care, of them, (83.1%) had their non-communicable diseases controlled. This difference in non-communicable diseases control proportions across access to care groups was statistically significant (P < 0.001). Women with good access to health care had higher odds (Adjusted Odds Ratio 6.33, 95% confidence interval: 3.24-12.55) of having their non-communicable diseases controlled compared with those with poor access.

CONCLUSION: Improving access to health care is essential for achieving better non-communicable diseases control.

PMID:39910573 | DOI:10.1186/s12889-025-21638-2

Parasit Vectors. 2025 Feb 5;18(1):42. doi: 10.1186/s13071-025-06671-9.

ABSTRACT

BACKGROUND: The intestinal protozoa Entamoeba spp. can infect humans and various animals, including donkeys, causing diarrhea and malabsorption and presenting significant risks to animal husbandry and public health. Most Entamoeba species are not pathogenic except for Entamoeba histolytica. China has among the highest rates of donkey farming worldwide. Donkey (Equus asinus) farming is increasingly important in China because of their draft and medicinal value; however, epidemiological data on Entamoeba spp. in donkeys remains limited globally. This study aimed to investigate the prevalence of Entamoeba in donkeys in Shanxi Province, North China, and assess associated risk factors using a molecular approach.

METHODS: Fecal samples of 815 donkeys from three representative geographical locations in Shanxi Province were collected to investigate the presence of Entamoeba spp. A portion of the small-subunit rRNA gene (SSU rRNA) was amplified and sequenced to determine the prevalence and species/genotypes of Entamoeba spp. Statistical analysis of possible risk factors was performed using Statistical Product and Service Solutions (SPSS) 26.0 software. The phylogenetic relationship of Entamoeba spp. was reconstructed using the neighbor-joining (NJ) method in Molecular Evolutionary Genetics Analysis (Mega) 7.0 software.

RESULTS: The overall prevalence of Entamoeba spp. in donkeys in Shanxi Province was 7.12% (58/815). Two species (Entamoeba sp. RL9 and Entamoeba equi) were identified by sequence analysis; of these, Entamoeba sp. RL9 was the most prevalent species in donkeys in this study. Statistical analysis revealed that the donkeys’ sex, region, age, and altitude are the risk factors associated with Entamoeba spp. prevalence (P < 0.05). Phylogenetic analysis indicated that the sequences of Entamoeba sp. RL9 and E. equi isolated from donkeys in this study were clustered with previously reported animal-derived Entamoeba sp. RL9 and E. equi sequences, respectively.

CONCLUSIONS: This study reports the occurrence and prevalence of Entamoeba spp. in donkeys worldwide for the first time to our knowledge. This not only expands the geographical distribution but also broadens the host range of Entamoeba spp., addressing the knowledge gap regarding the prevalence of Entamoeba spp. in donkeys, providing baseline data for carrying out prevention and control of Entamoeba spp. in donkeys in China.

PMID:39910570 | DOI:10.1186/s13071-025-06671-9

Trials. 2025 Feb 5;26(1):39. doi: 10.1186/s13063-025-08742-9.

ABSTRACT

BACKGROUND: The pervasive issue of microplastic (MP) contamination is undeniable. The primary solution to this global problem lies in significantly reducing the amount of plastic entering the environment. Addressing such a large-scale issue is no easy feat. However, a necessary strategy involves public education. In parallel, a randomized controlled trial (RCT) aims to evaluate the effect of interventional education via a mobile phone application on improving women’s knowledge, attitude, and practice regarding the health effects of MPs.

METHODS: This randomized controlled trial includes three phases. In the first phase, a questionnaire assessing women’s knowledge, attitudes, and practices (KAP) regarding microplastics will be developed and validated. In phase two, educational content for the mobile application “PlastiWise” will be created based on behavior change constructs. In phase three, a two-arm, parallel-design RCT will be conducted with 136 women aged 18 years and older who own smartphones, have basic literacy skills, and provide informed consent. Participants will be recruited through an online call disseminated via social media platforms and health system networks in Iran. They will be randomly assigned to an intervention group (n = 68) receiving the educational program through the app or a control group (n = 68). The sample size was calculated using G*Power software to ensure sufficient power (80%) with an alpha level of 0.05, factoring in a 15% dropout rate. Primary outcome data (KAP scores) will be collected at baseline, immediately post-intervention, and 8 weeks post-intervention using self-reported questionnaires. Data analysis will include descriptive statistics and inferential tests, such as independent t-tests and paired t-tests, to assess group differences and within-group changes over time.

DISCUSSION: Implementing an educational intervention on knowledge, attitude, and practice (KAP) about MPs using a mobile application will be a first in Iran. This research is expected to benefit Iranian women by contributing evidence on factors that might influence the effectiveness of educational training related to MP consumption. TRIAL STATUS : Protocol version 1, 2024-07-12. The enrolment of participants began on 2024-09-22. The recruitment is estimated to be completed by 2024-11-21. TRIAL REGISTRATION : Iranian Clinical Trial Register IRCT20240529061941N1. https://irct.behdasht.gov.ir/user/trial/77069/view . Date is July 12, 2024.

PMID:39910565 | DOI:10.1186/s13063-025-08742-9

BMC Ophthalmol. 2025 Feb 5;25(1):61. doi: 10.1186/s12886-024-03839-2.

ABSTRACT

BACKGROUND: This study aimed to evaluate the efficacy of a simple intravitreal injection of perfluoropropane (C₃F₈) in treating unclosed idiopathic macular holes (IMHs) in patients who had previously undergone primary pars plana vitrectomy (PPV).

METHODS: This study was a retrospective, observational clinical study. It included patients diagnosed with unclosed IMHs following primary PPV combined with internal limiting membrane peeling and air tamponade. Optical coherence tomography (OCT) performed 1 week after PPV revealed unclosed IMHs with the presence of the ‘cuff’ sign and intraretinal cysts. The following day, these patients received a simple intravitreal C₃F₈ injection. Comprehensive evaluations, including best-corrected visual acuity (BCVA), indirect ophthalmoscopy, fundus photography, and OCT, were performed before PPV, 1 week after surgery, and at follow-up intervals of 1-3 months after the intravitreal gas injection.

RESULTS: The minimum linear diameter (MLD) of the macular holes (MHs) 1 week before C₃F₈ injection was 335.1 ± 74.3 μm. Following C₃F₈ tamponade, the closure rate of the MHs was 100%. The mean BCVA before C₃F₈ tamponade was 0.68 ± 0.17 logMAR (20/100) after primary PPV, which improved to 0.48 ± 0.19 logMAR (20/63) after C₃F₈ tamponade, showing a statistically significant difference (P = 0.01).

CONCLUSIONS: For patients with unclosed MHs after primary PPV, the presence of the ‘cuff’ sign on OCT suggests that retreatment can be effectively achieved through a simple intravitreal gas injection. This approach is straightforward, practical, and effective.

PMID:39910548 | DOI:10.1186/s12886-024-03839-2

WMJ. 2024;123(6):434-440.

ABSTRACT

INTRODUCTION: Consistent access to health care before, during, and after pregnancy is critical in the United States, where high rates of maternal morbidity and pregnancy-related mortality persist. Medicaid plays a critical role in financing health care coverage for pregnancy and childbirth in the US, including postpartum care.

METHODS: We used Wisconsin birth certificate records linked to Medicaid enrollment files for 2009 through 2018 to determine maternal Medicaid coverage spanning the 12 months pre-pregnancy to 12 months postpartum. Covariates included age, race/ethnicity, parity, education, and marital status. Analysis included descriptive statistics and log-binomial regression to predict adjusted risk of postpartum Medicaid coverage loss.

RESULTS: Of 267,416 Medicaid-covered births in our sample, 50.5% (n= 1 34,970) were continuously enrolled while 33.1%, (n = 88,425) were never enrolled during the 12 months pre-pregnancy. Most (97.9%, n = 261,713) were enrolled at some time during the prenatal period, and a majority of mothers (86.1%, n = 230,325) were enrolled consistently throughout the first postpartum year. Postpartum unenrollment peaked in month 3, when 34.2% of unenrollment occurred. Those younger, married, and with lower parity had higher risk of unenrollment. Notably, those reporting non-Hispanic Black were at the lowest risk, while non-Hispanic Asian/Pacific Islanders were at a higher risk of unenrollment.

CONCLUSIONS: The extension of postpartum coverage to 90 days may address one-third of the postpartum Medicaid loss observed, postponing coverage loss an additional month. A full 12-month postpartum Medicaid extension would support postpartum health by ensuring health care access during this critical period.

PMID:39908490

Neurology. 2025 Mar 11;104(5):e213351. doi: 10.1212/WNL.0000000000213351. Epub 2025 Feb 5.

ABSTRACT

BACKGROUND AND OBJECTIVES: Headache evaluation and treatment are believed to be influenced by race and ethnicity. Specific headache diagnosis assigned in the pediatric emergency department (ED) may compound disparities. We sought to investigate racial and ethnic disparities in the diagnosis, testing, and treatment of pediatric patients with headache presenting to the ED.

METHODS: We performed a cross-sectional analysis of ED visits from 49 children’s hospitals between 2016 and 2022 from the Pediatric Health Information System, an administrative database of ED and hospitalized encounters within children’s hospitals in the United States. Index encounters in the ED from patients (aged 5-21 years, median age 13 [10-15]) with a primary diagnosis of migraine, headache, new daily persistent headache, or tension-type headache were included. Encounters with trauma, infection, and malignancy where secondary headache was possible were excluded. The primary outcomes were the rates of migraine diagnosis, testing, and treatment. We used generalized estimating equations to estimate associations between race and ethnicity and outcomes after adjusting for demographic factors, medical complexity, visit timing, and final headache diagnosis.

RESULTS: A total of 309,678 encounters were included while 61,677 repeat visits, 81,821 visits with diagnoses suggestive of secondary headache, and 5,714 visits from 3 hospitals with sparse data on patient race/ethnicity were excluded. Of 160,466 eligible visits (59.8% female), 41% were by non-Hispanic White (NHW) children, 24.8% non-Hispanic Black (NHB), and 26.0% Hispanic/Latino (HL). NHW children were more frequently diagnosed with migraine (45.5% vs NHB 28.2% and HL 28.3%, p < 0.001). NHB and HL children compared with NHW children received less testing including brain MRI scans (adjusted odds ratio [aOR]: NHB 0.56 [95% CI 0.46-0.69] and HL 0.54 [0.36-0.82]). There was no difference in the proportion of visits without administration of headache-related medications (NHW 23.3% vs NHB 24.6% and HL 23.4%, p = 0.64). NHB and HL children were more likely to receive only oral medications (aOR: NHB 1.37 [1.2-1.56] and HL 1.54 [1.34-1.76]) and less likely to be admitted inpatient (aOR: NHB 0.8 [0.66-0.97] and HL 0.65 [0.44-0.94]).

DISCUSSION: NHB and HL children in the pediatric ED with headache receive fewer migraine diagnoses, less testing, and less intensive treatment compared with NHW children. Beyond affecting headache management, this inequity in migraine diagnosis requires further consideration to include children from marginalized racial and ethnic groups in future migraine research.

PMID:39908468 | DOI:10.1212/WNL.0000000000213351

Dentomaxillofac Radiol. 2025 Feb 5:twaf011. doi: 10.1093/dmfr/twaf011. Online ahead of print.

ABSTRACT

OBJECTIVES: The current study aimed to automatically detect tooth presence, tooth numbering, and types of periodontal bone defects from CBCT images using a segmentation method with an advanced artificial intelligence (AI) algorithm.

METHODS: This study utilized a dataset of CBCT volumes collected from 502 individual subjects. Initially, 250 CBCT volumes were used for automatic tooth segmentation and numbering. Subsequently, CBCT volumes from 251 patients diagnosed with periodontal disease were employed to train an AI system to identify various periodontal bone defects using a segmentation method in web-based labeling software. In the third stage, CBCT images from 251 periodontally healthy subjects were combined with images from 251 periodontally diseased subjects to develop an AI model capable of automatically classifying patients as either periodontally healthy or periodontally diseased. Statistical evaluation included ROC curve analysis and confusion matrix model.

RESULTS: The AUC values for the models developed to segment teeth, total alveolar bone loss, supra-bony defects, infra-bony defects, perio-endo lesions, buccal defects, and furcation defects were 0.9594, 0.8499, 0.5052, 0.5613 (with cropping, AUC: 0.7488), 0.8893, 0.6780 (with cropping, AUC: 0.7592), and 0.6332 (with cropping, AUC: 0.8087), respectively. Additionally, the classification CNN model achieved an accuracy of 80% for healthy individuals and 76% for unhealthy individuals.

CONCLUSIONS: This study employed AI models on CBCT images to automatically detect tooth presence, numbering, and various periodontal bone defects, achieving high accuracy and demonstrating potential for enhancing dental diagnostics and patient care.

PMID:39908459 | DOI:10.1093/dmfr/twaf011