Category: Statistics

Acta Orthop. 2025 Sep 30;96:726-734. doi: 10.2340/17453674.2025.44752.

ABSTRACT

BACKGROUND AND PURPOSE: Pediatric proximal femoral fractures are rare and frequently complicated fractures with avascular necrosis (AVN), nonunion, deformity, leg-length discrepancy (LLD), and premature physeal closure (PPC). Our aim was to describe the incidence, complications and functional outcomes.

METHODS: In this register-based study from a 10-year period (2014-2023) we identified 51 non-pathological proximal femoral fractures from the KIDS Fracture Tool database. Statistical yearbooks of Helsinki were utilized to estimate annual incidence. We used interviews and Oxford Hip Scores (OHS) for functional outcome assessment. If any symptom or functional deficit was described, or if Oxford Hip Score (OHS) was < 41, patients were also invited for clinical examination and radiography.

RESULTS: 51 patients with a proximal femoral fracture (31 boys) were identified representing 0.2% (51/21,121) of all child fractures with a population-based annual incidence of 1.7/100,000 children. We interviewed 46/51 of the patients or their guardians via telephone. 6/46 were invited for clinical examination and radiography. Median follow-up of contacted patients was 4 (range 1-9.5) years. Complications occurred in 9/20 patients with collum and trochanteric fractures (pain from osteosynthesis 4, AVN 3, nonunion 1, coxa vara 1, LLD 1, PPC 0) and in 7/31 with subtrochanteric fractures (pain from osteosynthesis 5, misplaced pins 2, angular deformity 1, peri-implant fracture 1). All underwent reoperation. The median OHS was 48 (interquartile range 47-48) at last follow-up. Functional outcomes were impaired in 3 patients. All 3 had AVN.

CONCLUSION: The incidence of non-pathological pediatric proximal femoral fractures is low. Despite frequent complications, impaired functional outcomes concerned only patients with AVN at median 4-year follow-up.

PMID:41036566 | DOI:10.2340/17453674.2025.44752

Clin Cancer Res. 2025 Oct 2. doi: 10.1158/1078-0432.CCR-25-0098. Online ahead of print.

ABSTRACT

The maximum tolerated dose has historically been the recommended phase two dose, and this dosage has typically been evaluated in registrational clinical trials for oncology drugs. With the emergence of targeted therapies, this approach may lead to the investigation of unnecessarily high dosages that elicit additional toxicity without added benefit. The utilization of innovative trial designs and model-informed approaches during clinical development can potentially lead to more informed dosage selection. Exposure-response analyses, clinical utility index, and other model-informed approaches have been successfully applied to understand preliminary activity and safety data for various classes of modern oncology drugs, providing insight to support the proposed dosage(s) for the registrational trial. Seamless trial designs have also played an important role in dosage selection by leveraging pre-planned flexibilities and statistical procedures to increase efficiency during the conduct of trials. Critically, both approaches can be fit for purpose, allowing for adaptation and the usage of the totality of relevant clinical and nonclinical data. Despite this, the evaluation of maximum tolerated dose remains prevalent in registrational trials. This article, the third in a series of three describing best-practice approaches to dosage optimization in oncology drug development, highlights successful applications of and relevant considerations for innovative trial designs and model-based approaches to aid the selection of better optimized dosages for evaluation in registrational clinical trials.

PMID:41036557 | DOI:10.1158/1078-0432.CCR-25-0098

Acta Oncol. 2025 Oct 1;64:1334-1341. doi: 10.2340/1651-226X.2025.43990.

ABSTRACT

BACKGROUND AND PURPOSE: Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype where the prognostic implications of primary systemic therapy followed by surgery, compared to up-front surgery and subsequent adjuvant chemotherapy (ACT), are yet to be outlined. This retrospective registry-based study aimed to compare survival outcomes between patients treated with neoadjuvant chemotherapy (NACT) versus ACT for operable TNBC in a real-world setting. Patient/material and methods: We included all patients treated with chemotherapy for operable TNBC in Sweden between 2008 and 2019 using the Swedish national research database BCBaSe 3.0. To reduce confounding by indication, we implemented propensity score matching (PSM) and main study outcomes were defined as distant disease-free survival (DDFS), breast cancer-specific survival (BCSS) and overall survival (OS).

RESULTS: A total of 4,704 patients were included in the study, of which 1,183 received NACT. Following 1:1 PSM, 837 patients in each treatment setting were available for analyses. We found no statistically significant differences in terms of DDFS (adjusted hazard ratio [aHR] 1.18; 95% confidence interval [CI] 0.93 – 1.50), BCSS (aHR 1.10; 95% CI 0.83 – 1.45) or OS (aHR 1.07; 95% CI 0.82 – 1.39) between patients treated with NACT versus ACT. However, subgroup analysis of patients with clinically node-positive disease (cN+) demonstrated a significant DDFS benefit of NACT (aHR 0.65; 95% CI 0.47 – 0.90).

INTERPRETATION: Overall, we found comparable survival among patients with TNBC treated with NACT or ACT. Considering the anticipated survival improvements when response-guided post-neoadjuvant strategies are implemented in clinical practice, our findings may support the use of NACT in operable TNBC.

PMID:41036550 | DOI:10.2340/1651-226X.2025.43990

Scientifica (Cairo). 2025 Sep 23;2025:8849948. doi: 10.1155/sci5/8849948. eCollection 2025.

ABSTRACT

Inflammation helps the immune system identify and eliminate disease-causing and foreign stimuli and initiate the healing process. Nonsteroidal anti-inflammatory drugs have been often used in treating inflammation. Synthetic drugs have been associated with severe effects, necessitating the need for alternative medicinal agents. Herbal remedies have comparatively fewer side effects, are widely available, and are arguably affordable, which makes them more attractive therapeutic agents. Ficus sycomorus is utilized by Kenya’s Mbeere community to treat inflammation. However, the science-based data to support their claim were lacking. The purpose of this study was to ascertain whether methanol (MeOH) and dichloromethane (DCM) leaf and stem bark extracts of F. sycomorus have anti-inflammatory qualities in mice. Gas chromatography-mass spectrometry (GC-MS) andliquid chromatography-mass spectrometry (LC-MS) were used in phytochemical analysis of the extracts. In anti-inflammatory assays, 6-7-week-old mice were randomly grouped into six clusters with five mice each. Group one mice were administered normal saline. Groups of two to four mice were injected with carrageenan to induce inflammation and then received various treatments. Group two mice received the vehicle (normal saline), while group three mice received diclofenac (15 mg/kg body weight [bw]). The extracts were administered to the remaining groups at 50, 100, and 200 mg/kg bw. One-way analysis of variance was used to assess for statistically significant differences, followed by Tukey’s post hoc tests in case of statistical significance. The significance threshold was inferred at p < 0.05. This study revealed significant anti-edema effects of the extracts on carrageenan-induced paw inflammation in mice. The GC-MS analysis identified fatty acids, terpenoids, and terpenes, which have been associated with anti-edema effects. In conclusion, the findings showed that the extracts have anti-edema effects and phytocompounds associated with the effects. F. sycomorus extract is hence a novel candidate for developing efficacious anti-inflammatory agents.

PMID:41036536 | PMC:PMC12483736 | DOI:10.1155/sci5/8849948

J Phys Ther Sci. 2025 Oct;37(10):524-529. doi: 10.1589/jpts.37.524. Epub 2025 Oct 1.

ABSTRACT

[Purpose] To investigate differences in knee and hip muscle strength between successful and unsuccessful single leg sit to stand tests from a 20-cm-high box (SLST 20) in healthy young adults. [Participants and Methods] Sixty-six lower limbs from 33 healthy adults (20 males, 13 females; mean age 25.4 ± 3.4 years) were classified into successful and unsuccessful groups. Isokinetic strength of the knee (flexion/extension at 60°/s) and hip (flexion/extension/abduction/adduction at 30°/s) was measured. Statistical analyses included t-tests, Kruskal-Wallis tests, and analysis of covariance (ANCOVA) using sex as a covariate. Stratified analyses were also performed. [Results] The successful group had significantly greater strength in knee flexion/extension, hip flexion, and hip adduction. ANCOVA revealed that knee flexion and extension were significantly associated with SLST 20 performance, whereas hip strength was not, after adjusting for sex. Among females, hip adduction strength was significantly greater in the successful group, with no significant difference observed in males. [Conclusion] Knee strength is crucial for SLST 20 performance, and hip adduction strength may be important, particularly in females. Therefore, sex-specific assessments and training strategies should be considered in clinical practice.

PMID:41036527 | PMC:PMC12483485 | DOI:10.1589/jpts.37.524

Parkinsons Dis. 2025 Sep 23;2025:2386302. doi: 10.1155/padi/2386302. eCollection 2025.

ABSTRACT

Background: Previous studies revealed that optical coherence tomography (OCT) and visual evoked potential (VEP) were impaired in patients with Parkinson’s disease (PD), but the results were inconsistent; in this meta-analysis, we tried to answer this issue by including studies that performed these two tests on the same sample size. Methods: PubMed, Scopus, Cochrane, and Google Scholar were comprehensively reviewed to retrieve the published studies investigating changes in OCT and VEP responses in PD patients. We analyzed the pooled weighted difference in means between PD patients and healthy controls using the random-effects model. Results: Ten studies were included (12 sets of data), enrolling 337 PD patients and 273 healthy controls. The P100 latency in PD patients was significantly higher compared to healthy controls (difference in means = 6.16, 95% CI: 1.16-11.15, p=0.02, n = 11). Significant thinning of the retinal nerve fiber layer (difference in means = -4.38, 95% CI: -6.29 to -2.47, p ≤ 0.001, n = 11) was observed in the PD eyes compared to the healthy subjects. However, no statistically significant difference was found in the means of P100 amplitude (p=0.06) and the average central foveal thickness (p=0.08) between PD patients and the control group. There was a significant negative correlation between RNFL weighted mean difference and P100 latency (r = -0.65, p ≤ 0.001) in all subjects. Conclusions: Our results confirmed that Parkinson’s patients showed significant thinning of RNFL thickness and prolonged P100 latency time.

PMID:41036516 | PMC:PMC12483749 | DOI:10.1155/padi/2386302

Front Sports Act Living. 2025 Sep 16;7:1673199. doi: 10.3389/fspor.2025.1673199. eCollection 2025.

ABSTRACT

This study explores the impact of a training workshop on gender equality among vocational training students in teaching and social and sports activities in Aragon, Spain. The evaluation of attitudes, beliefs and gender stereotypes related to leadership in sports was conducted on the basis of an analysis of pre- and post-intervention surveys. The methodology incorporated participatory techniques such as brainstorming, killer data and gamified interactive tools, with the objective of encouraging critical reflection and active learning. The results indicate that, although no statistically significant changes were observed, there was an improvement in the Egalitarianism Index (+0.51) after the workshop, especially among female participants. Furthermore, cluster analysis revealed a shift towards attitudes that are more homogeneous and favourable towards equality. The study concludes that this type of intervention has the potential to raise awareness among future sports professionals about structural inequalities and gender stereotypes, and highlights the importance of incorporating specific equality content into vocational training curricula. Notwithstanding the constraints imposed by the sample size and duration, this experience is presented as a promising pedagogical proposal that can be replicated in other educational contexts.

PMID:41036503 | PMC:PMC12479542 | DOI:10.3389/fspor.2025.1673199

Front Sports Act Living. 2025 Sep 17;7:1658676. doi: 10.3389/fspor.2025.1658676. eCollection 2025.

ABSTRACT

INTRODUCTION: This study evaluates the impact of individual player performance-particularly the VAL rating-on team success in professional basketball. It examines whether basketball operates as a “strong-link” sport, where outcomes depend primarily on top-performing players.

METHODS: A quantitative analysis was conducted on the 2022/2023 Hungarian NB I/A men’s league, using 21 offensive and defensive statistical indicators. Data were collected from official league sources and analyzed using IBM SPSS Statistics version 28.0.

RESULTS: Our findings reveal no significant correlation between individual VAL rankings and team standings. However, offensive and defensive ratings, as well as NET ratings (points scored over opponents per 100 possessions), were strongly associated with team performance, especially among foreign and young players. The VAL metric was more influenced by offensive than defensive performance. Limited playing time and experience may have affected the performance metrics of young players.

DISCUSSION: These results suggest that while basketball reflects strong-link sport characteristics, traditional metrics like VAL may not fully capture a player’s contribution to team success. A more comprehensive approach-incorporating both offensive and defensive indicators-could offer a clearer evaluation of player impact. Future research should also explore psychological, tactical, and social factors to better understand individual roles in team performance.

PMID:41036502 | PMC:PMC12483447 | DOI:10.3389/fspor.2025.1658676

Adv Genet (Hoboken). 2025 Sep 10;6(3):e00018. doi: 10.1002/ggn2.202500018. eCollection 2025 Sep.

ABSTRACT

The genome is like a kaleidoscope through which researchers have obtained varied findings, including favored mutations, disease susceptibility sites, and drug-responsive sites. Whether these findings have inherent connections is a question deserving investigation. Favored mutations enable humans to adapt to changing environments and lifestyles; however, the adaptation may come with some costs. This is because a favored mutation can change the frequency of varied neutral nucleotides across a large genomic region, and a favored mutation may become disfavored as environments and lifestyles change further. These are the best-known classes of connections whose causes and consequences have been understood. However, many favored mutations remain unidentified. Using a deep learning network (DeepFavored) that integrates statistical tests and is trained on large datasets, favored mutations are recently identified in 17 human populations. The analyses of the results, in conjunction with genome-wide association study (GWAS) data, suggest that the connection between adaptive evolution, disease susceptibility, and drug responsiveness (referred to as a trade-off) is extensive and highly population-specific. The analyses, along with other emerging evidence, suggest that there are other types of connections. In this commentary, these issues are discussed from both retrospective and prospective views, including current challenges and future directions.

PMID:41036480 | PMC:PMC12482930 | DOI:10.1002/ggn2.202500018

J Nurs Manag. 2025 Sep 5;2025:5468634. doi: 10.1155/jonm/5468634. eCollection 2025.

ABSTRACT

Background: Float pools are increasingly used in healthcare to enhance staffing flexibility and efficiency. However, the impact of floating on nurses remains underexplored. Challenges may include adjusting to different ward routines and limited team integration. Aim: To explore the perceived demands and resources associated with hospital float pool work, comparing experiences of nurses in intraorganizational pools with expectations of those preparing for interorganizational floating. Methods: This qualitative study, guided by the job demands-resources (JD-R) model, involved semistructured interviews with 27 nurses across five Dutch hospitals. Participants included nurses currently working in intraorganizational float pools and those anticipating working in a float pool across organizations. Results: Nurses in intraorganizational float pools generally reported job satisfaction, experiencing minor demands such as limited team acceptance. Learning opportunities and variation in tasks were key resources. Effective coping was supported by openness, confidence, and communication skills. In contrast, nurses not yet deployed but are anticipating interorganizational floating expected greater demands, including adapting to varying protocols and working across multiple hospital cultures. They emphasized the need for extrinsic resources such as rewards and described personal challenges such as time management and a preference for routine. Conclusion: Interorganizational floating is perceived as more demanding than intraorganizational float pool work. However, experienced nurses often reframe demands as manageable. Findings highlight the importance of a person-centered float pool design that aligns with individual characteristics and support needs. Tailoring float pool policies may enhance job satisfaction, reduce burnout, and support retention among floating nurses.

PMID:41036469 | PMC:PMC12483744 | DOI:10.1155/jonm/5468634