Category: Statistics

Eur J Prev Cardiol. 2025 Oct 1:zwaf597. doi: 10.1093/eurjpc/zwaf597. Online ahead of print.

ABSTRACT

BACKGROUND: Inflammation contributes significantly to coronary artery disease (CAD). The neutrophil-to-lymphocyte ratio (NLR) has emerged as a readily available biomarker reflecting both inflammatory and immune cells’ activity, potentially enhancing risk stratification of patients with CAD. This study evaluates the clinical impact of baseline NLR in patients undergoing percutaneous coronary intervention (PCI) for both chronic coronary syndrome (CCS) and acute coronary syndrome (ACS).

METHODS: We conducted a retrospective analysis of patients undergoing PCI at Mount Sinai Hospital between 2012 and 2022. Patients were stratified into NLR quartiles and outcomes were analyzed using Cox regression models. The primary endpoint was major adverse cardiovascular events (MACE) at 1-year follow-up, including all-cause death, myocardial infarction (MI), and stroke.

RESULTS: A total of 7,287 patients were included in the study. Age, male sex, comorbidities, hsCRP and complexity of PCI tended to be higher in the highest NLR quartiles. At 1-year, MACE incidence increased across NLR quartiles, from 5.1% (1st quartile) to 9.3% (4th quartile) (P for trend = 0.004). Compared with the 1st quartile, the 4th NLR quartile (NLR >5.0) was associated with increased adjusted risks of MACE (adjHR 1.52, 95% CI 1.12-2.05), all-cause death (adjHR 1.71, 95% CI 1.10-2.65), MI (adjHR 1.53, 95% CI 1.00-2.35), and bleeding (adjHR 2.01, 95% CI 1.50-2.70). Ischemic risk associated with high NLR was more pronounced in patients presenting with ACS and chronic kidney disease (CKD).

CONCLUSIONS: Baseline NLR is associated with adverse cardiovascular outcomes in CAD patients undergoing PCI. Assessment of NLR could enhance risk stratification particularly in patients with ACS and CKD.

PMID:41031428 | DOI:10.1093/eurjpc/zwaf597

Eval Rev. 2025 Oct 1:193841X251380903. doi: 10.1177/0193841X251380903. Online ahead of print.

ABSTRACT

This study introduces a novel aligned technical index, derived from multiple technical indicators, that encompasses a broader spectrum of technical measurement strategies than those obtained from previous 3PRF (Three-Pass Regression Filter) research. Our empirical results demonstrate that this index exhibits significant predictive power for new energy price returns in both in-sample and out-of-sample tests. This index is extracted using the 3PRF method and yields significantly better results than those obtained with traditional methods. Considering that the market typically operates in two states, we incorporate a regime-switching model with time-varying transition probabilities into our forecasting framework. The findings indicate that the technical index influences the probability of regime transitions between states and that the inclusion of a regime-switching model further enhances predictive performance. The incorporation of the regime-switching mechanism further improves the predictive performance of the model. Moreover, from an asset allocation perspective, both the technical index and regime-switching models deliver considerable economic value to mean-variance investors.

PMID:41031418 | DOI:10.1177/0193841X251380903

Int J Chron Obstruct Pulmon Dis. 2025 Sep 24;20:3305-3315. doi: 10.2147/COPD.S524775. eCollection 2025.

ABSTRACT

OBJECTIVE: Neutrophilic inflammation, a key feature of chronic obstructive pulmonary disease (COPD), is associated with exacerbations and poor outcomes. Myeloperoxidase (MPO) is released from activated neutrophil granules. High or increasing MPO levels are associated with tissue damage, lung function decline and increased exacerbation risk in patients with COPD. We hypothesize that treatment with mitiperstat, a novel oral MPO inhibitor, may reduce lung oxidative stress, inflammation and exacerbations, thereby improving symptoms, lung function, and comorbidities in patients with COPD.

PATIENTS AND METHODS: CRESCENDO is a partially decentralized, Phase 2a, randomized, 24-week, double-blind study evaluating the efficacy and safety of mitiperstat versus placebo in patients (40-80 years, inclusive) with COPD at high risk of exacerbation (based on a documented history of ≥1 moderate or severe acute COPD exacerbation, frequent productive cough, or severe airflow limitation [forced expiratory volume in 1 second <50% predicted]). Patients recruited from approximately 100 sites across 14 countries, from primary or secondary care and community-based facilities, will be randomized 1:1 to receive mitiperstat 5 mg or placebo orally, once daily. The primary endpoint is the time to first CompEx event, a novel composite endpoint reflecting disease worsening, including changes in symptoms, reliever use, lung function, treatment for exacerbation, or study dropout. The study period is planned to take between 18 and 30 weeks for each patient.

CONCLUSION: CRESCENDO will assess efficacy and safety of mitiperstat using a novel, patient-centric trial design to enhance participant recruitment, partially via community-based facilities, helping to overcome restrictive trial designs and better reflect the real-world population with COPD, as well as reducing its environmental impact.

PMID:41031389 | PMC:PMC12477066 | DOI:10.2147/COPD.S524775

Front Nutr. 2025 Sep 15;12:1652718. doi: 10.3389/fnut.2025.1652718. eCollection 2025.

ABSTRACT

BACKGROUND AND AIM: Patients on maintenance hemodialysis (MHD) experience various complications, including malnutrition, reduced physical function, and psychological problems. Single-discipline medical approaches prove inadequate in addressing these complex situations. The multidisciplinary management model adopted by the nutritional support team has demonstrated effectiveness in managing such challenges. However, patient compliance remains suboptimal due to limited understanding of treatment regimens, fatigue from prolonged therapy, and insufficient psychological support. Consequently, establishing a patient-centered, transparent, and interactive communication platform is essential to improving treatment adherence through enhanced patient support.

METHODS: This prospective randomized controlled trial assigned patients to either an experimental group receiving community-based management or a control group receiving traditional management. Health status was evaluated through laboratory parameters, body composition analysis, anthropometric measurements, and standardized scale assessments.

RESULTS: A total of 28 patients with MHD were enrolled. Four patients died from primary disease (1 in the experimental group and 3 in the control group), leaving 24 who completed the trial. Statistical analysis was conducted on a dataset of 24 patients, including 13 in the experimental group and 11 in the control group. Seven outcomes demonstrated statistically significant differences. In terms of laboratory parameters, the experimental group achieved superior outcomes in serum albumin (12 patients, 92.3% versus 3 patients, 27.3%; p = 0.002), hemoglobin (11 patients, 84.6% versus 4 patients, 36.4%; p = 0.033), and blood phosphorus levels (10 patients, 76.9% versus 2 patients, 18.2%; p = 0.012), compared to control group. Body composition analysis indicated greater improvement in muscle mass (9 patients, 69.2% versus 3 patients, 27.3%; p = 0.038) and more favorable visceral fat distribution (11 patients, 84.6% versus 3 patients, 27.3%; p = 0.011) in the experimental group. Additionally, the experimental group scored higher on the Short Physical Performance Battery (SPPB; 10 patients, 76.9% versus 3 patients, 27.3%; p = 0.038) and exhibited better treatment compliance (10 patients, 76.9% versus 2 patients, 18.2%; p = 0.012). Notably, compliance mediated the effect of community-based management on SPPB scores (Proportion Mediated = 76.2%; p = 0.038).

CONCLUSION: Community-based management by the nutrition support team substantially improves patient compliance and enhances clinical outcomes.

CLINICAL TRIAL REGISTRATION: chictr.org.cn, identifier ChiCTR2500104523.

PMID:41031360 | PMC:PMC12477912 | DOI:10.3389/fnut.2025.1652718

Front Nutr. 2025 Sep 15;12:1624852. doi: 10.3389/fnut.2025.1624852. eCollection 2025.

ABSTRACT

BACKGROUND: Knee osteoarthritis (OA) is a disabling condition-characterized by pain, stiffness, and impaired quality of life-that affects more females than males. Chronic systemic inflammation is a key feature of knee OA and can be modulated by diet. We evaluated the sex-specific relationship between the inflammatory potential of diet and health-related quality of life (HRQOL), sleep quality, energy and fatigue levels, and psychological distress in individuals with knee OA.

METHODS: This cross-sectional study analyzed baseline data from 144 participants (64% female) aged 45-85 years with symptomatic knee OA enrolled in the FEAST (eFEct of an Anti-inflammatory diet for knee oSTeoarthritis) randomized controlled trial, which compared an anti-inflammatory dietary program to a standard low-fat dietary program. Dietary inflammatory potential was assessed using the dietary inflammatory index (DII^®) and energy-adjusted DII (E-DII™), calculated from 3-day food diaries. Higher scores reflect more proinflammatory diets. Outcomes were HRQOL (EQ-5D-5L utility score and 100 mm visual analogue scale [VAS]), self-reported sleep quality, energy and fatigue levels (100 mm VAS), and psychological distress (Kessler Scale). Linear regression with interaction terms assessed sex-specific associations between DII/E-DII and outcomes, adjusting for age and body mass index (BMI).

RESULTS: Male and female participants had a mean ± standard deviation BMI of 30.4 ± 3.8 and 30.2 ± 7.2 kg/m², respectively. Mean E-DII and DII were -0.35 ± 1.34 and 0.72 ± 1.49 (females), and -0.26 ± 1.52 and 0.33 ± 1.45 (males). Higher E-DII scores were associated with lower EQ-5D utility scores in females (unadjusted β = -0.03, 95% CI -0.05 to -0.001), but not after adjustment. Higher DII scores were associated with lower energy levels in males (unadjusted β = -4.34, 95% CI -8.44 to -0.23; adjusted β = -4.01, 95% CI -7.91 to -0.30). No associations were found between DII and HRQOL, sleep, fatigue, or psychological distress in either sex.

CONCLUSION: No associations were found between dietary inflammatory potential and sleep quality, fatigue, or psychological distress. A more proinflammatory diet was linked to lower energy levels in males with symptomatic knee OA. Findings from the FEAST trial will clarify whether reducing dietary inflammation improves these outcomes over time.

PMID:41031358 | PMC:PMC12476995 | DOI:10.3389/fnut.2025.1624852

Front Nutr. 2025 Sep 15;12:1617565. doi: 10.3389/fnut.2025.1617565. eCollection 2025.

ABSTRACT

BACKGROUND: Serum 25 (OH) D levels are associated with various diseases, including cancers, but inconsistencies exist for female-specific malignancies. This study is aimed to explore the real relationship between serum 25 (OH) D levels and incidence rates of female specific cancers in premenopausal women by a large-scale prospective cohort study.

STUDY DESIGN: We analyzed data from 51,286 UK Biobank participants using Cox regression models to explore associations. Subgroup analyses were based on vitamin D supplementation, alcohol, smoking, BMI, diabetes, sleep, and outdoor exposure. Categorical variables were described by frequencies and compared with chi-squared tests.

RESULTS: During a median follow-up of 13.8 years, all cancer incidence was 5.1% (n = 2,614), with ovarian cancer at 0.3% (n = 176), breast cancer at 4.4% (n = 2,232), and uterine body cancer at 0.5% (n = 235). Low serum 25 (OH) D (50 nmol/L) was linked to increased risks of ovarian (HR: 1.457, 95% CI: 1.047-2.027) and uterine body cancer (HR: 1.372, 95% CI: 1.023-1.841). Each 10 nmol/L increase in 25 (OH) D reduced ovarian cancer risk (HR: 0.904, 95% CI: 0.835-0.979). Alcohol use and sleep <6 h were risk factors for ovarian and uterine cancer in those with low 25 (OH) D levels.

CONCLUSION: Maintaining adequate serum 25 (OH) D levels is essential for overall health, reducing the risk of ovarian cancer, and potentially lowering susceptibility to uterine corpus cancer.

PMID:41031356 | PMC:PMC12477915 | DOI:10.3389/fnut.2025.1617565

Korean J Community Nutr. 2024 Aug;29(4):278-287. doi: 10.5720/kjcn.2024.00002. Epub 2024 Aug 31.

ABSTRACT

OBJECTIVES: This study investigates the relationship between smartphone usage and eating behavior among elementary school students.

METHODS: This survey was conducted on 4th- to 6th-grade students at elementary schools in Gangneung from September 6th to September 15th, 2023. Of the 129 copies of the questionnaire that were distributed to 5 schools, 66 copies (51.2%) were returned.

RESULTS: Compared to the nationwide statistics, the smartphone ownership rate of elementary school students in Gangneung was lower, but the rate of smartphone overdependence was higher. Smartphone dependence was 21.12 points for study subjects and 26.00 points for the overdependence risk group (Org). Compared to national statistics, the self-control failure factor was higher, so elementary school students in Gangneung City are thought to have great difficulty with self-control. The Org’s weekend smartphone use time of 7.54 hours was significantly more than the general user group (Gug)’s 4.06 hours. The number of days in which the Org consumed late-night snacks per week was 2.92 days, and the Gug had 2.15 days, but the difference was not significant. Eating fast food showed a positive correlation with eating sweet food, eating fatty food, and eating heavily seasoned food. It was found that frequent consumption of fast food is closely correlated with unhealthy eating behavior. Weekend smartphone use time showed a significant positive correlation with smartphone dependence and the number of days late-night snacks consumed per week.

CONCLUSIONS: Elementary school students in Gangneung are more dependent on smartphones than national statistics. Smartphone dependence had a negative correlation with healthy eating behavior and a correlation with average unhealthy eating behavior.

PMID:41031340 | PMC:PMC12269017 | DOI:10.5720/kjcn.2024.00002

Korean J Community Nutr. 2024 Aug;29(4):318-335. doi: 10.5720/kjcn.2024.00007. Epub 2024 Aug 31.

ABSTRACT

OBJECTIVES: Despite the growing market share of online grocery shopping, there is a need to understand customer perceived value due to the ongoing advancements in information technology. This study explores the connections between attributes, consequences, and values. Additionally, it conducts a cross-country comparison of consumers’ online grocery shopping behaviors to gain a deeper understanding of consumer market segments and any potential variations among them.

METHODS: Data was collected through an online questionnaire survey conducted from May 1 to 15, 2024, targeting 400 consumers in Seoul, Korea, and Shanghai, China, who have experience with online grocery shopping. The survey utilized the Means-End Chain theory and association pattern technique hard laddering. Data collation and analysis were conducted using the IBM SPSS Statistics 28.0 program. The LadderUX software was employed to analyze the links between attributes, consequences, and values and create the consumer purchasing process’s implication matrix and hierarchical value map (HVM).

RESULTS: The study identified key attributes that influence online grocery shopping decisions, including delivery service, price, freshness, and quality. Korean consumers demonstrated a higher sensitivity to price (19.0%) and delivery service (17.0%). In contrast, Chinese consumers prioritized delivery service (15.0%) and after-sales service (14.8%). Commonly cited consequences included time saving (12.6% for Koreans, 11.3% for Chinese), whereas prevalent values encompassed convenience (36.8% for Koreans, 19.6% for Chinese) and economic value (26.6% for Koreans, 14.7% for Chinese). The HVM underscored these insights, highlighting diverse consumer preferences and country-specific nuances.

CONCLUSIONS: The findings highlight the current state of online food consumption and consumers’ value systems, revealing variations among countries. These findings offer empirical insights that can be used to create customized global marketing strategies that resonate with various consumer preferences and market dynamics.

PMID:41031339 | PMC:PMC12269032 | DOI:10.5720/kjcn.2024.00007

Int J Womens Health. 2025 Sep 25;17:3271-3278. doi: 10.2147/IJWH.S539135. eCollection 2025.

ABSTRACT

OBJECTIVE: To investigate the effects of Modified Hupo San on reproductive hormone levels and microcirculation in patients with menstrual disorders of cold congelation and blood stasis pattern.

METHODS: A total of 102 patients from the gynecological outpatient department of our hospital were randomly assigned into a control group (n=51) and a study group (n=51). Randomization was performed using a computer-generated random number table The study group was treated with Modified Hupo San for 3 cycles, while the control group received routine therapy. Blood samples were collected on the 2nd day of menstruation before treatment and again on the 2nd day of the 4th cycle. Serum levels of TXB2, 6-keto-PGF1α, t-PA, PAI-1, estradiol (E2), and progesterone (P) were measured. Safety monitoring was performed throughout the study. Statistical analysis was conducted using SPSS 22.0, with t-tests and chi-square tests applied, and P<0.05 considered statistically significant.

RESULTS: The total effective rate of Modified Hupo San in treating menstrual disorders of cold congelation and blood stasis pattern was 96.30%. Compared with baseline, serum TXB2 and PAI-1 levels significantly decreased, while 6-keto-PGF1α, t-PA, and t-PA/PAI-1 ratio significantly increased after treatment in the study group. E2 levels significantly increased after treatment, and were higher than those in the control group (P<0.05). Progesterone showed no significant difference.

CONCLUSION: Modified Hupo San demonstrated significant therapeutic effects in improving reproductive hormones and regulating microcirculation in patients with menstrual disorders of cold congelation and blood stasis pattern, with good safety.

PMID:41031333 | PMC:PMC12478210 | DOI:10.2147/IJWH.S539135

J Clin Imaging Sci. 2025 Sep 18;15:34. doi: 10.25259/JCIS_36_2025. eCollection 2025.

ABSTRACT

Sample size is an essential step in any research study because it directly affects precision and statistical power. This article describes the main factors that determine the number of observations needed (power of a hypothesis test, significance criterion, minimum expected difference, variability, and asymmetry of the hypothesis test) and techniques for minimizing these factors. Our paper clearly presents examples of sample size calculations in radiology related to descriptive (mean and proportion) and comparative (two means, two proportions, intraclass correlations, and analysis of variance) studies. These examples are solved both manually and computationally using free R-based software.

PMID:41031314 | PMC:PMC12477981 | DOI:10.25259/JCIS_36_2025