Category: Statistics

Turk Kardiyol Dern Ars. 2025 Nov 24. doi: 10.5543/tkda.2025.47364. Online ahead of print.

ABSTRACT

Adjunctive vein of Marshall ethanol infusion (EIVOM) during atrial fibrillation (AF) ablation has emerged as a promising technique with the potential to significantly improve procedural outcomes. Despite the existing body of evidence, a comprehensive evaluation focusing on mitral isthmus block, AF recurrence, and procedural duration has not yet been conducted. This meta-analysis aims to rigorously assess the benefits of EIVOM combined with radiofrequency ablation (EIVOM-RF) compared with radiofrequency ablation alone (RF-only) in patients undergoing catheter ablation for AF or related arrhythmias. We systematically reviewed both randomized controlled trials and observational studies that compared EIVOM-RF with RF-only approaches, encompassing a total of 1,406 patients in the EIVOM-RF group and 1,849 in the RF-only group. The primary outcomes assessed included the rate of successful mitral isthmus ablation, recurrence of atrial arrhythmias, and overall procedure time. Patients treated with EIVOM-RF demonstrated a significantly lower likelihood of atrial arrhythmia recurrence compared to those receiving RF-only treatment. Furthermore, EIVOM-RF was associated with an impressive increase in the success rate of achieving mitral isthmus block. While total procedure time tended to be longer with EIVOM-RF, this difference was statistically significant and showed considerable variability. These findings compellingly indicate that EIVOM enhances procedural efficacy, albeit at the cost of increased procedural duration. In conclusion, EIVOM combined with RF ablation represents a transformative approach that markedly improves procedural success rates and significantly reduces arrhythmia recurrence in patients undergoing ablation for AF.

PMID:41277368 | DOI:10.5543/tkda.2025.47364

Food Funct. 2025 Nov 24. doi: 10.1039/d5fo03652f. Online ahead of print.

ABSTRACT

Aging is accompanied by a gradual decline in immune function. Previously, we demonstrated that daily intake of 4 g plant stanols, provided as fatty-acid esters, increased antibody titre responses following different vaccinations. Effects of lower intakes, however, are unknown. We therefore evaluated whether daily consumption of 2, 3 or 4 g of plant stanols, provided as fatty-acid esters, improved immune responses following influenza vaccination in older adults. A double-blind, randomized, placebo-controlled parallel trial was performed. Older participants (59-87 years) consumed products with added plant stanols (2, 3 or 4 g d^-1 provided as fatty-acid esters) or control products for approximately 14 days prior to vaccination until 4 weeks post-vaccination. Antibody titres, serum metabolic risk markers, and haematological and immunological parameters were measured and statistically evaluated using linear mixed models. Data of 128 participants were analysed. Changes in IgM and IgG concentrations did not differ significantly between the control and plant stanol groups. Also, changes in Hemagglutination Inhibition (HI) antibody titres were not significantly different between the groups for either the Phuket or Victoria strains. Serum LDL-cholesterol concentrations decreased significantly in the 4 g d^-1 and 3 g d^-1 groups compared with control. Serum LDL-cholesterol concentrations in the 2 g d^-1 group were also lowered, but did not reach statistical significance. No between-group differences in haematological and immunological parameters were observed. Daily consumption of 2, 3 or 4 g of plant stanols provided as fatty-acid esters, did not improve vaccination responses following annual influenza vaccination in men and women aged 60 years or older.

PMID:41277360 | DOI:10.1039/d5fo03652f

Neurourol Urodyn. 2025 Nov 24. doi: 10.1002/nau.70191. Online ahead of print.

ABSTRACT

PURPOSE: This study investigates the correlation between clinical characteristics, ultrasound measurements, and the severity of stress urinary incontinence (SUI) in women, aiming to identify key transperineal ultrasound measurements that can guide clinical management of SUI.

METHODS: The study was conducted with 519 women diagnosed with urinary incontinence from three hospitals in Fujian Province, China, who underwent clinical assessment and transperineal ultrasound examination from November 2019 and May 2024. Ultrasound measurements, including temporal and morphological metrics, were analyzed in relation to SUI severity, categorized as slight, moderate, or severe. Statistical analyses included Spearman’s rank correlation and logistic regression.

RESULTS: Among the 314 women with SUI, significant correlations were found between ultrasound measurements and SUI severity. The duration of maximum contraction showed the strongest correlation with severity, followed by twitch count during sustained contraction. Logistic regression revealed that age (OR = 1.052, p = 0.018) and larger differences in LHA between Valsalva and rest (OR = 1.227, p = 0.035) were risk factors for moderate-to-severe SUI, while longer the duration of maximum contraction reduced the risk (OR = 0.924, p < 0.001).

CONCLUSION: Transperineal ultrasound was proved to be a noninvasive, objective method for the evaluation and management of SUI. Key findings underscored the potential of ultrasound in advancing pelvic floor health and guiding personalized pelvic floor muscle training. Further research is needed to standardize these measurements and validate their clinical utlity.

PMID:41277356 | DOI:10.1002/nau.70191

J Hum Nutr Diet. 2025 Dec;38(6):e70169. doi: 10.1111/jhn.70169.

ABSTRACT

INTRODUCTION: Promoting healthy aging is a public health goal, especially in regions with a high proportion of older adults, such as Greece. This cross-sectional study investigated the association of fish n-3 PUFA intake with indicators of healthy aging among older Greek Peloponnesian adults.

METHODS: In total, 449 individuals > 60 years of age were enroled. Sociodemographic, anthropometrical, medical, mobility, balance, lifestyle, dietary, cognitive and mental characteristics were assessed through validated questionnaires and procedures.

RESULTS: Analyses revealed that n-3 PUFA intake was associated with fewer depression symptoms (p < 0.001), higher cognition levels (p = 0.012) and levels of healthy aging (p < 0.001), derived from Successful Aging Index (SAI). In parallel, n-3 PUFA intake was associated with higher adherence to the Mediterranean diet (p < 0.001). Additionally, n-3 PUFA intake was inversely correlated with the presence of long COVID-19 symptomatology (p = 0.036). No association of n-3 PUFA intake with mobility or physical performance and balance (all ps> 0.05) was detected.

CONCLUSION: The results underscore the significance of nutrition in older adults, highlighting the possible protective impact of n-3 PUFAs on maintaining functionality. Future prospective studies may validate these associations and contribute to the development of targeted nutritional strategies for older adults.

PMID:41277355 | DOI:10.1111/jhn.70169

J Hum Nutr Diet. 2025 Dec;38(6):e70171. doi: 10.1111/jhn.70171.

ABSTRACT

BACKGROUND: Dietetic education should reflect evidence on current practice and demands of the profession yet information regarding the employment profile of dietitians in Ireland is limited. The study aimed to establish the employment profile of graduate dietitians in Ireland and assess their perceived preparedness for employment.

METHODS: A mixed methods design was used. Individuals who graduated from dietetic degrees in Ireland between 2020 and 2024 were invited to participate. An online survey was used to collect information on employment profile and perceived preparedness for employment. Semi-structured interviews explored graduate experiences during their dietetic education and employment in more depth. Interview data were analysed to construct thematic domains.

RESULTS: The online survey had a 49% response rate (132/271). The majority of graduates were employed in hospital dietetics for their first role postgraduation (67%, n = 90) and for their current employment (58%, n = 76). Nondietetic related roles (19%, n = 25) was the second most common current employment followed by community dietetics (12%, n = 16). At the time of survey completion, 29% (n = 37) were living outside Ireland. Most graduates felt slightly (40%, n = 51) or very prepared (46%, n = 59) for their first employment. Four themes were identified from the 13 semi-structured interviews: (1) the value of placement, (2) narrow career preparedness, (3) struggling with the transition to employment and (4) workplace support.

CONCLUSION: This is the first study to establish the employment profile and perceived preparedness of Irish dietetic graduates. Continued graduate tracking and research on solutions to the challenges highlighted in this study could provide evidence to support curricula alignment with workforce demands.

PMID:41277351 | DOI:10.1111/jhn.70171

Biol Sex Differ. 2025 Nov 23. doi: 10.1186/s13293-025-00793-6. Online ahead of print.

ABSTRACT

Many systematic reviews have summarized evidence on the association between behavioural factors and incident cancers. To date, there has been little synthesis of heterogeneity by sex/gender of this evidence.An umbrella review was conducted of systematic reviews with quantitative synthesis (meta-analysis, meta-regression) examining the exposures of body size; physical activity; wholegrains, vegetables, fruit and beans; “fast foods”; red and processed meat; sugar sweetened drinks; dietary supplements; alcohol; tobacco; and sun exposure with incident non-sex-specific cancers. A search of Ovid MEDLINE, Ovid Embase, and Cochrane library from database inception to May 2023 was conducted. We calculated the proportion of systematic reviews that provided quantitative sex/gender findings (e.g., subgroup analyses) and summarized findings narratively. Methodological quality was appraised with the AMSTAR-2 tool.From 13,227 records, 705 full-text systematic reviews were identified as meeting inclusion criteria. Of these, 361 (51.2%) reported quantitative sex/gender findings. The terms “sex” and “gender” were used interchangeably by 36.3% of the 361 systematic reviews and none reported findings for transgender, gender-diverse, or non-binary individuals. Overall, 98.6% (356/361) of systematic reviews were rated “critically low” with the AMSTAR-2 tool. Most of the 361 systematic reviews with quantitative sex/gender findings reported no statistically significant differences by sex/gender.This umbrella review found conflation of sex and gender in systematic reviews of behavioural factors and non-sex-specific cancers and a lack of research among non-cisgender individuals. The existing evidence base is of critically low quality and our findings of no sex/gender-specific trends must be interpreted with caution.

PMID:41276857 | DOI:10.1186/s13293-025-00793-6

Arch Public Health. 2025 Nov 24. doi: 10.1186/s13690-025-01796-w. Online ahead of print.

ABSTRACT

BACKGROUND: Exclusive breastfeeding (EBF) promotes optimal growth and health in infants. Despite national and global initiatives, EBF rates in Malaysia remain below the 70% target set for 2030. This study evaluated the impact of structured breastfeeding education supplemented with WhatsApp follow-up on infant feeding practices, growth, and health outcomes.

METHODS: A quasi-experimental study was conducted at six public health clinics in Gombak District, Selangor. Mothers of healthy-term infants were assigned to either an intervention group (structured education with WhatsApp follow-up) or a comparison group (routine care). A total of 500 mother-infant pairs were enrolled. Data on feeding practices, anthropometric indicators, length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length z-scores (WLZ) and common illnesses, including upper respiratory tract infection (URTI), gastroenteritis (GE), contact dermatitis (CD), bowel disorders (BD), and other illnesses (OI), were collected at Months 1, 3, and 6. Analyses included descriptive statistics, linear mixed-effects models, and generalised logistic mixed models.

RESULTS: Of the 602 mothers screened, 500 were enrolled across six purposively selected clinics, and 460 (220 in the comparison group and 240 in the intervention group) were included in the final analysis. Baseline maternal and infant characteristics were comparable between groups. EBF prevalence was initially higher in the comparison group but increased more significantly in the intervention group by Month 6. Although some baseline z-scores were negative, descriptive trends showed modest, non-significant improvements in LAZ, WAZ, and WLZ over time, indicating overall upward growth trajectories. Linear mixed-effects models confirmed significant time effects, but no group-by-time interactions were observed. Illness prevalence decreased with age, with significant reductions observed for GE and OI and a borderline improvement for URTI in the intervention group. Overall, the intervention improved EBF practices and selected morbidity outcomes but did not significantly alter growth trajectories.

CONCLUSIONS: Structured breastfeeding education, combined with WhatsApp follow-up, effectively enhanced exclusive breastfeeding practices and reduced certain infant illnesses, but showed no significant short-term effects on growth. Longer-term follow-up is warranted to assess the sustained effects on growth and health.

PMID:41276849 | DOI:10.1186/s13690-025-01796-w

Chin Med. 2025 Nov 24;20(1):199. doi: 10.1186/s13020-025-01258-z.

ABSTRACT

BACKGROUND: Chlorhexidine is widely used as a chemical antibacterial mouthwash, but its potential side effects have spurred interest in safer natural alternatives.

PURPOSE: This study aimed to evaluate the anticariogenic efficacy and inhibitory effects of a functional mouthwash containing Clematis chinensis Osbeck (C. chinensis Osbeck) extract in a randomized controlled clinical trial.

STUDY DESIGN AND METHODS: In this randomized, double-blind, controlled clinical trial conducted at Busan M Dental Clinic, 69 participants were randomly assigned to three groups: saline gargle (n = 23), chlorhexidine gargle (n = 23), and C. chinensis Osbeck extract gargle (n = 23). Participants used 15 mL of the assigned mouthwash four times daily for 2 weeks. The oral environment was standardized with professional scaling and a 1-week recovery period before the intervention. Clinical outcomes were evaluated using the O’Leary index and the Cariview™ test kit (AIOBIO Co. Ltd., Seoul, South Korea) at baseline, 1 week, and 2 weeks, respectively, to evaluate dental plaque acidogenicity and user satisfaction. Saliva tests (including cariogenic bacterial counts, acidogenicity, and buffering capacity) were performed using the SillHa Oral Wellness System (ARKRAY Inc., Kyoto, Japan). Subgingival plaque samples were analyzed by quantitative real-time polymerase chain reaction (PCR) analysis to detect cariogenic bacteria (Streptococcus mutans [S. mutans] and Gram-positive cariogenic bacteria [GS group], comprising S. mitis, S. sobrinus, and Lactobacillus casei). Statistical analyses were performed using analysis of variance (ANOVA) and Duncan’s post hoc test, with significance set at P < 0.05.

RESULTS: The C. chinensis Osbeck extract gargle group showed reductions in the O’Leary index score and cariogenic activity, alongside a progressive increase in user satisfaction. Saliva analysis revealed significant decreases in caries-causing bacterial numbers and acid production and improved buffering capacity, enhancing salivary defense. Only the C. chinensis Osbeck extract gargle group showed a significant reduction in S. mutans and the GS group. Compared with the saline and chlorhexidine groups, this group demonstrated a continuous decrease in caries risk over the 2 weeks.

CONCLUSION: C. chinensis Osbeck extract significantly improved clinical parameters related to dental caries, suggesting its potential as a safe and effective natural alternative to chemical antibacterial agents for caries prevention and oral health maintenance.

TRIALS REGISTRATION: ClinicalTrials.gov, KCT0008539. Registered on June 21, 2023, https://cris.nih.go.kr/cris/search/detailSearch.do/23816 ).

PMID:41276841 | DOI:10.1186/s13020-025-01258-z

Gut Pathog. 2025 Nov 24;17(1):93. doi: 10.1186/s13099-025-00763-8.

ABSTRACT

BACKGROUND: The incidence of an infection with Helicobacter pylori, or H. pylori rises with age, mostly affecting children.The infection rate of Helicobacter pylori increases with age, primarily affecting children. The rate of cases of disease of the hands, feet, and mouth (HFMD), an infectious illness that mostly affects newborns and young children and is ubiquitous throughout the Asia-Pacific area, declines with age. Asthma, shigellosis, TB, anaphylactic disease, and other diarrheal illnesses are all prevented by H. pylori. It also has a strong correlation with infectious disorders brought on by infection with pathogens including Orientia tsutsugamushi, HIV, HCV, and Brucella abortus. Nonetheless, the status of infection with H. pylori in individuals already infected with HFMD and the clinical implications of CagA⁺ H. pylori strains remain unreported.

METHODS: From October 2020 to October 2023, 130 children clinically diagnosed with HFMD enrolled in the observation group at the Affiliated Hospital of Youjiang Medical University for Nationalities Affiliated Hospital of Youjiang Medical College of Nationalities and the People’s Hospital of Beihai. With respect to gender, age, and location of residence, 150 chronologically matched healthy children made up the control group. Serum H. pylori antibodies in patients were measured, and the strain was identified through the Western blot technique.

RESULTS: 1. The frequency of infections with H. pylori with the prevalence of CagA + strains were found to be 16.2% and 8.5%, respectively, in patients with HFMD. These figures are lower than the 29.3% and 18.0% that are seen in healthy children, respectively (P-value < 0.05 for both). 2. The infection rate of the bacteria H. pylori and CagA + strains was found to be 18.5% and 9.3% in HFMD patients over 5 years of age, which is lower than the 41.5% and 26.2% observed in healthy children over 5 years, respectively (P-value < 0.05). In contrast, the rate of H. pylori and CagA + strains in HFMD patients aged 5 years and below was comparable to that of healthy children in the same age group, with both results showing no statistically significant differences. 3. H. pylori and CagA + strain prevalence were similar in primary and subsequent HFMV infections, although neither was statistically significant. 4.The findings of the univariate and multivariate analyses indicated that vaccination against HFMD and infection with H. pylori CagA + were protective factors against HFMD (0.203; 0.069-0.593; 0.004).

CONCLUSION: When compared to children in good health, individuals with HFMD had much lower levels of Helicobacter pylori infection. Additionally, H. pylori that carries the CagA gene could be able to prevent the development of HFMD.

PMID:41276838 | DOI:10.1186/s13099-025-00763-8

BMC Prim Care. 2025 Nov 24. doi: 10.1186/s12875-025-03117-0. Online ahead of print.

ABSTRACT

AIMS: Chronic kidney disease (CKD) is a major global health concern, often underdiagnosed in primary care settings. This study aimed to assess CKD screening practices using estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) among individuals in a primary care population in Girona Sud, Catalonia.

METHODS: A cross-sectional analysis was conducted using anonymised electronic health records from Girona Sud primary care centres. We included active patients aged ≥ 15 years with a recorded medical history. Demographic, clinical, and laboratory data, including eGFR and UACR, were analysed. CKD was defined as eGFR < 60 ml/min/1.73 m² and/or UACR ≥ 30 mg/g. Descriptive and inferential statistical analyses were performed.

RESULTS: Among the studied population (N = 230,922), 37% had mildly decreased eGFR (60-89 ml/min/1.73 m²), while 3% had more advanced CKD (G3b-G5). Albuminuria was mostly A1 (89%), with moderate (9.4%) and severe (1.8%) cases observed. Screening was more frequent in patients with type 2 diabetes, hypertension, and dyslipidaemia. Renal protective drugs, such as ACE inhibitors, ARBs, and SGLT2 inhibitors, were mainly prescribed in early CKD stages.

CONCLUSIONS: Early-stage CKD is prevalent in our primary care population, particularly among those with cardiometabolic conditions. It is important to optimize the CKD detection and management in primary care. Despite the availability of renal protective treatments, their underutilization in advanced stages of CKD highlights missed opportunities for timely and optimal intervention.

PMID:41276836 | DOI:10.1186/s12875-025-03117-0