Category: Statistics

Clin Kidney J. 2025 Apr 28;18(5):sfaf125. doi: 10.1093/ckj/sfaf125. eCollection 2025 May.

ABSTRACT

BACKGROUND: Finerenone, a non-steroidal mineralocorticoid receptor antagonist, reduces renal risks in type 2 diabetic nephropathy, but its use in immunoglobulin nephropathy (IgAN) lacks evidence. This study assessed the safety and efficacy of 6-month finerenone treatment in IgAN patients.

METHODS: This retrospective cohort study was mainly conducted in three Grade 3A hospitals. Patients diagnosed with IgAN and receiving standard supportive care were included. Participants were divided into the renin-angiotensin system inhibitor (RASI) and RASI + finerenone groups. The primary outcome was the percentage decrease in protein-to-creatinine ratio (PCR) over 6 months following the index study visit.

RESULTS: In total, 178 patients were included in the analysis. PCR was reduced by 45.1% in the RASI + finerenone group and 32.5% in the RASI group (P = .013). Compared with 18 patients (20.2%) in the control group, 33 (37.1%) had residual PCR reduced to <0.3 g/g. After 6 months, serum potassium increased by 0.17 mmol/L from baseline, with no uncontrollable hyperkalemia (persistent serum potassium >5.5 mmol/L despite treatment). In addition, one patient presented with a blood pressure <90/60 mmHg without significant clinical symptoms in the RASI + finerenone group. And eGFR decreased by 1.94 ± 6.73 mL/min/1.73 m² from baseline, but not statistically significant. There were no differences in the incidence of adverse events between the two groups.

CONCLUSIONS: Finerenone added to optimized RAS blocker therapy significantly reduced PCR in IgAN patients, and its safety profile was consistent with previous reports, suggesting the need for long-term renal outcome studies.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06460987.

PMID:40357496 | PMC:PMC12067071 | DOI:10.1093/ckj/sfaf125

Front Psychol. 2025 Apr 28;16:1562807. doi: 10.3389/fpsyg.2025.1562807. eCollection 2025.

ABSTRACT

Cognitive diagnosis models (CDMs) are restricted latent class models that are widely used in educational and psychological fields. Attribute hierarchy, as an important structural feature of the CDM, can provide critical information for inferring examinees’ attribute mastery patterns. Previous studies usually formulate likelihood ratio (LR) tests for full models and hierarchical models to validate attribute hierarchies, but their asymptotic distributions tend to become non-standard, resulting in test failures. This study proposes the Wald statistic to statistically test the a priori defined attribute hierarchy. Specifically, two covariance matrix estimators, empirical cross-product information matrix (XPD), and observed information matrix (Obs), are considered to compute the Wald statistic, referred to as Wald-XPD and Wald-Obs, respectively. Simulation studies with various factors were conducted to investigate the performance of the new methods. The results show that Wald-XPD has an acceptable empirical performance with high or low quality items and a higher test efficiency. Real datasets were also analyzed for illustrative purpose.

PMID:40357483 | PMC:PMC12067792 | DOI:10.3389/fpsyg.2025.1562807

Front Psychol. 2025 Apr 28;16:1538200. doi: 10.3389/fpsyg.2025.1538200. eCollection 2025.

ABSTRACT

In recent decades, there has been extensive research on the impact of personality on academic achievement, among which conscientiousness was verified to be a stable contributor. This study aims to clarify the moderated mediation relationship among conscientiousness, gender, academic self-efficacy, academic motivation, and academic performance. To achieve this purpose, the current study proposed a hypothesized model and verified it through a random sampling survey. With the informed consent of the respondents, the survey was conducted on 304 Chinese university students through the Wenjuanxing platform. For data research and analysis tools, SPSS and PROCESS macro were used, specifically, descriptive statistics analysis, reliability analysis, correlation analysis, and SPSS PROCESS macro model 83. The results indicated that conscientiousness, academic self-efficacy, academic motivation, and academic performance were positively correlated. Furthermore, gender moderated the mediating relationship from conscientiousness to academic self-efficacy, academic motivation, and academic performance. Such research results provided new ideas on how to improve the academic performance of college students, namely, focusing on and improving their academic self-efficacy and academic motivation. Meanwhile, it also provides more targeted help for the gender-differentiated characteristics of college students.

PMID:40357474 | PMC:PMC12066635 | DOI:10.3389/fpsyg.2025.1538200

Front Psychol. 2025 Apr 28;16:1544626. doi: 10.3389/fpsyg.2025.1544626. eCollection 2025.

ABSTRACT

INTRODUCTION: In the context of the Belt and Road Initiative, inland China city such as Xi’an, is in a situation where native and foreign cultures are intertwined. Government leading officials are crucial to the effectiveness of intercultural communication in the region, but little attention has been paid to the government leading officials’ intercultural communication competence (ICC) and its factors.

METHODS: In this investigation, the factors of ICC were expanded to psychological factors (attitude and awareness of intercultural communication), knowledge factors (native and foreign cultural knowledge), and skill factors (resilience and pragmatic skills for intercultural communication). A structured questionnaire was administered to 578 government leading officials in Xi’an. The collected data were analyzed using descriptive statistics, factor analysis, difference analysis, and regression analysis.

RESULTS: The study revealed that among the factors of ICC, intercultural communication awareness exerted the strongest influence on resilience skills. Additionally, the highest foreign language score, participation in training, education status, and frequency of contact with foreigners significantly impacted ICC.

CONCLUSION: This study expanded existing intercultural communication models. Based on the results of the analysis, possible measures to promote ICC of government leading officials were proposed, including the enhancement of foreign language skills, participation in professional training, intercultural situational education, and study abroad.

PMID:40357473 | PMC:PMC12066315 | DOI:10.3389/fpsyg.2025.1544626

Front Psychol. 2025 Apr 28;16:1586278. doi: 10.3389/fpsyg.2025.1586278. eCollection 2025.

ABSTRACT

BACKGROUND AND AIMS: Mental toughness is a psychological construct related to resilience and perseverance, and quality of life encompasses physical, emotional, and social wellbeing, which are critical indicators of overall health and wellbeing. This study aims to investigate the effects of different levels of physical activity on mental toughness and quality of life in both male and female participants.

METHODS: This cross-sectional study consists of 220 participants with the age range of 18-31 years. The data were collected using the International Physical Activity Questionnaire, the Mental Toughness Questionnaire, and the World Health Organization Quality of Life. Gender specific differences were determined using an independent t-test (two-tailed). The effect of varying levels of physical activity in male and female participants was determined by analysis of variance.

RESULTS: Significant differences were found between male and female participants for physical activity levels as high (t = 4.21, p ≤ 0.001, d = 871.80), moderate (t = 3.72, p ≤ 0.001, d = 1309.59), and low (t = 3.21, p = 0.002, d = 520.91) physical activity participants. Statistically significant differences were also found between gender for mental toughness parameters [handling pressure (t = 17.96, p ≤ 0.001, d = 1.25), concentration (t = 16.07, p ≤ 0.001, d = 1.22), mental rebounding (t = 13.34, p ≤ 0.001, d = 1.45), winning attitude (t = 12.01, p ≤ 0.001, d = 1.17)] and quality of life parameters [physical (t = 13.16, p ≤ 0.001, d = 1.58), mental (t = 6.17, p ≤ 0.001, d = 1.69), social (t = 4.58, p ≤ 0.001, d = 2.05), environmental (t = 8.35, p ≤ 0.001, d = 4.95)].

CONCLUSION: Statistically significant differences were found between genders in levels of physical activity, mental toughness, and quality of life. Future research should aim to unravel the complex interlink between physical activity, mental toughness, and quality of life, using longitudinal designs and diverse populations to validate the findings and explore the underlying mechanisms further.

PMID:40357470 | PMC:PMC12066308 | DOI:10.3389/fpsyg.2025.1586278

Clin Ophthalmol. 2025 May 8;19:1531-1541. doi: 10.2147/OPTH.S508618. eCollection 2025.

ABSTRACT

Corneal ectasias are progressive conditions that impair vision and quality of life. Corneal collagen cross-linking (CXL) aims to halt disease progression by strengthening the cornea. This review compares two CXL methods, epithelium-on (epi-on) and epithelium-off (epi-off), to assess their safety and effectiveness for managing corneal ectasia. A systematic search up to July 2024 of PubMed, Medline, Web of Science, Cochrane Central, Google Scholar, and Scopus identified 13 randomized controlled trials (RCTs) involving 872 patients and 1041 eyes. Data were analyzed following PRISMA guidelines using fixed-effects and random-effects models. The primary outcome was the change in maximal keratometry (Kmax) at 12 months, with secondary outcomes including safety profile, best-corrected visual acuity (BCVA), uncorrected visual acuity (UCVA), spherical equivalent (SE), and endothelial cell count (ECC). The findings revealed no statistically significant differences between epithelium-on (epi-on) and epithelium-off (epi-off) CXL in Kmax, BCVA, UCVA, SE, or corneal curvature parameters. However, epithelium-off (epi-off) CXL was associated with less endothelial cell loss and higher rates of side effects, including corneal haze and postoperative discomfort. The choice of treatment should be tailored to individual patient needs, balancing clinical goals and safety considerations. This review highlights the need for further studies to optimize CXL approaches and improve outcomes while minimizing complications.

PMID:40357455 | PMC:PMC12068400 | DOI:10.2147/OPTH.S508618

J Public Health Res. 2025 May 11;14(2):22799036251336969. doi: 10.1177/22799036251336969. eCollection 2025 Apr.

ABSTRACT

BACKGROUND: Multidrug-Resistant Tuberculosis (MDR-TB) is fast becoming a major public health concern, with 80% of the reported global MDR-TB deaths occurring in high burden countries including Namibia where drug susceptibility testing is not routinely performed. Previous studies on TB in Namibia have primarily focused on TB and HIV co-infection and MDR-TB development. However, no study to date has specifically examined the epidemiology of MDR-TB mortality or its associated risk factors at a national level. Thus, this study aimed at examining the variation of mortality among MDR-TB patients in Namibia and identifying its risk factors.

DESIGN AND METHODS: The study adopted a retrospective cohort study design using the 2014-2017 MDR-TB records, and a Gompertz PH model with Gamma (shared) frailty for the frailty modelling of the MDR-TB mortality and its associated risk factors.

RESULTS: There were more MDR-TB deaths among females, HIV positive patients with pulmonary TB in the Khomas region. MDR-TB mortality was more likely to occur for patients who were aged 55 and above (HR = 3.57, p < 0.001, 95% CI: 2.18-5.91), HIV positive (HR = 2.07, p < 0.001, 95% CI: 1.39-3.08), and from the Khomas (HR = 3.68, p = 0.001, 95% CI: 1.72-7.87), Kunene (HR = 4.45, p = 0.022, 95% CI: 1.24-15.91), Omusati (HR = 2.70, p = 0.022, 95% CI: 1.15-6.31), and Oshana (HR = 2.51, p = 0.021, 95% CI: 1.15-5.48) regions.

CONCLUSIONS: It is therefore recommended that the Namibian government and policy makers consider conducting outreach sessions to increase awareness on MDR-TB including early detection and screening programmes, and patient’s adherence, especially among female patients aged 55 and above, with HIV and those living in these highlighted regions.

PMID:40357450 | PMC:PMC12066852 | DOI:10.1177/22799036251336969

Orthop Res Rev. 2025 May 7;17:189-198. doi: 10.2147/ORR.S514237. eCollection 2025.

ABSTRACT

STUDY DESIGN: Retrospective chart review.

OBJECTIVE: This study aims to investigate the application of robots in treating adult degenerative scoliosis (ADS) with circumferential minimal invasive surgery (cMIS).

BACKGROUND: The cMIS is useful but faces a lot of challenges in correcting ADS. One of the most important challenges is the difficulty in screw placement. Robot-assisted technique demonstrates lots of advantages but the data about its application in treating ADS is limited in literatures.

METHODS: A total of 51 cases diagnosed with ADS were retrospectively analyzed. All patients underwent cMIS technique with staged surgeries (OLIF and PPS fixation). Group A enrolled 21 patients and performed robot-assisted technique. Group B enrolled 30 patients and performed fluoroscopy guided technique. Clinical outcomes like the operation time, radiation exposure, pressure curve and post-operation VAS score were recorded. 3D-CT scan was also performed to evaluate the accuracy of the screws.

RESULTS: The average preparation time were much higher in group A (23.4 ± 2.8 vs 3.1 ± 1.0 min, p < 0.0001). But the total operation time was similar (62.7 ± 12.5 vs 55.7 ± 20.6 min, p = 0.174). The average fluoroscopic scan number were 9.4 ± 1.7 in group A, much lower than that of group A (27.7 ±5.9, p < 0.001). No statistical difference was found with the VAS scale between the groups (p = 0.631). No matter considers only screws of grade A as perfect screws (81.5% vs 73.8%) or considers both grade A and B as acceptable screws (93.8% vs 87.7%), group A demonstrated significant higher screw accuracy (p = 0.038, p = 0.018, respectively). Also, the robots demonstrated significant less facet joint violence (p < 0.0001), larger inward tilt angle (p < 0.0001), and longer screw length (p = 0.0008).

CONCLUSION: The robot-assisted technique demonstrated significant advantages like higher pedicle screw accuracy, better trajectory, less radiation exposure, but similar operation time compared with fluoroscopy guided technique in treating ADS with CMIS.

PMID:40357444 | PMC:PMC12067674 | DOI:10.2147/ORR.S514237

Front Cardiovasc Med. 2025 Apr 28;12:1531136. doi: 10.3389/fcvm.2025.1531136. eCollection 2025.

ABSTRACT

BACKGROUND AND AIMS: Progress in cardiology has extended the lifespan of patients with congenital heart defects (CHD). Cyanotic patients are exposed to typical diseases of adulthood, including atherosclerosis. Rheological changes typical of cyanosis affect the vascular endothelium’s function and may promote atherosclerosis development. We assessed the endothelial function and its relationship to biochemical parameters, particularly sphingosine-1-phosphate, in cyanotic CHD patients.

METHOD: A cross-sectional study including 36 adult CHD cyanotic patients [(12 males) (39 median, 19-73 years)] with arterial blood oxygen saturation less than 92% and 30 healthy controls [(11 males) (38.5 median, 26-59 years)] was performed. All patients underwent clinical examination, blood sampling, and ultrasonography, during which endothelial function was assessed using intima-media thickness (IMT) and flow-mediated dilatation (FMD).

RESULTS: We did not demonstrate any difference between CHD patients and the control group in the IMT complex and FMD. Patients with cyanosis are characterized by higher S1P serum levels (p = 0.04), lower ApoM (p = 0.04), and HDL concentrations (p = 0.02). Only FMD correlated positively with HDL cholesterol (p = 0.02) concentration. The IMT complex correlates positively only with BMI (p = 0.04). No factor was statistically significant in the multiple logistic regression model for FMD <6.5%.

CONCLUSIONS: The values of the analyzed biochemical and clinical factors (except for the reduced HDL fraction), the lack of inflammatory factor activity, and the increased S1P concentration indicate the dominance of antiatherosclerotic activity in this population. FMD and IMT are preserved, which suggests that the risk of early atherosclerotic changes in this group is comparable to the remaining population.

PMID:40357437 | PMC:PMC12066607 | DOI:10.3389/fcvm.2025.1531136

Actas Esp Psiquiatr. 2025 May;53(3):516-525. doi: 10.62641/aep.v53i3.1749.

ABSTRACT

BACKGROUND: Nasopharyngeal carcinoma (NPC) presents a substantial challenge for patients, impacting their physical and psychological well-being. Patients may experience moderate depression, anxiety, and reduced quality of life due to the disease and its treatments. Therefore, we retrospectively analyzed the adjunctive therapeutic potential of mindfulness-based stress reduction (MBSR) therapy for NPC patients with moderate depression.

METHODS: Psychological parameters were assessed using standardized scales, including the Hamilton Depression Scale-17 (HAMD-17), Self-Rating Depression Scale (SDS), Perceived Social Support Scale (PSSS), the Short-From-12 Health Survey (SF-12), and Mindfulness Attention Awareness Scale (MAAS). Statistical analyses were performed to compare the two groups.

RESULTS: A total of 131 patients including 67 patients with control group and 64 patients with Mindfulness-Based Stress Reduction therapy group were included. After 8 weeks of treatment, the MBSR therapy group showed significant improvements in psychological parameters, including depression, anxiety, perceived stress, quality of life, and mindfulness attention awareness (p < 0.05), compared to the control group. Additionally, the MBSR therapy group reported significantly higher overall satisfaction with treatment, willingness to recommend treatment, and perceived benefit from treatment (p < 0.05).

CONCLUSION: The study findings support the adjunctive therapeutic value of MBSR therapy in improving psychological outcomes and patient satisfaction among individuals with NPC-induced moderate depression.

PMID:40356009 | DOI:10.62641/aep.v53i3.1749