Category: Statistics

Pediatr Pulmonol. 2025 Jun;60(6):e71175. doi: 10.1002/ppul.71175.

ABSTRACT

BACKGROUND: The COVID-19 pandemic caused dramatic changes in daily routines, healthcare access, and utilization in children with asthma, particularly urban minority children with poorly controlled asthma.

OBJECTIVES: In this study, we aimed to elucidate changes in healthcare utilization, lung function, and weight as a result of the COVID-19 “shutdown” in patients followed at the Pediatric Asthma Center at the Children’s Hospital at Montefiore.

STUDY DESIGN: We conducted a retrospective cohort study including children aged 2-21 with physician-diagnosed persistent asthma. We compared healthcare utilization, lung function, asthma control, and weight changes before and after the COVID-19 lockdown (March 16, 2020 to June 1, 2020).

RESULTS: This study included 101 children (61% Hispanic, 28% Black) with an average age of 9.2 (±4.7) years. There was a statistically significant decrease in hospitalization rates, emergency department visits, oral steroid use, urgent care visits and office visits pre- and post-COVID-19 shutdown, which was associated with improvement in asthma control (p < 0.001) but there was no significant improvement in lung function. Obesity rates increased overall from 29.7% to 43.9%, but weight gain did not differ based on asthma severity. Weight gain was disproportionally higher in a small sub-population of patients who needed step-up therapy.

CONCLUSION: Inner-city children with high asthma morbidity saw a significant reduction in healthcare utilization during the COVID-19 pandemic, with improved asthma control but no change in spirometry results. Despite an increase in obesity rates overall, weight changes did not differ across asthma severities, suggesting increase in obesity was not mediated by asthma severity.

PMID:40571979 | DOI:10.1002/ppul.71175

Neurointervention. 2025 Jun 27. doi: 10.5469/neuroint.2025.00297. Online ahead of print.

ABSTRACT

PURPOSE: The Woven EndoBridge (WEB) was introduced in Japan in January 2021 and approved for all subtypes of wide-neck bifurcation aneurysms (WNBA). This retrospective study evaluated the safety and efficacy of the WEB device for all subtypes of WNBA.

MATERIALS AND METHODS: All patients treated with the WEB at our facility between January 2021 and May 2024 was reviewed. We selected the WEB device according to an oversizing policy, based on cumulative clinical evidence from global experience.

RESULTS: We analyzed 120 aneurysms in 117 patients (56 males and 61 females with a mean age of 65.5±12.7 years). There were 45 anterior communicating artery aneurysms, 27 middle cerebral artery aneurysms, 17 internal carotid artery-posterior communicating artery aneurysms, 15 basilar artery top aneurysms, and 16 aneurysms in other locations. Aneurysm characteristics included a maximum diameter of 6.5 [5.3, 7.7] mm, height of 4.9 [3.9, 6.0] mm, width of 4.8 [4.0, 6.2] mm, and dome/neck ratio of 1.2 [1.1, 1.4]. All data are expressed in median [interquartile range]. Angiographic follow-up at 12 months in 96 cases showed complete obliteration in 68.8% and adequate obliteration in 90.6% of cases. Intraoperative ischemic events occurred in 5 cases (4.2%). Hemorrhagic events occurred in 2 cases (1.7%), with symptoms resolving by discharge, except for 1 case of mild paralysis. During follow-up, 1 patient developed a major stroke, resulting in morbidity (0.8%). Retreatment was required in 3 cases (2.5%). On multivariate analysis for complete occlusion at 12 months following WEB treatment, age was statistically associated with the outcome (odds ratio, 0.957 per year; 95% confidence interval, 0.919-0.996; P=0.033).

CONCLUSION: WEB is safe and effective for all subtypes of WNBA, with a low retreatment rate using an oversizing policy. This is the first report in a Japanese population.

PMID:40571967 | DOI:10.5469/neuroint.2025.00297

Pediatr Pulmonol. 2025 Jun;60(6):e71177. doi: 10.1002/ppul.71177.

ABSTRACT

BACKGROUND: Food insecurity is increasing in prevalence throughout the general population and has been noted to substantially exist within the cystic fibrosis (CF) community as well. Nutritional grant programs are in place to provide additional support to people with cystic fibrosis (PwCF). This study was designed to determine the current usage rate of nutritional grant funding as well as clinical outcomes such as body mass index (BMI). We aim to describe our CF center’s enrollment and usage of privately funded nutritional grants and explore potential correlations to nutrition clinical outcomes.

METHODS: A single center retrospective chart review of the electronic health records (EHR) to collect requested data points was completed for all PwCF seen at that center between the dates of March 1, 2017 and February 29, 2024.

RESULTS: Two hundred and nineteen individuals met inclusion criteria. Over the course of the study period, the total number of PwCF enrolled in supplemental nutritional grant program(s) and amount of grant utilization increased steadily from 9% enrolled with 17% utilization in 2017 to 27% enrolled with 44% utilization in 2022, respectively. The percentage of PwCF with a BMI below Cystic Fibrosis Foundation (CFF) recommended goals also decreased over the course of the study period from 39% in 2017 to 31% in 2022.

CONCLUSIONS: We conclude that the results of our study support continued efforts to identify and remediate the presence of food insecurity within the CF community.

PMID:40571964 | DOI:10.1002/ppul.71177

BMC Public Health. 2025 Jun 26;25(1):2174. doi: 10.1186/s12889-025-23467-9.

ABSTRACT

BACKGROUND: The COVID-19 pandemic led to a global shutdown, with most countries implementing widespread lockdowns. While such measures were essential in curbing the spread of COVID-19, their impact on the mental health of parents with preschool-aged children is not yet sufficiently understood. This study aimed to assess anxiety and depression symptoms in parents during and after the COVID-19 lockdowns, and to examine how demographic and pandemic-related factors influenced these outcomes.

METHOD: A sample of 128 parents in Germany with preschool children (aged 2 to 6 years) participated in an online survey. The survey assessed three key periods: before the nationwide lockdowns (retrospectively), during the most challenging phase of the lockdown (retrospectively), and after the lockdowns were lifted. Symptoms of depression and anxiety were investigated with validated questionnaires and pandemic-specific stressors (e.g., isolation of child) with a self-developed set of 23 items. Descriptive statistics, group comparisons, and hierarchical multiple regression analyses were conducted.

RESULTS: Symptoms of anxiety and depression significantly increased during lockdowns in comparison to before pandemic onset and remained elevated after restrictions eased. Key predictors of poorer mental health included pre-pandemic symptoms, lower parental education, concerns about access to primary care, and children’s social isolation during lockdowns. Demographic factors alone were not consistently significant predictors.

CONCLUSIONS: Symptoms of anxiety and depression significantly increased during lockdowns compared to before pandemic onset and remained elevated after restrictions eased. COVID-19-related stressors played a greater role in parental mental health outcomes than demographic variables. These findings emphasize the need for early identification of at-risk families and the development of targeted interventions to support parental well-being in future public health emergencies.

PMID:40571934 | DOI:10.1186/s12889-025-23467-9

BMC Microbiol. 2025 Jun 26;25(1):371. doi: 10.1186/s12866-025-04106-0.

ABSTRACT

BACKGROUND: Dysbiosis, an imbalance in the bacterial composition of the human gut microbiota, is linked to inflammatory bowel disease (IBD). Advances in biological techniques have generated vast microbiota datasets, presenting both opportunities and challenges for clinical research in that field. Network theory offers powerful tools to analyze these complex datasets.

METHODS: Utilizing genetically unrelated individuals from the Kiel IBD-KC cohort, we compared network properties of the gut microbiota between patients with inflammatory bowel disease (IBD, n = 522) and healthy controls (n = 365), and between Crohn’s disease (CD, n = 230) and Ulcerative Colitis (UC, n = 280). Correlation-based microbial networks were constructed, with genera as nodes and significant pairwise correlations as edges. We used centrality measures to identify key microbial constituents, called hubs, and suggest a network-based definition for a core microbiota. Using Graphlet theoretical approaches, we analyzed network topology and individual node roles.

RESULTS: Global network properties differed between cases and controls, with controls showing a potentially more robust network structure characterized by e.g., a greater number of components and a lower edge density. Local network properties varied across all groups. For cases and both UC and CD, Faecalibacterium and Veillonella, and for unaffected controls Bacteroides, Blautia, Clostridium XIVa, and Clostridium XVIII emerged as unique hubs in the respective networks. Graphlet analysis revealed significant differences in terminal node orbits among all groups. Four genera which act as hubs in one state, were found to be terminal nodes in the opposite disease state: Bacteroides, Clostridium XIVa, Faecalibacterium, and Subdoligranulum. Comparing our network-based core microbiota definition with a conventional one showed an overlap in approximately half of the core taxa, while core taxa identified through our new definition maintained high abundance.

CONCLUSION: The network-based approach complements previous investigations of alteration of the human gut microbiota in IBD by offering a different perspective that extends beyond a focus solely on highly abundant taxa. Future studies should further investigate functional roles of hubs and terminal nodes as potential targets for interventions and preventions. Additionally, the advantages of the newly proposed network-based core microbiota definition, should be investigated more systematically.

PMID:40571931 | DOI:10.1186/s12866-025-04106-0

BMC Public Health. 2025 Jun 26;25(1):2176. doi: 10.1186/s12889-025-23578-3.

ABSTRACT

BACKGROUND: Academic performance in children is associated with a range of health-related factors, including physical fitness, mental well-being, sleep, and behavioral patterns. While previous studies have examined these factors individually, fewer have assessed their independent associations with academic achievement while accounting for other relevant health indicators. This study uses data from the I.Family study to explore how physical, mental, sleep-related, and behavioral health indicators relate to academic achievement among European adolescents, considering each factor’s contribution while adjusting for the others.

METHODS: We used data from the 2013-2014 wave of the I.Family study to investigate eight health indicators: health related quality of life (HRQoL), body mass index (BMI), diet, media use, physical activity, sleep duration and quality, and stressful life events. Their associations with self-reported academic performance in mathematics and language were analyzed using binary logistic regression models, adjusting for confounders such as parents’ education, income, survey country and child’s age. We conducted separate analyses for girls and boys to capture associations that are specific to academic subject and sex.

RESULTS: A number of significant associations were found between several health indicators and academic performance. Higher HRQoL scores, reduced media time, and increased physical activity were linked to better academic performance in both mathematics and language for both boys and girls. Variation by sex and academic subjects were observed, with lower BMI, higher healthy diet scores and better sleep quality associated with better academic performance in language among girls. For mathematics, emotional, self-esteem, and family-related HRQoL were all significantly associated with higher performance for both boys and girls. In contrast, for language achievement, only family-related HRQoL was significant for both sexes.

CONCLUSIONS: Our study underscores the need to consider both the importance of accounting for heterogeneity in sex and the differences between math and language academic subjects when investigating determinants of academic performance, setting the stage for further research on this topic to explore potential competing, synergistic, or time-dependent effects among these different health dimensions.

PMID:40571929 | DOI:10.1186/s12889-025-23578-3

Popul Health Metr. 2025 Jun 26;23(Suppl 2):31. doi: 10.1186/s12963-025-00389-7.

ABSTRACT

BACKGROUND: Measurement of excess mortality attributable to the COVID-19 pandemic is essential for quantifying the direct and indirect effects on mortality and informing future public health control strategies. This study assessed the impact of COVID-19 on excess mortality and life expectancy at birth in rural northern Ghana.

METHODS: Data was obtained from the Navrongo Health and Demographic Surveillance System (NHDSS) in Ghana. We computed the number of deaths and person-years contributed from January 1, 2015, to December 31, 2021, and estimated mortality rates for each year, age group, and gender. Mortality rate differences were calculated by comparing the period before (2018-2019) and during (2020-2021) the pandemic. To estimate excess mortality, a generalised additive model was fitted to the historical data from 2015 to 2019 to predict the expected mortality rates in the COVID-19 period (2020-2021). A Cox proportional hazards model was fitted to assess the risk factors associated with mortality, adjusting for socio-demographic variables. Conventional life table techniques were used to estimate period life expectancy at birth for males and females.

RESULTS: Overall, 12,413 deaths and 1,227,115 person-years were included in the analysis. This consists of 5,930 (49%) deaths and 572,963 person-years for the pre-pandemic period (2015-2019) and 6,483 (52%) deaths and 654,153 person-years for the pandemic period (2020-2021). From 2020 to 2021, the crude mortality rate was 23.9 deaths per 1000 person-years compared with 20.7 deaths per 1000 person-years predicted if COVID-19 had not occurred. COVID-19 also caused a decline in life expectancy at birth, especially in males, by 3.4 years. In addition, the adjusted risk of dying during the pandemic was higher in males (12.1%) compared to females and higher in the 65 + years age group (69.2%) compared to the younger population.

CONCLUSION: The COVID-19 pandemic caused an increase in deaths and a decrease in life expectancy in the NHDSS population in Ghana, particularly among men and those aged 65 years and older. These results reinforce the critical role of routine surveillance data in assessing the impact of public health emergencies such as the COVID-19 pandemic and informing public health strategies.

PMID:40571927 | DOI:10.1186/s12963-025-00389-7

BMC Public Health. 2025 Jun 26;25(1):2172. doi: 10.1186/s12889-025-23247-5.

ABSTRACT

BACKGROUND: Loneliness among children and adolescents has been increasingly recognized as a public health issue, for example, because of its associations with mental health problems. Nevertheless, there is a lack of evidence regarding the links between loneliness and mental health and the potential buffering role of social support. Thus, this study aims to investigate the prevalence of loneliness among children and adolescents in Germany and its associations with mental health. Furthermore, we analyze whether social support is negatively correlated with loneliness and mental health problems and whether it acts as a moderator of the association between loneliness and mental health issues.

METHODS: This study analyzed data from the Health Behavior in School-aged Children (HBSC) survey in Germany in 2022, which included 6,475 students aged 11, 13, and 15 years (girls: 50,6%, M_age = 13,4, SD = 1,7). Loneliness was measured via the University of California-Los Angeles Scale (UCLA) and a single-item measure. The mental health indicators included subjective health, life satisfaction, and multiple psychosomatic complaints. Social support from family, teachers, and classmates was assessed. Chi-square tests, t tests, logistic regressions, and moderation analyses were conducted.

RESULTS: A total of 17.2% of the students reported high levels of loneliness. Compared with boys, girls and gender-diverse students reported higher rates of loneliness. High levels of loneliness were strongly linked to poorer subjective health (OR = 5.56, p <.001), lower life satisfaction (OR = 7.32, p <.001), and increased psychosomatic complaints (OR = 7.38, p <.001). High social support from family, teachers, and students was associated with reduced loneliness and better mental health outcomes. Teacher support in grades 7 and 9 buffered the effect of loneliness on multiple psychosomatic complaints.

CONCLUSION: The findings highlight that loneliness is a prevalent phenomenon among children and adolescents and is strongly associated with mental health issues. Greater social support is linked to reduced loneliness and better mental health, so targeted interventions to promote social support in schools and families are needed to address loneliness. Future research should explore longitudinal relationships and further elucidate the mechanisms underlying these associations.

PMID:40571925 | DOI:10.1186/s12889-025-23247-5

Neurol Res Pract. 2025 Jun 26;7(1):45. doi: 10.1186/s42466-025-00399-8.

ABSTRACT

BACKGROUND: In the Find-AF 2 randomised controlled trial, we investigate whether a risk-adapted intensified heart rhythm monitoring with subsequent initiation of oral anticoagulation in ischaemic stroke patients leads to a reduction of recurrent ischaemic stroke and systemic embolism. The objective of this analysis is to present baseline characteristics of the overall Find-AF 2 study population and stratified by low or high risk for developing AF.

METHODS: The Find-AF 2 trial included acute ischaemic stroke patients ≥ 60 years of age within 30 days of ischaemic stroke of any cause. Before randomisation, patients received a 24-h Holter-ECG to exclude those with easily detectable AF and to determine the presence or absence of enhanced supraventricular ectopic activity (ESVEA), used as a marker indicating high or low risk for developing AF. Those without AF were randomly assigned 1:1 to either usual care diagnostics for AF detection (control group) or enhanced, prolonged and intensified ECG monitoring (intervention group). In the intervention group, patients with ESVEA received an implantable cardiac monitor (ICM), whereas those without ESVEA received repeated annual 7-day Holter ECGs. We present baseline characteristics of the overall Find-AF 2 population and stratified by ESVEA.

RESULTS: Between July 2020 and July 2024, 5227 patients (mean age 72.3 ± 7.5 years, 40% female, 2618 intervention group, 2609 control group) were randomised from 52 study centres in Germany within a median of 5 (IQR 3-7) days after the index stroke. The most frequent stroke aetiologies were cryptogenic (60%) and small vessel occlusion (19%). 1152 (22%) patients were at high risk for developing AF and 4075 (78%) at low risk. Patients within the high-risk stratum were significantly older (mean age 75.2 versus 71.5 years, p < 0.001), more often had moderate to severe stroke (34% versus 30%, p < 0.001), non-lacunar (70% versus 64%, p < 0.001) and of cryptogenic aetiology (64% vs 58%, p < 0.001).

CONCLUSIONS: The Find-AF 2 trial has successfully completed recruitment of a large acute ischaemic stroke population with different stroke subtypes. The follow-up is ongoing and results are expected within two years.

TRIAL REGISTRATION: ClinicalTrials.gov, Identifier NCT04371055, registered 24 April 2020.

PMID:40571918 | DOI:10.1186/s42466-025-00399-8

BMC Public Health. 2025 Jun 26;25(1):2175. doi: 10.1186/s12889-025-23539-w.

ABSTRACT

BACKGROUND: Although mental well-being is facing growing challenges against the background of global crises such as climate change, pandemics, and social inequality, little is known about longitudinal patterns of mental well-being in the general population.

METHODS: The study is based on self-report data from 1,605 adults aged 18 to 64 years who were proactively recruited at a municipal registration office (M = 31.0 years, SD = 10.8 years). Mental well-being was assessed at baseline, and 3, 6, 12, 36 and 48 months later using the five-item Mental Health Inventory (MHI-5). Covariates were smoking, alcohol consumption, fruit and vegetable intake, moderate-to-vigorous physical activity, age, sex, school education and relationship status. Growth Mixture Modeling was used to identify latent trajectory classes of mental well-being. Multinomial logistic regression was used to test whether class membership is predicted by health behaviors and sociodemographic variables.

RESULTS: Three latent trajectory classes were found. The first class (“stable high”, n = 1,251, 78%) showed the highest mental well-being throughout the study with only minor fluctuations over time. The second class (n = 192, 12%) showed a “steadily increasing” trajectory starting with the lowest MHI-5 sum score of the three classes at baseline that increased over time. The third class (“fluctuating”, n = 162, 10%) reported a slight increase in mental well-being during the first six months, followed by a steep decline to 36 months, which then increased to almost baseline-level at 48 months. The odds of being classified into the “steadily increasing” or “fluctuating” compared to the “stable high” class were higher for men and younger participants. The odds of belonging to the “steadily increasing” compared to the “stable high” class were higher for participants with more than 12 years of school education and those being in a relationship. Health behaviors did not predict latent trajectory class membership.

CONCLUSION: Three different temporal patterns of mental well-being were found in a German general population sample, with the majority showing a stable level of high mental well-being over four years. Further research is needed to understand fluctuating patterns and the causal factors influencing mental well-being.

PMID:40571917 | DOI:10.1186/s12889-025-23539-w