Category: Statistics

J Autism Dev Disord. 2025 Jun 24. doi: 10.1007/s10803-025-06901-0. Online ahead of print.

ABSTRACT

Atypical sensory processing has been recognized as a notable characteristic in individuals with autism spectrum disorder (ASD). While visual global-local processing in ASD has been widely studied, understanding of auditory processing across global and local levels remains less defined. To clarify the mixed findings in the literature, we conducted a systematic review with meta-analysis and searched for potential factors that might explain the heterogeneity of previous studies. Our thorough search across four electronic databases up to 2025 identified 25 eligible studies for quantitative synthesis, focusing on comparisons of auditory global-local pitch processing between individuals with ASD and typically developing peers. Our findings indicated that the pooled effect size (Hedges’ g = -0.05) for global pitch processing was not statistically significant, whereas there was a significant, albeit modest, pooled effect size (Hedges’ g = 0.29) for local pitch processing. Significant moderators influencing global pitch processing included the number of answer choices, language typology, and participants’ vocabulary size, while inconsistencies in local pitch processing outcomes were associated with the vocabulary size of autistic participants and variations in task paradigms employed. Overall, this meta-analysis supports the notion that individuals with ASD tend to prefer local pitch processing without apparent deficits in global processing abilities, aligning with the Enhanced Perceptual Functioning model. These findings contribute to our understanding of auditory processing differences in ASD, and offer implications for targeted interventions and further research directions.

PMID:40553249 | DOI:10.1007/s10803-025-06901-0

JAR Life. 2025 Jun 9;14:100016. doi: 10.1016/j.jarlif.2025.100016. eCollection 2025.

ABSTRACT

AIMS: To identify subgroups who may be more likely to respond well to a multidomain intervention among older adults with type 2 diabetes.

MATERIALS AND METHODS: This study was a secondary analysis of the Japan Multimodal Intervention Trial for Prevention of Dementia. A total 531 participants aged 65-85 years with mild cognitive impairment were randomized into intervention (vascular risk management, exercise, nutritional counseling, and cognitive training) and control (health-related information) groups. The outcome was the change in average Z scores of neuropsychological tests from baseline to 18 months. Interactions between intervention and age (65-74, 75-85 years), memory impairment (amnestic, nonamnestic), HbA1c levels (within, outside target range), or APOE genotype (0, ≥1 APOE ε4 alleles) among participants with diabetes were evaluated using the mixed-effects model for repeated measures.

RESULTS: Among 76 participants with diabetes, a significant age × intervention interaction (P = 0.007) was found, which was driven by benefits in the younger age group (Z score difference: 0.33, 95% CI: 0.09 to 0.55) that were not observed in the older age group. Intervention benefits were also detected in those with HbA1c levels outside the target range (Z score difference: 0.31, 95% CI: 0.06 to 0.56), with HbA1c levels × intervention interaction (P = 0.021). No significant interactions were detected between intervention and memory impairment or APOE genotype.

CONCLUSIONS: Multidomain interventions may benefit younger older adults or those with overly strict or lenient HbA1c control; however, these findings need confirmation in future studies.

PMID:40546712 | PMC:PMC12181009 | DOI:10.1016/j.jarlif.2025.100016

Autism Dev Lang Impair. 2025 Jun 17;10:23969415251350586. doi: 10.1177/23969415251350586. eCollection 2025 Jan-Dec.

ABSTRACT

BACKGROUND: Children with autism spectrum disorder (ASD) and children with development language disorder (DLD) often experience syntactic impairments. It is of the utmost importance to implement evidence-based intervention at the earliest possible stage to mitigate the adverse effects of these difficulties. Internationally, several programs are supported by scientific evidence. In Portugal, there are currently only two intervention programs, one of which is PROsyntax. However, its effectiveness has not yet been established.

AIM: This study aims to determine the effects of PROsyntax on expressive and receptive syntax in preschool-age children with syntactic impairments diagnosed with DLD or ASD.

METHODS AND PROCEDURES: This study is a nonrandomized controlled trial with a nonprobabilistic convenience sample. Thirty-one children aged between 3 and 6 years were recruited and allocated into an experimental group (EG, intervention group) (n = 14) and a control group (CG, without intervention) (n = 17). A blind pre- (T1) and postintervention (T2) assessment was conducted using two standardized instruments (SIN:TACS for expression and Subtest 3 of Avaliação da Linguagem Oral (ALO) for comprehension). Children in the EG received intervention with PROsyntax, comprising 24 sessions, biweekly, lasting 1 hr each. The intervention was conducted within the school setting by a speech and language therapist.

OUTCOMES AND RESULTS: Statistically significant improvements were observed in the EG compared to the CG in both expressive (F_{Time × Group}(1,27) = 293.22; p < .001; η_p ² = 0.92) and receptive (F_{Time × Group}(1,27) = 147.18; p < .001; η_p ² = 0.85) syntax. Large effect sizes were found (SIN:TACS: d = 4.07 (DLD) and d = 11.67 (ASD); ALO: d = 3.29 (DLD) and d = 4.31 (ASD)). Strong correlations between measures were observed at both time points. Postintervention, the CG also received the intervention and showed comparable gains. High satisfaction ratings were reported by both families and early childhood educators.

CONCLUSIONS AND IMPLICATIONS: The findings provide preliminary evidence supporting the effects of PROsyntax in improving expressive and receptive syntactic skills in preschool-age children with ASD or DLD. These findings have important implications for clinical practice, suggesting that explicit interventions can yield significant gains in preschool-age children with syntactic impairment. However, the nonrandomized design, small sample size, and absence of long-term follow-up limit the generalizability of results. Further research is needed to confirm these effects and explore differential responses across diagnostic groups.

PMID:40546705 | PMC:PMC12181704 | DOI:10.1177/23969415251350586

World J Exp Med. 2025 Jun 20;15(2):100548. doi: 10.5493/wjem.v15.i2.100548. eCollection 2025 Jun 20.

ABSTRACT

BACKGROUND: Duchenne muscular dystrophy (DMD) is a neuromuscular disorder caused by mutations in the dystrophin gene. DMD is reported to coexist with other comorbidities, although the occurrence of the triad, autism spectrum disorder (ASD), and epilepsy is very rare. Indeed, only one case of the triad has currently been reported. Here, we present a detailed case report of a ten-year-old boy with DMD, ASD, and epilepsy. We also investigated the dysregulation of miRNAs in this unusual triad (represented as DMD++) compared with a healthy individual and a DMD patient (represented as DMD+) without autism.

AIM: To understand the differential expression of miRNAs in rare comorbid DMD cases.

METHODS: The Sequin Form Board test, Gesell’s drawing test, multiplex ligation probe amplification, and Vineland Social Maturity Scale were applied to confirm the DMD and ASD. Total RNA was isolated from samples using TRIzol. cDNA was synthesized using the Mir-X™ miRNA First-Strand Synthesis kit. qRT-PCR was performed using SYBR Advantage qPCR Premix. The results were statistically analyzed using one-way analysis of variance with Tukey’s t-test.

RESULTS: miR-146a-5p and miR-132-5p showed significant downregulation in both patient samples. miR-199a-5p and miR-146a-3p showed no change in expression between the diseased and controls. miR-132-3p showed downregulation only in the DMD+ sample (0.21 ± 0.04). The decrease in miR-132-3p can result in failed silencing of the phosphatase and tensin homolog-mediated apoptotic pathway, leading to severe skeletal muscle atrophy. Here, the downregulation of miR-132-3p in DMD+ is consistent with severe muscle loss and higher disease progression than that in DMD++. DMD++ has slower disease progression, and the expression of miRNA involved in inflammatory and apoptotic responses is more similar to that of the control.

CONCLUSION: Our study shows marked difference in miRNA expression in this rare case of DMD with autism and epilepsy. These miRNAs also serve as regulators of several muscle regeneration, apoptosis, and inflammatory pathways. This study shows the significance of studying miRNAs in such rare cases in a larger cohort to progress in several intervention treatments utilizing miRNAs.

PMID:40546680 | PMC:PMC12019623 | DOI:10.5493/wjem.v15.i2.100548

World J Exp Med. 2025 Jun 20;15(2):102761. doi: 10.5493/wjem.v15.i2.102761. eCollection 2025 Jun 20.

ABSTRACT

BACKGROUND: Breast cancer (BC) continues to occupy a leading position in terms of morbidity and mortality from malignant neoplasms among the female population. One of the promising markers associated with BC progression is programmed death ligand 1 (PD-L1). Previously, we investigated PD-L1 expression in BC via a new antibody against programmed cell death protein 1 ligand 1 (PDCD1 LG1) and reported that high PDCD1 LG1 expression in tumor cells is an independent factor for a high risk of regional metastasis in patients with BC. However, the prognostic significance of PDCD1 LG1 expression in BC stromal cells has not been adequately studied.

AIM: To study the features of PDCD1 LG1 expression in BC stromal cells and its relationship with BC clinicopathological characteristics.

METHODS: In a prospective single-center observational study, tumor samples from 148 patients with newly diagnosed BC were examined. The tumor sections were immunohistochemically stained with antibodies against PDCD1 LG1. In the tumor samples, the PDCD1 LG1-positive lymphocyte (PDCD1 LG1+ LF) score, presence of nuclear PDCD1 LG1 expression in the LFs, PDCD1 LG1 expression in polymorphic cell infiltrates (PDCD1 LG1+ polymorphic cell infiltrates [PCIs]), and cells of the fibroblastic stroma and endothelial cells of the tumor microvessels were assessed. Statistical analyses were performed using Statistica 10.0 software.

RESULTS: A PDCD1 LG1+ LF score ≥ 3 was detected more often at stages N0 and N3 than at N1 and N2 (P = 0.03). Moderate and pronounced PDCD1 LG1+ PCIs and the presence of PDCD1 LG1+ fibroblastic stroma were associated with negative estrogen receptor status (P = 0.0008 and P = 0.03, respectively), human epidermal growth factor receptor 2-positive (HER2+) BC (P < 0.00001 and P = 0.0005), and luminal B HER2+, non-luminal HER2+ and triple-negative BC (P < 0.00001 and P = 0.004). The risk of metastasis to regional lymph nodes (RLNs) depend on lymphovascular invasion (LVI) and the PDCD1 LG1+ LF score. In the absence of LVI and a PDCD1 LG1+ LF score < 3 or ≥ 3, metastases in RLNs were absent in 66.6% and 93.9% of patients with BC, respectively. In the presence of LVI and a PDCD1 LG1+ LF score < 3 or ≥ 3, metastases in RLNs were detected in 82.6% and 92.7% of patients with BC, respectively.

CONCLUSION: The results indicated that the combined assessment of the PDCD1 LG1+ LF score and LVI can improve the accuracy of predicting the risk of metastasis to RLNs in patients with BC.

PMID:40546678 | PMC:PMC12019619 | DOI:10.5493/wjem.v15.i2.102761

World J Exp Med. 2025 Jun 20;15(2):101388. doi: 10.5493/wjem.v15.i2.101388. eCollection 2025 Jun 20.

ABSTRACT

BACKGROUND: Fever of unknown origin (FUO) remains a diagnostic challenge and was originally defined in 1961. Its classic criteria include fever ≥ 38.3 °C (≥ 101 °F) on multiple occasions, fever lasting three weeks or longer, and a diagnosis after one week of inpatient evaluation. However, these criteria may not fully encompass the varied clinical presentations seen in resource-limited settings such as India. The adaptation of FUO definitions to local healthcare contexts is crucial for enhancing diagnostic accuracy and optimizing patient outcomes.

AIM: To investigate the applicability of revised FUO criteria in a tertiary care setting in India.

METHODS: This longitudinal-exploratory study at All India Institute of Medical Sciences Rishikesh (January 2018-December 2022) analyzed 228 adult patients with fever ≥ 99.1 °F lasting over three days. Patients diagnosed within three days of admission were excluded. Data were collected retrospectively and prospectively using predefined FUO definitions based on durations of nondiagnosis (3-21 days, > 21 days), temperature ranges (99.1 °F-100.9 °F, ≥ 101 °F), and hospitalization durations (3-7 days, > 7 days). Descriptive statistics and comparative tests (Fisher’s exact test, χ ² test) evaluated outcomes across definitions.

RESULTS: Among the proposed FUO definitions, Definition B (fever lasting 3-21 days, temperatures between 99.1 °F-100.9 °F, hospitalization > 7 days) predominated (40.8%), while only 2.2% met the classical criteria. Notably, 36.5% of Definition B patients remained undiagnosed after 7-10 days, despite 94% undergoing diagnostic workups within 21 days. Infection emerged as the leading etiology across definitions, without significant variation in outcomes or mortality during hospitalization (χ ² = 27.937, P = 0.142).

CONCLUSION: Adapting FUO criteria to local contexts improves diagnostic accuracy and treatment. Definition B (40.8% prevalence) showed practical utility, with higher mortality in patients discharged on empirical ‘Anti-tuberculosis therapy’.

PMID:40546669 | PMC:PMC12019626 | DOI:10.5493/wjem.v15.i2.101388

Cureus. 2025 May 21;17(5):e84559. doi: 10.7759/cureus.84559. eCollection 2025 May.

ABSTRACT

BACKGROUND: To evaluate the efficiency of cotton (Apollo Sterilized Cotton Balls, Apollo Hospitals Enterprise Limited, Chennai, India), polytetrafluoroethylene (PTFE) tape (Holdtite Plus PTFE Tape, Pidilite Industries, Mumbai, India), and endo foam (Super Endo, Shenzhen Superline Technology Co., Ltd., Shenzhen, China) as an endodontic spacer material in combination with different intracanal medicaments.

MATERIALS AND METHODS: Ninety patients were randomized into three groups: Group I: cotton (n = 30), Group II: PTFE tape (n = 30), and Group III: endo foam (n = 30) after access opening and biomechanical preparation. Each group was further subdivided based on the intracanal medicament into subgroup A: sterile spacer (n = 10), subgroup B: spacer + calcium hydroxide (Ca(OH)₂) (Prime Dental Products Pvt. Ltd., Thane, India) (n = 10), and subgroup C: spacer + modified triple antibiotic paste (MTAP) (n = 10). Microbial load was assessed from samples collected from the access cavity at baseline (S₁) and again after seven days (S₂). Colony-forming units (CFUs) were determined after a 48-hour aerobic culture on brain-heart infusion (BHI) agar.

RESULTS: All three groups showed a statistically significant difference between the baseline and after seven-day mean values (p = 0.045, p = 0.049, p = 0.047). Intergroup comparison revealed a statistically significant difference in the mean values between the cotton and PTFE tape groups, as well as between the PTFE tape and endo foam groups. The mean difference values between the cotton and endo foam groups, however, did not differ in a way that was statistically significant.

CONCLUSION: Within the limitations of the study, it can be concluded that the PTFE tape and endo foam groups performed better than cotton.

PMID:40546637 | PMC:PMC12180776 | DOI:10.7759/cureus.84559

Cureus. 2025 May 21;17(5):e84530. doi: 10.7759/cureus.84530. eCollection 2025 May.

ABSTRACT

Background Exposure to nitrate through contaminated drinking water has been suggested as a potential risk factor for colorectal cancer (CRC). However, ecological evidence across the U.S. states remains limited. This study aims to examine the association between average nitrate concentrations and CRC incidence across 31 U.S. states. Methods An ecological analysis was conducted using data from the Centers for Disease Control and Prevention’s (CDC’s) Environmental Public Health Tracking Network and United States Cancer Statistics (2017-2021). Simple linear regression and Pearson correlation analyses were performed, stratified by gender. Results No significant associations were observed between nitrate concentrations and CRC incidence in both strata. Correlations were weak and non-significant. Conclusions In our study, state-level nitrate exposure was not significantly linked to CRC incidence. Further individual-level studies are recommended.

PMID:40546631 | PMC:PMC12179813 | DOI:10.7759/cureus.84530

Cureus. 2025 May 21;17(5):e84577. doi: 10.7759/cureus.84577. eCollection 2025 May.

ABSTRACT

BACKGROUND: The glomerular filtration rate (GFR) is considered the gold standard for assessing renal function. According to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, GFR estimation is often carried out using predictive equations that incorporate serum creatinine levels, along with demographic factors such as age, gender, race, and body size. However, these equations exhibit varying levels of accuracy across different populations, necessitating the evaluation of their performance and clinical relevance in diverse patient groups.

OBJECTIVES: This study aimed to evaluate the performance of three commonly used GFR estimation equations, the Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, along with their race-modified versions, by comparing them with measured 24-hour creatinine clearance (CrCl) in adult patients with chronic kidney disease (CKD).

METHODS: A cross-sectional descriptive study was conducted at Jos University Teaching Hospital (JUTH) between November 2019 and July 2020, involving 111 consecutively recruited CKD patients. Data collection included medical history, physical examination, laboratory investigations, calculation of CrCl, estimated glomerular filtration rate (eGFR) using different equations, and albumin-creatinine ratio (ACR). Statistical analysis was performed using SPSS version 20 (IBM Inc., Armonk, New York), with p-values <0.05 considered statistically significant.

RESULTS: The mean age of participants was 51.1±15.5 years. Diabetes mellitus was the most common cause of CKD, affecting 38% of the cohort. Among participants, 31% and 22% were classified as having stage 5 and stage 4 CKD, respectively. The median CrCl was 26 (9-56) mL/min. The median eGFR values across the equations were as follows: CG, 26 (11-60) mL/min/1.73m²; MDRD, 26 (11-60) mL/min/1.73m²; MDRD1, 22 (9-50) mL/min/1.73m²; CKD-EPI, 26 (10-62) mL/min/1.73m²; and CKD-EPI1, 22 (9-53) mL/min/1.73m². Strong positive correlations were observed between measured CrCl and the estimated GFR from each equation: CG (r=0.948, p=0.001), MDRD (r=0.940, p=0.001), MDRD1 (r=0.939, p=0.001), CKD-EPI (r=0.943, p=0.001), and CKD-EPI1 (r=0.942, p=0.001). Furthermore, significant correlations were found between the different GFR equations themselves, with the highest correlation observed between MDRD and CKD-EPI (r=0.999, p=0.001). The median ACR was 395.5 (45.3-2887.0) mg/g, and albuminuria was present in 82% of participants. All three GFR equations closely approximated the measured CrCl of 26 mL/min/1.73m². The equations performed optimally in patients with GFR values below 45 mL/min, with the CG equation exhibiting the least bias and the highest precision. Regression analysis revealed a significant association between albuminuria and all GFR equations and a notable association between age and CrCl, CG, and CKD-EPI estimates.

CONCLUSION: The CG, MDRD, and CKD-EPI equations demonstrated comparable accuracy to measured 24-hour CrCl in estimating GFR in Nigerian patients with CKD. These findings support the clinical use of these predictive equations for renal function assessment in CKD, though local validation in diverse populations is recommended for optimal clinical application.

PMID:40546627 | PMC:PMC12180909 | DOI:10.7759/cureus.84577

Cureus. 2025 May 23;17(5):e84659. doi: 10.7759/cureus.84659. eCollection 2025 May.

ABSTRACT

BACKGROUND: Chronic liver disease (CLD), traditionally considered a condition of older adults, has shown increasing mortality in younger US adults. Rising rates of alcohol-related liver disease and metabolic dysfunction-associated steatotic liver disease (MASLD) have shifted the demographic profile of CLD burden.

OBJECTIVE: This study aimed to identify significant trends and disparities in CLD mortality among US adults aged 25-44 years from 2000 to 2020, with analysis stratified by age subgroup, sex, and race/ethnicity.

MATERIALS AND METHODS: We conducted a retrospective analysis using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) Underlying Cause of Death database. Deaths attributed to CLD were identified using International Classification of Diseases 10th Revision (ICD-10) codes K70 (alcoholic liver disease), K73 (chronic hepatitis), and K74 (fibrosis and cirrhosis). Data were stratified by age (25-34 and 35-44), sex, and race. Crude death rates per 100,000 were calculated. One-way analysis of variance (ANOVA) was performed to evaluate racial disparities within subgroups.

RESULTS: CLD mortality increased in all subgroups from 2000 to 2020. The highest rates were observed among men aged 35-44, particularly American Indian or Alaska Native (AI/AN) men, who reached an average of 19.4 deaths per 100,000. Black men and Hispanic women also experienced significant increases. ANOVA confirmed statistically significant racial disparities (p<0.0001) within all sex and age groups.

CONCLUSION: CLD mortality is rising among young US adults, with disproportionately high rates in AI/AN and Black populations. These findings underscore the need for earlier screening, expanded public health interventions, and targeted support for underserved communities.

PMID:40546619 | PMC:PMC12182956 | DOI:10.7759/cureus.84659