Category: Statistics

Cureus. 2025 May 20;17(5):e84515. doi: 10.7759/cureus.84515. eCollection 2025 May.

ABSTRACT

Background Assessing accurate fetal gestational age is vital in ascertaining the accurate growth of the fetus. Even if there are multiple ways to evaluate the fetal gestational age using ultrasonography, foot length measurement of the fetus can be utilized as an alternate tool to ascertain the age of gestation accurately. The length of the fetal femur and foot was estimated and recorded, and their ratio was calculated in this study. This parameter helps in distinguishing dysplastic short limbs from those shortened due to constitutional factors or due to intrauterine fetal growth retardation. Ultrasonography was used in this study to assess the association between gestational age and fetal foot length. The aim of the study is to derive normogram correlating gestational age (in weeks) with fetal foot length and to derive the femur-to-foot length ratio in women with 17-25 weeks of gestation. Materials and methods In our study, 150 healthy women with singleton pregnancy and 17-25 weeks of gestation underwent routine ultrasound examination in the Department of Radio Diagnosis, Meenakshi Medical College Hospital and Research Institute. In addition to the routine parameters, foot length and femur-to-foot length ratio were estimated. Results A strong correlation (positive) was observed in this study with Pearson’s correlation coefficient of 0.996 seen between gestational age and foot length, and 0.930 between foot length and femur length, both with a statistically significant p value < 0.0001. The femur-to-foot length ratio ranged from 0.9 to 1 in all cases. Conclusion The study revealed a robust correlation, which was linear, between gestational age and foot length, thereby supporting the use of fetal foot length as an added biometric measure to estimate gestational age. Additionally, the study highlights that the femur-to-foot length ratio approximates 1, with a ratio below 0.92 serving as a reliable indicator for detecting most cases of dysplasia.

PMID:40546615 | PMC:PMC12179565 | DOI:10.7759/cureus.84515

Cureus. 2025 May 22;17(5):e84610. doi: 10.7759/cureus.84610. eCollection 2025 May.

ABSTRACT

BACKGROUND: Obesity is a well-established risk factor for various cancers, contributing to significant public health burdens. Disparities in obesity-associated cancer incidence exist across racial, age, and geographic groups, necessitating targeted prevention and intervention strategies.

OBJECTIVE: The aim of this study is to analyze the incidence rates of obesity-associated cancers across different racial, age, and geographic groups in the United States from 2017 to 2021, identifying key disparities to inform public health interventions.

METHODS: A retrospective analysis of cancer incidence data from national registries was conducted. Age-adjusted incidence rates (per 100,000 population) were calculated across racial/ethnic groups, age cohorts, and US states. Descriptive statistics and confidence intervals were used to assess disparities.

RESULTS: Black, non-Hispanic individuals had the highest obesity-associated cancer incidence (184.8 per 100,000), followed by American Indian/Alaska Native populations (179.3 per 100,000). Incidence rates increased with age, peaking at 75-79 years (788.7 per 100,000 overall). Geographically, Midwestern and Southern states exhibited higher incidence rates, with West Virginia reporting the highest (188.3 per 100,000) and Nevada the lowest (149.5 per 100,000). These findings highlight significant racial, age, and regional disparities.

CONCLUSION: The study underscores the need for targeted public health strategies, including enhanced screening, culturally tailored interventions, and policy-driven approaches to address obesity and its related cancer risks. Future research should explore individual-level risk factors and effective interventions to promote equitable healthcare access and improved cancer outcomes.

PMID:40546611 | PMC:PMC12181978 | DOI:10.7759/cureus.84610

Cureus. 2025 May 21;17(5):e84580. doi: 10.7759/cureus.84580. eCollection 2025 May.

ABSTRACT

Psychiatric nosology, traditionally represented by the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM), is based on categorical diagnoses that have not met the current needs of clinicians. The so-called transdiagnostic approach appears to offer promise for classifying mental disorders. In the present study, our objective was to conduct a descriptive analysis of this approach in psychiatry based on the current literature. This study is a narrative review that utilized a bibliographic search for original and review articles on the transdiagnostic approach in psychiatry. The following keywords were used: “transdiagnostic”, “psychiatry”, “diagnosis”, “approach”, and “classification.” Searches were conducted in PubMed, ScienceDirect, Scielo, the Cochrane Library, PsycINFO, Lilacs, and Hinari. Articles in English and Spanish with publication dates between 2003 and 2024 were included. A total of 261 records were identified for screening, and 104 were retrieved for full review. The DSM and ICD are systems that define aspects of our conceptualization of mental health. More recently, however, transdiagnostic perspectives have gained prominence, particularly through frameworks such as the RDoC (Research Domain Criteria) and HiTOP (Hierarchical Taxonomy of Psychopathology). The RDoC stands out for guiding research on the neurobiological bases of psychopathology. HiTOP is based on data and a hierarchy that conceptualizes psychopathology as a set of transdiagnostic dimensions and spectra. Both approaches, with their strengths and weaknesses, could be an interface and the basis for a new nosology in psychiatry. There is consensus on the need for a new operational framework for classification. The transdiagnostic approach could be the contemporary answer to this premise. The challenge is to develop further research and standardize the definition of the construct.

PMID:40546608 | PMC:PMC12181037 | DOI:10.7759/cureus.84580

Cureus. 2025 May 20;17(5):e84487. doi: 10.7759/cureus.84487. eCollection 2025 May.

ABSTRACT

Introduction Hepatocellular carcinoma (HCC) remains a significant global health concern, ranking as the third leading cause of cancer-related mortality worldwide. The risk factors for HCC include chronic hepatitis B and C, alcohol-associated liver disease, and non-alcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate trends in HCC incidence in the United States from 2000 to 2020 using the Surveillance, Epidemiology, and End Results (SEER) database, with stratification by age, sex, and race/ethnicity to identify demographic differences in temporal patterns. Methods Incidence rates of HCC per 100,000 population (age-adjusted) from 2000 to 2020 were calculated utilizing a population-based cancer registry, SEER*Stat (version 8.4.3). HCC cases were identified by the International Classification of Diseases for Oncology, third edition (ICD-O-3) site code C22.0 and histology codes 8170-8175, including only histologically confirmed malignancies. We utilized the Joinpoint Regression Program version 5.0.1 to report time-trends expressed as annual percentage change (APC). Cases with missing age, sex, or race data were excluded from stratified analyses. Statistical significance was set at a p-value less than 0.05. Results There were a total of 242,769 cases of HCC recorded from 2000 to 2020. Since 2015, HCC incidence has declined across all age groups, with the most significant reductions observed in individuals aged 45-54 years (APC, -8.22; p < 0.05) and 55-64 years (APC, -7.03%; p < 0.05). Among racial and ethnic groups, Black individuals experienced the most pronounced decline between 2018 and 2020 (APC, -10.64%; p < 0.05), followed by Hispanics (APC, -8.25%; p < 0.05) and Asians (APC, -8.06%; p < 0.05). With regards to sex, there was a greater decline among males (APC, -7.28%; p < 0.05) from 2018 to 2020 compared to females (APC, -2.4%; p < 0.05) from 2014 to 2020. Conclusions These findings reflect encouraging trends likely due to improved prevention and treatment of chronic liver diseases and are consistent with declining HCC incidence observed in other high-income countries. However, reliance on histologically confirmed diagnoses may underestimate the true incidence. Persistent disparities, potentially driven by differences in access to care and socioeconomic status, indicate a need for targeted interventions addressing underlying risk factors of HCC, such as obesity, alcohol, and viral hepatitis. With continued efforts focused on prevention, early detection, and treatment, the burden of HCC will continue to decline.

PMID:40546598 | PMC:PMC12178839 | DOI:10.7759/cureus.84487

Cureus. 2025 May 22;17(5):e84623. doi: 10.7759/cureus.84623. eCollection 2025 May.

ABSTRACT

Objectives The misuse of antibiotics fuels antimicrobial resistance (AMR), rendering treatments ineffective, increasing healthcare costs, and increasing mortality. This study estimated the prevalence, patterns, and drivers of self-medication with antibiotics (SMA) among adults, alongside exploring the reasons behind this practice. Methodology This community-based mixed-method study ran from January 2023 to June 2024. Simple random sampling selected 250 participants for the quantitative component, and purposive sampling chose 19 participants for the qualitative component. Descriptive statistics, cross-tabulation, and logistic regression were executed using SPSS (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp). Thematic analysis of focus group discussions (FGDs) was done using NVivo 14 (Lumivero 2023, NVivo Version 14, Denver). Results The prevalence of SMA was 36.4%(95% confidence interval (CI): 31.4-41.4), with 63 (69.2%) participants self-medicating at least once in the past three months, primarily for cold and flu-like symptoms (29, 31.86%) and fever (27, 29.69%). Key predictors of SMA were marital status, religion, education level, socioeconomic class, presence of chronic disease, knowledge, and attitude. Four (4.4%) participants experienced adverse drug reactions, 167 (66.8%) had inadequate knowledge about antibiotics, with only 13 (5.2%) aware of AMR, 142 (56.8%) had a favorable attitude towards SMA, and 171 (68.4%) followed appropriate practices. FGDs identified convenience, trust in local chemists, economic constraints, misinformation, long waiting times, limited healthcare access, and community acceptance as SMA drivers. Conclusion The study found that the prevalence of SMA in South-East Delhi surpasses rates in other regions of the country and signals a critical public health concern. To address SMA and mitigate AMR, authorities should enforce stricter regulations on over-the-counter antibiotic sales and implement targeted community education programs to enhance awareness of rational antibiotic use and AMR risks. These interventions, by improving regulatory oversight and knowledge, can effectively reduce SMA and safeguard antibiotic efficacy.

PMID:40546587 | PMC:PMC12182256 | DOI:10.7759/cureus.84623

Cureus. 2025 May 23;17(5):e84657. doi: 10.7759/cureus.84657. eCollection 2025 May.

ABSTRACT

BACKGROUND: Hodgkin lymphoma (HL) is a type of cancer that affects lymphatic tissues and is marked by the presence of Reed-Sternberg cells, which are large, abnormal lymphocytes. Involvement of the head and neck region is a prominent feature in HL, often serving as the initial clinical presentation of the disease.

OBJECTIVE: The main objective of the study is to find the incidence, mortality rate, and risk factors for HL in the Pakistani population.

METHODS: A retrospective study was conducted with 50 patients diagnosed with HL across three cancer treatment centers in Pakistan. Data were collected from medical records and structured patient interviews, examining demographic factors, clinical stage, treatment types, and risk factors, including Epstein-Barr virus (EBV) infection. Statistical analyses assessed correlations between risk factors, disease stage, and mortality.

RESULTS: The highest incidence was observed in young adults (18-30 years), with males representing 65% of cases. Mortality was significantly higher among patients diagnosed at advanced stages (stage III and IV), particularly in rural areas with limited access to treatment. EBV infection and low socioeconomic status were associated with late-stage diagnosis and poorer survival rates. Patients receiving combined chemotherapy and radiotherapy showed better one-year survival outcomes.

CONCLUSION: HL in Pakistan is characterized by late-stage diagnosis, high mortality, and socioeconomic disparities affecting access to care. Addressing these challenges through improved awareness, early screening, and accessible treatment could reduce mortality and improve outcomes.

PMID:40546577 | PMC:PMC12182637 | DOI:10.7759/cureus.84657

Cureus. 2025 May 21;17(5):e84591. doi: 10.7759/cureus.84591. eCollection 2025 May.

ABSTRACT

BACKGROUND: This study aimed to determine how well debridement, antibiotics, and implant retention (DAIR) work for treating infections after total hip and knee replacements. Specifically, it compared the success of this treatment in resolving infection, improving function, and preventing complications when the infection occurred early (within three months) versus late (three months to 12 months) after the joint replacement surgery.

OBJECTIVE: The objective of the study is to evaluate DAIR’s efficacy in resolving periprosthetic joint infections (PJIs) post-THAs (total hip arthroplasties) and TKAs (total knee arthroplasties), focusing on infection resolution, functional recovery, and complications.

METHODS: This retrospective cohort study reviewed 37 patients (25 TKA, 12 THA) treated with DAIR for PJIs at the UK tertiary centre (2019-2023). PJIs were diagnosed using the 2018 International Consensus Meeting (ICM) criteria.Outcomes (infection status, range of motion (ROM), pain, complications) were assessed via electronic health records, with a mean follow-up of 12.8 months for TKA and 10.4 months for THA. The statistical analysis tool used was IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States).

RESULTS: DAIR successfully treated infection in 73.9% of infected total knee replacements and 58.3% of infected total hip replacements (p=0.576). Early infections (within three months) responded better to DAIR (88% for TKA, 91.7% for THA) compared to late infections (0% success, p<0.01). Complications arose in nine TKA and eight THA patients (p=0.157), including three deaths, which were more frequent in late infections (p=0.04). Following DAIR, there were significant reductions in average C-reactive protein levels for both TKA (from 134.5 to 16.9 mg/L, p<0.01) and THA (from 147.1 to 41.6 mg/L, p = 0.03).

CONCLUSION: DAIR achieved infection resolution in 73.9% of TKA and 58.3% of THA cases, particularly when performed within three months of infection onset, while late infections (>three months) had 0% success, emphasising the need for timely intervention and patient selection.

PMID:40546573 | PMC:PMC12181649 | DOI:10.7759/cureus.84591

Cureus. 2025 May 21;17(5):e84560. doi: 10.7759/cureus.84560. eCollection 2025 May.

ABSTRACT

BACKGROUND AND OBJECTIVES: The relationship between the maxillary posterior teeth and the level of the maxillary sinus varies across different populations and can significantly impact the success of endodontic, prosthodontic, orthodontic, and surgical treatments. This study aimed to evaluate the alveolar bone anatomy of maxillary posterior teeth and the vertical relationship to the maxillary sinus in Mongolian adults using cone-beam computed tomography (CBCT) images.

MATERIALS AND METHODS: The study was designed as a retrospective study. We selected 30 CBCT images and examined a total of 202 maxillary posterior teeth using these CBCT images. We measured the alveolar bone thickness at six different distances (L1-L6) by millimeter scale, and the vertical relationship between the maxillary sinus and the maxillary molars was classified into five categories according to Kwak’s classification. Statistical analyses were done using IBM SPSS Statistics for Windows, Version 27 (Released 2020; IBM Corp., Armonk, New York).

RESULTS: The average distances measured were 1.66±1.10 mm at L1, 2.13±1.00 mm at L2, 3.03±2.21 mm at L3, 6.04±3.50 mm at L4, 2.41±3.54 mm at L5, and 0.74±2.09 mm at L6, with statistical significance (p<0.001). According to Kwak’s classification, the most commonly observed types are Type I (82.1%) at the maxillary first premolars, Type III (63.3%) at the maxillary second premolars, Type II (43.3%) at the maxillary first molars, and Type I (43.3%) at the maxillary second molars (p<0.001).

CONCLUSION: The horizontal distances between the buccal and palatal roots to the alveolar plate were shorter in molars than in premolars due to root numbers, indicating a narrower bone structure that may limit implant stability. Additionally, the vertical distance between the root apex and the maxillary sinus was shortest in second molars, increasing the risk of sinus perforation during implant placement.

PMID:40546554 | PMC:PMC12182215 | DOI:10.7759/cureus.84560

Cureus. 2025 May 22;17(5):e84640. doi: 10.7759/cureus.84640. eCollection 2025 May.

ABSTRACT

Malignant pleural mesothelioma (MPM) is an aggressive malignancy with limited evaluates the efficacy and safety of these treatments. A systematic review and meta-analysis were conducted, including 14 studies that compared multimodal therapies for early-stage MPM. Continuous variables were analyzed using random-effects modeling, with heterogeneity assessed using I² statistics. The primary outcomes included physical function, social function, and lethargy. The meta-analysis found no statistically significant differences between experimental and control groups in terms of physical function (standardized mean difference [SMD]: -0.34, 95% confidence interval [CI]: -1.14 to 0.45), social function (SMD: 0.01, 95% CI: -0.52 to 0.53), or lethargy (SMD: -0.34, 95% CI: -0.96 to 0.27). Heterogeneity across studies was moderate to high (I²: 47%-76%). These findings suggest limited improvements in quality-of-life domains with experimental approaches compared to controls. This systematic review and meta-analysis highlights the need for individualized, multimodal treatment strategies in MPM management. While extrapleural pneumonectomy and extended pleurectomy/decortication offer specific benefits, their impact on quality of life varies and may not consistently provide significant improvements. Future research should focus on large-scale, randomized trials with standardized protocols to optimize treatment outcomes.

PMID:40546549 | PMC:PMC12182882 | DOI:10.7759/cureus.84640

Cureus. 2025 May 22;17(5):e84649. doi: 10.7759/cureus.84649. eCollection 2025 May.

ABSTRACT

Background Despite the rising burden of end-stage renal disease (ESRD), cognitive assessment is not routinely incorporated into dialysis care, particularly in low-resource settings. This study aimed to assess the prevalence, severity, and predictors of cognitive impairment among patients on maintenance hemodialysis. Methods A descriptive cross-sectional study was conducted at a tertiary dialysis center from December 2023 to May 2024. Patients aged ≥18 years undergoing hemodialysis for six months or more were enrolled. Exclusion criteria included neurological disorders, severe psychiatric illness, or medications affecting cognition. Cognitive function was evaluated using the Urdu-validated Montreal Cognitive Assessment (MoCA), with scores <26 indicating impairment. Domain-wise deficits were classified using 1.5 standard deviation below the normative mean. Statistical analysis included chi-square tests, t-tests, and multivariable logistic regression. Results Out of 198 hemodialysis patients, 116 (58.6%) exhibited cognitive impairment. Severity was categorized as mild in 79 (39.9%), moderate in 31 (15.7%), and severe in eight (4.0%) patients. Multidomain impairment was present in 108 (54.5%), while 18 (9.1%) had single-domain and 72 (36.4%) had no impairment. Older age (p<0.001), lower education (p<0.001), low socioeconomic status (SES) (p=0.045), and longer dialysis duration (p<0.001) were significantly associated with cognitive impairment. Biochemical predictors included lower hemoglobin and albumin (p=0.018 and p=0.034), and higher phosphate and intact parathyroid hormone (iPTH) (p=0.001 and p=0.042). On regression analysis, age (adjusted odds ratio (AOR)=1.088, 95% confidence interval (CI)=1.031-1.149), education ≤12 years (AOR=10.423, 95% CI=1.199-90.633), low SES (AOR=9.075, 95% CI=1.473-55.916), dialysis duration (AOR=1.047, 95% CI=1.010-1.085), and biochemical markers remained significant. Conclusion Cognitive impairment, particularly multidomain, is highly prevalent among hemodialysis patients and frequently unrecognized. Integration of cognitive screening into routine nephrology care is essential to enable early intervention and improve long-term patient outcomes.

PMID:40546548 | PMC:PMC12182912 | DOI:10.7759/cureus.84649