Category: Statistics

BMC Gastroenterol. 2025 Jul 7;25(1):505. doi: 10.1186/s12876-025-04081-w.

ABSTRACT

OBJECTIVE: This meta-analysis aims to evaluate the efficacy and safety of ultrasound-guided percutaneous microwave ablation (MWA) for hepatocellular carcinoma (HCC) located at specific anatomical sites of the liver compared with non-specific sites.

METHODS: A systematic search was conducted across five databases, covering literature from database inception to September 30, 2024. Eligible studies included prospective and retrospective cohorts involving ultrasound-guided percutaneous MWA for HCC. Data extraction and analysis were performed using Stata 15.1. The primary outcomes were 1-year, 3-year, and 5-year overall survival (OS) rates, complete ablation rates, and incidence of major complications. Pooled results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs).

RESULTS: Nine studies involving 2,381 patients were included. Among them, 1,047 patients had HCC located at specific anatomical sites, and 1,334 at non-specific sites. The pooled ORs (95% CI) for OS at 1, 3, and 5 years were 0.89 (0.59-1.35), 0.83 (0.66-1.05), and 1.12 (0.91-1.38), respectively. The OR for complete ablation was 0.97 (0.61-1.53), and for major complications, 1.44 (0.59-3.51).

CONCLUSION: Ultrasound-guided percutaneous MWA demonstrates comparable efficacy and safety for treating HCC at specific anatomical sites of the liver relative to non-specific sites, with no statistically significant differences in survival outcomes, ablation success, or complication rates.

PMID:40624629 | DOI:10.1186/s12876-025-04081-w

BMC Ophthalmol. 2025 Jul 7;25(1):393. doi: 10.1186/s12886-025-04227-0.

ABSTRACT

BACKGROUND: To analyze the poor mental status of patients with primary closed-angle glaucoma(PACG), and to explore the correlation between mental status and ocular and systemic indices in patients with PACG.

METHODS: We collected patients’ axial length (AL), anterior chamber depth (ACD), nerve fiber layer thickness (RNFL), cup-to-disc ratio (C/D), antinuclear antibody (ANA), toxoplasmosis antibody (anti-Toxoplasma gondii IgM), and anxiety and depression scores (HAMA and HAMD scales). Statistical analysis was utilized to analyze the data for each of the patients in the PACG and cataract patient groups.

RESULTS: The results showed that there was a statistically significant difference between the glaucoma group and the cataract group in terms of anxiety and depression scores, AL, ACD, RNFL, C/D, ANA, and Anti-Toxo IgM (P < 0.05). Anxiety scores of glaucoma patients were positively correlated with AL and C/D (P < 0.05), negatively correlated with RNFL (P < 0.05), and correlation existed with ANA and Anti-Toxo IgM (Eta² > 0.16). Depression scores in glaucoma patients were positively correlated with C/D (P < 0.05), negatively correlated with AL and RNFL (P < 0.05), and correlated with ANA and Anti-Toxo IgM (Eta² > 0.16). In addition,RNFL and C/D can be considered significant predictors of anxiety status. AL and C/D can be considered significant predictors of depression status.

CONCLUSION: Patients with primary angle-closure glaucoma have higher anxiety and depression scores than the general population, and clinically we can predict the patient’s mental status by their ocular and systemic indicators so that appropriate treatment can be taken in time.

PMID:40624620 | DOI:10.1186/s12886-025-04227-0

BMC Cancer. 2025 Jul 8;25(1):1153. doi: 10.1186/s12885-025-14570-6.

ABSTRACT

BACKGROUND: Neoadjuvant chemotherapy (NAC) is gaining attention as a treatment for advanced colorectal cancer owing to its potential to improve surgical outcomes and prognosis. However, reliable biomarkers to predict the response to NAC are lacking. We aimed to investigate the predictive value of cell-free DNA (cfDNA) integrity index for NAC response, using machine learning to compensate for the small cohort size.

METHODS: This retrospective study included 31 locally advanced colorectal cancer patients who underwent NAC and surgery at the Nippon Medical School Hospital between 2016 and 2020. Blood samples were collected pre-post-NAC to assess cfDNA levels using quantitative polymerase chain reaction. The cfDNA integrity index was calculated based on the ratio of long to short fragments in the long-interspersed element-1 repeat sequence. Statistical analyses, including random forest modeling, were performed to evaluate the predictive value of the cfDNA integrity index for treatment response.

RESULTS: Of the 31 patients, 19 (61.3%) were classified as responders and 12 (38.7%) as non-responders. The post-NAC cfDNA integrity index was significantly different between the groups (P = 0.002, odds ratio = 16.0). Random forest analysis identified changes in the cfDNA integrity index as the most important predictor of NAC response (%IncMSE: 15.79; IncNodePurity: 2.21), while sex, age, tumor site, and pre-NAC cfDNA levels were not significant predictors.

CONCLUSIONS: Variability in the cfDNA integrity index shows promise as a biomarker for predicting NAC efficacy in colorectal cancer.

PMID:40624619 | DOI:10.1186/s12885-025-14570-6

Reprod Biomed Online. 2025 Apr 10;51(3):104995. doi: 10.1016/j.rbmo.2025.104995. Online ahead of print.

ABSTRACT

RESEARCH QUESTION: Is a history of pregnancy loss correlated with low age-adapted ovarian reserve in women aged 35 years or younger?

DESIGN: This was a retrospective cohort study.

RESULTS: A total of 931 women aged 35 years or less with anti-Müllerian-hormone (AMH) values measured at presentation to a fertility centre were included in the analysis. The pregnancy loss rate, modelled as pregnancy loss count per previous pregnancy, increased at both ends of the age-normalized AMH z-score, showing a statistically significant increase (odds ratio 0.49, 95% confidence interval 0.25-0.94; P = 0.032) at the lower end (z-score lower than -1.28, 10th percentile) of AMH values.

CONCLUSIONS: Women aged 35 years or less are assumed to have a low risk of aneuploidy as a cause of pregnancy loss. While the association between low ovarian reserve and pregnancy loss in this group is still debated, the findings presented describe a significant association between a history of pregnancy loss in women of 35 years or less and an age-adjusted low ovarian reserve. This calls for assessment of the ovarian reserve in women with pregnancy losses, as an early diagnosis of low ovarian reserve may have far-reaching implications for fertility counselling, especially in an era when women often postpone childbearing.

PMID:40623339 | DOI:10.1016/j.rbmo.2025.104995

Curr Pharm Teach Learn. 2025 Jul 6;17(10):102437. doi: 10.1016/j.cptl.2025.102437. Online ahead of print.

ABSTRACT

BACKGROUND: Traditional lectures may be less effective than active learning strategies in supporting student’s successful performance on assessments. Jigsaw method, an active learning strategy, fosters engaging classrooms, empowers students in collaborative learning, promotes peer teaching, and increases individual accountability. This study explores the impact of a modified jigsaw activity with educational YouTube reels on pharmacy students’ learning outcomes, students’ satisfaction, and willingness to recommend the strategy.

METHODS: A pilot modified jigsaw activity incorporating educational YouTube reel creation was implemented in a first-year pharmacy course. Pre- and post-surveys collected data using instruments designed to operationalize students’ academic self-confidence, exam expectations, understanding of class material, and knowledge. Instruments operationalizing satisfaction and likelihood of recommending the intervention were administered at the end of the study. Descriptive statistics summarized baseline student characteristics, satisfaction, and likelihood to recommend the strategy. Paired sample t-test and Wilcoxon signed-rank test compared pre- and post-survey scores for normally and non-normally distributed data, respectively.

RESULTS: All thirty-three students enrolled in the course completed the baseline survey. Nineteen students completed both pre- and post-surveys. Students were mostly white with an average age of 23 years. Improvements were seen in confidence level (p = 0.011), understanding (p < 0.001), and knowledge of course materials (p = 0.043). There were no changes in exam expectations (p = 0.712) About 58.3 % of the students were satisfied and 60 % were willing to recommend the strategy.

CONCLUSION: Findings from this exploratory pilot study suggest that using a modified jigsaw activity incorporating YouTube reel creation may improve learning outcomes, including confidence, perceived understanding, and knowledge. Future confirmatory research is warranted.

PMID:40623334 | DOI:10.1016/j.cptl.2025.102437

Alcohol Alcohol. 2025 May 14;60(4):agaf041. doi: 10.1093/alcalc/agaf041.

ABSTRACT

In this retrospective study of 251 300 patient encounters at Veterans Administration Emergency Departments associated with alcohol intoxication per blood testing or ICD 9/10 coding, we found that 79% of these patients had positive Alcohol Use Disorders Identification Test-Consumption screens within 6 months of their visit. Therefore, we propose that presentation to an emergency department with any detectable ethanol concentration should prompt intervention accordingly.

PMID:40623318 | DOI:10.1093/alcalc/agaf041

Ann Intern Med. 2025 Jul 8. doi: 10.7326/ANNALS-24-00713. Online ahead of print.

ABSTRACT

BACKGROUND: A 2020 consensus statement proposed body mass index (BMI)-specific waist circumference (WC) thresholds to improve patient care.

OBJECTIVE: To determine whether stratifying BMI categories by BMI-specific WC thresholds improves mortality risk prediction.

DESIGN: Prospective cohort study.

SETTING: Women’s Health Initiative multicenter, population-based U.S. study, with enrollment from 1993 to 1998 and follow-up through 2021.

PARTICIPANTS: 139 213 postmenopausal women aged 50 to 79 years were included in a development cohort (n = 67 774) and 2 external validation cohorts. Validation Cohort 1 had high prevalence of overweight or obesity (n = 48 335), and Validation Cohort 2 included diverse, geographically separate centers (n = 23 104).

MEASUREMENTS: Height, weight, and WC measured at enrollment. BMI categories were normal weight (18.5 to <25 kg/m²), overweight (25 to <30 kg/m²), obesity-1 (30 to <35 kg/m²), obesity-2 (35 to <40 kg/m²), and obesity-3 (≥40 kg/m²), with further stratification by prespecified WC thresholds (≥80, ≥90, ≥105, ≥115, and ≥115 cm, respectively). Mortality was ascertained annually and was supplemented with serial National Death Index queries. Ten- and 20-year mortality prediction models that included BMI categories were compared to models with BMI categories stratified by WC thresholds using c-statistics and continuous net reclassification improvement (NRI).

RESULTS: Over a median of 24 years of follow-up, 69 297 participants died. Multivariable-adjusted mortality risk was consistently greater for BMI categories with large WC than those with normal WC. Compared with women with normal weight and normal WC, women with normal or overweight BMI but large WC (hazard ratios [HRs], 1.17 [95% CI, 1.12 to 1.21] and 1.19 [CI, 1.15 to 1.24], respectively) had risk similar to those with obesity-1 but normal WC (HR, 1.12 [CI, 1.08 to 1.16]). Mortality associated with obesity-1 and large WC (HR, 1.45 [CI, 1.35 to 1.55]) was similar to that with obesity-3 and normal WC (HR, 1.40 [CI, 1.28 to 1.54]). Models with BMI-specific WC thresholds improved discrimination and risk stratification at 10 years for Validation Cohort 1; c-statistics improved by 0.7% (CI, 0.3% to 1.0%) to 61.3% (CI, 60.2% to 62.5%), and continuous NRI was 20.4% (CI, 17.3% to 23.6%). Results were mixed for Validation Cohort 2; risk stratification improved (continuous NRI, 12.3% [CI, 8.5% to 16.0%]), but not discrimination. Results were similar at 20 years.

LIMITATION: The study did not include men or younger women.

CONCLUSION: Further stratifying BMI categories by WC thresholds modestly improved mortality risk stratification, with larger WC predicting greater mortality, although the degree of improvement varied by cohort. Discrimination did not improve consistently.

PRIMARY FUNDING SOURCE: National Heart, Lung, and Blood Institute of the National Institutes of Health.

PMID:40623313 | DOI:10.7326/ANNALS-24-00713

Health Aff (Millwood). 2025 Jul;44(7):821-829. doi: 10.1377/hlthaff.2024.01160.

ABSTRACT

In 2019, Connecticut became the first state to implement a deidentified notification policy for infants with prenatal substance exposure in response to updated provisions contained in the federal Child Abuse Prevention and Treatment Act (CAPTA) of 1974. Our study aimed to test whether Connecticut’s notification policy was associated with an increase in Child Protective Services (CPS) interactions for this population. We analyzed child welfare and vital records over the course of a sixty-six-month time frame starting two years before the policy took effect. We used interrupted time series models to estimate monthly reports to CPS and foster care placements for infants with prenatal substance exposure in Connecticut’s eight counties between March 2017 and July 2022. Reports and foster placements decreased for newborns with prenatal substance exposure after policy implementation. After covariates were controlled for, the adjusted rate of reports per birth decreased by 7 percent per month after the policy’s implementation. The proportion of prenatal substance exposure reports resulting in foster care placement decreased by 4 percent per month. These findings suggest that Connecticut’s approach to CAPTA was associated with a reduction in child welfare encounters among infants with prenatal substance exposure.

PMID:40623260 | DOI:10.1377/hlthaff.2024.01160

Health Aff (Millwood). 2025 Jul;44(7):846-854. doi: 10.1377/hlthaff.2024.01014.

ABSTRACT

Studies have found that sexual minority populations more often report worse overall health, lower health-related quality of life, and greater risk for disability than their heterosexual counterparts. This study used a novel approach to identify people in same-sex relationships, using insurance administrative claims data, and compared the prevalence of morbidity in that population with its prevalence in the population of those in different-sex relationships. This observational retrospective cohort study used the Merative MarketScan Research Database, which pooled data from private insurers from the period 2016-22. We identified 340,728 people in same-sex relationships, making this one of the largest studies on sexual minority populations to date, and found that they had higher Elixhauser morbidity scores than their counterparts in different-sex relationships. Sexual minorities experienced a greater prevalence of mental health morbidities (that is, depression, psychoses, and alcohol and drug use disorders) than their peers in different-sex relationships, with adjusted prevalence risk ratios (PRRs) ranging from 1.23 to 2.07. Sexual minority men also were more likely to have HIV (PRR: 93.62) and lymphoma (PRR: 1.34) than their male counterparts in different-sex relationships. These findings support the survey literature that has documented that sexual minority populations experience greater mental health and HIV-related morbidity, and they offer a novel approach to identifying members of sexual minorities.

PMID:40623259 | DOI:10.1377/hlthaff.2024.01014

Health Aff (Millwood). 2025 Jul;44(7):806-811. doi: 10.1377/hlthaff.2024.01552.

ABSTRACT

We identified obstetric service status for every rural and urban short-term acute care hospital in every US state. During 2010-22, seven states had at least 25 percent of hospitals close their obstetric service lines. By 2022, more than two-thirds of rural hospitals in eight states were without obstetric services.

PMID:40623258 | DOI:10.1377/hlthaff.2024.01552