Category: Statistics

Clin Transl Oncol. 2025 Sep 7. doi: 10.1007/s12094-025-04048-z. Online ahead of print.

ABSTRACT

PURPOSE: To determine the real-world incidence and predictive factors for venous and arterial thromboembolic events (VTE/AT) in ovarian cancer patients treated with poly-(ADP-ribose) polymerase inhibitors (iPARP).

METHODS/PATIENTS: A multicenter retrospective study involving 329 ovarian cancer patients who initiated iPARP treatment between January 2015 and December 2022. The primary outcome was the incidence of VTE/AT. Secondary outcomes included predictive factors for thrombosis and the impact of thrombosis on overall survival (OS). Data were analyzed using logistic regression and Kaplan-Meier survival analysis.

RESULTS: The incidence of VTE/AT was 4.9% (16/329). BRCA2 mutations were significantly more prevalent among patients who developed VTE/AT (56.3% vs. 19.2%; p < 0.001). Combined treatment with bevacizumab was significantly associated with a decreased risk of thrombosis (OR: 0.262; 95% CI: 0.095-0.724; p = 0.010). No statistically significant differences were observed in the median OS between patients who experienced VTE/ATE (63 months) and those who did not (47 months), with a p value of 0.876.

CONCLUSIONS: BRCA2 mutations could be a significant predictor for VTE/AT among ovarian cancer patients treated with iPARP. Concomitant treatment with bevacizumab may offer protection against thrombotic events, although a concomitant bias cannot be ruled out. These findings may be of interest when designing future clinical trials in the field of thromboprophylaxis.

PMID:40914929 | DOI:10.1007/s12094-025-04048-z

J Relig Health. 2025 Sep 7. doi: 10.1007/s10943-025-02435-y. Online ahead of print.

ABSTRACT

This study aims to examine the effect of education interventions given to women with religious orientation on cervical cancer and Pap smear test health beliefs.The study used a quasi-experimental research design with the pre-test-post-test control group. It was conducted in Qur’an courses in a province in eastern Turkey between January and October 2023. The sample size was calculated using the Gpower computer program. The sample of the study constituted a total of 114 women, 38 women in each group. Data were collected through the Personal Information Form, the Religious Orientation Scale, and the Cervical Cancer and Pap Smear Test Health Belief Model Scale. The average age of the participating women was 43.41 ± 8.63 years, and 95.6% of them thought that early diagnosis was important in cancer. The groups demonstrated differences in terms of the perceived severity, Pap smear perceived benefit, and Pap smear perceived barrier pre-test mean scores. Pap smear perceived barrier mean score was found to decrease statistically significantly after the education given in the health education group (p < 0.05). This study found that while health education decreased perceived barriers to pap smear tests, religious-based education was found to have no effects.

PMID:40914909 | DOI:10.1007/s10943-025-02435-y

J Hand Surg Am. 2025 Sep 7:S0363-5023(25)00390-9. doi: 10.1016/j.jhsa.2025.07.027. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to evaluate how major US health care policy changes have influenced long-term Medicare reimbursement trends for upper-extremity flap and microvascular procedures from 2002 to 2023.

METHODS: Reimbursement data for 28 common flap and microvascular procedures were extracted from the Medicare Physician Fee Schedule database using Current Procedural Terminology codes. Adjustments for inflation were made using the Consumer Price Index. Statistical analyses included descriptive evaluations, trend analyses, and compound annual growth rate calculations. Sensitivity analyses were performed across four policy-relevant time periods.

RESULTS: From 2002 to 2023, inflation-adjusted Medicare reimbursement amounts for flap and microvascular procedures declined by an average of 36.9%. The compound annual growth rate was -2.3%, and inflation-adjusted reimbursements saw a sharper decline of 4.5% annually. Work relative value units increased modestly by 7.2%, whereas facility and malpractice relative value units increased by 15.9% and 95.7%, respectively. The steepest declines in reimbursement occurred during the COVID-19 pandemic (2020-2023), with an average decrease of 17.1%. Linear regression analyses revealed statistically significant downward trends for all procedures.

CONCLUSIONS: Medicare reimbursement amounts for upper-extremity flap and microvascular procedures have not kept pace with inflation, reflecting a broader trend of declining economic viability in surgical subspecialties.

CLINICAL RELEVANCE: This trend may exacerbate disparities in health care access, as physicians face increasing financial pressures. Policymakers must address these challenges to ensure sustainable compensation and equitable care for patients. Future research should explore strategies to mitigate the impact of declining reimbursement rates on patient care and provider practice patterns.

PMID:40914900 | DOI:10.1016/j.jhsa.2025.07.027

Anal Chem. 2025 Sep 7. doi: 10.1021/acs.analchem.5c03495. Online ahead of print.

ABSTRACT

In this Article, we present a novel data analysis method for the determination of copolymer composition from low-resolution mass spectra, such as those recorded in the linear mode of time-of-flight (TOF) mass analyzers. Our approach significantly extends the accessible molecular weight range, enabling reliable copolymer composition analysis even in the higher mass regions. At low resolution, the overlapping mass peaks in the higher mass range hinder a comprehensive characterization of the copolymers. Our approach, however, extracts the hidden information on the unique macromolecular chains embedded in these unresolved peaks. Regression relationships were developed between easily computable mass spectral parameters derived from the measured data and key characteristics of the copolymer structure including the average mole fraction, the number-average repeat unit count, and the monomer distribution. Two regression models were constructed: one using conventional statistical methods and the other employing a machine learning approach based on an Artificial Neural Network (ANN). The spectrum evaluation process is demonstrated for the analysis of various poly(N-acryloylmorpholine)-block-poly(N-isopropylacrylamide) (PNAM-b-PNIPAM) diblock copolymers. Our simplified approach is validated using experimental data and by comparison with our recently developed and reported highly computationally demanding method.

PMID:40914892 | DOI:10.1021/acs.analchem.5c03495

Womens Health (Lond). 2025 Jan-Dec;21:17455057251331700. doi: 10.1177/17455057251331700. Epub 2025 Sep 7.

ABSTRACT

BACKGROUND: Endometriosis symptoms have multifaceted manifestations, and there are few approved nonsurgical treatment options. Gonadotropin-releasing hormone (GnRH) agonists/antagonists for endometriosis vary on efficacy, safety profile, and out-of-pocket (OOP) cost, among other features.

OBJECTIVES: This study quantified the importance that women with endometriosis in the United States (US) placed on pain and non-pain features that differ among these medications.

DESIGN: English-speaking, 18 to 50 years (premenopausal) US women with healthcare coverage for the past 3 years, who self-reported a laparoscopy-confirmed endometriosis diagnosis, were recruited via healthcare research panels to complete a cross-sectional survey.

METHODS: A discrete choice experiment (DCE) with a surgery opt-out option assessed preferences for eight GnRH agonist/antagonist attributes (reducing different types of pain, treatment administration, impact on daily activities, etc.). Best-worst scaling (BWS) assessed preferences for 11 non-pain medication attributes (dosage flexibility, short treatment onset, reversible side effects, etc.). Relative importance (RI) was estimated for each attribute.

RESULTS: Overall, 300 women were included (mean age 33.0 years; 76.7% White). Across DCE choice tasks, GnRH agonist/antagonist was chosen over surgery 46.7% of the time. Non-menstrual pelvic pain relief (RI = 23.1%), reducing monthly OOP cost (RI = 22.1%), and relief of dyspareunia (RI = 21.4%) and dysmenorrhea (RI = 12.9%) were most important for GnRH treatment choice. Among non-pain attributes in the BWS, short onset of treatment effect (RI = 13.1%), long-term safety (RI = 12.9%), and reducing fatigue (RI = 11.2%) were most important to women when choosing a pharmacologic endometriosis treatment.

CONCLUSION: Relieving the three types of endometriosis pain and reducing cost are the most important considerations for women when selecting GnRH agonist/antagonist treatment. Women with endometriosis strongly prefer a medication that can be safely taken for longer periods of time, takes effect within a few menstrual cycles, and can reduce endometriosis-related fatigue. Findings can inform discussions between patients and healthcare providers to better align endometriosis treatment decision-making with patients’ individual needs and preferences.

PMID:40914891 | DOI:10.1177/17455057251331700

Mil Med. 2025 Sep 7:usaf415. doi: 10.1093/milmed/usaf415. Online ahead of print.

ABSTRACT

INTRODUCTION: Submarine environments pose unique challenges to maintaining physical activity and exercise routines due to confined spaces, demanding schedules, and limited resources. This study investigated submariners’ physical activity patterns, sleep quality, and perceived exercise barriers in both land- and sea-based settings, with the goal of informing targeted health interventions.

MATERIALS AND METHODS: Ethics approval was granted by the Defence Science and Technology Group and Edith Cowan University review panels. This cross-sectional study surveyed 21 Royal Australian Navy submariners (25-48 years; 18 male) using a modified version of the International Physical Activity Questionnaire. Participants reported weekly engagement in general physical activity (e.g., walking, moderate- and vigorous-intensity activity) and structured exercise training (high-intensity interval training, moderate-intensity continuous training, and resistance training [RT]), as well as sitting time and sleep duration. Additional items assessed perceived barriers and motivations to exercise, time spent on land and at sea over the past 12 months (9 ± 3 and 3 ± 3 months, respectively), and their longest continuous deployment. Descriptive statistics and paired t-tests were used to compare outcomes between land and sea environments.

RESULTS: Total physical activity was lower (P < .001) at sea (118 ± 30 minutes/week) compared to land (745 ± 60 minutes/week), with the greatest reductions observed in walking (-86%, P < .001) and moderate-intensity cardiovascular training (-95%, P = .002). High-intensity interval training declined by 81% (P = .006), and RT dropped by 84% (P = .045). Reported barriers at sea included water usage restrictions (57%), limited space (43%), inadequate facilities (43%), time constraints (38%), fatigue (38%), and noise restrictions (19%). Sleep quality declined by 37% at sea (P < .001), though changes in sleep duration were not statistically significant. Sitting time increased by 51% on workdays (P = .014).

CONCLUSIONS: Sea deployments are associated with substantial declines in physical activity and sleep quality among submariners, accompanied by increased sitting time and widespread behavioral disengagement. These findings highlight the need for practical strategies to support health, well-being, and operational readiness in constrained environments. Strengths of the study include context-specific survey design and rich participant engagement, as reflected by detailed qualitative responses. Limitations include small sample size, variability in responses, potential recall bias, and the inability to assess survey reliability because of ethical constraints. Future research should prioritize longitudinal designs and explore implementable interventions to promote physical activity and sleep during deployment. These findings may also apply to other constrained environments, such as naval surface ships, remote field sites, or mining operations, where similar occupational barriers exist. Overall, these results offer valuable insight into how deployment conditions shape health behaviors in submariners and provide a foundation for developing evidence-based strategies to improve activity and well-being in this and similar populations.

PMID:40914885 | DOI:10.1093/milmed/usaf415

Nutr Rev. 2025 Sep 7:nuaf153. doi: 10.1093/nutrit/nuaf153. Online ahead of print.

ABSTRACT

CONTEXT: Cardiovascular protective properties of berries have been reported in numerous studies. Berries and their bioactive compounds may also be effective for improving body composition and anthropometric indices.

OBJECTIVE: This systematic review and meta-analysis were aimed to investigate the effect of berries on anthropometric markers.

DATA SOURCES: A systematic search for studies published before June 2024 was conducted in 4 electronic databases-PubMed, Scopus, Web of Science and Google Scholar-to find randomized controlled trials that used berries or their extract as the intervention.

DATA EXTRACTION: Data from 42 intervention arms from 38 studies were included in the analysis.

DATA ANALYSIS: The meta-analysis revealed a statistically significant decrease in body mass index (weighted mean difference [WMD] = -0.13 [95% CI, -0.22 to -0.04]; P = .004) and in body fat percentage (WMD = -0.50 [95% CI, -0.77 to -0.23]; P = .000) and body fat mass (WMD = -0.67 [95% CI, -1.19 to -0.16]; P = .010). No significant changes were observed in weight, waist circumference, hip circumference, waist-to-hip ratio, or fat-free mass.

CONCLUSION: The results indicate the potential of berries to improve body mass index and body fat percentage; however, due to limited data, more well-designed studies are recommended.

SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration No. CRD42024556011.

PMID:40914881 | DOI:10.1093/nutrit/nuaf153

Mil Med. 2025 Sep 7:usaf386. doi: 10.1093/milmed/usaf386. Online ahead of print.

ABSTRACT

INTRODUCTION: An estimated 5.6 million individuals in the U.S. experience limb loss and absence, but national estimates exclude Military Health System (MHS) beneficiaries. The purpose of this study is to characterize MHS beneficiaries with limb loss and absence and estimate incidence and prevalence.

MATERIAL AND METHODS: We conducted a retrospective cohort study using data from the MHS Information Platform. Descriptive statistics were used to characterize the study population, including demographics, level of limb loss and absence, and etiology. Bivariate analyses between demographic characteristics and level of limb loss were conducted using analysis of variance and chi-square tests. The sample includes MHS beneficiaries diagnosed with limb loss or absence from 2005 to 2023. The study was determined exempt human subjects research by the Uniformed Services University of the Health Sciences Institutional Review Board.

RESULTS: The cohort (118,587) was 64.6% male and 35.4% female, with mean age 58 years (SD = 23.4). Racial distribution included 49.8% White, 6.4% Black, and approximately 42.1% other or unknown. Service branches were Army (41.0%), Air Force (26.7%), Navy (19.7%), Marine Corps (7.0%), other (3.9%), Coast Guard (1.7%), and Space Force (0%). The majority were retired (46.2%) or other (32.0%), with a smaller portion active duty (12.0%) and dependents (9.9%). Levels of limb loss were 72% lower limb, 26.1% upper limb, and 2% unspecified. Causes included acquired absence (53.8%), traumatic amputation (34%), and congenital absence (12.1%). Bivariate analysis showed significant associations between demographics and limb loss levels (P = .000). Incidence (z = -2.43, P = .015) and prevalence (z = -13.69, P = .000) rates declined over 19 and 8 years, respectively.

CONCLUSION: This study highlights demographic characteristics, causes, and declining rates of limb loss and absence among MHS beneficiaries, providing a foundation for future research and informing clinical practices and policies to enhance care and resource allocation.

PMID:40914878 | DOI:10.1093/milmed/usaf386

Inflamm Bowel Dis. 2025 Sep 7:izaf172. doi: 10.1093/ibd/izaf172. Online ahead of print.

ABSTRACT

BACKGROUND: The infliximab (IFX) biosimilar, CT-P13, is available as an intravenous (IV) and subcutaneous (SC) formulation. Although current indications allow the transition from IV CT-P13 to SC CT-P13 after two IV administrations, some clinicians prefer to postpone switching until stable clinical remission has been achieved.

METHODS: We evaluate the endoscopic response, treatment persistence, clinical remission, endoscopic remission, and safety profile after one year of treatment with IFX in patients switched from IV to SC after 6 weeks (early switch group) or after 6 months (late switch group).

RESULTS: There were no statistical differences between the two groups after one year in terms of endoscopic response (71.4% vs 70.8%, P = .95), steroid-free clinical remission (62.5% vs 68.7%, P = .51), or IFX retention rate (75.0% vs 66.7%, P = .35). We observed higher endoscopic remission rates in early switch patients as compared to late switch patients; however, this trend was not significant (69.6% vs 52.1%, P = .07). A return to IV-IFX was required in 1 of 43 early switch patients and in 3 of 44 late switch patients (2.3% vs 6.8%, P = .31). Clinical indexes, fecal calprotectin and C-reactive protein (CRP) levels significantly decreased after one year regardless of group. Adverse events were also comparable between groups (4.5% vs 8.3%, P = .46).

CONCLUSIONS: Our study has shown that early switch from IV-IFX to SC-IFX at 6 weeks is effective in terms of clinical and endoscopic remission at one year yielding similar results to late switch at 6 months.

PMID:40914876 | DOI:10.1093/ibd/izaf172

Disabil Rehabil. 2025 Sep 7:1-16. doi: 10.1080/09638288.2025.2554305. Online ahead of print.

ABSTRACT

PURPOSE: Initial studies identified the Perceive, Recall, Plan and Perform Assessment (PRPP-A) as a cognitive assessment with potential for culturally safe use with Aboriginal and Torres Strait Islander peoples with neurocognitive impairments in the Northern Territory of Australia. This study examines construct and concurrent validity of the PRPP-A.

METHODS: Data were collected from a medical record review. Construct validity was examined using multifaceted Rasch analysis on 44 PRPP-A scores. Concurrent validity was evaluated using Pearson’s product-moment correlation to examine relationships between the PRPP-A and Functional Independence Measure Cognitive subscale (FIM Cognition).

RESULTS: PRPP-A test items demonstrate good fit with the Rasch model, supporting unidimensionality. A hierarchy of cognitive strategies was generated. Ordering of test items was representative of the information processing skills required for task performance. There was a statistically significant, positive correlation between PRPP-A Total scores with FIM Cognition scores (r = 0.60, p = 0.003). The strongest relationship was identified between the PRPP-A Plan Quadrant and FIM Cognition scores (r = 0.68, p < 0.001). The strength of the relationship suggests evidence for concurrent validity.

CONCLUSIONS: The findings present emerging evidence supporting the construct and concurrent validity of PRPP-A when used with Aboriginal and Torres Strait Islander peoples in the Northern Territory with neurocognitive impairment.

PMID:40914866 | DOI:10.1080/09638288.2025.2554305