Category: Statistics

J Exp Biol. 2025 Sep 8:jeb.250650. doi: 10.1242/jeb.250650. Online ahead of print.

ABSTRACT

Effective locomotion requires physiological systems to adapt to instabilities. While gait perturbation recovery often appears rapid, it is possible that longer-lasting effects may be present. Therefore, this study explored recovery trends of gait dynamics following an experimenter-induced perturbation. Further investigation pertained to how responses to perturbations are influenced by walking to differently correlated auditory pacing cues (white noise, pink noise, isochronous, no cues) that altered stride-to-stride variability. The recovery rate of the temporal gait dynamics was measured 20 minutes post-perturbation using an Interrupted Time Series Analysis, a statistical method that evaluates the impact of an intervention by comparing trends in the data before and after the intervention is introduced. Pink noise gait, though seemingly affected by the perturbation initially, exhibited the fastest recovery to pre-perturbation gait dynamics. Conversely, white noise gait, despite appearing less affected at first, failed to completely recover, indicating a lasting perturbation effect. Isochronous gait remained unresponsive; an inflexibility that hinders adaptability to varying situations. The proposed statistical method reveals pre- and post-perturbation differences in gait dynamics and recovery rates, highlighting that pink noise gait offers faster adaptability to unexpected perturbations without long-term changes in gait dynamics.

PMID:40916693 | DOI:10.1242/jeb.250650

Clin Oral Implants Res. 2025 Sep 8. doi: 10.1111/clr.70036. Online ahead of print.

ABSTRACT

OBJECTIVE: A cross-sectional study was made to evaluate the role of local factors, including surgical, implant, and prosthesis-related parameters, in the presence of peri-implantitis.

METHODS: Consecutive partially edentulous patients with ≥ 1 implant presenting peri-implantitis were included. Clinical and radiographic data were collected to characterize local factors. Overall, 28 site-specific variables were analyzed for peri-implantitis and non-peri-implantitis implants. Simple and multiple logistic regression analyses were performed to explore potential associations. The diagnostic accuracy of those variables that demonstrated statistical significance in the multiple logistic regression analysis was further tested.

RESULTS: In total, 100 patients with 452 implants met the inclusion criteria. Of these, 227 implants (50.2%) were diagnosed with peri-implantitis, while 225 (49.8%) did not present peri-implantitis. The multiple logistic regression analysis demonstrated statistical significance for the following factors: (1) medial implant position within the prosthesis (OR = 3.9) was more prone to develop peri-implantitis; (2) internal Morse taper implant connection was the least likely to develop peri-implantitis (OR = 0.43); (3) mesio-distally centered implants were less prone to exhibit peri-implantitis (OR = 0.46); (4) bucco-lingual centered implants were less prone to exhibit peri-implantitis (OR = 0.29); (5) implants positioned inside (≥ 2 mm) the bony housing were less prone to exhibit peri-implantitis (OR = 0.13); and (6) implants tilted 10°-30° (OR = 5.84) and ≥ 30° (OR = 7.43) were more prone to exhibit peri-implantitis. Moreover, a prediction model based on the aforementioned factors yielded a high level of accuracy.

CONCLUSIONS: Implant malpositioning is a critical factor associated with peri-implantitis.

PMID:40916656 | DOI:10.1111/clr.70036

J Obes Metab Syndr. 2025 Sep 8. doi: 10.7570/jomes250520. Online ahead of print.

ABSTRACT

BACKGROUND: Research on the relationship between physical activity and medical expenses among individuals with obesity has been sparse. This study investigates that association using nationwide data from Korea.

METHODS: We analyzed data from the National Sample Cohort of the Korean National Health Insurance Service, including 112,531 adults with obesity who underwent at least two health screenings within a 2-year interval between 2009 and 2015. Participants were categorized into four groups based on changes in their regular physical activity during 2 years: non-exercisers, quitters, starters, and maintainers. A two-part model was used to assess the average and excess annual medical expenses per person, including outpatient and hospitalization expenses.

RESULTS: Lower levels of physical activity correlated with an increase in both average and excess annual medical expenses per person (P for trend <0.001). Non-exercisers showed the highest average annual medical expenses per person, followed by quitters, starters, and maintainers. The most substantial increases in overall medical expenses were observed among quitters, followed by non-exercisers, starters, and maintainers. These associations were prominent in individuals aged ≥65 years and those with both type 2 diabetes mellitus and hypertension.

CONCLUSION: In this nationwide study of individuals with obesity, lower physical activity levels were associated with increased medical expenses. Consistently engaging in physical activity might significantly lower medical expenses, particularly among elderly people and individuals with comorbidities. These findings highlight the importance of promoting This is a PDF file of an article accepted, but it is not yet the definitive version of record. sustained physical activity as a strategy for managing healthcare costs among individuals with obesity.

PMID:40916607 | DOI:10.7570/jomes250520

J Obes Metab Syndr. 2025 Sep 8. doi: 10.7570/jomes25009. Online ahead of print.

ABSTRACT

BACKGROUND: This study explores how relative skeletal muscle mass is associated with the development of metabolic dysfunction-associated steatotic liver disease (MASLD) and the remission of baseline MASLD in a community-based population cohort.

METHODS: The study included 1,544 participants with an average age of 58 years. All participants underwent baseline and follow-up assessments in 2015 or 2016. Appendicular skeletal muscle mass was measured using an automatic bioelectrical impedance analysis (BIA), and total skeletal muscle mass was calculated using the BIA equation. Relative skeletal muscle mass was evaluated in two ways: divided by weight and divided by visceral fat area (VFA). Liver fat content was assessed using ultrasonography, and the NAFLD fibrosis score was calculated to quantify the degree of liver fibrosis.

RESULTS: During a median follow-up of 2.1 years, each one-standard deviation increase in relative total skeletal muscle mass was associated with a decreased risk of MASLD incidence among males (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.43 to 0.74, adjusted for weight; and HR, 0.23; 95% CI, 0.13 to 0.42, adjusted for VFA) and females (HR, 0.62; 95% CI, 0.47 to 0.83, adjusted for weight; and HR, 0.37; 95% CI, 0.19 to 0.70, adjusted for VFA). In both sexes, the increase in relative appendicular skeletal muscle mass was also associated with a reduced MASLD risk. We found statistically significant inverse associations between relative skeletal muscle mass and both liver fat content and liver fibrosis.

CONCLUSION: Low relative muscle mass is associated with an increased risk of MASLD incidence and persistence. Therefore, increasing skeletal muscle mass over time might aid in the prevention and management of MASLD.

PMID:40916605 | DOI:10.7570/jomes25009

Aust J Rural Health. 2025 Oct;33(5):e70085. doi: 10.1111/ajr.70085.

ABSTRACT

AIMS: Workforce maldistribution is a challenge to the equitable provision of healthcare in Australia. This Commentary details how a multi-university, large-scale, and growing data asset is positioned to contribute strategically and operationally to addressing national workforce priorities.

CONTEXT: The Nursing and Allied Health Graduate Outcome Tracking (NAHGOT) study is a prospective longitudinal research project with a commitment to nationwide geographical coverage. NAHGOT links practice location data (the outcome) from the Australian Health Practitioner Regulation Agency (Ahpra) with university administrative records, such as admission and placement data (explanatory variables). NAHGOT also links external surveys and publicly available spatial data describing socio-economic conditions and access to services. There are seven universities formally part of the collaboration, with five others in the process of joining. NAHGOT has established a framework including project governance, data linkage and management protocols, and a central repository for de-identified data.

APPROACH: The background of NAHGOT, the benefits to the Rural Health Multidisciplinary Training program, current limitations and challenges, and the case for scale-up and future direction are described.

CONCLUSION: Universities are uniquely positioned to lead graduate tracking as they have access to a suite of key explanatory variables not available elsewhere. Increasing the number of participating universities within NAHGOT is a priority, as is broadening the pool of disciplines beyond those covered by Ahpra. The geo-enrichment of placement and practice data is also a priority. This will allow a more granular understanding of local workforce dynamics that can be overlooked if analysis is limited to existing geographical classifications.

PMID:40916591 | DOI:10.1111/ajr.70085

J Med Virol. 2025 Sep;97(9):e70595. doi: 10.1002/jmv.70595.

ABSTRACT

Hepatitis E virus (HEV) has emerged as a major agent of acute viral hepatitis, with zoonotic genotype 4 (HEV-4) representing a public health concern in China. In this study, we integrated province-wide enhanced hepatitis E surveillance data and molecular profiling from Shandong Province of eastern China, 2019-2023, with the aim of elucidating the epidemiology, genetic diversity, and clinical correlations of autochthonous HEV infections. In total, 5826 cases were reported during the study period, with 72.8% in males and 90.6% aged ≥ 40 years. 695 sequences were obtained from 553 males, 142 females, and an age range of 3-96 years (median 59 years). HEV-4d was predominant (84.0%), followed by 4b (9.9%), 4a (3.7%), and 4h (1.6%). Three HEV-3 strains and two imported HEV-1 strains were also identified. A high degree of nucleotide similarity was observed between dominant HEV-4d strains circulating in human populations and indigenous strains previously isolated from swine, cattle, and sheep within the province. Comparative analysis revealed no statistically association between the four principal HEV-4 subtypes and specific clinical manifestations, likely reflecting conserved pathogenic potential across these subtypes. Ongoing molecular surveillance is essential to monitor evolutionary trends and transmission dynamics of HEV within the framework of One Health.

PMID:40916566 | DOI:10.1002/jmv.70595

Pediatr Transplant. 2025 Nov;29(7):e70174. doi: 10.1111/petr.70174.

ABSTRACT

BACKGROUND: Fontan-associated liver disease can progress to advanced fibrosis, raising the potential need for combined heart-liver transplantation (CHLT) in selected patients. However, the benefits of CHLT over isolated orthotopic heart transplantation (HT), particularly in terms of mortality, remain uncertain. In this systematic review, we compared mortality outcomes following CHLT versus HT in patients with Fontan circulation, with the aim of supporting clinical decision-making.

METHODS: This systematic review was conducted according to the 2020 PRISMA guidelines and registered in PROSPERO. PubMed, Scopus, and Embase were searched. Studies examining HT or CHLT in patients with Fontan circulation that provided information about total and/or 1-year mortality were included. Bias risks were assessed using the Newcastle-Ottawa Scale. We used random- and fixed-effect models, depending on heterogeneity, to estimate pooled effects.

RESULTS: Sixteen studies were included in this analysis. CHLT was associated with a lower mortality rate per patient-year compared to HT (0.03 vs. 0.09; p < 0.01). However, after excluding studies in which transplantations were performed before the year 2000, the difference between groups was no longer statistically significant. One-year mortality rates were also not significantly different between CHLT and HT (0.09 vs. 0.14; p = 0.28), with similar results observed after excluding pre-2000 studies.

CONCLUSION: Overall, this systematic review suggests that CHLT may result in mortality rates comparable to those of isolated HT. These findings support the consideration of CHLT in patients with concomitant liver disease and reinforce the importance of comprehensive liver evaluation in transplant candidates.

PMID:40916564 | DOI:10.1111/petr.70174

Cancer. 2025 Sep 15;131(18):e70009. doi: 10.1002/cncr.70009.

ABSTRACT

BACKGROUND: Opioid exposure during cancer therapy may increase long-term unsafe opioid prescribing. This study sought to determine the rates of coprescription of benzodiazepine and opioid medications and new persistent opioid use after surgical treatment of early-stage cancer.

METHODS: A retrospective cohort study was conducted among a US veteran population via the Veterans Affairs Corporate Data Warehouse database. Participants were opioid-naive persons aged ≥21 years with a new diagnosis of stage 0-III cancer between January 1, 2015, and December 31, 2016. Outcomes were days of coprescription of benzodiazepines and opioids in the 13 months posttreatment and new persistent opioid use. The exposure was total morphine milligram equivalents (MMEs) attributed to treatment and prescribed from 30 days before through 14 days after the index surgical procedure.

RESULTS: Among 9213 veterans, coprescription of benzodiazepines and opioids occurred in 366 patients (4.0%) and new persistent opioid use in 981 patients (10.6%). In a linear model adjusting for patient, clinical, and geographic factors, persons in the highest quartile compared to no opioid exposure had increased days with coprescription of benzodiazepines and opioids (mean difference, 1.0; 95% CI, 0.3-1.7). In a discrete time survival analysis, persons in the highest quartile of MME exposure compared to none had a greater risk of new persistent opioid use (hazard ratio, 1.6; 95% CI, 1.3-1.9).

CONCLUSIONS: More than one of 10 opioid-naive veterans undergoing curative-intent surgical treatment for cancer developed new persistent opioid use. Optimizing cancer treatment pain management strategies to mitigate long-term opioid-related health risks is crucial.

PMID:40916563 | DOI:10.1002/cncr.70009

Nan Fang Yi Ke Da Xue Xue Bao. 2025 Aug 20;45(8):1768-1776. doi: 10.12122/j.issn.1673-4254.2025.08.21.

ABSTRACT

OBJECTIVES: To explore the key role of myeloid-derived suppressive cells (MDSCs) in pre-metastatic niche (PMN) and analyze their interrelationships with the main components in the microenvironment using a mathematical model.

METHODS: Mathematical descriptions were used to systematically analyze the functions of MDSCs in tumor metastasis and elucidate their association with the major components (vascular endothelial cells, mesenchymal stromal cells, and cancer-associated macrophages) contributing to the formation of the pre-metastatic microenvironment. Based on the formation principle of the pre-metastatic microenvironment of tumors, the key biological processes were assumed to construct a coupled partial differential diffusion equation model. The existence and uniqueness of the model solutions were investigated using approximation methods, the qualitative theory of partial differential equations and Banach’s immovable point theorem, and numerical simulations were carried out by differential numerical methods to verify the reliability and accuracy of the model.

RESULTS: The existence and uniqueness of the local and overall solutions of the model were proved using the approximation method, the qualitative theory of partial differential equations and Banach’s immovable point theorem in combination with the regularity estimation of the local solutions and the embedding inequality. Numerical simulation results further validated the reliability of the model and demonstrated the important role of MDSCs in the pre-metastatic microenvironment of tumors, especially in angiogenesis and immunosuppression.

CONCLUSIONS: This study reveals the important functions of MDSCs in the pre-metastatic microenvironment of tumors through mathematical modeling and numerical simulation, which provides an important theoretical basis for understanding the mechanism of tumor metastasis and devising cancer treatment strategies.

PMID:40916538 | DOI:10.12122/j.issn.1673-4254.2025.08.21

J Forensic Sci. 2025 Sep 7. doi: 10.1111/1556-4029.70158. Online ahead of print.

ABSTRACT

In routine forensic chemical casework where measurements are performed on reference materials, determination of measurement uncertainty is described in several guidelines. The proposed methods often have the drawback that they are not derived from a statistical framework and may lead to conservative confidence intervals. Furthermore, the formulas involved may vary considerably for different types of reference material. The current study presents a method for determination of measurement uncertainty that is both statistically sound and uniform for different types of reference material, namely material from proficiency tests, certified reference material, and noncertified reference material. The statistical model used for measurements uses relative standard deviations. The method is based on analysis of two sources of uncertainty, namely the random variation in the measurement itself and uncertainty connected to the bias of the process. It is explained how the method works when there is bias correction of results. It is also described how the method works if no correction is applied. Furthermore, the results are compared using simulation experiments, showing a better performance of the proposed method when compared with commonly used alternatives.

PMID:40916084 | DOI:10.1111/1556-4029.70158