Category: Statistics

J Racial Ethn Health Disparities. 2025 Nov 10. doi: 10.1007/s40615-025-02724-y. Online ahead of print.

ABSTRACT

PURPOSE: Breast cancers are the leading cancers in American women. This study aims to reveal racial and ethnic trends observed in breast cancer deaths in the United States (US).

METHODS: We analyzed 1999 to 2021 mortality data from the CDC WONDER database by race/ethnicity. Crude and age-adjusted mortality rates (AAMRs) (per 100,000 population) were calculated for each race/ethnicity, stratified by age and US census region, and then standardized to the 2000 US population. Joinpoint regression software was used to study temporal changes in mortality rates.

RESULTS: From 1999 to 2021, there were 951,536 reported deaths attributed to breast cancer in women. When aggregated, the AAMRs for breast cancer in women decreased over the study period (Annual Average Percent Change (AAPC) decrease of 1.52 (p < 0.001)). Similarly, all racial/ethnic groups, age groups, and US census regions had statistically significant declines in the AAPC over the study period (p < 0.05). However, upon stratification, we found that across all the age groups and US census regions, non-Hispanic Black women had the highest mortality rates, whereas non-Hispanic Asian American/Pacific Islander (AAPI) women had the lowest mortality rates. Across all race/ethnicity groups, women aged ≥ 65 had the highest mortality rates. We also found that most race/ethnicity groups had decreases in AAPCs over the study period for all age groups and US census regions, but non-Hispanic AAPI women had a significant overall AAPC increase of 0.65 (p = 0.002) in the ≥ 65 age group and an AAPC increase of 0.99 (p = 0.007) in the south.

CONCLUSION: Despite overall declines in breast cancer mortality, persistent racial and ethnic disparities remain by age and US census region. Future research should integrate demographic trends with molecular and genetic markers to refine prevention and treatment strategies, ultimately reducing breast cancer disparities and improving outcomes.

PMID:41214396 | DOI:10.1007/s40615-025-02724-y

Behav Res Methods. 2025 Nov 10;57(12):338. doi: 10.3758/s13428-025-02801-4.

ABSTRACT

Selecting an appropriate statistical method is a challenge frequently encountered by applied researchers, especially if assumptions for classical, parametric approaches are violated. To provide some guidelines and support, we compared classical hypothesis tests with their typical distributional assumptions of normality and homoskedasticity with common and easily accessible alternative inference methods (HC3, HC4, and six bootstrap methods) in the framework of ordinary least squares (OLS) regression. The method’s performance was assessed for four different regression models with varying levels of non-normality and heteroskedasticity of errors, and for five different sample sizes ranging from 25 to 500 cases. For each scenario, 10,000 samples of observations were generated. Type I error and coverage rates, power, and standard error bias were examined to assess the methods’ performance. No method considered here performed satisfactorily on all accounts. Using HC3 or HC4 standard errors, or a wild bootstrap procedure with percentile confidence intervals, could yield reliable results in many, but not all, scenarios. We suppose that, in the case of assumption violations, researchers might refer to a method that performed best in a scenario most similar to their data situation. To aid the selection of an appropriate method, we provide tables comparing relative performances in all considered scenarios.

PMID:41214373 | DOI:10.3758/s13428-025-02801-4

Ann Hematol. 2025 Nov 11. doi: 10.1007/s00277-025-06725-z. Online ahead of print.

ABSTRACT

We aimed to evaluate the clinical value of splenectomy as a treatment for Chronic active Epstein-Barr virus disease (CAEBVD). We retrospectively reviewed the clinical data from clinical records of patients received splenectomy in our institution from October 1, 2014, to October 1, 2024. The splenectomy cohort (n = 16) was matched to non-splenectomy controls (n = 32) at a 1:2 ratio using propensity scores derived from gender, age, baseline EBV-DNA copies, whether with HLH, and whether received Allo-HSCT. A total of 48 CAEBVD patients were enrolled in this study. Splenectomy cannot minimize the EBV-DNA copies in peripheral blood. The median OS of patients who received splenectomy was 86 months, while that of patients without splenectomy was 23 months. There was no statistically significant difference between the two groups (P = 0.189). When patients experienced recurrence-related death, no significant difference in survival time was observed between the two groups (P = 0.607). In the CAEBVD with HLH subgroup, there was no significant difference in survival times between patients with and without splenectomy (P = 0.423). A total of 18 patients received Allo-HSCT. The time to WBC and PLT engraftment between the non-splenectomy group and splenectomy group showed no significant difference (P = 0.788, P = 0.407). Splenectomy demonstrated no significant benefit in reducing EBV copies and symptom relief, and suggests splenectomy fails to prolong patient survival supporting its limited role in CAEBVD management.

PMID:41214341 | DOI:10.1007/s00277-025-06725-z

Aesthetic Plast Surg. 2025 Nov 10. doi: 10.1007/s00266-025-05411-9. Online ahead of print.

ABSTRACT

BACKGROUND: Depression is a major global health issue. Recent studies suggest that botulinum toxin (BoNT/A), commonly used in aesthetic procedures, might have potential as an adjunct to traditional treatments for depressive symptoms. It is hypothesized that BoNT/A could influence neurochemical pathways to help alleviate depressive symptoms.

METHODS: A systematic literature review was conducted focusing on Botulinum Neurotoxin Type A (BoNT/A) for depressive disorders. Primary studies published in English were included. Data were extracted on injection sites, dosage, adverse events, and outcomes. Statistical analysis included chi-squared tests and logistic regression to identify treatment predictors.

RESULTS: Twelve studies were included, primarily targeting the glabellar region with BoNT/A injections. Approximately 71% of patients demonstrated reductions in depression symptoms. The chi-square test revealed a significant association between injection sites and depression improvement (p = 0.009). Higher doses of BoNT/A showed a marginally negative relationship with depression reduction (p = 0.098). Most adverse effects were mild, such as local site reactions and mild headaches, with no severe adverse events like suicidal ideation reported.

CONCLUSIONS: This review describes the possible use of BoNT/A as an adjunct therapy for depressive symptoms, particularly when targeting facial muscles. Further research is needed to optimize dosage and explore the neurobiological mechanisms involved to improve therapeutic outcomes.

LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

PMID:41214321 | DOI:10.1007/s00266-025-05411-9

Biochem Genet. 2025 Nov 11. doi: 10.1007/s10528-025-11270-5. Online ahead of print.

ABSTRACT

Elevated TSH with normal T3 and T4 levels is a sign of subclinical hypothyroidism (SCH), is often linked to autoimmune thyroiditis. Thyroid peroxidase antibodies (anti-TPO) are early markers, but their diagnostic value and genetic associations in Middle Eastern populations are not well understood. This study assessed serum TPO levels and TPO gene polymorphisms in relation to SCH in Duhok, Iraq (September-December 2024). In a case-control design, 78 patients with SCH and 75 age- and gender-matched euthyroid controls were recruited. Serum levels of TSH, T3, T4, Vitamin D, and anti-TPO were measured. Genotyping of the TPO T1936C variant was performed by ARMS-PCR. Two-sided statistical tests were applied. Correlations were assessed using Spearman’s ρ, and genotype frequencies were tested for Hardy-Weinberg equilibrium. Diagnostic performance of anti-TPO was evaluated by receiver operating characteristic (ROC) analysis, including area under the curve (AUC), 95% CI, and Youden index. Patients with SCH showed significantly elevated anti-TPO levels compared to controls (107.5 ± 149.6 vs. 39.5 ± 81.6 IU/mL; p = 0.014). ROC analysis identified ≥ 60.4 IU/mL as the optimal anti-TPO cut-off for SCH prediction (AUC = 0.62, 95% CI: 0.52-0.71, sensitivity = 47.44%, specificity = 89.33%). TPO levels correlated positively with TSH (Spearman ρ = 0.174, p = 0.031), but not with T3, T4, or Vitamin D. TPO (T1936C) gene polymorphism analysis revealed no significant association with SCH (AA genotype: 80.77% in cases vs. 77.33% in controls), (GA genotype: 19.23% in cases vs. 22.67% in controls) p = 0.85. The GG genotype was absent in both groups. Anti-TPO antibodies demonstrated high specificity but modest sensitivity as diagnostic markers for SCH. The TPO T1936C variant was not associated with SCH, though this null finding may reflect the study’s limited statistical power. These results highlight the role of autoimmune markers in SCH diagnosis within the Kurdish population of Duhok, Iraq.

PMID:41214316 | DOI:10.1007/s10528-025-11270-5

Int J Obes (Lond). 2025 Nov 10. doi: 10.1038/s41366-025-01940-0. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to investigate the association between adherence to the EAT-Lancet diet and the prevalence of sarcopenia as well as sarcopenic obesity in adults.

METHODS: This study included 9672 participants from the National Health and Nutrition Examination Survey. We developed an EAT-Lancet score based on 24-hour dietary recall data and grouped the participants according to the quartiles of this score. Weighted multivariate logistic regression models and restricted cubic splines were employed to assess the association between the EAT-Lancet diet and sarcopenia and sarcopenic obesity. Additionally, mediation analysis was conducted to evaluate the mediating role of inflammatory biomarkers in this relationship.

RESULTS: Among the 9672 participants, 910 (9.41%) were identified with sarcopenia, and 607 (6.28%) were identified with sarcopenic obesity. After adjusting for potential confounders, the odds ratios (OR) and 95% confidence intervals (CI) for sarcopenia and sarcopenic obesity in the highest quartile groups were 0.72 (0.54-0.95) and 0.58 (0.42-0.82), respectively, compared to those in the lowest quartile group. A 10-point increase in the EAT-Lancet diet score was significantly associated with a reduced risk of sarcopenia and sarcopenic obesity, with OR (95% CI) of 0.90 (0.84-0.98) and 0.86 (0.79-0.93), respectively. Furthermore, white blood cell count demonstrated the strongest mediating effect on this association, followed by C-reactive protein, systemic inflammation response index and systemic inflammatory index.

CONCLUSION: Our study indicated that adherence to the EAT-Lancet diet was associated with a lower risk of sarcopenia and sarcopenic obesity, with this association partially mediated by inflammatory biomarkers.

PMID:41214306 | DOI:10.1038/s41366-025-01940-0

J Urban Health. 2025 Nov 10. doi: 10.1007/s11524-025-01024-4. Online ahead of print.

ABSTRACT

While the number of state legislative changes to relaxed concealed firearm carrying laws continues to increase, research examining the impact of these laws on changes in criminal behavior, particularly in urban contexts, has not kept pace. To enhance our understanding of the potential impact of permitless carry legislative changes, we examined the temporal association between legislative changes and changes in illegal and dangerous behavior most likely to be associated with firearms violence and arrests in Lexington (KY), Oklahoma City (OK), and Tulsa (OK). We use statistical controls to account for a major temporal confounder: the disruption of social order that occurred during and after the global COVID-19 pandemic in 2020. Our findings show violent criminal offenses did not shift in the post-permitless carry period. However, there were consistent and robust statistically significant increases in illegal possession of a firearm, as well as an upward shift in threatening firearm behavior (i.e., brandishing a gun/pointing a firearm), net of controls and confounders. We also find significant and sizeable increases in stolen and recovered firearms in Lexington (KY), the lone setting that collected this outcome measure during our study period. We conclude by discussing how the findings can inform policy, forthcoming legislative initiatives, and future research.

PMID:41214298 | DOI:10.1007/s11524-025-01024-4

Int J Behav Med. 2025 Nov 10. doi: 10.1007/s12529-025-10398-3. Online ahead of print.

ABSTRACT

BACKGROUND: Pain is the leading reason patients seek orthopedic care, but many experience significant delays before seeing a provider. This single-site, parallel-group randomized controlled trial evaluated whether an audio-recorded, brief mindfulness-based intervention (BMBI) delivered in an orthopedic clinic waiting room could reduce pain among patients awaiting an x-ray.

METHODS: Participants (n = 159) had a mean age of 52 years (SD = 16.3), were predominantly female (64%) and white (78%). Average pain intensity at baseline was 5.65 (SD = 2.18). Participants were randomized in a 1:1 ratio to receive either a 4-min audio-recorded BMBI or a 4-min injury management control recording. Pain unpleasantness and pain intensity were measured pre- and post-intervention using numeric rating scales.

RESULTS: BMBI Participants reported significantly lower post-intervention pain unpleasantness (4.26 vs. 4.95, p = .021, d = .39) and pain intensity (4.23 vs. 5.21, p < .001, d = .59) compared to the control group. Although pain decreased in both groups, reductions were significantly greater in the BMBI group (p < .05). Notably, 52% of BMBI participants experienced a clinically meaningful pain reduction (i.e., ≥ 10%), compared to 33% in the control group (p = .041). Additionally, more BMBI participants expressed interest in further pain management resources (54% vs. 38%, p = .032).

CONCLUSIONS: An audio-recorded BMBI can produce statistically significant and clinically meaningful reductions in acute pain among orthopedic patients in the waiting room and may enhance their desire to seek additional pain management resources. As such, audio-delivered BMBIs represent a complementary pain management approach that can be delivered without clinician involvement. Findings highlight the need to further enhance patient engagement with MBIs in the waiting room and assess their effectiveness across a variety of healthcare environments.

TRIAL REGISTRATION: This trial was prospectively registered. Registry: ClinicalTrials.gov, TRN: NCT06171009, Registration date: September 19th 2024.

PMID:41214294 | DOI:10.1007/s12529-025-10398-3

Int Urogynecol J. 2025 Nov 10. doi: 10.1007/s00192-025-06398-2. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: The objective was to compare the anatomical and functional outcomes of laparoscopic lateral suspension (LLS) with and without concomitant hysterectomy in the treatment of pelvic organ prolapse, in order to guide patient-centered surgical planning.

METHODS: This retrospective cohort study included 87 patients who underwent LLS between 2021 and 2024. Patients were divided into two groups: LLS with concomitant total laparoscopic hysterectomy (n = 43), and uterus-preserving LLS (n = 44). Surgical parameters, Pelvic Organ Prolapse Quantification (POP-Q) scores, complication rates, recurrence, pelvic pain, and urinary incontinence outcomes were compared over a minimum of 12 months’ follow-up.

RESULTS: Both groups achieved significant improvements in all POP-Q points (p < 0.0001), with no statistically significant difference in anatomical success, recurrence, pelvic pain, or urinary incontinence. Operative time, blood loss, and hospital stay were significantly higher in the hysterectomy group (p < 0.0001). Vaginal length was better preserved in uterus-preserving procedures. No major intra- or postoperative complications were reported.

CONCLUSIONS: Concomitant hysterectomy during LLS increases surgical burden without offering clear anatomical or functional advantages. Uterus-preserving LLS is a safe and effective option and may be preferred in appropriately selected patients through shared decision making.

PMID:41214285 | DOI:10.1007/s00192-025-06398-2

Int Urogynecol J. 2025 Nov 10. doi: 10.1007/s00192-025-06325-5. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESES: A variety of instruments have been used to measure UI in studies about athletic UI (AUI). However, few studies used instruments with questions about bowel, bladder, and sexual habits. A more comprehensive screening tool has been developed: the Active Women Incontinence Screening Tool (AWIST). The purposes of this study were to identify gaps left by prior UI instruments, describe attributes of the AWIST previously excluded by UI screening tools, and evaluate validity and reliability of the AWIST.

METHODS: Key concepts were identified using a comparative analysis of 17 instruments used across 92 AUI studies. We used the Delphi method to validate the content of the AWIST, which involved two phases of review by eight experts. The Content Validity Index (CVI) was assessed at the item (I-CVI) and the scale (S-CVI) levels, where consensus among all selected items was determined using a modified Kappa statistic (K*) set at $\ge$ 0.60.

RESULTS: In the first phase, the AWIST demonstrated a mean relevance score of 3.67 (σ = 0.61, range 2-4; mean I-CVI 0.98, σ = 0.07). In the second phase, the AWIST had a main relevance score of 3.67 (σ = 0.57, range 2-4; mean I-CVI 0.99, σ = 0.05). The S-CVI/UA was 0.95 and the S-CVI-Ave was 0.99.

CONCLUSION: The AWIST is a comprehensive, validated screening tool created to evaluate key factors of AUI in women. Branching logic makes it equally useful for assessing nonathletic women. The AWIST is equally appropriate for research and clinical use.

PMID:41214284 | DOI:10.1007/s00192-025-06325-5