Category: Statistics

Fam Pract. 2025 Jun 4;42(4):cmaf033. doi: 10.1093/fampra/cmaf033.

ABSTRACT

BACKGROUND: The 2024 Final Rule for physician fee schedule under the Medicare Prospective Centers for Medicare & Medicaid Services (CMS) has sunset and combined seven screening and quality measures for traditional Medicare Merit-Based Incentive Payment System (MIPS) reporting with a single composite clinical quality process measure, Preventive Care and Wellness (PCW). While composites offer benefits including statistical efficiency and increased stability over time, the contextless nature of composite scores may result in disadvantaging low-resource primary care health centers (“health centers”) serving medically underserved communities that face healthcare access and outcome challenges.

OBJECTIVE: Evaluate the CMS composite score metric in health centers to identify characteristics that are associated with higher versus lower composite scores.

METHODS: We conducted a 4-year (2019-2022) retrospective data analysis with more than 1.5 million patients from 191 primary care health centers within the OCHIN national network of community health organizations (CHOs). The primary outcome is a modified version of the PCW. Generalized linear mixed models assessed clinic factors associated with score variation, accounting for repeated measures.

RESULTS: Our analysis demonstrated that prepandemic scores started to recover by the end of 2022 (0.6644 vs. 0.6153) and that five factors (pediatric or 65+ patients, Hispanic adults, uninsured patients, and clinic encounter volumes in Q2 and Q4) significantly affected clinic score variation over time.

CONCLUSIONS: Our analyses show that preventive service delivery in health centers has nearly recovered from pandemic declines. Differences in subpopulations highlight the importance of context in interpreting health centers’ score variation.

PMID:40557464 | DOI:10.1093/fampra/cmaf033

Eur J Paediatr Dent. 2025 Jun 1:1. doi: 10.23804/ejpd.2025.2403. Online ahead of print.

ABSTRACT

AIM: To evaluate the association between dietary consistency, masticatory patterns, and the presence of posterior crossbite in growing patients, and to explore potential preventive strategies.

BACKGROUND: Maxillary constriction, frequently associated with posterior crossbite, presents challenges to craniofacial development. Modern dietary habits, characterised by softer food textures, reduce masticatory demand, potentially contributing to maxillary hypoplasia. However, the translational impact of dietary consistency on general health and craniofacial development remains underexplored.

METHODS: A case-control study was conducted with 106 participants divided into two groups: case (posterior crossbite) and control (non-crossbite). Dietary habits were assessed through a validated questionnaire that categorised foods by consistency. Masticatory cycles were analysed using a kinesiograph to identify normal, reverse, and atypical patterns. Statistical analyses included chi-square tests and regression models, with significance set at p < 0.05.

CONCLUSION: This study confirms a significant association between dietary consistency, masticatory patterns, and posterior crossbite. The findings underscore the role of dietary texture in craniofacial development, highlighting the importance of preventive dietary strategies to support both craniofacial growth and general health. Further longitudinal studies are recommended to validate these findings and guide translational orthodontic interventions.

PMID:40557459 | DOI:10.23804/ejpd.2025.2403

Int J Surg. 2025 Jun 24. doi: 10.1097/JS9.0000000000002645. Online ahead of print.

ABSTRACT

BACKGROUND: Peripheral nervous system tumors are abnormal proliferations originating from neural tissues (such as the nerve sheath and nerve fibers), classified as either benign or malignant. Common subtypes encompass schwannomas, neurofibromas, and malignant peripheral nerve sheath tumors. Notably, malignant peripheral nerve sheath tumors are characterized by their high malignancy potential and have demonstrated a concerning rise in both incidence and mortality rates in recent epidemiological studies.

METHODS: Based on the Global Burden of Disease (GBD) 2021 database, we conducted a statistical analysis of the trends of incidence, disability-adjusted life years (DALYs) per 100,100 population along with 95% uncertainty intervals(UIs), as well as deaths among adults aged 70 years and older from 1990 to 2021 in peripheral nervous system tumors. The date were subjected to stratified analyses across age, sex, socio-demographic index (SDI), 21 regions, and 204 countries. A Bayesian age- period- cohort (BAPC) model incorporating integrated nested Laplace approximations was applied to forecast the disease burden up to 2050. On a global scale, all stratified analyses demonstrated a consistent trajectory trend in incidence, DALYs, and deaths among older adults, with projections indicating this trend is likely to persist until 2050.

RESULTS: Over the past three decades (1990-2021), the incidence rates of peripheral nervous system tumors have risen by 185%, with disability-adjusted life years (DALYs) rates increasing by 164% and deaths rates climbing by 167%. Notably, high SDI regions exhibited declining trends in incidence rates (-10.1%), DALYs rates (-14.3%), and mortality rates (-11.6%) after 2003, low- and middle SDI regions maintained annual increases. A significant gender reversal occurred in 2021, where male incidence numbers, DALYs and deaths numbers surpassed female rates. Bayesian age-period-cohort (BAPC) modelling predicts a 2.0-fold increase in ASIR by 2050 relative to 2021 levels, with DALY and mortality burdens projected to rise 2.2-fold and 1.8-fold respectively under current trajectories.

CONLUSION: The analysis results revealed that there were pronounced disparities across SDI regions, with high-middle SDI regions shouldering the greatest burden. These findings underscore the urgent need for region-specific prevention and control strategies to address the growing epidemiological and socioeconomic impacts of these malignancies in aging populations.

PMID:40557436 | DOI:10.1097/JS9.0000000000002645

Neuroradiol J. 2025 Jun 25:19714009251351290. doi: 10.1177/19714009251351290. Online ahead of print.

ABSTRACT

This study sought to categorize anatomical variations of the septum pellucidum (SP), cavum vergae (CV), and cavum veli interpositi (CVI), as well as to examine potential correlations between these variations and psychiatric disorders. A total of 2949 patients were retrospectively analyzed utilizing brain MRIs. Variations were categorized into nine types according to the coexistence of CSP and CVI in either mild or moderate manifestations. The prevalence of CSP, CV, and CVI in the study population was 7.9%, 1.4%, and 9.0%, respectively, with an overall occurrence of variation at 13.8%. A chi-square test indicated a significant correlation between moderate CSP with mild CVI (Type VIII) and a reduced prevalence of psychiatric disorders (p = .007), implying a possible protective effect. Nevertheless, the majority of SP variations exhibited no statistically significant correlation with psychiatric diagnoses, including schizophrenia, OCD, or bipolar disorder. Logistic regression analysis revealed a significant interaction between gender and SP variations in predicting psychiatric disorders, with females exhibiting a higher overall prevalence. The interaction term was statistically significant (p < .001), suggesting that variations in SP and gender collectively affect the probability of psychiatric disorders. The findings offer valuable insights; however, limitations including the retrospective design, small subgroup sizes, and absence of genetic data necessitate caution in result interpretation. This study enhances comprehension of SP variations and their possible involvement in psychiatric disorders, emphasizing the necessity for additional research to clarify the underlying neurobiological mechanisms and clinical ramifications.

PMID:40557431 | DOI:10.1177/19714009251351290

J Saudi Heart Assoc. 2025 Jun 12;37(3):3. doi: 10.37616/2212-5043.1439. eCollection 2025.

ABSTRACT

Olezarsen emerged as a novel promising Apo-C3 inhibitor for dyslipidemia. However, its dose-response relationship remains uncertain. This review aims to evaluate the lipid-lowering effect of olezarsen, safety measures, and dose-response effects to determine the optimal dose. A systematic search was conducted across Scopus, PubMed, Science-Direct, and CENTRAL on January 2, 2025. Randomized controlled trial (RCT) comparing olezarsen with placebo in dyslipidemia was included. The Rob 2.0 tool was implemented to assess quality. R-studio and STATA were used to conduct statistical analysis. From a total of 194 documents at initial search, four RCTs involving 361 patients were included in the present analysis. Olezarsen significantly reduces plasma Apo-C3 across all dosage cohorts, including a 50 mg dose (MD: -70.31 %; 95 % CI: -83.89 to -56.74; p < 0.01) and an 80 mg dose administered every four weeks. It also significantly lowered triglycerides at any dose level, with reductions observed at 50 mg (MD: -49.84 %; 95 % CI = -70.42 to -22.37; p = 0) and 80 mg (MD: -52.32 %; 95 % CI: -58.25 to -46.40; p < 0.01). Olezarsen has minimal effect on low-density lipoprotein (LDL) but significantly increases high-density lipoprotein (HDL). Dose-response meta-analysis modeling suggests that 50 mg administered every four weeks may represent the optimal dose, beyond which added benefits diminish. Safety analysis revealed tolerability in liver, renal, and hematological parameters. In conclusion, olezarsen is an effective Apo-C3 inhibitor that improves lipid profiles with a favorable safety profile. This modeling-based insight refines previous findings by delineating a clearer therapeutic window.

PMID:40557417 | PMC:PMC12186734 | DOI:10.37616/2212-5043.1439

J Curr Ophthalmol. 2025 Jun 5;36(3):291-295. doi: 10.4103/joco.joco_107_24. eCollection 2024 Jul-Sep.

ABSTRACT

PURPOSE: To assess the safety and efficacy of the 4-year administration of 0.01% atropine following a 1-year observation period in high myopic children.

METHODS: The RAMCOM-II study continues the RAMCOM study, designed as an interventional nonrandomized study. Participants were observed for 1 year without any intervention to establish a baseline. Subsequently, children were divided into two arms: participants in the intervention group received one drop of 0.01% atropine daily at bedtime from years 1 to 5, while the control arm received no treatment and was monitored with routine clinical examinations. Annual assessments captured myopia progression, visual acuity, adverse events, and compliance. Statistical analyses compared outcomes between the two groups, considering demographic factors.

RESULTS: At the 4-year follow-up, myopia progression from baseline in the intervention group (atropine-treated eyes) was significantly lower than in the control group (2.0 ± 2.0 diopter [D] vs. 3.2 ± 1.9 D, P = 0.01). Axial elongation also favored the intervention group. At the 5-year follow-up, similar trends persisted, underscoring the sustained efficacy of 0.01% atropine. Myopia progression remained significantly reduced in the intervention group compared to the control group (2.2 ± 2.0 D vs. 3.4 ± 1.9 D, P = 0.01). Although differences in axial elongation were less pronounced, these findings highlight the long-term benefits of 0.01% atropine in managing high myopia in children.

CONCLUSION: The RAMCOM-II study supports the efficacy of 0.01% atropine in controlling myopia progression over 5 years, emphasizing its promising role in pediatric high myopia management.

PMID:40557415 | PMC:PMC12184860 | DOI:10.4103/joco.joco_107_24

J Curr Ophthalmol. 2025 Jun 5;36(3):242-251. doi: 10.4103/joco.joco_285_23. eCollection 2024 Jul-Sep.

ABSTRACT

PURPOSE: To perform a meta-analysis to compare the efficacy of selective laser trabeculoplasty (SLT) in phakic and pseudophakic eyes.

METHODS: Scopus, Embase, PubMed, and gray literature were searched for studies comparing SLT outcomes in phakic and pseudophakic patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). The mean change in intraocular pressure was compared using a standardized mean difference (SMD) meta-analysis (RevMan 5.4.1). Begg’s funnel plots and Egger’s test were used to assess publication bias.

RESULTS: Eleven studies with 1058 eyes (323 pseudophakic and 735 phakic) were identified. There was no statistically significant difference in the observed efficacy of SLT between pseudophakic and phakic eyes (SMD = -0.10; 95% confidence interval = -0.24, 0.03; P = 0.14). There was no publication bias or heterogeneity (I ² = 0%; P = 0.66) detected. Subgroup analysis of studies stratified by length of follow-up in months (6, 12, and 24 or greater) revealed no significant difference in SLT efficacy at the different time points (P = 0.86, P = 0.59, and P = 0.16, respectively).

CONCLUSIONS: Our pooled and subgroup analysis revealed no significant difference in SLT response between the two populations. Our results support SLT as a viable treatment option for patients with OAG or OHT regardless of pseudophakic status.

PMID:40557409 | PMC:PMC12184856 | DOI:10.4103/joco.joco_285_23

J Curr Ophthalmol. 2025 Jun 5;36(3):258-266. doi: 10.4103/joco.joco_79_24. eCollection 2024 Jul-Sep.

ABSTRACT

PURPOSE: To determine the distribution of corneal higher-order aberrations (HOAs) measured by pentacam HR in a rural Iranian population and their relationship with age, sex, and refractive errors.

METHODS: In this study, sampling was performed from villages in the north and southwest of Iran using the multistage stratified random cluster sampling method. The ocular examination included measurement of uncorrected and best-corrected visual acuity, refraction, and slit-lamp biomicroscopy. Finally, all study participants underwent corneal imaging using Pentacam HR.

RESULTS: The mean root-mean-square (RMS) (±standard error) of total HOA in the anterior and posterior corneal surfaces was 0.498 ± 0.004 μm and 0.212 ± 0.001 μm, respectively. The mean RMS of anterior and posterior spherical aberration was 0.270 ± 0.002 μm and -0.134 ± 0.001 μm, respectively. The mean RMS of anterior horizontal and vertical coma was -0.084 ± 0.003 μm and 0.029 ± 0.004 μm, respectively. The mean RMS of posterior horizontal and vertical coma was 0.011 ± 0.001 μm and -0.011 ± 0.001 μm, respectively. The anterior HOAs were significantly different between age, sex, and refractive groups (all P < 0.05). The total anterior HOA had a statistically significant relationship with the male sex, older age, higher mean keratometry (K), and hyperopia. The anterior spherical aberration was significantly directly related to age, mean K, and hyperopia and inversely related to myopia.

CONCLUSIONS: The amounts of HOAs in the present study were different from previous studies, and these residence place differences (urban/rural) in the HOAs should be taken into account when designing refractive surgery nomograms and therapeutic and diagnostic considerations in each population. Moreover, the corneal HOAs, especially on the anterior surface, increased significantly with aging.

PMID:40557405 | PMC:PMC12184854 | DOI:10.4103/joco.joco_79_24

J Curr Ophthalmol. 2025 Jun 5;36(3):272-278. doi: 10.4103/joco.joco_152_24. eCollection 2024 Jul-Sep.

ABSTRACT

PURPOSE: To evaluate the agreement between topographical and tomographic measurements of the cornea with three methods of Placido-disc, Scheimpflug, and optical coherence tomography in normal eyes with myopic refractive error candidate for keratorefractive surgery.

METHODS: Subjects within the age range of 18-55 years old candidates for keratorefractive surgery with no history of systemic disorder, eye diseases except refractive errors, and ocular surgery were enrolled in the study. The intraclass correlation coefficient and Bland-Altman diagrams evaluated the agreement between different devices.

RESULTS: In this study, 97 subjects, including 35 men and 62 women, participated. There was a statistically significant agreement between the three corneal imaging devices’ keratometry measures. Bland-Altman plots show a mean difference of 0.5 diopter (D) for mean anterior keratometry, and 95% limits of agreement reached the value ± 1.00 D for mean anterior astigmatism. Evaluation of the elevation maps showed that the central and maximum elevation of the cornea’s anterior and posterior surfaces with Pentacam and Optopol have poor agreement.

CONCLUSION: Despite an excellent statistical agreement, the differences in the anterior keratometry values may not be clinically acceptable.

PMID:40557401 | PMC:PMC12184861 | DOI:10.4103/joco.joco_152_24

Front Psychol. 2025 Jun 10;16:1569486. doi: 10.3389/fpsyg.2025.1569486. eCollection 2025.

ABSTRACT

BACKGROUND: An optimal work environment is essential for the effective performance of healthcare workers, particularly nurse managers, in order to achieve high-quality services. The current study aims to assess and compare nurse managers’ perceptions of the adequacy of support within their work environment and availability of resources in four main hospitals in the Kingdom of Saudi Arabia.

SUBJECTS AND METHODS: Through a cross-sectional study design, 260 nurse managers from four main general hospitals in Jeddah and Riyadh were selected using convenience sampling and invited to participate in the study. Their perception of the work environment was assessed using the Quality Work Environment Study (QWEST) questionnaire, which has been proven valid and reliable. Data were stored and analyzed using the Statistical Package for the Social Sciences (SPSS, Version 26) software. In addition to descriptive statistics, independent sample t-tests and ANOVA were used to test the significance of the differences between subgroups. Statistical significance was set at a P value of < 0.05.

RESULTS: The perception of nurse managers toward items reflecting work environment ranged from moderate (mean = 3.72, SD = 0.678) regarding support from supervisors regarding acting on values, even if it was at personal cost, to too high to support teamwork to achieve goals and outcomes (mean = 4.13, SD = 0.621). There was no statistically significant difference in the perceived work environment in the studied hospitals. Non-Saudis had a higher positive perception of the work environment (mean = 4.0, SD = 0.52) than Saudis (mean = 3.8, SD = 0.50), P = 0.006. They also showed moderate perceptions of the availability of resources and logistics, with no statistically significant differences between hospitals except for the availability of clerical support staff.

CONCLUSION: Nurse managers generally perceive a moderate-to-high level of empowerment and support, indicating a positive environment across general hospitals. Non-Saudi nurse managers viewed their work environments more positively than Saudi nurse managers did. Although all hospitals had uniform resources, there was variance in clerical support between them. Hospitals should empower clerical staffing levels and adjust them to reduce administrative burdens to enable nurse managers to focus more on clinical leadership and patient care.

PMID:40557370 | PMC:PMC12186654 | DOI:10.3389/fpsyg.2025.1569486