Category: Statistics

Cancer Rep (Hoboken). 2025 Sep;8(9):e70341. doi: 10.1002/cnr2.70341.

ABSTRACT

BACKGROUND AND AIMS: Breast cancer is the most commonly diagnosed cancer in women worldwide. Several studies have investigated the relationship between breast cancer and specific foods or nutrients, rather than examining an overall dietary pattern. This study aims to investigate the association between breast cancer and the predominant dietary pattern in Ahvaz city.

METHODS: This hospital-based case-control study was conducted on 106 women with breast cancer and 107 controls. Dietary intake data were collected using a 147-item food frequency questionnaire. We merged the data on the 147 foods into 20 food groups to identify major dietary patterns. Factor analysis with varimax rotation was then employed to determine the primary dietary patterns. Binary logistic regression was used to assess the association between dietary patterns and breast cancer, with adjustment for potential confounders.

RESULTS: Three dietary patterns were identified: healthy, western, and traditional. The Western dietary pattern was robustly associated with a higher risk of breast cancer in premenopausal women (OR = 4.22; 95% CI: 1.09, 16.31; p = 0.03) in the adjusted model. However, no association was found between a healthy and traditional pattern and breast cancer.

CONCLUSION: These findings suggest that the Western dietary pattern is positively associated with breast cancer risk in premenopausal Iranian women.

PMID:40923112 | DOI:10.1002/cnr2.70341

Brain Behav. 2025 Sep;15(9):e70839. doi: 10.1002/brb3.70839.

ABSTRACT

BACKGROUND: Living with multiple sclerosis (MS) means facing significant obstacles in managing the unpredictable nature of this lifelong condition. Studies highlight a concerning connection between the disease and an elevated risk of suicide. In this study, we assessed the prevalence of suicide and suicide mortality risk in people with MS (PwMS).

METHODS: A comprehensive and systematic search of Medline, EMBASE, Scopus, and Web of Science databases was conducted. Studies of any design were included if they reported at least one of the following outcomes: (1) the prevalence of suicide ideation, suicide attempts, suicide deaths, and the proportion of suicide deaths among total deaths in MS populations (2) the risk of suicide mortality in PwMS compared to healthy controls.

RESULTS: The systematic review and meta-analysis included 64 studies across 19 countries, predominantly from Europe and North America, encompassing over 200,000 PwMS. The pooled prevalence of suicide ideation was 22.6% (95% CI: 16.9-28.3). Suicide attempts were reported at 3.4% (95% CI: 1.6-5.2), while suicide mortality was 0.5% (95% CI: 0.3-0.7), accounting for 2.1% (95% CI: 1.5-2.7) of total mortality in PwMS. PwMS had a significantly higher suicide mortality risk compared to healthy controls (standardized mortality ratio [SMR] = 1.49, 95% CI: 1.08-2.05).

CONCLUSION: This study highlights the elevated suicide mortality risk among PwMS, underscoring the urgent need for integrated mental health care in MS management. Future research should explore the impact of disease-modifying therapies, protective factors, and standardized risk assessment tools to improve early intervention and reduce suicidal behavior in this vulnerable population.

PMID:40923110 | DOI:10.1002/brb3.70839

Br J Nutr. 2025 Sep 9:1-107. doi: 10.1017/S0007114525103607. Online ahead of print.

ABSTRACT

Although numerous clinical studies suggest that ginseng supplementation may benefit cardiovascular disease (CVD) risk factors, results remain inconclusive. This systematic review and meta-analysis evaluated the effects of ginseng supplementation on CVD-related risk factors. Relevant studies were identified through electronic searches in Embase, Web of Science, Scopus, PubMed, and CENTRAL up to August 2024. Statistical analyses, including a random-effects model, meta-regression, and non-linear modeling, were used to assess heterogeneity, dose-response relationships, and the overall effects of ginseng supplementation. A total of 70 studies, published between 1998 and 2024 and involving 4,506 participants, were included. Ginseng supplementation significantly affected several biochemical markers, including high-sensitivity C-reactive protein (hs-CRP) (SMD: -0.23; 95% CI: -0.38, -0.08; P = 0.002), gamma-glutamyl transferase (GGT) (SMD: -0.20; 95% CI: -0.36, -0.04; P = 0.015), glutathione reductase (GSH-Rd) (SMD: 0.90; 95% CI: 0.38, 1.42; P = 0.001), reactive oxygen species (ROS) (SMD: -0.94; 95% CI: -1.27, -0.60; P < 0.001), and superoxide dismutase (SOD) (SMD: 0.48; 95% CI: 0.10, 0.87; P = 0.014). Meta-regression analysis showed significant linear associations between ginseng dosage and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (P = 0.044), and between supplementation duration and malondialdehyde (MDA) (P = 0.007). Dose-response analysis revealed significant associations between ginseng dose and fasting blood glucose (FBG) (P < 0.001), hs-CRP (P = 0.043), Interleukin-6 (IL-6) (P = 0.041), diastolic blood pressure (DBP) (P = 0.022), Interleukin-10 (IL-10) (P = 0.048), fasting insulin (P = 0.012), and total protein (P = 0.010). Supplementation duration was positively associated with MDA levels (P = 0.008). Ginseng supplementation was associated with improvements in inflammatory markers, liver function, and oxidative stress parameters. No significant effects were observed on anthropometric indices, blood pressure, glycemic profile, lipid profile, adipokines, or heart rate.

PMID:40923100 | DOI:10.1017/S0007114525103607

Scientifica (Cairo). 2025 Aug 31;2025:8232143. doi: 10.1155/sci5/8232143. eCollection 2025.

ABSTRACT

The gelada (Theropithecus gelada), Ethiopia’s only endemic primate and the last surviving graminivorous cercopithecid, was studied in Susgen Natural Forest, South Wollo, to examine seasonal variations in activity budgets and ranging ecology. From February to August 2023, encompassing both dry and wet seasons, 3519 behavioral scans were collected from 1680 group observations using instantaneous scan sampling at 15-min intervals (07:00-17:00 h). Data were analyzed with descriptive statistics and nonparametric tests (Kruskal-Wallis H and Mann-Whitney U), while home ranges were mapped via minimum convex polygon (MCP) and kernel density estimation (KDE). Results revealed that geladas allocated 43.2% of their time to feeding, 15% to movement, 15.5% to social activities, 13.1% to resting, and 13.2% to other behaviors. Dry seasons elicited significantly greater feeding effort (46.1% vs. 40.4%; p < 0.05) and daily travel distances (3658.4 ± 0.902 m vs. 3132.1 ± 2.367 m in wet season; Mann-Whitney U, p ≤ 0.05), with home ranges analyzed through the MCP method expanding to 190.1 ha in dry season as compared with 118.18 ha in wet season. KDE analysis identified the intensive use of core areas (54 ha) within broader ranges (164.95 ha). These findings underscore how geladas in human-modified landscapes face chronic nutritional stress, adapting through extended foraging and ranging patterns. We recommend immediate conservation measures, including habitat restoration and buffer zone establishment, to mitigate anthropogenic pressures on this threatened endemic species.

PMID:40923090 | PMC:PMC12414623 | DOI:10.1155/sci5/8232143

JTCVS Open. 2025 Jun 28;26:122-131. doi: 10.1016/j.xjon.2025.06.017. eCollection 2025 Aug.

ABSTRACT

BACKGROUND: Proper risk stratification tools for patients with obstructive hypertrophic cardiomyopathy (oHCM) undergoing septal myectomy are lacking. Our objective was to assess the predictive value of preoperative N-terminal pro-brain natriuretic peptide (NT-proBNP) on perioperative outcomes and late survival in patients with oHCM undergoing transaortic septal myectomy.

METHODS: Between 2008 and 2021, 834 patients with preoperative NT-proBNP measurements underwent septal myectomy. Restrictive cubic splines, along with multivariable logistic and Cox regression models, were used to examine the association between NT-proBNP and the outcomes. The study endpoints were early postoperative complications (postoperative atrial fibrillation, need for blood transfusion, intensive care unit [ICU] length of stay [LOS], total hospital LOS), and long-term all-cause mortality.

RESULTS: A total of 834 patients were included in the study (median age, 58 [interquartile range (IQR), 48-65] years; 41.8% females). The median NT-proBNP concentration was 698 (IQR, 265-1446) pg/mL. Maximal septal thickness and maximal left ventricular outflow tract gradient, among other echocardiographic parameters, were linearly associated with NT-proBNP concentration (P < .001). Two patients died in the hospital (0.2%). On multivariable analysis, each 1000 pg/mL increase in NT-proBNP was independently associated with a 13% increase in blood transfusions (odds ratio, 1.13; 95% confidence interval [CI], 1.02-1.26), a 2-hour increase in ICU LOS (P < .001), and a 4-hour increase in total hospital LOS. Additionally, every 100 pg/mL increase in NT-proBNP within the range of 0 to 800 pg/mL was independently correlated with a 10% increase in the odds of postoperative atrial fibrillation. NT-proBNP also was associated with long-term mortality (hazard ratio, 1.1; 95% CI 1.04-1.14; P < .001).

CONCLUSIONS: Preoperative NT-proBNP has strong, independent associations with early and late outcomes and may be useful in stratifying, managing, and monitoring oHCM patients.

PMID:40923082 | PMC:PMC12414423 | DOI:10.1016/j.xjon.2025.06.017

JTCVS Open. 2025 May 20;26:132-137. doi: 10.1016/j.xjon.2025.05.003. eCollection 2025 Aug.

ABSTRACT

OBJECTIVE: Postoperative intraluminal thrombosis after frozen elephant trunk replacement has been reported to occur with a frequency of 6% to 17% and is associated with poor outcomes. The purpose of this institutional review is to analyze thrombosis rate, predisposing patient and operative factors, and assess different anticoagulation regimens.

METHODS: This retrospective cohort study includes 174 patients operated on over 10 years. one hundred forty-five of these underwent elective aortic arch replacement; 29 had the procedure for Type A aortic dissection repair.

RESULTS: Sixteen elective (11%) and 3 dissection patients (10%) had radiographic evidence of intraluminal thrombus. There were no statistical differences in demographic or intraoperative characteristics between the 2 groups. Of the 16 elective patients with thrombus, 12 (75%) had aneurysmal disease. Central graft position is associated with a higher incidence of intraluminal thrombus formation than eccentric position in both cohorts, 17% versus 7% in elective patients and 15% versus 0% in the dissection group. Patients with intraluminal thrombosis had significantly lower 6-month survival in both cohorts (69% vs 92% and 66% vs 88%; P = .0037) and this was also true for the elective group (69% vs 96%; P = .0001). Of several anticoagulation regimens employed over the study period, early introduction of warfarin proved superior.

CONCLUSIONS: The incidence of thrombus formation is higher in patients with aneurysmal disease and when the graft is positioned centrally. Early anticoagulation with warfarin appears to be protective. We advocate the creation of a registry to help improve outcomes after this complex surgery.

PMID:40923077 | PMC:PMC12414351 | DOI:10.1016/j.xjon.2025.05.003

JTCVS Open. 2025 May 22;26:234-241. doi: 10.1016/j.xjon.2025.05.005. eCollection 2025 Aug.

ABSTRACT

OBJECTIVE: To evaluate whether results of the JCOG0802/WJOG4607L trial, which demonstrated the superiority of segmentectomy over lobectomy in terms of overall survival for patients with peripheral small-sized lung cancer, are applicable to clinical practice.

METHODS: In this single-center retrospective analysis, we categorized patients who underwent lobectomy or segmentectomy during the enrollment period of the JCOG0802/WJOG4607L trial into 3 groups: patients enrolled in the trial (Cohort A), patients who were eligible but not enrolled (Cohort B), and ineligible patients (Cohort C). We assessed whether trial participants reflected typical patients seen in clinical practice (representativeness) and whether trial results could be applied in routine practice (generalizability) by comparing patient characteristics and survival between cohorts, using Cohort A as the reference.

RESULTS: Cohorts A, B, and C included 91, 163, and 81 patients, respectively. Overall survival at 5 years was 91.2% (95% confidence interval [CI], 83.1%-95.5%), 93.9% (95% CI, 88.5%-96.8%), and 87.7% (95% CI, 77.7%-93.4%), respectively, with no significant different among the 3 cohorts (P = .269). Hazard ratios for segmentectomy over lobectomy were 0.125 (95% CI, 0.015-0.987) in Cohort A, 0.281 (95% CI, 0.036-2.147) in Cohort B, and 1.806 (95% CI, 0.573-5.690) in Cohort C, indicating that the results observed in Cohort A were not replicated in Cohort B.

CONCLUSIONS: In this single-center retrospective study, segmentectomy was associated with numerically improved overall survival rates than lobectomy in JCOG0802-eligible patients not enrolled in the trial, although the difference was not statistically significant. Given the study’s retrospective nature and underpowered statistics with a small sample size, these findings should be interpreted cautiously.

PMID:40923055 | PMC:PMC12414405 | DOI:10.1016/j.xjon.2025.05.005

Trauma Surg Acute Care Open. 2025 Sep 5;10(Suppl 5):e001592. doi: 10.1136/tsaco-2024-001592. eCollection 2025.

ABSTRACT

INTRODUCTION: Developing and implementing trauma clinical guidance is integral to providing quality care to all trauma patients while maintaining a minimum standard of treatment. A mixed-methods novel consensus-building approach was used to identify the current barriers to developing and implementing trauma clinical guidance and highlight the priority areas for change to better support end users.

METHODS: As part of year 1 of the Design for Implementation: The Future of Trauma Clinical Guidance and Research Conference Series, preconference participant surveys and hybrid, professionally facilitated, structured dialogue were used to define the ideal future state of trauma clinical guidance development and dissemination. Novel to this context, in-person and virtual “user stories”, a form of structured focus group, were generated, and a “minimum viable product” (MVP), a form of brokered dialogue, was developed. Descriptive statistics and thematic analysis were used to evaluate preconference survey and “user story” results.

RESULTS: 72 in-person and up to 35 virtual attendees participated. The majority (92%) of in-person attendees and nearly half (48%) of virtual attendees completed the preconference survey. Participants identified barriers along the continuum of clinical guidance development, dissemination, and adoption. Areas for improvement centered around the creation, storage, and use of guidance. Across the survey and user stories, participants expressed the need for clinical guidance that is comprehensive, evidence-based, coordinated, and easily accessible by all clinicians both domestically and abroad. The MVP targeted the risks and objectives to improved guidance. A prominent theme throughout this consensus-building assessment was the imperative for collaboration between professional societies for clinical guidance development and dissemination.

DISCUSSION: Trauma clinical guidance must be current, consolidated, and coordinated with patient-centered outcomes prioritized. Next steps include turning the MVP produced into a prototype and refining it to inform a national redesign of trauma clinical guidance.

LEVEL OF EVIDENCE: Level III.

PMID:40923036 | PMC:PMC12414228 | DOI:10.1136/tsaco-2024-001592

Drug Des Devel Ther. 2025 Sep 3;19:7707-7718. doi: 10.2147/DDDT.S529526. eCollection 2025.

ABSTRACT

BACKGROUND: The dopamine D2/D3 antagonist amisulpride has demonstrated its superiority and efficacy in prophylaxis of postoperative nausea and vomiting (PONV). Given the branded intravenous amisulpride (Barhemsys^®) has not been approved in China, there is unmet clinical need for amisulpride. Our primary objective was to ascertain the efficacy and safety of the generic intravenous amisulpride (QLG2069) in the prophylaxis of PONV.

METHODS: In this phase III, multicenter, randomized, double-blind, placebo-controlled study, 551 adult Chinese patients (with ≥2 Apfel risk factors for PONV) undergoing elective laparoscopic gynecological or abdominal surgery were randomly allocated in a 1:1 ratio to receive either generic intravenous amisulpride or placebo. The primary endpoint was the complete response (CR) rate, defined as the proportion of patients demonstrating neither emetic episodes (vomiting/retching) nor requiring rescue antiemetics throughout the 24-hour postoperative window.

RESULTS: Totally, 542 patients (amisulpride group: n=275; placebo group: n=267) were included in the full analysis set. Amisulpride demonstrated significantly higher CR rate compared to placebo (53.82% vs 40.07%; P=0.0011) within 24-h postoperative period. Patients treated with intravenous amisulpride exhibited significantly lower incidence of moderate-to-severe nausea (28.36% vs 37.08%; P=0.0266) and emesis (44.73% vs 57.30%; P=0.0030) compared to the incidence in the placebo group. The proportion of patients without nausea was numerically higher (45.09%) in the amisulpride group compared to that in the placebo group (37.45%), although the difference did not reach statistical significance (P=0.0685). No significant difference in the proportions of patients receiving rescue medication was noticed between the two groups (21.09% vs 28.09%; P=0.0569). The incidence of adverse events were comparable in two groups.

CONCLUSION: The generic intravenous amisulpride was safe and effective in prophylaxis of PONV in Chinese patients with moderate-to-high risk of PONV to were undergoing laparoscopic gynecological or abdominal surgery.

PMID:40923005 | PMC:PMC12414449 | DOI:10.2147/DDDT.S529526

Stat Med. 2025 Sep;44(20-22):e70255. doi: 10.1002/sim.70255.

ABSTRACT

This article addresses the problem of determining whether the dose response relationships between subgroups and the full population in a multiregional trial are similar. Similarity is assessed in terms of the maximal deviation between the dose response curves. We consider a parametric framework and develop two powerful bootstrap tests: one for assessing the similarity between the dose response curves of a single subgroup and that of the full population, and another for comparing the dose response curves of multiple subgroups with that of the full population. We prove the validity of these tests, investigate their finite sample properties through a simulation study and illustrate the methodology with a case study.

PMID:40922064 | DOI:10.1002/sim.70255