Category: Statistics

J Health Popul Nutr. 2025 Dec 28. doi: 10.1186/s41043-025-01182-w. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic low-grade inflammation and insulin resistance are hallmark features of metabolic syndrome (MetS). The pathways through which healthy diets influence metabolic health outcomes remain unclear.

METHODS: This study utilized six cycles (2005-2016) of cross-sectional data from the National Health and Nutrition Examination Survey (NHANES). A total of 10,518 adults (≥ 20 years) with complete data on diet, metabolic risk factors, and relevant covariates were included. Dietary live microbe intake was quantified and categorized into three groups-low, medium, and high- on the basis of estimated colony-forming units in foods, as well as by categorizing the consumption of foods with medium/high microbial content (MedHi). MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Multivariate logistic regression, restricted cubic spline analyses, and mediation analyses were performed to examine the associations and potential mechanistic pathways via inflammation [white blood cell (WBC) counts, neutrophil counts, serum albumin, and systemic immune-inflammation (SII) index] and insulin resistance [triglyceride-glucose (TyG) index and homeostatic model assessment of insulin resistance (HOMA-IR)].

RESULTS: Compared with the non-MedHi group participants, the risk of MetS was 17% lower (odds ratio [OR]: 0.83, 95% confidence interval [CI]: 0.71, 0.98) in the high-MedHi food intake group. Compared with that of the low microbe food group, the risk of MetS was 16% lower (OR: 0.84, 95% CI: 0.72, 0.98) in the medium microbe food group. Mediation analysis indicated that the association between dietary live microbe intake and a reduced risk of MetS was mediated by improved systemic inflammation, but no significant mediating effect of insulin resistance was found.

CONCLUSIONS: Moderately increasing the intake of foods rich in high level microbes in the daily diet is associated with a reduced risk of MetS and may have potential benefits for maintaining stable blood pressure and blood lipid levels. Systemic inflammation markers, including the serum neutrophil counts and SII, partially mediate the association between dietary live microbe intake and MetS.

PMID:41457230 | DOI:10.1186/s41043-025-01182-w

Respir Res. 2025 Dec 29. doi: 10.1186/s12931-025-03467-4. Online ahead of print.

ABSTRACT

BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease (ILD) with high mortality and a high prevalence of comorbidities. Hypertension is among the most common extrapulmonary complications, but the underlying mechanisms linking IPF and hypertension remain poorly understood. This study aimed to explore the potential causal relationship and shared immune-genetic mechanisms between IPF and hypertension.

METHODS: A real-world cohort of 110 IPF patients from Peking Union Medical College Hospital (PUMCH) was enrolled. Clinical comorbidity profiles were analyzed, and whole-exome sequencing (WES) was performed on peripheral blood samples. Two-sample Mendelian randomization (MR) analysis was conducted using PUMCH data and external GWAS summary statistics to assess the causal effect of IPF genetic susceptibility on hypertension. Functional enrichment, protein-protein interaction (PPI) networks, and immune pathway analysis were performed, followed by multi-tiered validation through qPCR, Western blotting, and immunohistochemistry.

RESULTS: Hypertension was observed in 61.8% of IPF patients and was independently associated with poor survival. Two-sample MR analyses based on both internal WES and external GWAS data supported a causal effect of IPF genetic susceptibility on hypertension. Enrichment analyses revealed involvement in antigen presentation and immune regulation. CD74, HLA-DPA1, and HLA-DRA were consistently downregulated in comorbid IPF and hypertension across GEO datasets and experimental validation, suggesting impaired antigen presentation as a key mechanistic link.

CONCLUSION: This study provides genetic and immunological evidence supporting a causal relationship between IPF and hypertension. Dysregulated antigen presentation may serve as a common pathogenic pathway, offering potential targets for precision comorbidity management in IPF patients.

PMID:41457226 | DOI:10.1186/s12931-025-03467-4

BMC Oral Health. 2025 Dec 28. doi: 10.1186/s12903-025-07397-x. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of the study was to compare the retentive force and deformation of conventional casting and selective laser melting (SLM) cobalt-chromium (Co-Cr) clasps assembly of removable partial dentures (RPD) following recurrent insertion and removal forces.

MATERIALS AND METHODS: A total of 12 RPD samples were used in this study, which were divided equally into two groups: Group A (indirect digital conventional casting) and Group B (direct digital SLM) Co-Cr clasp assembly. The retention was measured using a universal testing machine after the recurrent removal and insertion of the RPD. Deformation was measured using Geomagic Control X professional metrology software. The retention and deformation data were compared between the two groups using an independent sample t-test. The association between the variables was studied using the Pearson correlation test. A statistical significance was established at P < 0.05.

RESULTS: A statistically significant difference in retention was observed between the two groups. Direct digital SLM Co-Cr clasp assembly showed higher retention and lower distortion compared to the indirect digital conventional casting Co-Cr clasp assembly. A significant negative correlation (correlation coefficient=-0.807, p-value = 0.004) between deformation and retention suggests that increased deformation reduces the retention.

CONCLUSION: The direct digital SLM Co-Cr clasp assembly in the RPD showed higher retentive force and lower deformation than the indirect digital conventional casting Co-Cr clasp assembly in the RPD.

PMID:41457213 | DOI:10.1186/s12903-025-07397-x

BMC Public Health. 2025 Dec 29. doi: 10.1186/s12889-025-26062-0. Online ahead of print.

ABSTRACT

BACKGROUND: Air pollution seriously threatens residents’ respiratory health, the objective of this study is to explore the relationship between air pollution-related factors and chronic respiratory diseases (CRDs), analyze the association between air pollution-related factors and chronic obstructive pulmonary disease (COPD) prevalence, and evaluate the current status of residents’ awareness of air pollution through questionnaire analysis.

METHODS: A cross-sectional was conducted in Minhang District, Shanghai. Personal information, air pollution-related risk factors, and residents’ cognitive level were collected through questionnaire investigations. Descriptive statistics, chi-square tests, univariate and multivariate logistic regression and receiver operating characteristic curve (ROC) were used.

RESULTS: The questionnaire was completed by 3136 respondents. The prevalence of CRDs was 24.6% and COPD was 12.1%. Among the air pollution-related variables, exposure to dust or fumes at work, used to cook with firewood or coal, frequent home cooking, and living proximity to industrial areas or other pollution sources were significantly associated with CRDs. The area under the curves (AUC) of COPD was 0.821 for assessing the prevalence of COPD with basic variables combined with air pollution-related variables. In terms of air pollution cognition, CRDs patients were generally lower than no-CRDs.

CONCLUSION: Air pollution-related factors are significantly related to the prevalence of CRDs, considering the significant harm of air pollution to COPD, it is recommended to add air pollution-related factors to the screening questionnaire of COPD to improve the screening accuracy. In addition, residents’ cognition levels of air pollution are associated with CRDs prevalence.

PMID:41457211 | DOI:10.1186/s12889-025-26062-0

BMC Public Health. 2025 Dec 29. doi: 10.1186/s12889-025-26007-7. Online ahead of print.

ABSTRACT

BACKGROUND: Only little is known about the social and health conditions of overindebted individuals in Switzerland. Very few studies on the mental health outcomes or correlates of overindebtedness have been performed so far, and to date, hardly any study has been conducted on the social well-being and connectedness of overindebted people.

METHODS: Survey data collected in 2019 from clients of all four official debt advisory centers in the Canton of Zurich were used and merged with a subsample of the Swiss Health Survey 2017 of the same age and canton of residence. The combined dataset and pooled study sample covered a total of 2,216 individuals, 219 overindebted adults and 1,997 respondents of the Swiss Health Survey and residents of the Canton of Zurich. Contingency tables were constructed, and multiple logistic and linear regression analyses were performed to estimate different measures of effect or association (bivariate frequency distributions, multiple-adjusted odds ratios, standardized beta coefficients).

RESULTS: Overindebted individuals show a markedly increased frequency and risk of being socially disconnected or isolated. They are much more likely to be insufficiently supported (55%) and to frequently feel lonely (43%) than not overindebted representatives of the general population (10%/4%). Overindebted individuals accordingly have – even after adjustment for control variables – a strongly increased risk of being comparably unsupported (aOR = 12.6) and frequently feeling lonely (aOR = 15.4) in comparison with their counterparts. However, this association does not fully explain the strong negative mental health impact of overindebtedness. Half or less of this effect was indirect and thus was mediated by perceived social support and felt loneliness.

CONCLUSIONS: The very poor mental health status of overindebted people cannot be completely attributed to the strong association between overindebtedness and social disconnectedness that was found in this study and shown for the first time.

PMID:41457206 | DOI:10.1186/s12889-025-26007-7

J Med Virol. 2026 Jan;98(1):e70776. doi: 10.1002/jmv.70776.

ABSTRACT

The burden of hand, foot, and mouth disease (HFMD) in children under five is substantial, with the greatest burden in China. Most cases are mild, although some are severe and even fatal. A vaccine against EV-A71, the pathogen most commonly associated with severe HFMD, was licensed in China in Dec 2015 but not introduced into the National Immunisation Programme (NIP). It was hence not covered by routine national vaccine surveillance and its coverage remained unknown for the years following its initial licensure. Here we report the results of a novel data collection and analysis approach to address this knowledge gap. Local public health entities were invited to report county-specific numbers of EV-A71 vaccine doses administered between 2016 and 2019 in mainland China. A cohort model was then used to estimate vaccine coverage. The association between county-level factors (epidemiological, socioeconomic, demographic, and environmental) and vaccine coverage was assessed using zero-inflated beta regression models. We received responses from 2,248 out of 3,252 counties in 23 of 31provinces in mainland China. The median county-level EV-A71 vaccine coverage was 10.17% [IQR: 3.50%, 19.39%] in 2018 and 16.70% [IQR: 8.78%, 27.45%] in 2019. However, the median absolute differences in coverage (i.e., max-min) within-prefecture were ~30%. Results from the regression model indicate that low vaccine coverage was associated with low socioeconomic status, small populations and high proportions of young children. Coverage of EV-A71 vaccines was low in China prior to the COVID-19 pandemic, with substantial geographical disparities over 4 years after the initial vaccine licensure. Our results illustrate the private market response to a new childhood vaccine that is licensed but not centrally funded. Despite economic growth, vaccine coverage among marginalised populations will likely be low without targeted policy and financial support.

PMID:41457185 | DOI:10.1002/jmv.70776

Cardiovasc Intervent Radiol. 2025 Dec 28. doi: 10.1007/s00270-025-04303-4. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the feasibility, safety, and short-term outcomes of off-label stent use for extracranial internal carotid artery (ICA) revascularization in anatomically challenging patients.

METHODS: We conducted a retrospective multicenter cohort study including all consecutive patients treated for extracranial internal carotid artery stenosis between 2017 and 2025 across several high-volume stroke centers. Patients underwent one of three revascularization strategies: carotid endarterectomy (CEA), conventional carotid artery stenting (CAS), or off-label intracranial stent deployment in patients where severe tortuosity, high-cervical anatomy, sharply angulated bulbs, or unfavorable access rendered CEA and standard CAS technically unfeasible. Clinical presentation, angiographic severity, technical success, 30 day mortality, restenosis ≥ 50% at 3 months, and functional outcome (modified Rankin Scale (mRS) ≤ 2) were recorded. Three-group comparisons were performed using ANOVA/Kruskal-Wallis and chi-square/Fisher’s exact tests. Given the small, anatomically preselected off-label cohort and low event numbers, neither propensity score matching nor multivariable regression was feasible. Statistical significance was set at p < 0.05.

RESULTS: A total of 1,522 patients underwent carotid revascularization (48 ACCLINO® stent, 1,274 CAS, 200 CEA). At baseline, pre-procedural near-occlusion or complete occlusion was significantly more common in the off-label group (68.8% [33/48]) compared with CAS (25.5% [325/1274]) and CEA (23.0% [46/200]) (p < 0.001). Symptomatic presentation was also highest in the off-label cohort (100% [48/48]) versus CAS (75.6% [963/1274]) and CEA (81.5% [163/200]) (p < 0.001). Acute ischemic stroke occurred in 25.0% (12/48), 7.8% (99/1274), and 6.0% (12/200) respectively (p < 0.001). Technical success was achieved in all off-label and CEA procedures and in 99.4% of CAS (p = 0.41). Thirty-day mortality did not differ significantly (6.3% vs. 2.7% vs. 3.0%; p = 0.17). At 3 months, restenosis ≥ 50% was comparable across groups (4.2% vs. 5.3% vs. 5.5%; p = 0.78). Functional independence (mRS ≤ 2) improved from 31.3 to 100% in the off-label cohort (p < 0.001), compared with 87.2% → 96.5% in CAS and 82.0% → 94.0% in CEA (all p < 0.001).

CONCLUSIONS: Off-label stenting may offer high technical feasibility, acceptable vessel patency, and meaningful functional recovery in patients with complex, surgically challenging proksimal ICA stenosis, suggesting that it could serve as a potential rescue option in carefully selected anatomically difficult patients.

PMID:41457160 | DOI:10.1007/s00270-025-04303-4

Cardiovasc Intervent Radiol. 2025 Dec 28. doi: 10.1007/s00270-025-04310-5. Online ahead of print.

ABSTRACT

PURPOSE: To develop expert consensus recommendations for patient selection and procedural techniques in cryoneurolysis for chronic pain management using a Delphi process.

MATERIALS AND METHODS: A panel of 22 international interventionists participated in a two-round Delphi process. Participants rated 42 statements on a 10-point Likert scale (1 = strongly disagree, 10 = strongly agree). Consensus was predefined as ≥ 75% of ratings ≥ 7. Descriptive statistics (n, mean ± SD, % ≥ 7) were calculated.

RESULTS: High agreement supported cryoneurolysis for localized chronic pain refractory to conservative therapies (mean 8.55 ± 0.60; 100% ≥ 7) and cases with identifiable peripheral nerve targets (8.45 ± 0.74; 100% ≥ 7). Imaging guidance was deemed essential for nerve identification and probe placement (8.91 ± 0.29; 100% ≥ 7). The panel endorsed individualized freeze-thaw cycles to achieve Sunderland II injury (8.27 ± 0.83; 91% ≥ 7) and emphasized thorough patient education (9.0 ± 0.0; 100% ≥ 7). Experts recommended repeat cryoneurolysis within weeks if initial response was incomplete (8.64 ± 0.65; 100% ≥ 7) and alternative therapies after two unsuccessful sessions (8.36 ± 0.73; 95% ≥ 7). No consensus was reached on restricting treatment to a single anatomical region (5.82 ± 2.91; 50% ≥ 7) or routine prophylactic antibiotics (6.27 ± 2.57; 54% ≥ 7).

CONCLUSION: This Delphi study establishes expert-derived consensus standards for cryoneurolysis, highlighting careful patient selection, mandatory imaging guidance, and flexible freeze protocols while identifying areas requiring further research.

PMID:41457159 | DOI:10.1007/s00270-025-04310-5

Discov Ment Health. 2025 Dec 28. doi: 10.1007/s44192-025-00361-9. Online ahead of print.

ABSTRACT

Amongst the correctional worker population, a wide range of demographic characteristics shape mental health outcomes, organizational stigma, and treatment-seeking, including gender and/or sex differences. Yet, considerations of the relationship between gender and especially sex and mental health in correctional systems internationally remain understudied and have not been investigated on a national scale. In the current national study, we quantitatively analyze Canadian provincial and territorial correctional workers’ (n = 3,740) sex correlates with other sociodemographic variables, and examine the prevalence of potentially psychologically traumatic events (PPTEs), correctional-specific PPTEs, occupational stressors, suicide-related behaviour (ideation, plan, and attempt), and several mental health disorders. Survey findings indicate statistically significant sex differences in exposure to all types of PPTEs, with the exception of captivity and life-threatening illness or injury. Males reported higher odds of being exposed to all types of PPTEs than females, with the exception of sexual assault and other unwanted or uncomfortable sexual experiences, which females had higher odds of experiencing. Statistically significant sex differences were also evident in exposure to all types of correctional-specific PPTEs, except for instances where a person died while under their supervision. Other significant relationships found are discussed and reiterate the necessity of incorporating concerns for gender and/or sex equality and balance in correctional settings into mental health training regimen, as well as highlight several areas for future research.

PMID:41457148 | DOI:10.1007/s44192-025-00361-9

J Gastrointest Cancer. 2025 Dec 28;56(1):246. doi: 10.1007/s12029-025-01367-w.

ABSTRACT

BACKGROUND: Colorectal cancer (CRC) remains the third leading cause of cancer-related deaths in the United States. Although diagnostic and treatment improvements have reduced overall mortality, disparities persist across populations and regions.

METHODS: We analyzed the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database (1999-2023), calculating age-adjusted mortality rates (AAMRs) per 100,000 and average annual percent change (AAPC), stratified by age, sex, race, urbanization, and state.

RESULTS: From 1999 to 2023, the overall AAMR for CRC declined by 38.9 percent, from 32.06 to 19.57 per 100,000 (AAPC: -2.08). However, disparities remain. In 2023, males had an AAMR of 23.23, which was 41.1 percent higher than that of females at 16.45. Non-Hispanic (NH) Black individuals had the highest mortality (AAMR: 24.90). Among adults aged 35 to 44, the AAMR rose from 2.87 to 3.71 (AAPC: 1.03), marking a 29.3 percent increase. Nonmetropolitan areas had a 24.0% higher mortality rate than metropolitan areas, with AAMRs of 23.16 and 18.69, respectively. Southern states such as Texas and Georgia saw notable increases in death counts, rising by 34.1 and 38.7 percent, respectively.

CONCLUSION: Despite overall progress, rising mortality in adults under 55 and certain racial groups signals an urgent need for targeted action. Recommendations include refining racial categories in national data, expanding screening in high-risk states with slower mortality declines, and providing mobile screening units in rural areas with consistently high AAMR. Additionally, recovery efforts should address COVID-19-related backlogs in screening, diagnostic colonoscopy, and timely treatment.

PMID:41457141 | DOI:10.1007/s12029-025-01367-w