Category: Statistics

Postgrad Med. 2025 Dec 21:1-15. doi: 10.1080/00325481.2025.2603034. Online ahead of print.

ABSTRACT

OBJECTIVES: For many decades, guaifenesin and dextromethorphan have been two of the most well-established and commonly used nonprescription medications to manage cough and cold symptoms. A single source that summarizes the clinical data supporting the use of guaifenesin and dextromethorphan as self-care treatment options in cough and cold could assist healthcare professionals (HCPs) in making informed recommendations to patients. The objective of this narrative review is to discuss the benefits of guaifenesin and dextromethorphan for the management of cough and mucus-related cold symptoms in adults by examining published data on the effectiveness and safety of the products containing these ingredients.

METHODS: Literature searches were performed on PubMed, Embase, and MEDLINE to identify randomized, controlled studies comparing guaifenesin or dextromethorphan treatment with placebo control in adults with cough and cold (mucus) symptoms. Of 36 guaifenesin and 53 dextromethorphan clinical studies initially identified by the literature search, 13 guaifenesin and 19 dextromethorphan publications met the predefined inclusion criteria. Additional studies were identified during manuscript development by reviewing the citations of included articles, for a total of 17 guaifenesin and 21 dextromethorphan publications.

RESULTS: Data from studies of guaifenesin and dextromethorphan either used alone or combined with other active ingredients showed statistically significant improvements compared with placebo control in sputum looseness/adhesiveness and reductions in cough frequency/severity, respectively. A small number of studies did not show significant improvements with study drug compared with placebo control. Conflicting data may originate from differences in study design, patient enrollment, and a relatively high placebo control effect across studies.

CONCLUSION: The data reviewed in this article support the importance of guaifenesin and dextromethorphan in the armamentarium of effective nonprescription treatment options for cough and mucus-related cold symptoms.

PMID:41423743 | DOI:10.1080/00325481.2025.2603034

ACR Open Rheumatol. 2025 Dec;7(12):e70152. doi: 10.1002/acr2.70152.

ABSTRACT

OBJECTIVE: The epidemiology of urinary incontinence (UI) in systemic lupus erythematosus (SLE) remains understudied. We estimated the prevalence and life burden of UI and examined associations of UI with SLE activity and disease damage in a population-based US SLE cohort.

METHODS: Participants (N = 425; mean age, 46.3 years; 82.8% Black; 92.0% women) were recruited from an ongoing adult SLE cohort (October 2019 to May 2022) for a single study visit. UI was assessed via questionnaire and defined as any urinary leakage occurring at least monthly. SLE activity and cumulative organ damage were measured using the Systemic Lupus Activity Questionnaire and Brief Index of Lupus Damage and dichotomized (higher vs lower) at the median score. Logistic regression models adjusted for age, sex, education, and body mass index were used to evaluate associations of SLE activity and cumulative disease damage with UI.

RESULTS: Overall, 36.2% reported UI at least monthly. Of those with UI, 57.7%, 18.8%, and 19.6% reported mixed-type, stress, and urge UI; 39.0% reported that UI was a substantial bother, and 16.2% reported that UI had a substantial impact on daily activities. UI prevalence was higher in women and in participants who were older and who had obesity. Higher disease activity was independently associated with 3-fold higher prevalence odds of UI (odds ratio = 3.02, 95% confidence interval: 1.91-4.76). Higher cumulative disease damage was associated with 36% higher odds of UI, but the association was not statistically significant.

CONCLUSION: UI is common in those with SLE and associated with higher disease activity, highlighting the need for updated clinical UI screening and management strategies in this unique population.

PMID:41423728 | DOI:10.1002/acr2.70152

Zygote. 2025 Dec 22:1-10. doi: 10.1017/S0967199425100245. Online ahead of print.

ABSTRACT

This study aimed to evaluate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and inactivated virus vaccination on intracytoplasmic sperm injection (ICSI) outcomes in infertile couples. A retrospective case-control study was conducted at the Royan Institute from August 2020 to March 2022. The study included 90 couples in the COVID-19 infection phase and 31 in the vaccination phase. A total of 30 infected but unvaccinated couples were compared to a control group of 60 couples with no COVID-19 infection or vaccination history. Additionally, 31 couples underwent treatment before and after receiving the Sinopharm inactivated vaccine. Key variables analysed included sperm parameters (concentration, motility, progressive motility and morphology), ovarian parameters (antral follicle count, oocyte retrieval), embryological outcomes and pregnancy outcomes. SARS-CoV-2 infection significantly reduced sperm motility (P = 0.02) and progressive motility (P = 0.01) compared to controls. Sperm concentration and morphology showed non-significant declines. Post-vaccination analysis revealed similar but statistically insignificant changes in sperm parameters. Ovarian stimulation parameters and embryological outcomes remained unaffected by both infection and vaccination. Although biochemical, clinical pregnancy and live birth rates were lower among the infected group, these differences did not reach statistical significance (p = 0.16, 0.08 and 0.09). SARS-CoV-2 infection has been associated with impaired sperm progressive motility, which may negatively influence ICSI outcomes. In contrast, vaccination with an inactivated virus does not appear to impact fertility outcomes. These findings provide crucial guidance for physicians and infertile couples managing treatments during and after the pandemic, suggesting the need for extended recovery periods before ART procedures following COVID-19 infection.

PMID:41423724 | DOI:10.1017/S0967199425100245

Contact Dermatitis. 2025 Dec 21. doi: 10.1111/cod.70073. Online ahead of print.

ABSTRACT

BACKGROUND: Chronic actinic dermatitis (CAD) is a photodermatosis associated with contact allergy. Changes in the contact allergen profile in patch-tested CAD patients from our department have been reported over several decades.

OBJECTIVES: To determine the frequency of positive patch tests and allergen profiles in recently investigated CAD patients and compare this to profiles in earlier decades.

METHODS: A retrospective cohort study was undertaken at a tertiary Cutaneous Allergy department between 2011 and 2021. Demographics and 10 allergens with highest positivity in CAD and non-CAD patients were compared.

RESULTS: Patch testing was performed in 309 (88.3%) of 349 CAD patients, with 186 (60.2%) testing positive to any allergen and 8 (2.6%) positive on photo-patch testing. Patients aged > 40 and with Fitzpatrick skin type V-VI were statistically more likely to be patch test positive (age > 40: p = 0.0082; Fitzpatrick skin type: p = 0.0361). Sesquiterpene lactones (SQL) (6.8%) and formaldehyde (4.8%) were amongst the top 10 most frequently positive allergens in CAD but not in non-CAD patients.

CONCLUSION: Allergic contact dermatitis remains prevalent amongst CAD patients, although sensitisation to allergens historically linked to CAD is decreasing. The cause of this is unclear but potentially due to changes in environmental exposures, particularly in younger CAD patients.

PMID:41423722 | DOI:10.1111/cod.70073

Med Phys. 2026 Jan;53(1):e70235. doi: 10.1002/mp.70235.

ABSTRACT

BACKGROUND: Accurate cardiac structure segmentation from echocardiography is essential for quantitative cardiac function assessment in clinical cardiology. However, traditional manual annotation is time-consuming and subjective, and existing automated methods often overlook inter-patient anatomical differences, particularly sex-related variability, limiting their generalizability.

PURPOSE: We propose BTY-Net (Bidirectional Encoder Representations from Transformers (BERT) Text-based Y-shaped Network), a novel automatic segmentation framework designed to incorporate patient-specific attributes, enabling personalized and anatomically adaptive segmentation of echocardiograms.

METHODS: BTY-Net is built upon a Unet3+ backbone combined with a Transformer encoder, incorporates a multi-layer denoising filter to enhance image quality, and employs a pre-trained BERT model to encode patient demographic and acquisition context as natural language embeddings. Experiments were conducted on the Cardiac Acquisitions for Multi-structure Ultrasound segmentation dataset (500 biplane cases, 400/50/50 train/validation/test split). We benchmarked eight state-of-the-art models (e.g., variants of Unet and generative adversarial networks). Dice similarity (Dice) and Hausdorff Distance (HD) served as the primary metrics. Statistical significance was assessed via the Wilcoxon signed-rank test with p < 0.05 as the threshold, and Holm-Bonferroni correction (α = 0.05) was applied for multiple comparisons. The Hedges’ g effect was calculated to quantify the difference.

RESULTS: BTY-Net achieved the highest Dice coefficients across the three cardiac structures (LV endocardium: 0.9316 ± 0.027; LV myocardium: 0.8617 ± 0.050; left atrium: 0.8703 ± 0.086) and the lowest HD values (8.14 ± 3.44, 10.97 ± 7.41, and 11.13 ± 8.16, respectively). Compared with the strongest baseline, BTY-Net improved Dice by up to 0.02-0.03 and reduced HD by approximately 1.1-1.5 mm, with Holm-adjusted p < 0.05 and small-to-medium Hedges’g effect sizes. Across all test cases, BTY-Net yielded the highest agreement with reference ejection fraction (correlation = 0.9119, MAE = 3.40%). Sex-stratified analyses further confirmed stable performance in both male and female subgroups, indicating robust adaptation to anatomical diversity.

CONCLUSIONS: BTY-Net offers an effective and interpretable solution for personalized echocardiographic analysis. By leveraging multimodal fusion of patient information and image data, it enhances segmentation accuracy, and embeds clinically meaningful attention maps, thereby delivering a multimodal, sex-robust and clinically interpretable solution for routine echocardiographic analysis.

PMID:41423714 | DOI:10.1002/mp.70235

Nutr Bull. 2025 Dec 21. doi: 10.1111/nbu.70040. Online ahead of print.

ABSTRACT

The double burden of malnutrition (DBM), defined as the coexistence of undernutrition and overnutrition within the same population or individual, is a growing concern in low- and middle-income countries (LMICs) such as Nepal. Identifying malnutrition in schools supports targeted interventions. This study estimates the prevalence of stunting, underweight, overweight and obesity among Nepalese schoolchildren and examines the coexistence of stunting and overweight. We conducted a cross-sectional study of 11 782 students aged 6-18 years from 111 randomly selected schools in Kaski, Nepal. Sociodemographic data were collected via questionnaire, and trained researchers measured height and weight. Malnutrition was classified using the World Health Organization (WHO) growth standards, and chi-square tests were used for statistical comparisons. The prevalence of stunting, underweight, overweight and obesity was 15.8%, 6.1%, 10.7% and 3.3%, respectively, while 1.0% of students were both stunted and overweight/obese. Stunting was more common in rural schools (20.5% vs. 15.1%, p < 0.001), whereas overweight (11.2% vs. 7.1%, p < 0.001) and obesity (3.6% vs. 1.5%, p < 0.001) were more common in urban schools. Public school students were more often stunted (18.2% vs. 13.2%, p < 0.004) and underweight (6.7% vs. 5.4%, p < 0.001), whereas private school students were more often overweight (13.3% vs. 8.2%, p < 0.001) and obese (5.0% vs. 1.7%, p < 0.001). The DBM occurs at both school and individual levels, including within the same school, with undernutrition more common in rural and public schools and overnutrition in urban and private schools. Tailored school-based nutrition programmes are urgently needed.

PMID:41423711 | DOI:10.1111/nbu.70040

J Cardiothorac Surg. 2025 Dec 21. doi: 10.1186/s13019-025-03773-4. Online ahead of print.

ABSTRACT

OBJECTIVE: To systematically review the clinical efficacy of amiodarone in the treatment of myocardial infarction in prehospital emergency.

METHODS: Articles related to the use of amiodarone in prehospital emergency treatment of myocardial infarction were retrieved from PubMed, Cochrane Library, EMBASE, Wanfang, VIP and CNKI databases, and the retrieval time was from the establishment of the database to October 31 2024. Meta-analysis and risk bias evaluation were carried out with R 4.2.2 software, and the results were considered statistically significant when P < 0.05.

RESULTS: A total of 16 studies involving 832 patients receiving prehospital amiodarone and 800 control patients were included in this systematic review and meta-analysis. Pooled results demonstrated that, compared to the control group, amiodarone significantly reduced the incidence of malignant arrhythmia (RR = 0.29, 95% CI: 0.22 to 0.37, P < 0.01), decreased the average number of defibrillations (MD = -2.40, 95% CI: -2.61 to -2.19, P < 0.01), improved the success rate of rescue (RR = 1.16, 95% CI: 1.12 to 1.21, P < 0.01), lowered the recurrence rate of myocardial infarction (RR = 0.22, 95% CI: 0.13 to 0.35, P < 0.01), reduced the incidence of adverse reactions (RR = 0.33, 95% CI: 0.12 to 0.87, P = 0.02), and shortened the length of hospital stay (MD = -3.81, 95% CI: -4.02 to -3.59, P < 0.01).

CONCLUSION: This systematic review and meta-analysis demonstrated that prehospital amiodarone administration in patients with myocardial infarction significantly reduced the incidence of malignant arrhythmia and the average number of defibrillations, while improving the success rate of rescue. Furthermore, it lowered the incidence of adverse reactions, the recurrence rate of myocardial infarction, and shortened the length of hospital stay. These findings support the clinical promotion of amiodarone in prehospital emergency care for myocardial infarction.

PMID:41423705 | DOI:10.1186/s13019-025-03773-4

Sci Rep. 2025 Dec 21. doi: 10.1038/s41598-025-29644-5. Online ahead of print.

ABSTRACT

The purpose of the current investigation is to design a novel radial basis neural network for solving the dynamical hepatitis C virus model in patients with a high baseline viral load, which represents the nonlinear dynamical structure. The infection and treatment in the hepatitis C virus comprise uninfected hepatocytes, creatively infected hepatocytes, and viruses. The aim of this study is to solve the dynamical hepatitis C virus model in patients with a high baseline viral load with the optimization of the Bayesian regularization scheme. A database reference solution is achieved by the explicit Runge-Kutta in interval 0 and 1 with the step size of 0.01 by data division into training as 72%, while 14%, 14% for endorsement, and testing. Twenty numbers of neurons, a feed forward neural network, activation radial basis function, and the optimization Bayesian regularization approach have been used to solve the hepatitis C virus model. The precision of the scheme is perceived by the outcomes overlapping and the reducible absolute error values, which are found as 10^-06 to 10^-08. A statistical evaluation utilizing various operators and proportional approaches is carried out in order to assess the solver’s efficiency.

PMID:41423703 | DOI:10.1038/s41598-025-29644-5

BMC Cancer. 2025 Dec 22. doi: 10.1186/s12885-025-15436-7. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the value of quantitative parameters and radiomic features based on dual-layer spectral detector CT (DLCT) in predicting spread through air spaces (STAS) of lung adenocarcinoma (LUAD).

METHODS: This study analyzed 266 patients with pathologically confirmed LUAD from two medical centers. Patients from center 1 were divided into training (n = 131) and internal validation (n = 57) sets, while center 2 (n = 78) formed the external validation set. Clinical data, conventional imaging features, and DLCT quantitative parameters were analyzed to develop a clinical-radiological model. Radiomic features were extracted from venous-phase images, including conventional images, virtual monoenergetic images (VMI) at 40 keV, 65 keV, and 100 keV, along with iodine density maps, effective atomic number (Zeff) maps, and electron density (ED) maps. The best-performing radiomics model was combined with clinical-radiological predictors to create a nomogram. Model performance was evaluated through ROC analysis, calibration curves, and decision curve analysis.

RESULTS: Multivariate analysis revealed that tumor-lung interface and ED values were independent predictive factors in the clinical-radiological model. The optimal radiomics model was constructed based on VMI 40 keV, demonstrating AUCs of 0.899, 0.835, and 0.828 in the training, internal validation, and external validation sets, respectively. The nomogram, which incorporated the VMI 40 keV radiomics signature along with tumor-lung interface and ED values, outperformed the clinical-radiological model in the training set (AUC = 0.910 vs. 0.870; P = 0.018) and the internal validation set (AUC = 0.868 vs. 0.798; P = 0.046). While the improvement in the external validation set was not statistically significant (AUC = 0.848 vs. 0.819; P = 0.184).

CONCLUSION: The nomogram, which integrates conventional imaging features, DLCT quantitative parameters and VMI 40 keV radiomic features, demonstrates promising performance and represents a potential valuable non-invasive tool for the preoperative assessment of STAS in LUAD.

PMID:41423690 | DOI:10.1186/s12885-025-15436-7

BMC Oral Health. 2025 Dec 22. doi: 10.1186/s12903-025-07526-6. Online ahead of print.

ABSTRACT

BACKGROUND: The complex and irregular morphology of prepared oval root canals poses optimal sealing in oval canals as a key endodontic challenge. To address this, this study utilized five types of standardized 3D-printed models replicating prepared anatomy of extracted teeth with oval canal, to characterize the morphological diversity of oval canals after preparation and evaluate the efficacy of three obturation techniques across different morphologies.

METHODS: Five standardized 3-dimensional printed models replicating prepared oval canal morphology were produced using cone-beam computed tomography (CBCT)-derived data from sixty extracted premolars, which had undergone standardized collection, screening, and in vitro preparation procedures. Three obturation techniques (n = 15 each) were evaluated: (1) lateral condensation with AH-Plus sealer (AHP-LC), (2) continuous wave vertical compaction with AH-Plus sealer (AHP-CWC), and (3) single-cone technique with iRoot SP sealer (SP-SC). Micro-CT scanning and volumetric analyses were employed to quantify the obturation quality. Statistical analysis was performed using Mann-Whitney U test, Kruskal-Wallis H test, Dunn’s test or Spearman rank’s correlation depending on the experimental design.

RESULTS: Micro-CT analysis revealed significant differences in the percentage of void volume (PVV) among the obturation techniques. Over the entire canal length, SP-SC demonstrated significantly lower PVV compared to AHP-LC and AHP-CWC (p < 0.01). In the apical third, canal morphology significantly influenced the PVV of AHP-CWC (p < 0.05), with a more circular cross-section (higher roundness) correlating strongly with a lower PVV (p < 0.001). No significant effects of morphology were observed in other canal segments or with the other obturation techniques.

CONCLUSIONS: SP-SC achieved more complete three-dimensional adaptation regardless of morphological variations in oval canals including varied diameter ratios, isthmus and recess. Conversely, AHP-CWC’s performance was significantly dependent on canal morphology in the apical third, where more circular cross-sections correlated with lower void volumes.

PMID:41423672 | DOI:10.1186/s12903-025-07526-6