Category: Statistics

Res Sq [Preprint]. 2025 Jul 15:rs.3.rs-6874039. doi: 10.21203/rs.3.rs-6874039/v1.

ABSTRACT

Purpose : The impact of the COVID-19 pandemic on employment and various financial burden domains has not been well researched, particularly in vulnerable populations. This study examined the impact of the pandemic among those living in an Ohio metro county compared to a non-metro county on employment and financial concerns. Methods : We conducted a survey between June and November 2020 and collected participants’ demographics, employment status, perceived financial status, and health-related conditions. Multivariable logistic regression models assessed the association between regions of residence (metro or non-metro) and various perceived financial concerns. Findings : Among the 6,123 respondents with complete data, the average age was 55.7 years, 67.2% were female, 87.1% were white non-Hispanic, and 30.2% lived in a non-metro county. Compared to those living in metro counties, non-metro respondents had significantly higher odds of reporting not having full- or part-time employment right before the start of the lockdown (aOR=1.24; 95% CI 1.02-1.52) and significantly higher odds of being unpaid for a full- or part-time job (aOR=1.5; 95%CI 1.23-1.84) during the pandemic. Region of residence did not significantly differ in terms of employment loss or concern regarding financial outcomes. Conclusions : Although metro and non-metro residents did not differ in employment loss due to the COVID-19 pandemic, non-metro residents had a higher likelihood of not having a full- or part-time job prior to the pandemic and remained more likely to be unpaid during the pandemic. However, nonmetro residents reported fewer financial concerns, although statistically insignificant, highlighting potential differences in perception and cognitive processes.

PMID:40709267 | PMC:PMC12288524 | DOI:10.21203/rs.3.rs-6874039/v1

Addiction. 2025 Jul 24. doi: 10.1111/add.70134. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: In California, USA, adult cannabis legalization (ACL) was passed in 2016, with implementation of legal sales commencing in 2018. This study examined whether these policy changes were associated with changes in alcohol use patterns and explored age-group differences.

DESIGN: We examined monthly rates of positive alcohol screens in primary care patients in California from 2015 to 2019. Using an interrupted time series design and autoregressive integrated moving average (ARIMA) models, changes were evaluated in the overall sample and stratified by age groups (21-34, 35-64 and 65+) across two key intervention points for ACL: 9 November 2016 (ACL passage) and 1 January 2018 (ACL implementation). Time-varying confounders of seasonality and autocorrelation were controlled for.

SETTING: California, United States; Kaiser Permanente Northern California Healthcare System.

PARTICIPANTS: Across the study period, n = 8 028 627 screenings were completed for n= 3 525 493 unique patients aged 21+ .

MEASUREMENTS: Aggregated monthly rates of patients exceeding daily limits, weekly limits, exceeding both daily and weekly limits and frequent heavy episodic drinking (HED), based on current US guidelines set by the National Institute on Alcohol Abuse and Alcoholism.

FINDINGS: Statistically significant, gradual declines in rates of both exceeding weekly alcohol limits [estimate (95% confidence interval [CI]) of slope change = -0.013(-0.019 to -0.008), P < 0.001] and frequent HED followed ACL passage [estimate (95% CI) of slope change = -0.015(-0.024 to -0.005), P = 0.003]. ACL implementation was generally not associated with further changes, suggesting changes after ACL passage were sustained over time. Age-group patterns varied: young adults (21-34) demonstrated an immediate increase, followed by a statistically significant gradual decline in rates of HED post-ACL passage [estimate (95% CI) of slope change = -0.096(-0.160, -0.033), P = 0.003], as well as an immediate decrease post ACL implementation; adults 35-49 showed consistent declines in step and slope in rates of frequent HED post ACL passage; adults 50-64 showed an immediate increase in rates of exceeding weekly limits [estimate (95% CI) of step change = 0.167(0.036-0.297), P = 0.012], with gradual declines in the other drinking limits; adults 65 + had small, gradual decreases. In addition, exploratory analyses in 18-20-year-olds showed gradual increases in rates of frequent HED post ACL passage, but the P value was not significant after Bonferroni correction.

CONCLUSIONS: Cannabis policy changes in California, USA, appear to be linked to age-specific changes in alcohol use, with moderate reductions, particularly among middle-aged adults. Findings were associative in nature and causality could not be determined.

PMID:40708086 | DOI:10.1111/add.70134

J Prosthodont. 2025 Jul 24. doi: 10.1111/jopr.70011. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to investigate the impact of an increasing level of monomer contamination of isopropanol (isopropyl alcohol [IPA]) during post-rinsing on the dimensional stability of test samples produced by vat photopolymerization. The effect of resin deposits due to insufficient post-rinsing on the accuracy (volume, mean, and maximum deviation) of additive manufacturing workflows was investigated, which has received limited attention in studies on accuracy.

MATERIALS AND METHODS: Forty test specimens (four groups, n = 10) were produced from a commonly used resin for dental model fabrication and underwent post-rinsing in IPA with different levels of monomer contamination (0, 10, 20, and 30 wt%). The dimensional stability was assessed by comparing the optical scan of the produced test specimens with the original digital design. Both the volume of the deposited resin and the effect of different model shapes (inner edges, smooth surfaces, and outer edges) on deposition were investigated. Statistical evaluation was performed using the Kruskal-Wallis test and Dunn’s test for pairwise comparisons with Holm correction. To simulate clinical conditions, 20 dental models (four groups, n = 5) were produced, post-processed, and examined using a scanning method.

RESULTS: No significant deviations in specimen dimensions occurred when the monomer contamination was 0%-10%. In the range of 10%-20% contamination, a few significant deviations occurred in the area of sharp inner edges, “inside structures” and small structures (diameter <1000 µm). At contamination levels of 30%, significant deviations were observed eventually in all measured areas.

CONCLUSIONS: This study showed that, contrary to the manufacturer’s specifications, the IPA should only be replaced during post-rinsing if the monomer contamination of the rinsing solution is >20%. At contamination levels of 10%-20%, post-rinsing of components with large smooth surfaces without sharp edges (e.g., custom trays) is possible without significant deformation. Only for components with very small, sharp-edged, or inverted structures is it advisable to replace the IPA from a contamination level of 10%.

PMID:40708085 | DOI:10.1111/jopr.70011

Int J Retina Vitreous. 2025 Jul 24;11(1):83. doi: 10.1186/s40942-025-00711-3.

ABSTRACT

BACKGROUND: Epiretinal proliferation (ERP) is an extension of preretinal tissue, creating a thin, semi-translucent layer of fibrous tissue on the retina. ERP has been recently associated with degenerative lamellar macular holes (DLMH) and full-thickness macular holes (FTMH). The proposed surgery for patients has been vitrectomy and ERM peeling, but there is no consensus on whether DLMH is a stable condition or should be resolved with surgical treatment. The purpose was to investigate optical coherence tomography (OCT) changes and visual outcomes of degenerative LMH and FTMH secondary to ERP after pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling.

METHODS: This retrospective case series evaluated 14 eyes with DLMH and eight eyes with FTMH. All 22 eyes were associated with ERP and treated with PPV with ILM peeling. Best-corrected visual acuity (BCVA, in logMAR), OCT findings, including presence of foveal bump and ellipsoid zone integrity, were documented. Wilcoxon signed-rank tests were used for numerical data. Statistical significance was based on a value of p < 0.05.

RESULTS: Among the 14 DLMH cases, the mean Snellen equivalent VA was 20/75 at baseline; 20/59 at the 4-12-month postoperative period; and 20/56 at the final follow-up visit. For the eight FTMH cases, the mean Snellen equivalent VA was 20/94 at baseline; 20/45 at the 4-12-month postoperative period; and 20/38 at the final follow-up visit. Compared to baseline VA, FTMH cases demonstrated a statistically significant improvement in the 4-12-month postoperative VA (p < 0.05) and in the final postoperative VA (p < 0.05). Among all cases, a strong correlation was observed between baseline logMAR and change in logMAR from baseline to final follow-up (R² = 0.671).

CONCLUSION: This study demonstrated that surgical intervention led to improved visual and anatomic outcomes in patients with DLMH and FTMH, with a correlation between baseline VA and postoperative visual outcomes. The results suggest that patients with worse preoperative VA experienced the greatest benefit in visual outcome from PPV and ILM peeling. Future studies would look at the timing of when to ideally intervene to improve anatomic and visual outcomes.

PMID:40708062 | DOI:10.1186/s40942-025-00711-3

Eur J Med Res. 2025 Jul 25;30(1):672. doi: 10.1186/s40001-025-02934-4.

ABSTRACT

OBJECTIVE: The morphology of the tongue and its relationship with the hard palate play an important role in the rehabilitation of patents with temporomandibular joint disorders (TMD). This study aimed to evaluate the intra-and inter-evaluator reliability of ultrasound measurements of tongue-palate distance and tongue thickness in healthy individuals.

METHODS: Thirty healthy volunteers were assessed using a Mindray ultrasound device with a C5-1s probe. Two trained evaluators conducted two measurement sessions 1 week apart. Pearson or Spearman correlation analyses and intraclass correlation coefficients (ICCs) were used to determine measurement reliability.

RESULTS: The ICCs for tongue-palate distance were 0.745 (intra-evaluator) and 0.611 (inter-evaluator). For tongue thickness, the ICCs were 0.855 (intra-evaluator) and 0.730 (inter-evaluator). Individual evaluator reliability was consistent: Evaluator A showed ICCs of 0.761 (distance) and 0.862 (thickness); Evaluator B showed ICCs of 0.788 (distance) and 0.841 (thickness). All correlations were statistically significant (p < 0.05).

CONCLUSION: Ultrasound provides a reliable method for quantifying tongue-palate distance and tongue thickness in healthy subjects. These measures could support clinical assessment and rehabilitation planning for conditions such as TMD.

PMID:40708056 | DOI:10.1186/s40001-025-02934-4

BMC Sports Sci Med Rehabil. 2025 Jul 24;17(1):213. doi: 10.1186/s13102-025-01263-7.

ABSTRACT

BACKGROUND: Neuromuscular exercise (NEXA) and celecoxib each are effective for treating knee osteoarthritis (OA), but the potential benefits of combination therapy remain unclear. The aim of this study was to investigate the effects of NEXA in addition to celecoxib compared to celecoxib alone on pain and physical function in patients with symptomatic and radiographic knee OA.

METHODS: A prospective, assessor-blinded, two-arm, superiority randomised controlled trial. Sixty participants with Kellgren and Lawrence (KL) grade 2-3 symptomatic knee OA were included and randomly assigned 1:1 to undergo 12 weeks NEXA and celecoxib or to receive celecoxib 200 mg once daily alone. The primary outcomes were visual analog scale (VAS) and total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at 6 months. The secondary outcomes included the Knee injury and Osteoarthritis Outcome Score (KOOS), six-minute walk test, and Timed Up and Go (TUG) test at 3 months and 6 months.

RESULTS: At 6 months, the between-group differences in the VAS score (mean difference, -10.30; 95% CI, -19.38 to -1.23; P = 0.026) and total WOMAC score (mean difference, -10.40; 95% CI, -15.54 to -5.27; P < 0.001) were statistically in favour of the NEXA and celecoxib group. There was evidence that NEXA in addition to celecoxib were superior to celecoxib alone for KOOS symptoms score (P = 0.040), KOOS activities of daily living score (P < 0.001), KOOS sport and recreation score (P = 0.014), KOOS quality of life score (P = 0.036), six-min walk test (P = 0.006), and TUG test (P = 0.001) at 6 months. The NEXA and celecoxib group achieved significantly higher proportions of patients above the minimal clinically important difference in total WOMAC score (78.6% vs. 51.9% for absolute improvement; 75% vs. 37% for relative improvement) at 6 months.

CONCLUSIONS: Compared with celecoxib alone, there was a beneficial effect of NEXA in addition to celecoxib on pain and physical function in patients with symptomatic and radiographic knee OA at 6 months.

TRIAL REGISTRATION: ChiCTR-IOR-14,005,414, 31/10/2014.

PMID:40708052 | DOI:10.1186/s13102-025-01263-7

J Health Popul Nutr. 2025 Jul 24;44(1):267. doi: 10.1186/s41043-025-01021-y.

ABSTRACT

BACKGROUND: Drug-resistant tuberculosis (DR-TB) is a significant challenge to the national tuberculosis (TB) control program in Ethiopia. The Tigray region in northern Ethiopia has shown a surge in the incidence of DR-TB cases. However, the determinants of DR-TB in the region are not studied. This study is aimed at identifying the factors associated with the development of DR-TB in the Tigray region of northern Ethiopia.

METHODS: The study used an unmatched case-control design to identify determinants of DR-TB in the Tigray region, northern Ethiopia, whereby 86 patients and 86 controls who registered for TB treatment follow-up in selected hospitals were recruited. Trained nurses collected both primary and secondary data, which were analyzed using descriptive statistics and binary logistic regression. The test statistics was conducted with a 95% confidence level, and a p-value of less than 0.05 was considered significant.

RESULTS: The study included 86 patients with DR-TB (cases) and an equal number of patients with drug-susceptible (controls). The case and control groups had 38 (44.2%) and 47 (54.7%) males, respectively. The study revealed the study participants with male gender (adjusted odds ratio [AOR] = 4.9, 95% confidence interval [CI: 1.2-19.9), single marital status (AOR = 13.6, 95% CI: 2.3-81.2), history of TB treatment (AOR = 58.2, 95% CI: 11.2-302.1), experienced a delay of more than 60 days before TB diagnosis (AOR = 4.8, 95% CI: 1.2-19.3), interrupted treatment at least once (AOR = 4.9, 95% CI: 1.02-23.9), and unsuccessful treatment outcome at first treatment (AOR = 7.6, 95% CI: 1.8-35.9) had a higher risk of DR-TB.

CONCLUSIONS: The study highlights determinants of DR-TB in the region, including gender, marital status, delayed diagnosis (over 60 days), previous treatment history, interrupted treatment, and unsuccessful treatment outcomes during initial treatment. It is recommended that healthcare providers focus on targeted interventions, such as supporting males and unmarried individuals, ensuring early diagnosis and prompt initiation of treatment, improving treatment adherence, and providing tailored support for patients with histories of incomplete treatment and unsuccessful initial treatment outcomes.

PMID:40708047 | DOI:10.1186/s41043-025-01021-y

Infect Dis Poverty. 2025 Jul 25;14(1):75. doi: 10.1186/s40249-025-01344-2.

ABSTRACT

BACKGROUND: Despite price advantages, local direct-acting antiviral agents (DAAs) for hepatitis C (hep C) have not been widely used in China compared with the imported ones. There is no evidence on their relative efficacy and safety, nor whether the small market share of local DAAs was attributable to the potential differences.

METHODS: This study systematically evaluated the efficacy and safety evidence of 5 local and 6 imported DAAs with valid Chinese registration numbers as of January 25, 2024. Meta-analyses, subgroup analyses and meta-regressions were performed to synthesize evidence and compared the outcomes by using the random-effects empirical Bayes model.

RESULTS: Nineteen randomized controlled trials and 82 single-arm trials (SATs) were included. The results demonstrated no statistically significant difference in 12-week sustained virological response [0.97, (95% confidence interval (CI) 0.95, 0.99) vs 0.96, (95% CI: 0.94, 0.98), P = 0.21], relapse [0.02, (95% CI: 0.01, 0.04) vs 0.02, (95% CI: 0.01, 0.03), P = 0.65], virological breakthrough [0.003, (95% CI: < 0.001, 0.02) vs 0.0000002, (95% CI: < 0.001, 0.0006), P = 0.51] and serious adverse events (SAEs) [0.04, (95% CI: 0.03, 0.06) vs 0.03, (95% CI: 0.02, 0.03), P = 0.12] between local and imported DAAs. By controlling for ethnicities of patients in multiple meta-regression, the local DAAs had a 33.7% higher rate of adverse events (AEs) [0.337, (95% CI: 0.188, 0.486), P < 0.001]. No statistically significant difference was found in the interaction test between local and imported pan-genotypic DAAs regarding the rate of AEs [0.72, (95% CI: 0.64, 0.79) vs 0.73, (95% CI: 0.65, 0.50), P = 0.81].

CONCLUSIONS: Current evidence demonstrates no statistically significant differences in efficacy and SAEs between local and imported DAAs. Given that simplified pan-genotypic DAA regimens are now standard care, local pan-genotypic DAAs hold potential to increase hepatitis C virus treatment rates in China. It is critical for local DAA developers to generate more evidence with expanded patient population in terms of age, treatment experience and genotype of hepatitis C virus, conducting head-to-head studies directly comparing the efficacy and safety. Clinical and policy decision-making should be adaptive and evolve as new evidence is generated.

PMID:40708038 | DOI:10.1186/s40249-025-01344-2

BMC Musculoskelet Disord. 2025 Jul 24;26(1):699. doi: 10.1186/s12891-025-08947-8.

ABSTRACT

PURPOSE: The management of displaced anterior glenoid rim fractures remains a topic of debate, particularly in elderly patients where surgical risks are heightened. While surgical intervention is often recommended to prevent instability and degenerative arthritis, some studies suggest that nonoperative treatment may yield satisfactory results. This study aims to evaluate whether nonoperative treatment of displaced anterior glenoid rim fractures leads to anterior shoulder instability in elderly patients.

METHODS: A retrospective review was conducted on patients over 60 years of age diagnosed with Ideberg type Ia anterior glenoid rim fractures (> 5 mm fragment) who underwent nonoperative treatment. Patients with associated injuries, neurological disorders, or dislocated fractures requiring reduction were excluded. Treatment involved sling immobilization for up to 4 weeks, followed by a structured rehabilitation program. Clinical outcomes were assessed using Constant Score (CS), American Shoulder and Elbow Surgeons (ASES) score, Subjective Shoulder Value (SSV), and range of motion. Radiographic evaluation included fracture healing, displacement, and osteoarthritis progression. Statistical analyses were performed using the Wilcoxon signed-rank test and Fisher exact test.

RESULTS: A total of 21 patients (mean age: 69 years, mean follow-up: 82 months) were included. No cases of subsequent instability (dislocation or subluxation) were observed. At final follow-up, 71% of fractures showed complete healing, while 28% exhibited partial healing with a ≤ 5 mm step. Functional outcomes were favorable, with mean CS of 86, ASES of 87, and SSV of 89%. External rotation in abduction was slightly limited compared to the contralateral side (p = 0.0026). Radiographic signs of new-onset osteoarthritis were present in 4 patients, but none reported instability-related symptoms.

CONCLUSION: Nonoperative treatment of displaced anterior glenoid rim fractures without dislocation in elderly patients provides satisfactory functional and radiographic outcomes, with no evidence of subsequent instability. This approach effectively avoids surgical risks and complications while preserving shoulder function, supporting its role as a viable treatment strategy in this population.

PMID:40708020 | DOI:10.1186/s12891-025-08947-8

BMC Res Notes. 2025 Jul 24;18(1):322. doi: 10.1186/s13104-025-07371-4.

ABSTRACT

The ongoing COVID-19 pandemic has seen the emergence of numerous SARS-CoV-2 variants, each posing distinct public health challenges. The XEC variant, a recombinant Omicron subvariant, has rapidly gained prevalence globally, raising critical questions about its potential implications on health systems and public policy. This paper examines the emergence, spread, and unique characteristics of XEC, especially in the context of the global decline of KP.3.1.1, another significant Omicron lineage. We discussed the public health implications, including vaccine effectiveness, genomic surveillance, and healthcare system preparedness, underscoring the need for adaptive strategies in response to evolving SARS-CoV-2 variants.

PMID:40708011 | DOI:10.1186/s13104-025-07371-4