Category: Statistics

Knee Surg Sports Traumatol Arthrosc. 2025 Jul 21. doi: 10.1002/ksa.12757. Online ahead of print.

ABSTRACT

PURPOSE: Determine whether patellar height differs significantly between knees with objective patellar instability (OPI) and controls, and to develop a magnetic resonance imaging-based (MRI-based) quantitative method for classifying ‘functional patella alta’ relative to both tibia and trochlea.

METHODS: This cross-sectional study included all records of adults who underwent an MRI of their knee between 2019 and 2022 at the senior authors’ centre. The OPI group (n = 127) included patients with >2 documented episodes of lateral patellar dislocation and no previous knee surgery, and the control group (n = 97) included patients with isolated meniscal tears and no history of patellofemoral disorders or knee surgery. Four readers independently measured the MRI patellar height index (PHI), the sagittal patellar engagement (SPE) index and the patellar tendon length (PTL). The control group’s interquartile ranges of PHI (75th percentile) and SPE index (25th percentile) were used to define ‘patella norma’ (PHI ≤ 1.16 and SPE index ≥ 0.38) and ‘functional patella alta’ (PHI > 1.16 and SPE index < 0.38). Multivariable logistic regression analyses assessed the associations between patellar height and trochlear dysplasia with knees exhibiting OPI.

RESULTS: Comparison between ‘patella norma’ and ‘functional patella alta’ revealed statistically significant differences for PHI (mean difference [MD], -0.23; p < 0.001), SPE index (MD, 0.28; p < 0.001) and PTL (MD, -7; p < 0.001). The prevalence of ‘functional patella alta’ was 24% in OPI knees (30 of 127) and 6% in control knees (6 of 97). Multivariable logistic regression revealed that ‘functional patella alta’ and trochlear dysplasia were independently associated with OPI.

CONCLUSION: Standardized MRI-based assessment of patella alta relative to both tibia and trochlea is reliable using thresholds of PHI (>1.16) and SPE index (<0.38). These thresholds, specifically developed for MRI, should improve the conventional assessment using the Caton-Deschamps index, originally developed for true lateral radiographs.

LEVEL OF EVIDENCE: Level III.

PMID:40686068 | DOI:10.1002/ksa.12757

Analyst. 2025 Jul 21. doi: 10.1039/d5an00521c. Online ahead of print.

ABSTRACT

Detection and discrimination of neonicotinoid insecticides (NNIs) are highly desired, but they are still challenging tasks owing to the minor differences in the molecular structures among the massive subtypes of NNIs. In this work, a room-temperature phosphorescence (RTP) sensor array for the detection and discrimination of NNIs was fabricated via a host-guest doping strategy. NNIs were doped into a boric acid host, which enhanced its RTP intensities by inhibiting the molecular motion, narrowing the energy gap between the singlet and triplet states, and providing rigid protection structures. A sensor array was fabricated by integrating the RTP intensities and emission lifetimes. Five types of NNIs were quantitatively detected and discriminated using statistical algorithms. Aided by the delayed collection model of the RTP signal, the sensor array showed excellent detection performance in real food samples. These results open a new door for designing various detection routes for applications in food analysis.

PMID:40686059 | DOI:10.1039/d5an00521c

Disaster Med Public Health Prep. 2025 Jul 21;19:e198. doi: 10.1017/dmp.2025.10124.

ABSTRACT

Anesthesiologists are broadly trained members of the health care workforce, managing patients daily using advanced stabilization/resuscitative techniques. They work in a collaborative, team-based model and lead multidisciplinary teams. Their work includes prioritizing patients according to the complexities of their disease presentations, and threats to life and limb. Trauma care is a regular part of the anesthesiologist’s job. The presence of anesthesiologists is required in hospitals to achieve the designation “level 1” trauma center. Anesthesiology is a specialty known for promoting safe practice principles and improving quality of care, utilizing crisis resource management and implementing cognitive aids. Despite these skillsets, anesthesiologists are generally overlooked in disaster preparedness. The number of trained anesthesiologists is similar to that of emergency medicine physicians, and they are nearly twice as abundant as general surgeons. In countries outside the US, anesthesiologists are often included in the pre-hospital team.The purpose of this article is to emphasize the skillsets of anesthesiologists and to advocate for their inclusion in disaster preparedness teams. Due to their presence and comfort throughout the hospital system, broad training in emergent and elective cases, resuscitation skills, procedural skills, communication skills, daily triage, and team management, anesthesiologists should be considered essential leaders during mass casualty incident preparation and response.

PMID:40686050 | DOI:10.1017/dmp.2025.10124

Disaster Med Public Health Prep. 2025 Jul 21;19:e196. doi: 10.1017/dmp.2025.10071.

ABSTRACT

OBJECTIVES: The objective of this scoping review is to identify the types of EMC provided by humanitarian organizations in response to sudden-onset disasters in Southeast Asia in the last 10 years.

METHODS: We followed Arskey and O’Malley method and Joanna Briggs Institute guidance. Limited to online-based journal databases (PubMed, Embase, and ProQuest) and ReliefWeb and PreventionWeb for grey literature between 2014 and 2023. Study was performed from January-June 2024.

RESULTS: Finally, 33 studies were included covering 17 disasters (Indonesia, Philippines, Laos, and Myanmar). Fourteen disasters were caused by a single hazard: earthquakes (6, 35.3%), floods (4, 23,5%), cyclones (2, 11.8%), tsunamis (1, 5.9%), and volcanic eruptions, and 3 were multi-hazard: earthquakes and tsunamis (2, 11.8%) and flood and landslide (1, 5.9%). The main services provided were mental health and psychosocial support; assessment, resuscitation, and stabilization; referral and transfer; and health promotion and community engagement.

CONCLUSIONS: Humanitarian organizations should prioritize services to meet demands: mental health and psychosocial support; assessment, resuscitation, and stabilization; referral and transfer; and health promotion and community engagement. This can guide national governments in scaling up preparedness and response efforts, ensuring that demands are met at a local level but also aligned with international disaster response.

PMID:40686046 | DOI:10.1017/dmp.2025.10071

Disaster Med Public Health Prep. 2025 Jul 21;19:e197. doi: 10.1017/dmp.2025.10062.

ABSTRACT

OBJECTIVES: Large-scale crises, including wars and pandemics, have repeatedly shaped human history, and their simultaneous occurrence presents profound challenges to societies. Understanding the dynamics of epidemic spread during warfare is essential for developing effective containment strategies in complex conflict zones. While research has explored epidemic models in various settings, the impact of warfare on epidemic dynamics remains underexplored.

METHODS: We proposed a novel mathematical model that integrates the epidemiological SIR (susceptible-infected-recovered) model with the war dynamics Lanchester model to explore the dual influence of war and pandemic on a population’s mortality. Moreover, we consider a dual-use military and civil health care system that aims to reduce the overall mortality rate, which can use different administration policies such as prioritizing soldiers over civilians. Using an agent-based simulation to generate in silico data, we trained a deep reinforcement learning model based on the deep Q-network algorithm for health care administration policy and conducted an intensive investigation on its performance.

RESULTS: Our results show that a pandemic during war conduces chaotic dynamics where the health care system should either prioritize war-injured soldiers or pandemic-infected civilians based on the immediate amount of mortality from each option, ignoring long-term objectives.

CONCLUSIONS: Our findings highlight the importance of integrating conflict-related factors into epidemic modeling to enhance preparedness and response strategies in conflict-affected areas.

PMID:40686043 | DOI:10.1017/dmp.2025.10062

Br J Psychiatry. 2025 Jul 21:1-2. doi: 10.1192/bjp.2025.113. Online ahead of print.

NO ABSTRACT

PMID:40686042 | DOI:10.1192/bjp.2025.113

J Dairy Res. 2025 Jul 21:1-5. doi: 10.1017/S0022029925100976. Online ahead of print.

ABSTRACT

To understand the requirements of animals their calls can be analysed. This potentially enables specific and more precise individual care under different emotional and physiological conditions. This study was conducted to identify three different conditions (oestrus, delayed milking and isolation) of buffaloes based on vocalization patterns. A total of 600 acoustic samples of buffaloes for each condition were collected under different conditions consisting of 300 records for confirming and 300 for non-confirming of a particular condition. Important acoustic features like amplitude (P), total energy (P²s), pitch (Hz), intensity (dB), formants (Hz), number of pulses, number of periods, mean period (sec) and unvoiced frames (%) were extracted using the MFCC (mel frequency cepstrum coefficients) technique. Algorithms (model) were trained by partitioning the acoustic data into training and validation sets to develop predictive models. Three different ratios were assessed: 60%-40%, 70%-30% and 80%-20%. Decision tree models were optimized based on decision and average square error (probability) options and other parameters were set to default values of the software package to deveop the best model. The performance of algorithms was evaluated on the parameter accuracy rate. Decision tree models predicted the physiological conditions oestrus, isolation and delayed milking with an accuracy of 66.1, 84.3 and 71.3%, respectively, while the logistic regression model predicted with an accuracy rate of 59.5, 71.1 and 65.7%, respectively, and the artificial neural network (ANN) model predicted these three conditions with 77.7, 85.2 and 79.4% accuracy, respectively. The ANN model was found to be best on the basis of minimum misclassification rate (on 80%-20% portioning). However, decision tree algorithms also provided the additional information that intensity (maximum), amplitude (minimum) and formant (F1) are the most important features of vocal signals to identify physiological conditions like oestrus, isolation and delayed milking respectively in dairy buffalo.

PMID:40686040 | DOI:10.1017/S0022029925100976

Biol Res Nurs. 2025 Jul 21:10998004251362369. doi: 10.1177/10998004251362369. Online ahead of print.

ABSTRACT

Biomarkers may complement patient-reported outcomes by providing objective insight into the multidimensional nature of chronic pain. The urine metabolite pain indicator (UMPI), a composite of four urine metabolites, has previously demonstrated cross-sectional associations with pain-related symptoms; however, it is unclear whether these associations are consistent over time. This study evaluated whether the UMPI and its individual metabolites remain associated with chronic pain outcomes following intervention, which would support its potential as a monitoring biomarker. A secondary analysis of a pragmatic clinical trial, where 148 active-duty service members with chronic pain provided urine samples and completed 11 self-reported outcome measures at baseline and 6-week follow-up after either a complementary and integrative health or a standard rehabilitative care pain intervention. Associations were examined using linear regression and mixed models. The UMPI remained significantly associated with physical function and overall pain impact post-intervention. Ethylmalonic acid showed associations with fatigue, anger, and physical function. Notably, methylmalonate, while not significant at baseline, had the most robust association with pain post-intervention, including significant correlations with both physical function and pain impact. Kynurenic acid was associated with sleep-related impairment. Pyroglutamic acid showed no significant adjusted associations. No statistically significant differences in metabolite and symptom correlations were found between time points, suggesting that these associations remained consistent over the short term. The UMPI may serve as a reliable, noninvasive index biomarker for tracking chronic pain burden, particularly physical outcomes. Findings support integrating the UMPI into biologically informed chronic pain assessment.

PMID:40686028 | DOI:10.1177/10998004251362369

Brain Behav. 2025 Jul;15(7):e70704. doi: 10.1002/brb3.70704.

ABSTRACT

BACKGROUND: Hemorrhagic stroke remains a major cause of mortality, with hypertension being a key modifiable risk factor. Despite advancements in management, demographic and geographic disparities persist. This study aims to analyze hemorrhagic stroke-related mortality trends among hypertensive adults in the United States from 1999 to 2023, stratified by sex, race, and geographic location.

METHODS: We utilized death certificate data from the CDC WONDER database for individuals aged ≥ 25 years from 1999 to 2023. Crude mortality rates (CMR) and Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and annual percentage change (APC) were determined using Joinpoint regression analysis.

RESULTS: From 1999 to 2023, a total of 372,922 deaths were identified related to hemorrhagic stroke and hypertension. The overall AAMR was 0.45 in 1999 and 6.88 in 2023, with no significant trend observed over the study period. Males consistently exhibited higher AAMRs than females (Males: 7.76 vs. Females: 6.06 in 2023). When stratified by race, the highest AAMR was observed in non-Hispanic (NH) Black or African American populations, followed by NH other, Hispanic or Latino, and NH White populations (AAMR of 10.95, 8.20, 7.83, and 5.86, respectively, in 2023). Regionally, the highest mortality was observed in the West, followed by the South, the Midwest, and lastly, the Northeast (with values of 7.91, 7.76, 5.91, and 4.82, respectively, in 2023). Urban areas (6.79) exhibited consistently higher AAMRs than rural areas (6.13) from 1999 to 2020.

CONCLUSION: Hemorrhagic stroke and hypertension-related mortality remained stable in the United States from 1999 to 2023, with males, NH Black or African American populations, and the Western region exhibiting the highest AAMRs. These findings highlight the importance of improving hypertension management and addressing mortality disparities.

PMID:40686020 | DOI:10.1002/brb3.70704

Prostate. 2025 Jul 21. doi: 10.1002/pros.70018. Online ahead of print.

ABSTRACT

BACKGROUND: We aim to evaluate whether increased lymph node yield at prostatectomy (RP) is associated with improved outcomes in NRG/RTOG 9601, a randomized clinical trial of men who underwent either radiation (RT) alone or RT + bicalutamide for PSA elevation following RP for pT2/T3 prostate cancer.

METHODS: We reviewed available pathology reports for patients in NRG/RTOG 9601 to determine the nodal count at RP. Cox proportional hazards models were used to assess effect of lymph nodes yield, arm (RT alone or RT + bicalutamide), Gleason score, positive margins, and seminal vesicle invasion on the following endpoints: times to local and distant failure and overall and disease-specific survival.

RESULTS: Of 760 patients, 552 (73%, 276 in each arm) had complete data available. Median node count in the entire cohort was 6 (range: 0-33, IQR: 3-9). There were no significant differences between arms in terms of patient demographic or clinical characteristics, including total lymph nodes removed in either arm. There was no significant association between total lymph nodes and overall or disease-specific survival with both arms combined and when adjusting for arm. Notably, interaction analysis revealed that in seminal vesicle invasion, there was a significant association between lymph node yield and OS and DSS (HR = 0.91, 95% CI: 0.83-0.99, p = 0.034; HR = 0.87, 95% CI: 0.77-0.99, p = 0.029, respectively).

CONCLUSIONS: Although lymph node yield in NRG/RTOG 9601 did not show association with adverse outcomes in the entire cohort or either arm alone, there was significant association between lymph node yield and adverse outcomes when seminal vesicle invasion was present. The therapeutic benefit of extensive lymph node dissection remains uncertain but could be more relevant in higher risk patients.

PMID:40686005 | DOI:10.1002/pros.70018