Category: Statistics

J Clin Periodontol. 2025 Sep 7. doi: 10.1111/jcpe.70019. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Traditional and planimetric plaque indices rely on plaque-disclosing agents and cannot quantify three-dimensional (3D) structures of dental biofilms. We introduce a novel computer-assisted method for evaluating and visualising plaque volume using intraoral scans (IOSs).

MATERIALS AND METHODS: This was a 4-day, non-brushing, plaque-regrowth study (n = 15). All plaque was removed at baseline (T0). IOSs at T0 and after 4 days (T4) were used for volumetric plaque assessment in six steps: model acquisition, model superimposition, computer-aided determination of tooth-surface margins, tooth-surface superimposition, visualisation and volumetric evaluation of biofilms. Plaque formation at T4 was additionally assessed with the Turesky Modification of the Quigley-Hein Plaque Index (TMQHPlI). We used Pearson’s correlation coefficients and multilevel models to investigate the relationships between TMQHPlI, volumetric plaque index (VPI) and the adjusted volumetric plaque index (AVPI, plaque volume/area).

RESULTS: VPI and AVPI positively correlated with the TMQHPlI, showing higher variability at lower TMQHPlI scores. VPI had a lower threshold for plaque detection and higher sensitivity than the TMQHPlI. VPI and TMQHPlI were highest on vestibular, maxillary and molar surfaces.

CONCLUSION: VPI quantifies biofilm deposits, is a more precise measure for plaque detection than the TMQHPlI and can be visualised using colour-coded maps displaying areas of equal plaque thickness.

PMID:40915977 | DOI:10.1111/jcpe.70019

J Clin Periodontol. 2025 Sep 7. doi: 10.1111/jcpe.70029. Online ahead of print.

ABSTRACT

AIM: To characterise periodontal and faecal microbiomes of individuals with periodontal health (PH) and diseases, and evaluate associations with periodontal, sociodemographic, anthropometric, nutritional and lifestyle factors.

MATERIALS AND METHODS: Dental biofilm and faecal samples from individuals (n = 24/group) with PH, gingivitis (GG) and periodontitis (PE) were sequenced (16S rRNA). Anthropometric data and questionnaires on demographics, lifestyle, diet and intestinal habits were collected. Data were statistically analysed (p < 0.05).

RESULTS: GG and PE groups showed higher age, BMI, waist/abdominal circumferences and trans-fat intake and lower selenium and vitamin E intake compared to PH. Individuals with PE had higher hip circumference and lower income, education and intake of iron as well as vitamins A and B9. PE microbiomes (oral and faecal) showed distinct compositions, with the highest number of unique oral species. Faecal richness was lower in PE and GG compared to PH. Specific microbial taxa correlated with periodontal status and host factors.

CONCLUSION: Periodontal and faecal microbiomes vary across periodontal conditions. Discriminant analysis classified 77% of individuals by periodontal status, with key markers for PE including older age, poor dietary quality and distinct microbial oral and faecal signatures. These findings highlight the role of clinical, dietary and microbial factors in periodontal disease profiling.

PMID:40915974 | DOI:10.1111/jcpe.70029

Clin Breast Cancer. 2025 Aug 5:S1526-8209(25)00221-6. doi: 10.1016/j.clbc.2025.07.024. Online ahead of print.

ABSTRACT

BACKGROUND: Emerging evidence suggests that the gut microbiota (GM) may influence the progression of breast cancer by modulating immune responses. Given the vast diversity of GM and immune cell phenotypes, this study aimed to utilize the most advanced and comprehensive data to explore the causal relationships among the GM, immune cell phenotypes, and survival rates in hormone receptor-positive (HR+) breast cancer patients under different treatment regimens.

METHODS: We investigated the causal relationships between the GM, immune cell phenotypes, and survival rates in HR+ breast cancer patients treated with 11 distinct therapeutic strategies using Mendelian randomization. Inverse variance weighted analysis served as the primary statistical method. Additionally, we explored whether immune cell phenotypes act as mediators in the pathway from the GM to HR+ breast cancer survival rates.

RESULTS: In this comprehensive study, we identified 116 distinct GM species that established causal links with survival rates across 11 different subgroups of HR+ breast cancer patients. Furthermore, we discovered 13 potential pathways through which the GM might influence immune cell phenotypes, thereby affecting patient survival rates.

CONCLUSION: The GM is causally associated with survival rates in HR+ breast cancer patients treated with 11 different therapeutic strategies, and immune cell phenotypes serve as mediators in the pathway from the GM to HR+ breast cancer survival rates.

PMID:40915962 | DOI:10.1016/j.clbc.2025.07.024

Encephale. 2025 Sep 6:S0013-7006(25)00139-3. doi: 10.1016/j.encep.2025.06.004. Online ahead of print.

ABSTRACT

INTRODUCTION: Body Dysmorphic Disorder (BDD) is a condition characterized by a distorted perception of one’s own body image. Individuals with BDD exhibit excessive concern about their appearance, often fixating on perceived flaws that are either imaginary or minor. The prevalence of body image-related eating disorders has been increasing among university students, particularly in health-related fields, where students frequently experience pressure to maintain an ideal body shape and weight.

METHODS: This cross-sectional qualitative study was conducted with Nutrition students at a community university in Caçador, Santa Catarina, Brazil. Body image perception was assessed using the Silhouette Matching Task (SMT) by means of an online questionnaire via Google Forms. Data analysis was performed using Student’s t-test and Pearson’s correlation, with statistical significance set at P<0.05.

RESULTS: A total of 46 students participated, of whom 76.08% (n=35) were female. The mean BMI was 23.33kg/m², with a predominance of eutrophic individuals (74.28%). In contrast, the mean BMI for males was 28.42kg/m², with overweight being the predominant nutritional status. Regarding body image perception, 77.14% of females and 63.64% of males reported dissatisfaction with excess weight. The study found that males had a significantly higher weight (P=0.00003; r=0.578). Additionally, body dissatisfaction was more prevalent among females (P=0.00531; r=0.357) and increased with BMI (P=0.0015; r=0.455).

CONCLUSION: The findings indicate a high prevalence of body dissatisfaction among students, even among those with a nutritionally adequate status, particularly females. These results highlight the strong sociocultural pressure surrounding body image which significantly impacts this population.

PMID:40915951 | DOI:10.1016/j.encep.2025.06.004

J Matern Fetal Neonatal Med. 2025 Dec;38(1):2522998. doi: 10.1080/14767058.2025.2522998. Epub 2025 Sep 7.

ABSTRACT

OBJECTIVE: To evaluate the association between low-volume chorionic villus sampling (CVS) and delay in patient care.

METHODS: This is a retrospective cohort study of patients who underwent CVS from 8/19/2019 to 12/31/2022 in a single center. The exposure was low-volume CVS, defined as less than 15 mg of sample. The primary outcome of delay in patient care, was a composite of need for repeat procedure, delay in karyotype results ≥14 days, and ≥14 days to time of pregnancy termination. Secondary outcomes included change in lab protocol and canceled fluorescence in situ hybridization (FISH) tests.

RESULTS: There were 305 patients included with 113 (37%) with low-volume CVS. The primary outcome of delay in patient care occurred more often in the low-volume group compared to the high-volume group (23.9% vs 10.4% OR 2.70 95% CI 1.43-5.09). This association persisted in the adjusted models after adjusting for significant covariates. However, the individual outcome of delay to pregnancy termination was not different between the groups, even with controlling for covariates (14.2% vs 8.9% OR 1.70 95% CI 0.82-3.51).

CONCLUSION: Low-volume CVS was associated with an increased of delay in genetic testing results but did not increase the time to pregnancy termination in patients who opted for this outcome.

PMID:40915916 | DOI:10.1080/14767058.2025.2522998

Nihon Koshu Eisei Zasshi. 2025 Sep 8. doi: 10.11236/jph.25-060. Online ahead of print.

ABSTRACT

Objectives The Basic Act on Suicide Prevention was enacted in 2006, and 2026 will mark the 20th anniversary of this act. To commemorate this milestone, a symposium titled “20th Anniversary of the Basic Act on Suicide Prevention: Understanding the Reality of Suicide” was held at the 83rd Annual Meeting of the Japanese Society of Public Health. The aim was to reflect on Japan’s suicide prevention efforts to date through collaboration with experts.Methods: To accelerate suicide prevention efforts in Japan, we identified and organized the key challenges involved in understanding the reality of suicide.Results Considering the history of suicide prevention, we carefully reviewed the issues surrounding the Basic Act on Suicide Prevention and the Act on the Promotion of Research and Studies on Suicide. We conclude that revisions are necessary where appropriate. It is also important to incorporate measures for cultivating specialized professionals across various fields into the Basic Act on Suicide Prevention that will be responsible for suicide prevention in the next generation, as well as mechanisms that enable suicide-bereaved families to participate in policymaking. In terms of statistical issues, there has been a significant “apparent change” in the suicide statistics between 2021 and 2022 due to the revision of original data, which requires careful attention. There is an upward trend in deaths from external causes, including suicide and deaths from unknown causes, and it is necessary to analyze these trends carefully. In addition, municipalities can use police statistics to understand the realities of regional suicides. However, when analyzing municipal-level data, it is important to consider the underlying processes that lead to self-harm and suicide attempts, using regional suicide profiles as a reference. In addition, conducting independent surveys and research at the municipal level, separate from national statistics, is crucial for suicide prevention.Conclusion Suicide-related behavior is a complex issue influenced by various factors. It is essential to coordinate national measures with local initiatives. The following proposals are suggested to enhance future suicide prevention efforts:1. A review of the legal frameworks and establishment of support systems involving diverse stakeholders.2. Training of specialized personnel, including bereaved families, in the policymaking process.3. Conducting a thorough analysis of the statistical changes.4. Encouraging independent research and studies at the municipal level.By continuously updating our knowledge and fostering interdisciplinary discussions, we aim to ensure that these efforts are effectively implemented.

PMID:40915900 | DOI:10.11236/jph.25-060

J Epidemiol. 2025 Sep 6. doi: 10.2188/jea.JE20240447. Online ahead of print.

ABSTRACT

BackgroundIn 2023, a collaborative UNICEF-WHO group introduced the concept of small vulnerable newborns (SVNs) to improve the identification of newborns at increased risk of adverse outcomes and to guide more effective preventive strategies. However, global data on the prevalence of SVNs remains scarce. This study aimed to examine secular trends in the prevalence of SVNs and their three subgroups, namely term small for gestational age (SGA), preterm SGA, and preterm non-SGA, in the Japanese population.MethodsWe analyzed data from vital statistics including livebirths and stillbirths between 1997 and 2021. Secular trends in the prevalence of SVNs and their subgroups were assessed. In addition, we conducted regional analyses to explore associations with the distribution of medical resources.ResultsA total of 26,172,760 newborns were included. The overall prevalence of SVNs was 7.8% in 1997, peaked at 8.7% in 2005, and declined to 7.7% by 2021. This decline was primarily attributed to a reduction in term SGA births. In contrast, the prevalence of preterm SGA and preterm non-SGA remained largely unchanged. In 2021, the prevalence of term SGA, preterm SGA, and preterm non-SGA was 2.0%, 0.44%, and 5.3%, respectively. No significant association was found between the regional variation in the prevalence of SVNs and the distribution of medical resources.ConclusionThe prevalence of SVNs in Japan has declined since 2005, mainly due to reduced term SGA births. Persistent rates of preterm subgroups highlight the ongoing burden of prematurity, underscoring the need for targeted strategies to improve neonatal outcomes.

PMID:40915894 | DOI:10.2188/jea.JE20240447

Ultrasound Med Biol. 2025 Sep 6:S0301-5629(25)00328-X. doi: 10.1016/j.ultrasmedbio.2025.08.014. Online ahead of print.

ABSTRACT

Accurate identification of fetal torso ultrasound planes is essential in pre-natal examinations, as it plays a critical role in the early detection of severe fetal malformations and this process is heavily dependent on the clinical expertise of health care providers. However, the limited number of medical professionals skilled at identification and the complexity of fetal plane screening underscore the need for efficient diagnostic support tools. Clinicians often encounter challenges such as image artifacts and the intricate nature of fetal planes, which require adjustments to image gain and contrast to obtain clearer diagnostic information. In response to these challenges, we propose the contrast and gain-aware attention mechanism. This method generates images under varying gain and contrast conditions, and utilizes an attention mechanism to mimic the clinician’s decision-making process. The system dynamically allocates attention to images based on these conditions, integrating feature fusion through a lightweight attention module. Positioned in the first layer of the model, this module operates directly on images with different gain and contrast settings. Here we integrated this attention mechanism into ResNet18 and ResNet34 models to predict key fetal torso planes: the transverse view of the abdomen, the sagittal view of the spine, the transverse view of the kidney and the sagittal view of the kidney. Our experimental results showed that this approach significantly enhances performance compared with traditional models, with minimal addition to model parameters, ensuring both efficiency and effectiveness in fetal torso ultrasound plane identification. Our codes are available at https://github.com/sysll/CCGAA.

PMID:40915866 | DOI:10.1016/j.ultrasmedbio.2025.08.014

Int J Oral Maxillofac Surg. 2025 Sep 6:S0901-5027(25)01432-8. doi: 10.1016/j.ijom.2025.08.009. Online ahead of print.

ABSTRACT

This study was performed to evaluate the amount of bone implant engagement (BIE) of zygomatic implants (ZIs) at the malar bone level and its correlation with the ZAGA classification (zygoma anatomy-guided approach). One hundred ZIs placed in 32 patients with severe maxillary atrophy using a fully digital protocol were assessed: 80 placed in pairs (40 anterior (AI), 40 posterior (PI)) and 20 as single ZIs (SI). The ZAGA classification was determined preoperatively. Postoperative computed tomography scans were analysed using 3D Slicer to measure medial and lateral BIE, the mean value of these (mvBIE), and the ferrule area. Comparisons of the mean mvBIE of the implants (AI, PI, SI) were made according to the ZAGA categories and within each ZAGA group. Descriptive statistics and a linear mixed-effects model were performed (α = 0.05). The overall mean mvBIE was 12.38 ± 3.53 mm (AI: 12.38 ± 3.85 mm, PI: 11.50 ± 3.01 mm, SI: 14.16 ± 3.32 mm). A significant relationship was found between mvBIE and the ZAGA classification (0.005 <P < 0.008), with the lowest mean mvBIE in ZAGA 0 and ZAGA 4, and progressively increasing from ZAGA 1 to ZAGA 3. The mean mvBIE was significantly lower in PI compared to AI and SI (0.001 <P < 0.011). Three-dimensional analysis provided detailed measurements of mvBIE in ZIs placed using a digitally guided protocol. Considerable mvBIE variation among implant positions between and within ZAGA categories was observed, highlighting the influence of implant location and anatomy on bone engagement.

PMID:40915864 | DOI:10.1016/j.ijom.2025.08.009

J Prof Nurs. 2025 Sep-Oct;60:144-150. doi: 10.1016/j.profnurs.2025.08.001. Epub 2025 Aug 5.

ABSTRACT

Increasing the diversity of nursing students is an essential step toward diversifying the nursing workforce. There is a growing number of publications on ways to utilize diversity, equity, and inclusion (DEI) principles to better attract, admit, and enroll students from traditionally underrepresented backgrounds. This paper presents a synthesis of 31 articles found on this topic. Significant findings include ensuring that DEI principles are embedded throughout a nursing school’s mission, vision, values, and strategic plan. To improve recruitment, inclusive recruitment practices should be considered alongside the development of pathway and outreach programs between baccalaureate colleges of nursing and minority-serving schools and community colleges. Admission should follow holistic admission practices guided by the holistic admission rubrics. To improve the enrollment of admitted students from underrepresented backgrounds, nursing schools should consider hosting admitted student and family days and providing financial assistance for enrollment-related fees to those who qualify. This synthesis was completed in the fall of 2024. Since then, numerous socio-political changes have occurred in the United States, necessitating updated recommendations for incorporating DEI principles to diversify the nursing workforce. A discussion of these recommendations based on findings from this synthesis is presented.

PMID:40915753 | DOI:10.1016/j.profnurs.2025.08.001