Category: Statistics

Hypertension. 2025 Jun 27. doi: 10.1161/HYPERTENSIONAHA.125.24664. Online ahead of print.

ABSTRACT

BACKGROUND: With aging, frailty and hypertension become increasingly prevalent comorbidities in the older population. Therefore, the aim of the study is to identify effective druggable targets for these conditions.

METHODS: We performed a 2-sample Mendelian randomization analysis to assess the causal effects of 2532 druggable genes on frailty, hypertension, systolic blood pressure and diastolic blood pressure. RNA expression profiling data and single-cell RNA sequencing were performed for validation. Mediation Mendelian randomization analysis was conducted to identify possible mediators participating in the effects of target genes on outcomes. Molecular docking was used to identify potential drugs.

RESULTS: After screening, the expression of Glutathione peroxidase 1 (GPX1) in whole blood was found to positively correlate with hypertension (β, 0.308 [95% CI, 0.266-0.349]; P=3.40×10^-48) and frailty index (β, 0.172 [95% CI, 0.141-0.204]; P=1.21×10^-26), which was validated by RNA expression profiling data. Mediation Mendelian randomization analysis indicated that glycine and carnitine/ergothioneine mediated the effects of GPX1 on hypertension and frailty. Single-cell RNA sequencing further validated the mediating effects of glycine metabolism and carnitine transport at the cellular level. Moreover, GPX1 expression in mononuclear phagocytes was associated with upregulated inflammatory responses and immune activation. Molecular docking analysis identified biochanin A and epigallocatechin gallate as potential agents for GPX1 with high affinity.

CONCLUSIONS: Collectively, GPX1 is a potential therapeutic target for mitigating both frailty and hypertension.

PMID:40575858 | DOI:10.1161/HYPERTENSIONAHA.125.24664

Neuroreport. 2025 Jun 24. doi: 10.1097/WNR.0000000000002190. Online ahead of print.

ABSTRACT

BACKGROUND: Rhegmatogenous retinal detachment (RRD) is known to induce functional alterations in the gray matter regions associated with vision. However, the impact of RRD on the white matter (WM) connectome remains largely unexplored.

METHODS: We applied graph theory to evaluate the functional network topology of the WM connectome in RRD patients. A support vector machine (SVM) classifier, combined with SHapley Additive exPlanations (SHAP), was then employed to distinguish RRD patients from healthy controls (HCs) and to identify key brain regions driving model predictions.

RESULTS: Compared to HCs, RRD patients exhibited significant disruptions in both global and nodal network topology. Network-based statistics identified 23 subnetworks with altered connectivity. Notably, the integration of SVM and SHAP analyses revealed that betweenness centrality (Bc) was the most discriminative topological feature, achieving an area under the curve of 0.9211.

CONCLUSION: These findings suggest that RRD disrupts critical hubs within the central visual and higher-order cognitive networks, leading to characteristic network reorganization. Moreover, Bc shows promise as an early neuroimaging biomarker for RRD. Overall, our results advance the understanding of neuroadaptive changes in RRD and support the clinical application of network topological metrics in early diagnosis.

PMID:40575857 | DOI:10.1097/WNR.0000000000002190

J Cardiovasc Med (Hagerstown). 2025 Jun 24. doi: 10.2459/JCM.0000000000001759. Online ahead of print.

ABSTRACT

INTRODUCTION: Transcatheter patent foramen ovale (PFO) closure has emerged as the therapeutic gold standard in patients with a PFO-related stroke. New-onset atrial fibrillation appears as an early complication of this procedure. Our study aims to evaluate if the MVP (Morphology-Voltage-P wave duration) ECG risk score calculated before PFO closure might be a valuable predictor of early postprocedural atrial fibrillation occurrence.

METHODS: We enrolled all consecutive patients (aged 18-65 years) who underwent percutaneous PFO closure between July 2020 and August 2023. The MVP ECG risk score was calculated. Patients were reassessed with clinical and echocardiographic follow-up at 1 month and 6 months later, to assess the efficacy and safety of the procedure as well as atrial fibrillation occurrence. Patients were then divided into two groups according to the occurrence of early atrial fibrillation after PFO closure.

RESULTS: We enrolled 103 patients, 63.1% male (mean age 48.7 ± 10.6 years). At the end of follow-up, atrial fibrillation occurred in five patients (4.9%). When comparing groups with and without atrial fibrillation diagnosis at follow-up, there was a statistically significant difference in MVP ECG risk scores (3.0 versus 1.0; P = 0.001). At receiver operating characteristic analysis, the MVP ECG risk score showed good diagnostic accuracy in predicting the diagnosis of atrial fibrillation at follow-up [AUC: 0.90; 95% confidence interval (CI) 0.81-0.98]. In the multivariate Cox proportional hazard model, the MVP ECG risk score remained the only independent predictor of atrial fibrillation onset (hazard ratio 2.96; 95% CI 1.13-7.71; P = 0.03).

CONCLUSION: The MVP ECG risk score could be an independent predictor of early atrial fibrillation occurrence in patients undergoing percutaneous PFO closure.

PMID:40575851 | DOI:10.2459/JCM.0000000000001759

Ann Neurol. 2025 Jun 27. doi: 10.1002/ana.27304. Online ahead of print.

ABSTRACT

OBJECTIVE: Clonal hematopoiesis of indeterminate potential (CHIP) is an emerging risk factor for cardio-cerebrovascular diseases. This study aimed to investigate CHIP’s association with cerebrovascular or glymphatic changes in a community-based population.

METHODS: This study examined Chinese community cohort participants. CHIP mutations were identified through whole-exome sequencing. Intracranial arterial stenosis, silent brain infarcts, cerebral small vessel disease markers, and diffusion along the perivascular space index were identified by magnetic resonance imaging. The correlation between CHIP and neuroimaging outcomes was investigated through univariate and multivariate logistic/linear regression. The multivariate regression model was adjusted for cerebrovascular disease risk factors, including age, sex, body mass index, smoking status, hypertension, diabetes, and hyperlipidemia.

RESULTS: In total, 18.2% (224 out of 1,229) participants were identified as carriers of CHIP mutations. The prevalence of CHIP generally increases with age (p = 0.009). After adjusting for vascular risk factors using multivariate regression, CHIP mutations were found to be significantly associated with increased odds of large magnetic resonance imaging-defined infarcts (>15 mm; OR 3.20; 95% CI 1.18 to 8.43; p = 0.018), inversely associated with diffusion along the perivascular space (β = -0.02; 95% CI -0.04 to 0; p = 0.034), and showed a borderline association with intracranial arterial stenosis (OR 1.52; 95% CI 0.99 to 2.30; p = 0.053). Notably, no statistically significant correlations were observed between CHIP and cerebral small vessel disease markers or brain atrophy measures.

INTERPRETATION: CHIP was significantly associated with glymphatic dysfunction and large infarcts, and marginally associated with intracranial arterial stenosis. Further research is needed to elucidate the pathophysiology linking CHIP to cerebral covert changes. ANN NEUROL 2025.

PMID:40575838 | DOI:10.1002/ana.27304

Tidsskr Nor Laegeforen. 2025 Jun 17;145(8). doi: 10.4045/tidsskr.25.0025. Print 2025 Jun 24.

ABSTRACT

BACKGROUND: For patients with Crohn’s disease, surgery can be appropriate when medical treatment fails to adequately control the condition, or in cases of stenosis, fistulas or abscesses. We aimed to investigate the types of bowel surgery these patients undergo, as well as waiting times and the prevalence of serious complications.

MATERIAL AND METHOD: This is a retrospective observational study investigating the surgical treatment of Crohn’s disease at the University Hospital of North Norway, Tromsø, in the period 1 January 2013 to 31 December 2021.

RESULTS: A total of 179 patients were included in the study: 92 women and 87 men, with a median age of 44 years (interquartile range: 26-57). Of these, 151 patients (84 %) underwent elective surgery with a median waiting time of 89 days (interquartile range: 43-142), while 28 patients (16 %) underwent emergency surgery.

INTERPRETATION: There was considerable variation in the types of surgery performed on patients with Crohn’s disease in this cohort. The prevalence of complications was high and waiting times for surgical treatment were long.

PMID:40575820 | DOI:10.4045/tidsskr.25.0025

J Diabetes Metab Disord. 2025 Jun 24;24(2):155. doi: 10.1007/s40200-025-01666-w. eCollection 2025 Dec.

ABSTRACT

BACKGROUND: Diabetes increases healthcare load and seriously compromises quality of life. This study aimed to develop a hospital-based educational and follow-up strategy at Ziaeian Hospital and assess how it affected the diabetic patients’ health outcomes.

METHODS: This study was a community-level intervention based on Compassion-Focused Therapy (CFT). The study was conducted from 2020 to 2022 at Ziaeian Hospital in District 17 of Tehran, involving 312 diabetic patients. Participants were randomly allocated to two groups: the intervention group (n = 156) and the control group (n = 156). The intervention group received structured education, continuous follow-up, and family engagement, while the control group underwent standard treatment. Data were collected using a researcher-developed questionnaire and the SF-36 quality of life assessment. Statistical analyses were performed using STATA version 14.02, with significance set at P < 0.05. The statistical tests employed included t-tests, Chi-squared tests, Fisher’s exact test, and paired t-test.

RESULT: The mortality rate in the control group was therefore 9.03%, higher than the 5.52% noted in the intervention group. Baseline clinical markers (FBS, HbA1c, triglycerides, cholesterol, and BMI) showed no appreciable differences across the groups. Though no significant changes in social functioning, mental health, or physical performance, the intervention group showed notable improvements in overall quality of life (p = 0.0053), general health (p < 0.0001), energy/fatigue (p < 0.0001).

CONCLUSION: In conclusion, systematic instruction and continuous monitoring improved quality of life and lower mortality among diabetics. These results highlight the need of patient monitoring in diabetes management as well as of hospital-based training programs.

PMID:40575801 | PMC:PMC12187616 | DOI:10.1007/s40200-025-01666-w

Front Pharmacol. 2025 Jun 12;16:1626274. doi: 10.3389/fphar.2025.1626274. eCollection 2025.

ABSTRACT

INTRODUCTION: Chinese patent medicine is a crucial component of traditional Chinese medicine, significantly promoting public health. Despite the extensive research on Chinese patent medicine for children, various issues persist in its application. Leveraging the national drug coding standard code database of the National Medical Products Administration (NMPA), this investigation delved into the accessibility of Chinese patent medicines tailored for children, offering a comprehensive overview of the current landscape in China. This analysis serves as a valuable resource for formulating targeted policies to promote the use of Chinese patent medicines for children, guiding drug selection, and facilitating the development of pediatric pharmaceuticals.

METHODS: Taking Chinese patent medicines with “National Medicine Approval Number Z” and “National Medicine Approval Number B” from the NMPA National Drug Coding Database as the research subjects, this study systematically analyzed the distribution, characteristics, and existing issues of Chinese patent medicines for children using descriptive statistical methods.

RESULTS AND DISCUSSION: As of May 2023, 8,903 approved “National Medicine Approval Number Z” Chinese patent medicines, 951 approved “National Medicine Approval Number B” Chinese patent medicines in China, with 1,164 Chinese patent medicines for children identified. Chinese patent medicines for children are predominantly administered orally (92.87%), while external preparations are limited. The taste profile is primarily bitter or sweet, with some medications having other undesirable flavors. The therapeutic focus is skewed toward pulmonary system diseases (31.9%) and spleen-stomach diseases (26.5%). Notably, 49.66% of the medications mention Western medical disease names, and 63.92% reference traditional Chinese medicine (TCM) syndrome types. Critical gaps include unclear age-specific dosage instructions (56.70%), lack of specified treatment duration (92.01%), and incomplete safety information, with adverse reactions mainly involving the gastrointestinal system. Current issues include the limited availability of Chinese patent medicines for children, poor suitability for children, imbalanced research and supply (over-concentration in pulmonary and spleen-stomach disorders), and inadequate safety labeling in drug instructions, posing potential risks. Recommendations include developing new Chinese patent medicines for children, improving drug suitability, conducting post-marketing evaluations, and refining drug labeling to ensure safe and rational pediatric medication use.

PMID:40575788 | PMC:PMC12198179 | DOI:10.3389/fphar.2025.1626274

Int J Gen Med. 2025 Jun 22;18:3289-3300. doi: 10.2147/IJGM.S522911. eCollection 2025.

ABSTRACT

BACKGROUND: Hypertension is the leading cause of preventable deaths globally. However, reports on its prevalence and risk factors in rural sub-Saharan Africa have been inconsistent, making targeted interventions challenging. This study examines the prevalence, awareness, and associated factors of hypertension among adults in a rural community in southwestern Uganda.

METHODS: We conducted a baseline survey in Ngango, Mbarara district, enrolling adults aged 18-79 years from eleven villages. Research assistants and community health workers recruited participants from their homes using the WHO STEPS questionnaire, collecting data on demographics, lifestyle behaviors (tobacco and alcohol use, diet, and physical activity), and other risk factors. Blood pressure (BP) was measured three times, with hypertension defined as BP ≥140/90 mmHg or self-reported antihypertensive use. Logistic regression was applied to identify factors associated with hypertension.

RESULTS: A total of 953 adults were enrolled, with a median age of 43 years (IQR: 30-57). Women accounted for 61.5%, and only 43.5% recalled ever having their blood pressure measured. Hypertension prevalence was 27.3%, with 61.5% of cases undiagnosed. Among those receiving treatment (27.7%), 65.3% had controlled blood pressure. Despite 66.8% of participants reporting regular physical activity, 63.7% were overweight. The key factors associated with hypertension included age over 40 years (OR: 2.26), consuming fewer than three servings of fruits or vegetables per week (OR: 1.62), and being overweight (OR: 1.57) or obese (OR: 2.73).

CONCLUSION: Hypertension is highly prevalent in rural southwestern Uganda, underscoring the need for targeted interventions-especially within a relatively young and physically active population.

PMID:40575767 | PMC:PMC12199733 | DOI:10.2147/IJGM.S522911

Utah Womens Health Rev. 2025 May;3(1):40-48. doi: 10.26054/d-k952-0keb. Epub 2025 Jan 17.

ABSTRACT

OBJECTIVES: The objective of this study is to test the association between preconception polycystic ovary syndrome (PCOS) and gestational diabetes mellitus (GDM) using Utah’s Pregnancy Risk Assessment Monitoring System (2016-2021). In addition, pre-pregnancy hypertension will be tested as a potential effect moderator.

METHODS: This cross-sectional study utilizes data from Phase 8 of the Utah Pregnancy Risk Assessment Monitoring System (PRAMS) survey (2016-2021). The association between PCOS and GDM was tested using Poisson regression to generate adjusted prevalence ratios and 95% confidence intervals.

RESULTS: PCOS was associated with higher prevalence of GDM in all models, regardless of whether the outcome data (GDM) came from the infant’s birth certificate, the PRAMS survey, or the combined measure. When adjusting for sociodemographic characteristics, lifestyle factors, reproductive history, and comorbidities, women with PCOS were 1.50 (1.16-1.95) times as likely to have GDM (reported on birth certificate and/or survey) compared to women without PCOS. Pre-pregnancy hypertension was not found to be a statistically significant effect moderator.

CONCLUSIONS: The findings from this study were consistent with the majority of research indicating that women with PCOS have increased risk for GDM. This is also the first known study to test pre-pregnancy hypertension as an effect moderator between PCOS and GDM. More research is needed on the role of comorbidities such as chronic hypertension as effect modifiers between PCOS and GDM.

IMPLICATIONS: These findings show that women with PCOS are at high risk for GDM, among a population-based sample of mothers. Interventions to reduce the risk of GDM among women with PCOS need to be developed and evaluated.

PMID:40575759 | PMC:PMC12201940 | DOI:10.26054/d-k952-0keb

Caspian J Intern Med. 2025 Mar 21;16(2):297-304. doi: 10.22088/cjim.16.2.297. eCollection 2025.

ABSTRACT

BACKGROUND: Patient management and necessary supportive treatments, an accurate prognosis of the illness is essential for patients with acute pancreatitis. Thus far, no diagnostic technique has demonstrated superiority over the other in terms of clinical judgment. The aim of this study was to examine the predictive accuracy of the Bedside Index for Severity in Acute Pancreatitis (BISAP) score in contrast to Ranson’s criteria.

METHODS: Our research is a retrospective cross-sectional analysis. Inclusion criteria encompassed patients admitted to the emergency department with acute pancreatitis. Exclusion criteria comprised individuals with liver, heart, or renal failure upon admission or during hospitalization. Each patient’s demographic data, including age, gender, education level, and consciousness level, were considered. Statistical analysis was conducted using SPSS 16 software with a significance level set at p <0.05.

RESULTS: Out of 286 patients, 221 were diagnosed with moderate acute pancreatitis, while 65 were diagnosed with severe acute pancreatitis. Among these patients, 5 (7.1%) succumbed to complications related to pancreatitis, including 3 males and 2 females. Both the BISAP and Ranson criteria demonstrated significant capability in assessing the severity of both moderate and severe acute pancreatitis with a 95% confidence level. The analysis revealed a statistically significant area under the curve for both criteria (P= 0.002).

CONCLUSION: Although BISAP and Ranson have both good accuracy and efficacy to determine the severity of pancreatitis, BISAP scoring criteria have higher prognostic accuracy.

PMID:40575756 | PMC:PMC12189003 | DOI:10.22088/cjim.16.2.297