Category: Statistics

Ann Ist Super Sanita. 2025 Oct-Dec;61(4):277-284. doi: 10.4415/ANN_25_04_06.

ABSTRACT

BACKGROUND: Accurate estimation of vaccine effectiveness (VE) in real-world settings is essential for guiding immunization strategies, especially in older populations. However, observational studies are prone to bias due to confounding factors, and the choice of statistical method can significantly influence VE estimates.

MATERIALS AND METHODS: We compared the performance of a multivariable Cox proportional hazards model with seven propensity score (PS)-based models to estimate the relative vaccine effectiveness (rVE) of the bivalent Original/Omicron BA.4-5 mRNA vaccine as a second or third booster, compared to a first mRNA booster received ≥120 days earlier. Data from 11,879,461 individuals aged ≥60 in Italy (April-June 2023) were analyzed.

RESULTS: All models produced consistent rVE estimates, with values ranging from 16.4% to 22.1%. Over time, booster effectiveness declined, with the reference model showing a drop in rVE from 45.6% (15-60 days) to 14.3% (181-265 days). PS-based methods improved covariate balance but did not outperform the Cox model in terms of precision or interpretability.

CONCLUSIONS: In large, relatively balanced datasets, traditional multivariable models remain a robust and reliable choice for estimating VE. While PS-based methods offer theoretical advantages, their practical benefit may be limited when confounding is well controlled.

PMID:41392961 | DOI:10.4415/ANN_25_04_06

Folia Parasitol. 2025 Nov 28;72:2025.031. doi: 10.14411/fp.2025.031.

ABSTRACT

The pathogenicity of haemogregarines and their effects on the health status of ectothermic hosts remain largely unexplored. In this study, we examined the impact of Hemolivia mauritanica (Sergent et Sergent, 1904) infection on the differential leukocyte count (DLC) as a measurable indicator of health in tortoise hosts. A total of 206 blood smears were analysed, including 181 from spur-thighed tortoises (Testudo graeca Linnaeus) and 25 from marginated tortoises (Testudo marginata Schoepff). Light microscopy was used to identify infected individuals, determine DLC, and quantify parasitaemia levels. Overall, H. mauritanica was detected in 125 of 181 (69%) T. graeca samples and 21 of 25 (84%) T. marginata samples. To assess whether infection influenced DLC, we statistically compared leukocyte profiles between infected and uninfected individuals. Additionally, we evaluated the effects of other factors, including host species, parasitaemia intensity, sex, age, and the month and year of blood collection. Wilcoxon rank-sum tests revealed that parasitaemia and age had a statistically significant effect on DLC in T. graeca. Further analysis using linear models showed a significant association between parasitaemia and DLC, specifically affecting azurophils in T. graeca and basophils in T. marginata. Nine T. graeca tortoises positive for H. mauritanica were co-infected with haemosporidian parasites of the genus Haemocystidium Castellani et Willey, 1904, specifically three with Haemocystidium anatolicum (Orkun et Güven, 2013) and six with Haemocystidium caucasicum (Krasilnikov, 1965). Although co-infection itself was not statistically significant, a separate analysis of Haemocystidium parasitaemia revealed a significant effect on lymphocyte DLC. Furthermore, the frequent presence of mitotic and polychromatophilous erythrocytes in H. mauritanica-infected tortoises suggests a potential increase in erythrocyte regeneration.

PMID:41392952 | DOI:10.14411/fp.2025.031

Drug Alcohol Rev. 2026 Jan;45(1):e70091. doi: 10.1111/dar.70091.

ABSTRACT

ISSUES: This review aimed to estimate the prevalence of non-medical anabolic-androgenic steroid (AAS) use among same-sex attracted men (SSM).

APPROACH: We conducted a systematic review of peer-reviewed articles in English, focusing on AAS use among SSM. We excluded grey literature and studies that measure AAS use through some form of analysis (e.g., hair or urine). Ten databases were searched. Titles and abstracts for all articles were screened, followed by full-text assessment and data extraction by multiple authors. The pooled overall and subgroup (gym/community-recruited SSM) lifetime and past 12-month prevalence of AAS use among SSM was obtained using a generalised linear random effects model, which was reported when heterogeneity of estimates was not high. Risk of bias was assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool.

KEY FINDINGS: Nine studies met inclusion criteria. All studies were conducted in high-income countries. Overall, the pooled lifetime and past 12-month prevalences of AAS use were 13.9% (95% CI 9.2%-20.5%, 6 studies) and 8.1% (95% CI 3.9%-16.2%, 3 studies), respectively. Among the gym subgroup, the pooled lifetime and past 12-month prevalences were 15.2% (95% CI 11.6%-19.6%, I² = 72.8%, 3 studies) in the gym subgroup and 13.3% (95% CI 9.9%-17.7%, I² = 73.1%, 2 studies). The difference in lifetime prevalence between gym and community-recruited SSM was not statistically significant (p = 0.676).

CONCLUSIONS: The non-medical use of AAS among SSM is higher than general global estimates, with some evidence that use may be higher among gym users.

PMID:41392947 | DOI:10.1111/dar.70091

Ann Noninvasive Electrocardiol. 2026 Jan;31(1):e70139. doi: 10.1111/anec.70139.

ABSTRACT

BACKGROUND: Venous puncture failure during cardiac implantable electronic device (CIED) implantation is a significant procedural challenge, particularly in fasting patients. Pre-procedural intravenous normal saline (NS) infusion may enhance venous filling and improve procedural outcomes, but evidence in this setting is limited.

METHODS: We conducted a retrospective cohort study at Abbas Institute of Medical Sciences, including 2852 patients undergoing CIED implantation. Patients were divided into two groups: those who received intravenous NS infusion prior to the procedure (n = 1130) and those who did not (n = 1722). Baseline demographics, procedural details, and outcomes-including venous puncture failure, arterial puncture, site change, and acute kidney injury (AKI)-were compared.

RESULTS: The NS group demonstrated a significantly lower rate of venous puncture failure (4.6% vs. 8.9%, p < 0.001) and arterial puncture failure (1.6% vs. 2.8%, p = 0.03). AKI occurred less frequently in the NS group, although this difference was not statistically significant (1.8% vs. 2.6%, p = 0.09). Predictors of venous puncture failure included absence of NS infusion (OR 2.1, 95% CI 1.5-3.0), BMI ≥ 30, and CKD. ROC analysis demonstrated good model discrimination (AUC = 0.81).

CONCLUSION: Pre-procedural NS infusion significantly improves venous puncture success in fasting patients undergoing CIED implantation.

PMID:41392938 | DOI:10.1111/anec.70139

J Environ Sci Health A Tox Hazard Subst Environ Eng. 2025 Dec 15:1-12. doi: 10.1080/10934529.2025.2602353. Online ahead of print.

ABSTRACT

This study applies total reflection X-ray fluorescence (TXRF) to assess multielement contamination in river sediments from a small urban basin in western Paraná, Brazil. Eleven elements (Al, K, Ca, Ti, Cr, Mn, Fe, Ni, Cu, Zn and Pb) were quantified using an internal standard, and the concentration data were evaluated using Spearman correlation, principal component analysis and hierarchical cluster analysis. Cu, Zn and especially Pb reached concentrations up to 703, 349 and 344 mg kg^-1, with several values exceeding Brazilian guideline thresholds for soils impacted by anthropogenic activities. Multivariate results indicate that Ti, Cr and Fe form a predominantly lithogenic assemblage related to the basalt-derived parent material, whereas Cu and Zn define a distinct anthropogenic group associated with urban, industrial and wastewater inputs; Mn, Ni, Ca and Pb show mixed origin. The combined use of TXRF and multivariate tools thus provides a robust, resource-efficient framework for sediment monitoring, source differentiation and support of pollution control strategies in contaminated aquatic environments.

PMID:41392928 | DOI:10.1080/10934529.2025.2602353

Recent Adv Inflamm Allergy Drug Discov. 2025;19(3):374-379. doi: 10.2174/0127722708319486241202113259.

ABSTRACT

BACKGROUND: It is well known that acute or chronic kidney injury could be due to free radicals and pro-oxidants. This investigation aimed to monitor tacrolimus or cyclosporine blood trough levels and anti-oxidant capacity after kidney transplantation.

METHODS: There was no intervention in the routine management of transplant recipients. The sample size (n=70) included healthy individuals and kidney-transplanted recipients (n=25 on tacrolimus and n=10 on cyclosporine). The study population was matched for age. The attained information was examined by using the Statistical Package (SPSS Inc, Chicago, IL, USA). The significance level was considered as P ≤ 0.05.

RESULTS: In healthy individuals, the mean ± SD for the capacity of antioxidants was 91.9 ± 16.6 (u/ml), which was significantly higher when compared to the mean value of 28.5 ± 22.6 (u/ml) versus 24.7 ± 25.5 (u/ml), kidney recipients with tacrolimus versus cyclosporine (P ≤ 0.04) as immunosuppressive drugs. The mean value of tacrolimus levels was 14.6 ± 6.4 (ng/ml). The correlation between tacrolimus and cyclosporine trough levels and anti-oxidant capacity was 0.19 (P ≤ 0.14). There were no significant differences regarding age in cases and controls (P ≤ 0.42).

CONCLUSION: This study showed that the capacity of anti-oxidants in kidney transplant recipients, those on tacrolimus or cyclosporine, might be lower than in healthy individuals. Subsequent investigations are recommended to delve into the therapeutic consequences of the influence of antioxidant therapies on the clinical outcomes of transplanted recipients.

PMID:41392914 | DOI:10.2174/0127722708319486241202113259

J Reprod Infant Psychol. 2025 Dec 15:1-16. doi: 10.1080/02646838.2025.2599244. Online ahead of print.

ABSTRACT

BACKGROUND: India’s rising dependence on institutional childbirth through Caesarean sections has intensified both the health-related risks and the financial pressures experienced by women and their households. The escalating costs of Caesarean deliveries have become a significant source of out-of-pocket spending, with the burden falling most heavily on low-income families in Kerala.

OBJECTIVE: This study aims to identify the cognitive, emotional, and healthcare related predictors that influence women’s intentions to opt for elective Caesarean delivery. It seeks to understand the underlying factors that shape this preference, using the theory of planned behavior framework, which emphasizes the role of attitudes, subjective norms, and perceived behavioral control in shaping behavioral intentions.

METHODS: Using a cross-sectional design, a structured household survey was conducted among 1,030 married women in Kerala planning future pregnancies. The main outcome measured was their stated intention to opt for a Caesarean delivery in a subsequent birth. Key predictors included unmet health needs, childbirth-related knowledge, depression severity, attitudes, subjective norms, and perceived behavioral control. Binary logistic regression and propensity score matching (STATA 14.0; p < 0.05) were applied to identify statistically significant associations.

RESULTS: Greater childbirth-related knowledge significantly lowered the likelihood of intending to choose a Caesarean delivery (intermediate knowledge: OR = 0.167; good knowledge: OR = 0.297). Depression severity displayed a nonlinear relationship: moderately severe depression reduced the intention to opt for a C-section (OR = 0.140), whereas severe depression substantially increased it (OR = 4.357). The most influential predictor was unmet healthcare need (OR = 27.876), a result further supported by propensity score matching.

CONCLUSION: Women’s intentions to choose elective Caesarean delivery are strongly influenced by their level of knowledge, psychological well-being, and access to healthcare. Strategies that strengthen health literacy, bolster mental health support, and reduce healthcare barriers may help decrease unnecessary C-sections and enhance maternal health outcomes.

PMID:41392907 | DOI:10.1080/02646838.2025.2599244

Hypertension. 2025 Dec 15. doi: 10.1161/HYPERTENSIONAHA.125.25949. Online ahead of print.

ABSTRACT

BACKGROUND: Hypertension is a multifactorial disease influenced by sex hormones, with notable sex-specific differences in its development and progression. Extracellular vesicles have emerged as important mediators in hypertension pathophysiology. This study aimed to investigate sex-specific extracellular vesicle-derived microRNA and protein profiles in deoxycorticosterone acetate-salt-induced hypertension.

METHODS: Male and female C57BL/6J mice underwent deoxycorticosterone acetate-salt treatment, with blood pressure monitored via telemetry and cardiac function assessed using echocardiography and invasive hemodynamics. Extracellular vesicles from plasma and cerebrospinal fluid were isolated and analyzed for microRNA (high-throughput RNA sequencing) and protein (LC/ms) content. To determine the contribution of sex hormones, gonadectomy was performed before deoxycorticosterone acetate-salt exposure. Hypothalamic and plasma samples were then used to validate key molecular findings.

RESULTS: Deoxycorticosterone acetate-salt treatment caused more severe hypertension, cardiac dysfunction, and mortality in males compared with females. Gonadectomy reduced hypertension and mortality in males but exacerbated them in females, confirming the protective effect of estrogens and the deleterious influence of androgens. Sex-specific extracellular vesicle-derived microRNA and protein expression profiles were identified, revealing 10 key regulatory microRNAs and highlighting potential regulatory axes such as miR-125b-5p/ACE (angiotensin-converting enzyme) 2, miR-1a-3p/G6PD, miR-410-3p/AT₁R (angiotensin II type 1 receptor), and miR-378a-5p/IRAP. Gonadectomy altered expression patterns, supporting the hormone-dependent regulation of these microRNAs. Proteomic data showed renin-angiotensin system and diabetic cardiomyopathy pathway activation in hypertensive males. In silico and ex vivo analyses identified 25 microRNA-targeted genes, such as G6pdx and IRAP, reinforcing the role of sex hormone-sensitive microRNA-protein interactions.

CONCLUSIONS: This study highlights potential sex-specific microRNA networks in hypertension and proposes novel molecular targets for validation toward personalized, sex-tailored therapies.

PMID:41392884 | DOI:10.1161/HYPERTENSIONAHA.125.25949

Int J Gynaecol Obstet. 2025 Dec 15. doi: 10.1002/ijgo.70742. Online ahead of print.

ABSTRACT

OBJECTIVE: The main objective was to describe women with fibroids who were treated with ultrasound-guided high intensity focused ultrasound (USgHIFU) at the Chris Hani Baragwanath Academic Hospital (CHBAH) and to evaluate the outcomes at least 6 months after treatment.

METHODS: This was a cross-sectional study using retrospectively collected data of women treated between November 2015 and December 2018 with USgHIFU at CHBAH. A clinical database that was used at the USgHIFU clinic and medical files were reviewed. The following data were retrieved; demographic information, characteristics of the fibroid (size, number, position, magnetic resonance imaging [MRI] intensity), symptoms before and after the procedure. Variables are described using descriptive statistics and were compared using a McNemar’s chi2, t-test or Wilcoxon sign rank test.

RESULTS: The mean age, median body mass index (BMI) and median parity was 35 years (standard deviation [SD] ±5.43), BMI of 25.3 (interquartile range [IQR]: 22.31-29.05), parity 0 (IQR: 0-1; range: 0-6), respectively. The presenting symptoms were dysmenorrhea (85.41%), infertility (50.92%) and menorrhagia (67.69%). The proportion of dysmenorrhea decreased from 84.10% before treatment to 54.06% after treatment. Menorrhagia was reduced from 66.08% to 41.34%. The median size of fibroids changed from 38.00 to 26.88 cm³. These changes were statistically significant.

CONCLUSION: This is the first USgHIFU study that reports outcomes in a South African population. The treatment has resulted in a noticeable alleviation of symptoms and a measurable reduction in fibroid size and this was statistically significant and clinically relevant.

PMID:41392873 | DOI:10.1002/ijgo.70742

Ulus Travma Acil Cerrahi Derg. 2025 Nov;31(11):1088-1094. doi: 10.14744/tjtes.2025.73730.

ABSTRACT

BACKGROUND: Injuries to the anterior cruciate ligament (ACL) are prevalent, particularly following athletic incidents. Most clinicians use MRI for diagnostic purposes and therapy assessment, but it can present challenges in terms of cost and accessibility. While ultrasound guidance (USG) is more readily available, it is inadequate for diagnosing ACL injury in isolation. Therefore, our study aimed to evaluate the effectiveness of sonoelastography, a novel method for assessing tendon injuries, in the context of anterior cruciate ligament (ACL) injuries.

METHODS: This study involved a cohort of 45 patients who fulfilled the designated inclusion criteria. We selected the patients from a cohort of 105 individuals who underwent anatomical ACL restoration at the orthopedics and traumatology clinic between 2017 and 2020. The clinical examination results and the stability and quality of the ACL in patients who underwent ACL reconstruction were compared with those from magnetic resonance imaging (MRI) and stress echo laxity (SEL) testing.

RESULTS: The study comprised 40 individuals with a mean age of 30.7+-1.4 years. The patients’ Lysholm scores exhibited consider-able enhancement post-operation, with a mean increase from 2.2+-0.9 pre-operation to 6.1+-1.6 post-operation. The Lachman, anterior drawer, and pivot-shift tests demonstrated improvements relative to the preoperative values. No substantial difference was observed in the single-leg hop test relative to the unaffected side. The SEL findings indicated that 15.6% of the healthy ACL instances were categorized as type 2a, 68.9% as type 2b, and 15.6% as type 3a. In the reconstructed ACL cohort, 17.8% were categorized as type 2a, 62.2% as type 2b, and 20% as type 3a. No substantial statistical difference was detected between the healthy ACL and the reconstructed ACL. No occurrences of type 3b or type 4 were identified in any of the patients.

CONCLUSION: We used SEL to find a torn ACL and check its stability and condition after the ligament was reconstructed with a graft. We utilize SEL, or stress sonoelastography, to monitor graft viability and evaluate the progression of ACL injuries. It is also beneficial in evaluating whether the restored ligament possesses a functional structure akin to that of a normal ligament. Moreover, considering its accessibility, cost-effectiveness, replicability, and patient preference, it may provide a more advantageous alternative to MRI.

PMID:41392848 | DOI:10.14744/tjtes.2025.73730