Category: Statistics

Cureus. 2025 Mar 10;17(3):e80353. doi: 10.7759/cureus.80353. eCollection 2025 Mar.

ABSTRACT

Background Patients undergoing dialysis require intensive treatment and supportive care, which affects their caregivers physically, socially, economically, and psychologically. However, this topic has been largely underexplored. Objectives This study aimed to examine the socio-economic and psychological burdens experienced by primary caregivers of patients undergoing dialysis. Method This cross-sectional study was conducted over 12 weeks using purposive sampling of primary caregivers of patients undergoing dialysis at two public and two private dialysis centers in Trinidad and Tobago. The questionnaire collected data on socio-demographics, economics, and selected psychological issues. Selected global health status questions adapted from the World Health Organization Quality of Life Brief Version were included. Participants were assured of confidentiality and anonymity. Verbal consent was obtained by completing an online questionnaire. The collected data were entered into a Statistical Package for the Social Sciences spreadsheet. Data analysis included hypothesis testing at a 5% level of significance using chi-square tests of association and analysis of variance. Results The final sample comprised 150 participants (response rate: 100%). The majority of caregivers were aged 46-55 (n = 44, 29.3%), women (n =82, 54.7%), and had attained tertiary-level education (n = 82, 54.7%). Most caregivers were the patient’s son or daughter (n = 53, 35.3%), lived with the patient (n = 83, 55.3%), and were employed full time (n = 104, 69.3%). More than half (n = 79, 52.7%) reported having at least one health condition, with 40% (n = 61) reporting “getting sick easily” after becoming a caregiver. The majority experienced psychological symptoms of feeling nervous, anxious, or on edge (n = 115, 76.7%). Caregivers reported feeling depressed (n = 49, 32.7%), experiencing burnout (n = 101, 67.8%), and having suicidal thoughts (n = 10, 6.7%). Caregivers spent between one (n = 4, 2.7%) and four (n = 30, 20.0%) days a week taking patients for dialysis treatments, with the majority (n = 80, 53.3%) spending three days weekly. Travel time to dialysis centers ranged from 45 minutes (n = 46, 30.7%) to three hours (n = 5, 3.0%). Most caregivers also reported difficulty having a good work-life balance (n = 106, 70.7%), inability to attend social events (n = 93, 62.0%), reduced personal time (n = 86, 57.3%), and the need to adjust their work hours (n = 99, 66.0%). The majority also experienced economic hardships such as worrying about finances (n = 102, 68.0%). Caregivers also wished other family members contributed financially to patient care (n = 107, 71.3%), especially because the majority (n = 99, 66.0%) were unable to afford to send the patient to a nursing home. Nearly half (n = 66, 44%) of caregivers rated their quality of life (QoL) as “less than good”and more than half (n = 99, 66%) felt that their life lacked meaning. Conclusion Caregivers spend a considerable amount of time with patients, which affects them biologically, socially, economically, and psychologically. More than half of caregivers had challenges in maintaining a work-life balance. The majority were worried about finances (n = 102, 68.0%). Participants experienced anxiety (n = 116, 76.7%), burnout (n = 102, 68.0%), depression (n = 49, 32.7%), and suicidal thoughts (n = 10, 6.7%). These findings underscore the need for targeted intervention to support caregivers and improve their overall QoL.

PMID:40213708 | PMC:PMC11984004 | DOI:10.7759/cureus.80353

Front Pharmacol. 2025 Mar 27;16:1504230. doi: 10.3389/fphar.2025.1504230. eCollection 2025.

ABSTRACT

One-class modeling is a supervised multivariate botanical identification method based on principal component analysis (PCA) that constructs a model based only on the characteristics of the reference samples and uses the Q statistic as a combined metric. Test samples are judged to be similar (authentic) if their combined metric falls within the model limits or different (adulterated or contaminated) if the metric falls outside the model limits. This review initially considers three major factors affecting identification: the number of variables (univariate versus multivariate), the number of classes (one-class versus multi-class), and the type of analysis (quantitative versus qualitative). Multivariate analysis is commonly used for identification, providing a broader coverage of the identity specifications of the samples. With a combined metric, multivariate methods are analogous to univariate methods. One-class modeling and multi-class modeling employ different approaches for identification with one-class modeling being more flexible. While most methods to date have had a quantitative basis, qualitative methods are possible. This review focuses on multivariate, one-class modeling based on PCA. Examples are presented for the application of one-class modeling to identification of American ginseng (Panax quinquefolius), Echinacea purpurea, Black Cohosh (Actaea racemosa), and Maca (Lepidium meyenii). These examples demonstrate the utility and flexibility of one-class modeling.

PMID:40213685 | PMC:PMC11983402 | DOI:10.3389/fphar.2025.1504230

Adv Biomed Res. 2025 Jan 30;14:8. doi: 10.4103/abr.abr_313_24. eCollection 2025.

ABSTRACT

BACKGROUND: One of the major drawbacks of cone beam computed tomography (cone beam CT) is that unlike CT, the gray density values obtained from cone beam CT are relative, and not absolute as obtained in the case of CT. The present study was conducted with the intent to perform a comparative bone densitometric analysis using cone beam CT and CT and to determine if there was a mathematical correlation between the two.

MATERIALS AND METHODS: The present in-vitro study included CT and cone beam CT scans of 30 dry mandibles wherein the gray density values from well-demarcated, precise anatomical areas were obtained, analyzed, and compared. Also, the dependent t-test and Pearson’s correlation coefficient test were used for statistical analysis, while probability values (P values) < 0.05 were contemplated as being statistically significant.

RESULTS: Pearson’s correlation between the gray density values for different combinations of point(s)/group(s) as derived on CT and cone beam CT images revealed the results to be statistically significant for each of the imaging methods used, individually and when compared in between the two methods, in all the cases (P < 0.001) when analyzed at 5% level of significance.

CONCLUSIONS: The mean gray density values obtained with cone beam CT were found to be significantly higher than the ones derived from CT in the present study, though, a linear correlation was observed between the values obtained from cone beam CT and CT, which can be used to convert the relative values obtained with cone beam CT into absolute values derived with CT.

PMID:40213598 | PMC:PMC11981036 | DOI:10.4103/abr.abr_313_24

Adv Biomed Res. 2025 Jan 30;14:6. doi: 10.4103/abr.abr_283_24. eCollection 2025.

ABSTRACT

BACKGROUND: Diffusion-weighted imaging with background body signal suppression (DWIBS) is a new imaging tool for the diagnosis of breast lesions. This study aims to compare DWIBS with contrast-enhanced magnetic resonance imaging (CE-MRI) sequences.

MATERIALS AND METHODS: Eighty consecutive patients underwent both CE-MRI and DWIBS images. DWIBS was assessed qualitatively and quantitatively using the apparent diffusion coefficient mapping. A threshold of 1.44 × 10^-3 mm²/s was considered as a cutoff value between malignant and benign lesions. CE-MRI images were evaluated based on a combination of kinetic and morphological information and reported using Breast Imaging Reporting and Data System lexicon. Statistical analysis was performed for both sequences based on pathologic findings as a gold standard.

RESULTS: Fifty-five out of 80 lesions (69%) were benign, and 25 malignant lesions (31%) have been reported. The sensitivity, specificity, positive predictive value, and negative predictive value for CE-MRI were 100, 38, 42, and 100%, respectively, and those for DWIBS were 77, 70, 53, and 87%, respectively. By comparing DWIBS and CE-MRI data, no statistically significant difference was reported.

CONCLUSION: DWIBS can be used as an effective alternative for breast CE-MRI in cases of contradictions of IV contrast injection.

PMID:40213596 | PMC:PMC11981034 | DOI:10.4103/abr.abr_283_24

Afr J Emerg Med. 2025 Jun;15(2):577-583. doi: 10.1016/j.afjem.2025.02.006. Epub 2025 Mar 21.

ABSTRACT

BACKGROUND: Mental illness and substance use are major global challenges, with their impact on Emergency Centres becoming evident, especially in South Africa. Patients facing these issues require significant resources from both hospital and community services. However, there is a lack of local data regarding the prevalence of concurrent mental health and substance use disorders. This study aims to evaluate the extent of psychoactive substance use within the psychiatric population at a District Hospital in Cape Town, South Africa.

METHODS: This study is a single-centre, retrospective descriptive analysis. It includes all patients referred to the inpatient psychiatric service over six months, recorded in an electronic database. Data were statistically analysed, considering the following variables: urine drug test results to identify specific substance (s) used, sex, age, diagnosis, and repeat visits.

RESULTS: A total of 597 patient visits were analysed. Fifty-nine percent tested positive for at least one substance. The patients’ average age was 34 years. A greater percentage of visits were for males (58 %), with males exhibiting a higher rate of positive test results (64 %) than females (51 %). Among the 146 repeat visits, a significant association was found between the number of visits and positive test results, with 73 % of patients with ≥2 repeat visits testing positive for substances (p < 0.001). Cannabis (60 %), methamphetamines (47 %), benzodiazepines (26 %), opioids (7 %), and cocaine (1 %) were the substances most frequently reported.

CONCLUSIONS: Emergency Centres in South Africa are impacted by individuals seeking mental health care, and substance use significantly exacerbates these challenges. Substance use creates serious physical, mental, and social implications for patients. As emergency care practitioners and members of the broader healthcare system, we play vital roles in addressing these issues. This study provides valuable insights into the complexities of the situation and suggests potential approaches for intervention.

PMID:40213582 | PMC:PMC11982960 | DOI:10.1016/j.afjem.2025.02.006

Front Immunol. 2025 Mar 27;16:1570502. doi: 10.3389/fimmu.2025.1570502. eCollection 2025.

ABSTRACT

BACKGROUND AND OBJECTIVE: This study aims to explore the relationship between melanocortin-1 receptor (MC1R) expression levels and clinical pathological parameters of melanoma, as well as its potential as a prognostic biomarker.

METHODS: This retrospective study included 99 melanoma patients in our hospital from June 2017 to July 2023. MC1R expression was assessed by immunohistochemistry assays. Histochemistry score (H-score) determined the level of MC1R immunohistochemistry expression in melanoma. The relationships among MC1R expression, clinical pathological parameters in melanoma patients were assessed using Chi-square and Fisher’s precision probability tests. Kaplan-Meier assay and log-rank test were utilized to estimate survival curves. Potential independent factors among the enrolled patients were investigated using COX regression analysis.

RESULTS: According to median value of H-score, 38 cases with low MC1R expression and 61 cases with high MC1R expression in melanoma tumor tissues were observed. Patients with high MC1R expression in melanoma tissues exhibited a worse prognosis compared to patients with low MC1R expression. The survival time difference was statistically significant [MC1R expression in melanoma tumor tissue (MC1RT): median DFS, 12.83 vs. 17.53 months, χ2 = 5.395, P=0.0202; median OS, 16.47 vs. 21.77 months, χ2 = 5.082, P=0.0243. MC1R expression in normal adjacent to melanoma tissue (MC1RN): median DFS, 12.03 vs. 14.29 months, χ2 = 6.864, P=0.0088; median OS, 16.73 vs. 21.77 months, χ2 = 5.649, P=0.0175]. Multivariate COX regression model analysis indicated that MC1RN, MC1RT, sex, ESR, tumor site, targeted therapy, and immunotherapy were potential prognostic factors for the DFS. Furthermore, MC1RN, MC1RT, sex, tumor site, TLN, PLN, and immunotherapy were potential prognostic factors for the OS. Calibration curve indicated the predicted probabilities of nomogram models were in accordance with the actual probabilities, and the prediction accuracy was relatively high at one year and three years following surgery. The decision clinical curve revealed that the nomogram models had better predictive performance for DFS and OS than the MC1RT or MC1RN thresholds.

CONCLUSIONS: Low MC1R expression in melanoma tumor tissues and adjacent normal tissue might be beneficial for the prognosis of melanoma patients. MC1R was a predictive factor for the prognosis of melanoma patients. Nomogram models based on MC1R demonstrated good prediction ability.

PMID:40213552 | PMC:PMC11983465 | DOI:10.3389/fimmu.2025.1570502

JAAD Int. 2024 Jan 13;20:23-30. doi: 10.1016/j.jdin.2023.12.010. eCollection 2025 Jun.

ABSTRACT

BACKGROUND: There are multiple topical agents for papulopustular rosacea (PPR), but the most effective for the management of moderate-to-severe PPR remains unknown.

OBJECTIVE: To compare the efficacy and safety of topical agents for moderate-to-severe PPR.

METHODS: Medline, Embase, and CENTRAL databases were searched. The efficacy of topical agents was explored through frequentist network meta-analysis using random-effects model. Treatments were ranked using net rank function, yielding P scores.

RESULTS: Nineteen randomized control trials (RCTs) that enrolled and 8208 participants were deemed eligible. Azelaic acid 20% yielded the highest effect size (OR = 8.54, 95% CI: 2.48-29.45) and highest P-score (P score = 0.97) with respect to improvement in investigator global assessment (IGA) score. Azelaic acid 15%, Metronidazole 0.75%, and Ivermectin 1% yielded comparable effect sizes. Azelaic acid 15% yielded statistically significant odds ratio (OR = 1.95, 95% CI: 1.30-2.93, P score = 0.14) for adverse events. Adverse event risk for other topical agents was not significant.

LIMITATION: The sample size was limited for some of the topical agents. Also, many clinically important outcomes were overlooked by most of the included RCTs.

CONCLUSION: Azelaic acid 20% was the most effective in improving IGA score for moderate-to-severe PPR and azelaic acid 15% as having the highest adverse event profile.

PMID:40213532 | PMC:PMC11979399 | DOI:10.1016/j.jdin.2023.12.010

Gynecol Oncol Rep. 2025 Mar 17;58:101725. doi: 10.1016/j.gore.2025.101725. eCollection 2025 Apr.

ABSTRACT

OBJECTIVE: The incidence and mortality of endometrial cancer is increasing. After surgical staging, patients with high-risk disease often undergo adjuvant treatment, which may include systemic therapy, radiation therapy, or combined modalities. Patients in rural Appalachia have limited access to subspecialty care needed for optimal disease management. This study aims to compare adjuvant treatment regimens and outcomes among patients with high-risk endometrial cancer living in Appalachian and non-Appalachian regions.

METHODS: We retrospectively identified 179 patients with high-risk endometrial carcinoma who underwent surgical staging at a single academic medical center and received adjuvant therapy between 2012 and 2019. Patients were identified as Appalachian (n = 119) and non-Appalachian (n = 60) residents based on home ZIP code. Adjuvant therapy regimen, recurrence rate, recurrence location, progression free survival (PFS), and overall survival (OS) were compared. Statistical comparisons were performed using multinomial and ordinal logistic regression models, Kaplan-Meier curves, Log Rank test, two-sample t-tests, Fisher’s exact, and chi-square tests.

RESULTS: There was no significant difference in adjuvant therapy regimen between groups. Overall recurrence rates were similar, though rate of vaginal recurrence was higher among non-Appalachian patients compared to Appalachian patients (42 % vs. 14 %, p = 0.05). There were no differences in rate of pelvic or distant recurrences, PFS, or OS.

CONCLUSION: Despite lower densities of subspecialists in rural Appalachia, Appalachian and non-Appalachian patients with high-risk endometrial cancer received similar adjuvant therapy regimens and had similar disease outcomes. Further efforts should work to optimize treatment and surveillance for patients with endometrial carcinoma with barriers to subspecialty care.

PMID:40213528 | PMC:PMC11985054 | DOI:10.1016/j.gore.2025.101725

J Clin Orthop Trauma. 2025 Mar 17;65:102977. doi: 10.1016/j.jcot.2025.102977. eCollection 2025 Jun.

ABSTRACT

BACKGROUND: Tranexamic acid (TXA) is increasingly used to minimize blood loss associated with total hip replacement (THR), yet its comparative efficacy in inflammatory versus degenerative arthritis during THR remains underexplored in Indian patients. The objective of this study was to evaluate and compare the estimated intraoperative blood loss in patients undergoing THR with and without TXA administration, stratified by underlying degenerative and inflammatory joint conditions.

METHODS: This retrospective cohort study analyzed medical records of patients undergoing THR at a single center from October 2020 to October 2023. Patients were stratified by TXA usage and the type of arthritis (inflammatory and degenerative). The primary outcome was intraoperative blood loss, while secondary outcomes included operative time and time to full weight-bearing.

RESULTS: The study enrolled 126 patients, including 21 with inflammatory arthritis and 105 with degenerative arthritis, of whom 106 received TXA (n = 19, inflammatory arthritis; n = 87, degenerative arthritis).The primary outcome of mean intraoperative blood loss was lower in the TXA group (350.57 ± 162.36 mL) compared to the non-TXA group (380.00 ± 192.22 mL), although this difference did not reach statistical significance (p = 0.472).Secondary outcome, operative time was significantly shorter in patients receiving TXA (88.53 ± 24.38 min) compared to those who did not receive TXA (102.58 ± 45.27 min, p = 0.046). While the time to full weight-bearing was comparable between the TXA users and non-users (p = 0.341).Subgroup analysis suggested a more pronounced reduction in blood loss with TXA use among patients with degenerative arthritis than those with inflammatory arthritis, though the difference was not statistically significant.

CONCLUSION: TXA administration in THR significantly reduced operative time but showed no significant difference in blood loss or postoperative recovery. The results suggest a potential for more pronounced benefits in patients with degenerative arthritis.

PMID:40213505 | PMC:PMC11979939 | DOI:10.1016/j.jcot.2025.102977

Lancet Reg Health Eur. 2025 Feb 10;51:101231. doi: 10.1016/j.lanepe.2025.101231. eCollection 2025 Apr.

ABSTRACT

BACKGROUND: Local transmission of dengue, chikungunya, and Zika infection is an emerging public health threat in Europe. Monitoring the epidemiological trends can help define the intervention strategy. The aim of this work was to analyse epidemiological characteristics of autochthonous transmission of Aedes-borne arboviruses in Europe.

METHODS: A systematic review of the literature published from January 1, 2007, to January 31, 2024, reporting autochthonous cases of dengue, chikungunya, and Zika detected in Europe was performed. We searched MEDLINE, EMBASE, and the ECDC reports. Descriptive statistics and a secondary analysis were used to summarize the epidemiological characteristics of local transmission events (LTEs), explore potential temporal trends and identify relevant associations between epidemiological variables. Time intervals between key events were analysed to identify potential delays in LTE identification and intervention.

FINDINGS: A total of 59 studies were included, describing 56 LTEs. The frequency of LTEs increased over time, with an average of 1.25 (95% CI: 1.17-1.35) times increment every year. While the highest number of dengue LTEs was reported in France (N = 37), Italy faced the largest number of cases detected in an LTE (N = 41). Considering all the arboviral LTEs, the median time between the symptom onset of the primary case and the diagnosis of the index case (“outbreak detection”) was 35.5 days (range 23.0-76.0). Only for chikungunya, higher delays correlated with higher cumulative number of cases detected per LTE, though this may be biased due to the low sample size.

INTERPRETATION: We have observed a gradual increase of Aedes-borne arboviral LTEs in Europe over time, and a considerable delay in outbreak detection. Improving the timeliness of LTE identification is essential.

FUNDING: This work was partly funded by the Italian Ministry of Health (Ricerca corrente) and by the European Union (Next Generation EU, Missione 4 Componente 1 CUP H93C22000640007).

PMID:40213502 | PMC:PMC11984593 | DOI:10.1016/j.lanepe.2025.101231