Category: Statistics

Obes Surg. 2025 Jun 10. doi: 10.1007/s11695-025-07946-x. Online ahead of print.

ABSTRACT

INTRODUCTION: The rising prevalence of obesity and demand for minimally invasive treatments has led to increased adoption of endoscopic sleeve gastroplasty (ESG). As telemedicine expands in bariatrics, understanding the role of virtual follow-up care is crucial. This study aims to use propensity-matching to compare weight loss and metabolic outcomes between virtual and in-person follow-up modalities post-ESG.

METHODS: Data from patients with obesity who underwent ESG at a single tertiary care center between August 2013 and November 2024 were prospectively collected and retrospectively analyzed. Eligible patients were those with a body mass index (BMI) of 30 kg/m² or greater (or > 27 kg/m² with comorbidities). All procedures were performed by a single therapeutic endoscopist using a full-thickness technique. Patients were categorized into virtual or in-person follow-up groups based on whether over 70% of their post-procedure visits were conducted virtually or in-person, respectively. To account for potential baseline differences, propensity score matching was employed. The primary outcomes assessed were the impact of follow-up method on percent total body weight loss (%TBWL) and changes in metabolic parameters at 12 and 36 months post-ESG.

RESULTS: Data from 113 patients (mean age, 43.9 years; 80.5% female, BMI 36.0 kg/m²), were analyzed, and stratified by follow-up modality (in-person: n = 54, virtual: n = 59). After propensity matching, baseline differences were eliminated and both groups demonstrated improvements in ALT, HbA1c, LDL, TG, SBP, and mean %TBWL exceeding ten at all time points, with no statistically significant differences between groups at 12 or 36 months.

DISCUSSION: Telemedicine is expected to remain in the management of obesity due to its convenience. This study found no significant differences in weight loss or metabolic changes between propensity-matched groups, demonstrating comparable effectiveness of virtual and in-person follow-up. Future research should refine telemedicine strategies and assess their long-term impact on weight maintenance.

PMID:40493351 | DOI:10.1007/s11695-025-07946-x

Environ Sci Pollut Res Int. 2025 Jun 10. doi: 10.1007/s11356-025-36584-0. Online ahead of print.

ABSTRACT

This study employed a passive dust sampling method using flat glass traps at 44 locations across Tehran, which allowed for detailed analysis of V, Pb, Cu, Zn, Cd, Ni, and Cr concentrations. It offers an essential understanding of the spatial distribution and seasonal variation of urban dust pollution, along with its associated environmental and human health risks. The results indicate that Zn, Pb, Cu, and Cd are key factors influencing the dust pollution burden in Tehran. The findings highlight the pollution and ecological impacts of dust, showing that most of the dust throughout Tehran has “moderate to high pollution levels” and “considerable ecological risk”. In addition, these studies show that Cd and Pb need special attention. Multivariate statistical analyses demonstrated that Cu, Zn, Pb, and Cd were predominantly affected by human activities, while Ni and Cr were affected to a lesser degree, and V appeared to be more influenced by geological sources. The assessment of health risks showed that these levels were within the safe limits (non-carcinogenic < 1 and carcinogenic < 1 ✕ 10^-6), and the possible health risks in children were more than in adults. The most unsafe route of exposure in children was ingestion, followed by dermal contact and inhalation. The findings of this research showed that cold seasons can be most problematic with the negative effects of pollution and ecological risks, and may also have health risks in the long term. The findings pointed to reasons such as increased consumption of fossil fuels, increased traffic, temperature inversion, and atmospheric stability.

PMID:40493347 | DOI:10.1007/s11356-025-36584-0

Adv Ther. 2025 Jun 10. doi: 10.1007/s12325-025-03227-2. Online ahead of print.

ABSTRACT

INTRODUCTION: Understanding the 24-h efficacy and safety of a novel therapy option, sepetaprost ophthalmic solution 0.002% vs. latanoprost ophthalmic solution 0.005%, may delineate its future position in glaucoma treatment.

METHODS: In this exploratory study (EudraCT 2020-004836-93), adults with primary open-angle glaucoma (POAG) or ocular hypertension (OHT) were randomized to sepetaprost or latanoprost for 3 months following a ≤ 35-day screening period. The primary endpoint was mean 24-h intraocular pressure (IOP) at month 3 with sepetaprost vs. latanoprost. Safety outcomes included rate of adverse events (AEs).

RESULTS: Overall, 33 participants received treatment (sepetaprost, n = 17; latanoprost, n = 16). Mean 24-h IOP was numerically lower with sepetaprost vs. latanoprost at month 3 (- 0.88 mmHg; 95% confidence interval [CI] – 2.89, 1.14; not statistically significant at the 0.05 level [NS]). Mean change from baseline in IOP at month 3 ranged from – 5.63 to – 7.00 mmHg for sepetaprost and – 3.84 to – 6.66 mmHg for latanoprost. Lower nocturnal IOP was observed with sepetaprost vs. latanoprost at month 3 (- 1.61 mmHg difference; 95% CI – 4.05, 0.83; not statistically significant; however, the 90% CI was – 5.27, – 0.17 and therefore, nominal statistical significance was achieved at the 0.10 level). Mean difference between groups indicated similar, or numerically lower, IOP with sepetaprost at individual time points at week 6 and month 3. At 36 and 48 h following sepetaprost cessation, mean IOP was lower vs. baseline IOP at the same time points. AEs occurred in 13 (76.5%) vs. 11 (68.8%) participants treated with sepetaprost vs. latanoprost.

CONCLUSION: In participants with POAG or OHT, mean 24-h IOP and nocturnal IOP at month 3 were consistently numerically lower with sepetaprost vs. latanoprost. Safety profiles were similar between groups.

TRIAL REGISTRATION: EudraCT 2020-004836-93.

PMID:40493333 | DOI:10.1007/s12325-025-03227-2

Int J Clin Pharm. 2025 Jun 10. doi: 10.1007/s11096-025-01947-7. Online ahead of print.

ABSTRACT

BACKGROUND: Pharmaceutical calculations are required elements of the Doctor of Pharmacy curriculum in the United States. With the growth of artificial intelligence chatbots, pharmacists and educators are exploring their application. The accuracy of artificial intelligence chatbots in performing pharmaceutical calculations remains unknown.

AIM: To evaluate the accuracy of artificial intelligence chatbots for pharmaceutical calculations.

METHOD: Eleven free-access chatbots were tested using 7 faculty-generated questions: 1 control, 2 creatinine clearance, 1 oral to intravenous dose conversion, 2 antibiotic pharmacokinetic dosing, and 1 number needed to harm. Descriptive statistics were used to evaluate the primary outcome, which was proportion of correct responses. Secondary outcomes included types of errors and teachability.

RESULTS: Ten (90.9%) chatbots answered the control question correctly, and all answered the dose conversion question correctly. Eight (72.7%) chatbots correctly calculated number needed to harm. Only 1 (9.1%) provided the correct antibiotic dosing, and none correctly calculated creatinine clearance. Common errors included incorrect weight selection for creatinine clearance and use of incorrect formulas. Nine (81.8%) chatbots were teachable on at least 1 question.

CONCLUSION: Artificial intelligence chatbots demonstrated limited accuracy for multi-step pharmaceutical calculations and may be more reliable for low complexity calculations.

PMID:40493330 | DOI:10.1007/s11096-025-01947-7

Am J Cardiovasc Drugs. 2025 Jun 10. doi: 10.1007/s40256-025-00738-9. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim was to systematically evaluate the effect of semaglutide on blood pressure in obese populations using meta-analysis methods.

METHODS: Randomized controlled trials on the effect of semaglutide on blood pressure regulation published from the inception of the databases to October 2024 were searched for in PubMed, Embase, the Cochrane Library, and Web of Science. Stata software was used for statistical analysis of the outcome measures in all included studies. Egger’s test was applied to assess the risk of publication bias.

RESULTS: A total of 22 studies involving 15,347 participants were included in this meta-analysis. The results showed that, compared to the control group, the semaglutide group significantly reduced systolic blood pressure (SBP) (mean difference [MD] – 2.90, 95% confidence interval [CI] – 3.70 to – 2.11; P < 0.01) and diastolic blood pressure (DBP) (MD – 0.86, 95% CI – 1.34 to – 0.38; P < 0.01). Further subgroup analysis revealed that, compared to diabetic populations, semaglutide had a more significant reduction in SBP (- 1.87, 95% CI – 2.67 to – 1.06, vs – 5.02, 95% CI – 6.10 to – 3.94) and DBP (- 0.43, 95% CI – 0.89 to 0.02, vs – 1.96, 95% CI – 3.12 to – 0.80) in non-diabetic populations. The higher dose of semaglutide (2.4 mg) was found to significantly lower SBP (MD – 4.31, 95% CI – 5.18 to – 3.44) and DBP (MD – 1.84, 95% CI – 2.70 to – 0.98), although mild heterogeneity was present. Sensitivity analysis showed that the exclusion of any single study did not significantly affect the final results.

CONCLUSION: Current evidence suggests that semaglutide can lower SBP and DBP, and increasing the dosage can enhance the blood pressure-lowering effect.

PMID:40493329 | DOI:10.1007/s40256-025-00738-9

J Epidemiol Glob Health. 2025 Jun 10;15(1):82. doi: 10.1007/s44197-025-00420-y.

ABSTRACT

BACKGROUND: Despite a high burden of injuries in low-income and middle-income countries (LMICs), a lack of empirical evidence on mechanism, location, and distribution of unintentional injuries requiring medical attention (hereafter injuries) hinders informed health system policy development.

METHODS: Using individual-level data from nationally representative surveys conducted in LMICs between 2014-2019, we describe the weighted annual prevalence of non-fatal injuries, their mechanisms, environments in which they occur, and characteristics of people injured, in individuals aged 15-64 years. Multivariable logistic regression models were estimated to evaluate associations of injuries with individual-level characteristics.

RESULTS: We included data on 47,747 participants from 12 LMICs in four WHO regions. The weighted prevalence of non-fatal injuries in the past year was 6.8% (95% CI: 6.3%-7.2%); men suffered a greater prevalence of injuries than women (8.3% [95% CI 7.6%-9.0%] vs. 5.4% [95% CI 5.0%-5.9%], respectively). In the multivariable logistic regression, the odds of having any injury were lower among females and married people and higher among individuals with some primary education. Prevalence of non-road traffic collision injuries was almost threefold that of road traffic collision (RTC) injuries: 5.6% (5.2%-6.0%) vs. 1.7% (1.5%-2.0%). When considering non-RTC injuries, falls were the most common mechanism (47.0%, 95% CI 44.0%-50.1%), and homes were the most common location (38.1%, 95% CI 34.9%-41.4%), followed by road (17.9%, 95% CI 15.7%-20.4%), and workplace (17.4%, 95% CI 15.2%-19.8%). The largest proportion (23.2%, [95% CI 20.6%-25.9%]) of non-RTC injuries happened to women at home.

CONCLUSION: Non-RTC injuries, in particular falls, predominate in this population. This highlights a neglected side of injuries, many of which happen at home to women, whereas global attention tends to focus on RTCs. Data on all mechanisms of injuries and care-seeking behaviour after injuries are required for health system planning.

PMID:40493309 | DOI:10.1007/s44197-025-00420-y

Egypt Heart J. 2025 Jun 10;77(1):57. doi: 10.1186/s43044-025-00651-1.

ABSTRACT

BACKGROUND: Acute type A aortic dissection is a rapidly progressive and life-threatening condition. Without timely surgical intervention, the mortality rate can reach up to 50% within the first 48 h. Although surgery remains the primary effective treatment, it is associated with significant complexity and potential risks, particularly in managing the aortic root, where both intraoperative and postoperative bleeding complications are common. This study aims to evaluate the efficacy of the modified “sandwich” technique using a synthetic vascular patch for aortic root reconstruction in acute type A aortic dissection surgery.

METHODS: A retrospective analysis was conducted on the clinical data of 28 patients with acute type A aortic dissection who underwent aortic root reconstruction using the modified “sandwich” technique with synthetic vascular patches at the Department of Cardiovascular Surgery, the Third Hospital of Hebei Medical University, from October 2020 to November 2022. All patients underwent surgical treatment, during which the modified “sandwich” technique was applied for aortic root reconstruction. Statistical analysis was performed on operative time, cardiopulmonary bypass (CPB) time, aortic cross-clamp (ACC) time, postoperative drainage volume, perioperative mortality, and complications.

RESULTS: All 28 patients underwent successful surgery with a cardiopulmonary bypass (CPB) time of 265.0 (210.0-322.5) min, an aortic cross-clamping (ACC) time of 151.0 (112.0-209.0) min, and a drainage flow rate of 237.5 (126.0-297.0) mL at 12 h postoperatively. There were 2 (7.1%) perioperative deaths caused by renal failure, ischemia in 1 case, and coronary artery causes in 1 case. Postoperative complications included reopening of the chest for hemostasis in 1 case (3.6%) for reasons unrelated to the vascular anastomosis, hemodialysis in 3 cases (10.7%), paraplegia in 1 case (3.6%), and cerebral infarction resulting in impaired mobility of the left upper extremity in 1 case (3.6%). Tracheotomy was performed in 1 case (3.6%), and the duration of mechanical ventilation was 89 (48.0-165) h. Among the 26 recovered patients reviewed with aortic enhancement CT before discharge, the artificial vascular anastomosis had smooth blood flow, though 1 case still had residual entrapment in the sinus of the aorta.

CONCLUSION: In acute type A aortic dissection surgery, the “modified sandwich” technique using an artificial vascular sheet for aortic root shaping is simple, effective, and easy to master. This method can reduce anastomotic blood seepage and prevent anastomotic tear and bleeding, making it worth recommending for clinical application.

PMID:40493299 | DOI:10.1186/s43044-025-00651-1

Infection. 2025 Jun 10. doi: 10.1007/s15010-025-02580-2. Online ahead of print.

ABSTRACT

BACKGROUND: Clostridioides difficile infection (CDI) poses a significant healthcare challenge, with the most frequent cause being antibiotic-associated diarrhea, affecting hospitalized individuals with substantial cost and mortality concerns. However, there is no information regarding probiotic efficiency for initial CDI treatment, and the modulation of microbiota by probiotics has been suggested as a potential preventive measure against CDI.

OBJECTIVE: To evaluate the efficacy of probiotics in preventing CDI in hospitalized patients.

METHODS: An exhaustive literature search was performed using PubMed to identify controlled/clinical trials investigating the use of probiotics for CDI prevention among hospitalized individuals based on PRISMA guidelines and the PICO framework. Relevant data were extracted from selected studies. Statistical meta-analysis (subgroup or sensitivity analyses) was performed using R Studio to calculate the pooled effect size, odds ratio (OR) with a 95% CI, p-value, and heterogeneity. The risk of bias was assessed using the Cochrane risk-of-bias (RoB) tool to determine publication bias and sensitivity of the included studies.

RESULTS: Four studies with a significant number of participants were identified and included in the meta-analysis. The incidence of CDI was reduced in the probiotic group compared to the placebo group, with an overall OR of 0.99 (95% CI [0.56; 1.7]), increased heterogeneity, and a non-significant p-value, using a random effects model in R Studio. Subgroup analysis suggested possible beneficial outcomes regarding the selection of probiotic strain and dose regimen, supporting the effective use of probiotics in preventing CDI. Two of the included studies showed a high risk of bias in the randomization process, while others indicated a significantly low risk of bias.

CONCLUSION: Detailed or systematic information on CDI treatment provides evidence that the direction of the odds ratio suggests a possible protective role of probiotics, although the overall effect was not significant. The OR < 1.0 indicates a neutral efficiency of probiotics, on CDI incidence observed in the probiotics group compared to the placebo group.

PMID:40493294 | DOI:10.1007/s15010-025-02580-2

J Epidemiol Glob Health. 2025 Jun 10;15(1):81. doi: 10.1007/s44197-025-00417-7.

ABSTRACT

PURPOSE: This study aims to describe the social-relational context of adolescents and young adults living with (AYALHIV) and without HIV (AYAHIV-) in the city of Beira (Mozambique) and to assess how it can impact their mental health.

METHODS: A cross-sectional study with three-level assessment was conducted between July and August 2023. Socio-economic factors were assessed through an ad-hoc questionnaire, mental health through symptom Checklist-90 (SCL-90), and social-relational networks using social network analysis (SNA). SNA parameters included were: average degree centrality, closeness centrality, betweenness centrality, eigenvector centrality and transitivity. Robust linear regression model was used to assess association between SNA parameters and SCL-90 scores.

RESULTS: AYAs involved were 352 (F: 50.7%) and 341 (96.9%) completed both sociogram and SCL-90. Average degree centrality was 1.44 (SD 0.77) for supportive networks (supSN) and 0.49 (SD 0.39) for stressful ones (strSN). The average degree centrality was higher in AYAHIV- compared to AYALHIV (0.009). Supportive edges occurred more often between the individual and their mother (65.1%), while stressful edges between one (24.3%) or two (18.8%) neighbourhood people. The supSN betweenness was 0.27 (SD 0.24) in females and was significantly lower compared to males (0.33, SD 0.27, p = 0.017). The mean score at the SCL-90 was 1.1 (SD 0.5). An increase in 1 SD of the average degree centrality of the supSN was associated with a decrease of 0.14 SD at the SCL-90 (p = 0.014). The SCL-90 score was significantly lower in males (p = 0.045) and in AYAs from the high socio-economic group (p = 0.009).

CONCLUSION: Two groups proved to be more vulnerable with regard to socio-relational networks, women and AYALHIV. Better interconnected social support networks were associated with better mental health (i.e. lower scores on the SCL-90). Improving support within the community is therefore important for achieving better mental well-being for all.

PMID:40493276 | DOI:10.1007/s44197-025-00417-7

Res Health Serv Reg. 2025 Jun 10;4(1):7. doi: 10.1007/s43999-025-00066-0.

ABSTRACT

INTRODUCTION: The German hospital reform introduces population-based planning to allocate hospital budgets, considering each hospital’s role in meeting regional care needs. However, current hospital case numbers may reflect supply-side factors, such as physician density and socioeconomic disparities, rather than actual morbidity. Ambulatory care utilization inversely correlates with hospital usage, emphasizing the need to integrate ambulatory sector data into hospital planning. This study examines factors influencing hospital and office-based case numbers at the district level.

METHODS: Linking 2021 data from the Federal and State Statistical Offices, INKAR data and health insurance claims data in Germany at the district level, a multiple linear regression model assessed the association between case counts in hospitals or office-based practices per 10,000 residents and distance to the nearest general practitioner (GP), as well as hospital bed and GP density. The Global Moran’s I as well as a geographically weighted regression (GWR) analysis were conducted to assess regional differences.

RESULTS: Multiple linear regression revealed that greater GP distance, fewer GPs and more hospital beds were linked to more hospital cases, while office-based cases rose with shorter GP distance. Global Moran’s I confirmed spatial clustering, and GWR revealed heterogeneous effects of primary-care access on hospital admissions, whereas bed capacity uniformly increased hospital cases and shorter GP distances consistently predicted more office visits across Germany.

DISCUSSION: Our findings align with research showing supply-induced demand of hospital cases and emphasize the need for coordinated hospital and ambulatory care planning to improve access, reduce unnecessary hospital admissions, and optimize patient outcomes.

PMID:40493273 | DOI:10.1007/s43999-025-00066-0