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Nevin Manimala Statistics

The Cardiometabolic Index (CMI) is associated with an increased risk of obstructive sleep apnea: a population-based study

Eur J Med Res. 2025 Dec 20. doi: 10.1186/s40001-025-03687-w. Online ahead of print.

ABSTRACT

BACKGROUND: Obstructive sleep apnea (OSA) is closely associated with cardiometabolic abnormalities. However, the role of a comprehensive index integrating multiple cardiometabolic parameters in OSA risk assessment remains unclear. This study aimed to explore the potential association between the Cardiometabolic Index (CMI) and OSA risk in a large-scale population cohort.

METHODS: Data were derived from the 2005-2008 and 2015-2018 cycles of the National Health and Nutrition Examination Survey (NHANES), with a total of 39,722 participants included. OSA was defined using self-reported indicators (e.g., daytime sleepiness, nocturnal choking/snoring) rather than objective criteria such as polysomnography (PSG). Logistic regression analysis was performed to examine the association between CMI and OSA. Segmented regression and non-linear models were constructed to verify the non-linear relationship between the two variables. Propensity score matching (PSM) was used to validate the stability of the results, and finally, subgroup analysis was conducted to investigate heterogeneity across different populations.

RESULTS: The study found a potential association between elevated CMI and OSA. Multivariate adjusted regression analysis showed that in Model 3, the continuous CMI variable was significantly associated with OSA risk (odds ratio [OR] = 1.014, P = 0.024), and the OSA risk in the Q4 group (highest CMI quartile) was significantly higher than that in the Q1 group (lowest CMI quartile) (OR = 1.272, P < 0.001), showing a linear upward trend. The threshold for the association between CMI and OSA was 2.03: when CMI < 2.03, the OR was 1.50 (P < 0.001), while no statistically significant association was observed when CMI exceeded this threshold, indicating a significant “inverted L-shaped” non-linear relationship between the two. After PSM, the OSA risk in the Q4 group was 1.174 times that in the Q1 group (P = 0.018). Subgroup analysis revealed that the association between CMI and OSA might be stronger in populations without hypertension or stroke, especially among females.

CONCLUSIONS: This study found a non-linear positive association between CMI and OSA risk. Specifically, the OSA risk in the Q4 group was significantly higher than that in the Q1 group (OR = 1.272, P < 0.001). Additionally, the association was more prominent in young people, females, and populations without hypertension or stroke. These findings suggest that CMI may serve as a convenient indicator for early screening, particularly applicable to high-risk OSA populations with metabolic disorders. The results of this study provide a new perspective for public health interventions and clinical risk assessment of OSA.

PMID:41422298 | DOI:10.1186/s40001-025-03687-w

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Assessment of equipment and human resources in a national survey of neonatal resuscitation in Iran

Sci Rep. 2025 Dec 20. doi: 10.1038/s41598-025-32553-2. Online ahead of print.

NO ABSTRACT

PMID:41422285 | DOI:10.1038/s41598-025-32553-2

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Oral sodium hyaluronate improves skin hydration, barrier function and signs of aging: a randomized, double-blind, placebo-controlled trial in 150 healthy adults

Sci Rep. 2025 Dec 20. doi: 10.1038/s41598-025-32758-5. Online ahead of print.

ABSTRACT

Oral hyaluronan has been reported to improve various aspects of skin physiology, but existing trials often lack methodological rigor, comprehensive outcome assessment, and diverse populations. This randomized, double-blind, placebo-controlled trial evaluated the effects of sodium hyaluronate (SH) supplementation at two daily doses on skin parameters in healthy Caucasian adults. A total of 150 participants were randomized to receive SH (1.8 MDa) at 60 mg/day (SH60), 120 mg/day (SH120), or placebo for 12 weeks. Facial hydration, transepidermal water loss (TEWL), sebum, elasticity, wrinkle depth, skin gloss, colorimetric parameters, epidermal thickness, dermal density, red areas, and pore size were assessed at baseline and monthly. Subjective skin condition was evaluated every two weeks, and components of natural moisturizing factor (NMF) in forearm skin were quantified by LC-MS/MS. SH120 significantly enhanced skin hydration and elasticity, while reducing TEWL, sebum, and periorbital wrinkle depth versus placebo. It also improved skin structure by increasing epidermal thickness, dermal density, and NMF levels. SH60 showed similar but more modest effects. No changes were observed for colorimetric parameters, red areas, pore size, or gloss. In conclusion, oral SH supplementation improved multiple aspects of skin physiology, supporting its use as a functional food ingredient with measurable benefits for skin health and healthy aging.Trial registration: ClinicalTrials.gov, NCT07065110 (retrospectively registered on 15 Jul 2025); EFSA (European Food Safety Authority) registry: EFSA202400027979 (prospectively filed on 06 Jun 2024).

PMID:41422283 | DOI:10.1038/s41598-025-32758-5

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Nevin Manimala Statistics

Factors influencing complete abstinence during Thailand’s temporary alcohol abstinence campaign

Sci Rep. 2025 Dec 21. doi: 10.1038/s41598-025-33405-9. Online ahead of print.

ABSTRACT

Thailand’s temporary abstinence campaign aims to persuade drinkers to abstain from alcohol for three months during Buddhist Lent. In recent years, a decline in the popularity of the campaign has been observed. This study aims to determine factors associated with success in complete abstinence during the campaign period and to determine whether the associations change over time to provide insight into the decline in complete abstinence. This study analyzes pooled data of 5898 current drinkers from three waves (2015, 2018, and 2021) of the campaign evaluation survey. The primary outcome is complete abstinence during the campaign. Multivariable analysis indicated that campaign media exposure was associated with complete abstinence (OR, 1.42; 95% CI 1.17-1.72). Similarly, the year 2018, older age, lesser drinking frequency prior to the campaign, and higher level of affordability were positively associated with complete abstinence. There was a statistically significant interaction between year and drinking frequency prior to the campaign (p < 0.001). The decline in complete abstinence was plausibly explained by reduced campaign media exposure, increased drinking frequency among drinkers, and the 2021 period effect (presumably COVID-19). Diversifying campaign media distribution across traditional, community-based, and digital platforms may enhance the campaign’s success by ensuring wider exposure to campaign messages.

PMID:41422281 | DOI:10.1038/s41598-025-33405-9

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High-resolution landfill characterization using SAR remote sensing and cloud-based processing

Sci Rep. 2025 Dec 21. doi: 10.1038/s41598-025-32908-9. Online ahead of print.

ABSTRACT

Solid waste management in developing countries such as India faces persistent challenges due to weak monitoring systems and the absence of reliable reporting mechanisms for landfill statistics. To address this gap, this study develops a remote sensing methodology that integrates Python programming with the Sentinel Application Platform (SNAP) to generate Digital Elevation Models (DEMs) from Sentinel-1 synthetic aperture radar (SAR) imagery for quantifying landfill characteristics. Key parameters, including waste height and volumetric estimates, were extracted from satellite observations and processed through Google Earth Engine (GEE), enabling efficient large-scale analysis. A total of 80 landfill sites distributed across India were examined, providing the first nationwide assessment of landfill volume using a uniform and replicable framework. Field validation was conducted at two representative sites, Gondiya Landfill and Ujjain Ring Road Trenching Ground, through drone surveys and Differential Global Positioning System (DGPS) measurements. The evaluation showed deviations of 21.12% and 0.12% in height, 0.7% and 0.65% in area delineation, and 20.21% and 0.8% in volume for Gondiya and Ujjain, respectively, confirming the reliability of the proposed approach. These results demonstrate that SAR-based DEMs offer a cost-effective and scalable solution for systematic, near real-time monitoring of landfills across large regions. The framework not only supports capacity planning, environmental assessments, and policy formulation but also provides a pathway for developing countries to transition toward data-driven waste management strategies in the context of rapid urbanization and increasing waste generation.

PMID:41422276 | DOI:10.1038/s41598-025-32908-9

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Synergistic anti-tumor effects of novel two-domain soluble Fms-like tyrosine kinase-1 and paclitaxel on three-dimensional breast cancer models: implications for targeted therapy

J Transl Med. 2025 Dec 20. doi: 10.1186/s12967-025-07585-x. Online ahead of print.

ABSTRACT

BACKGROUND: Three-dimensional (3D) multicellular spheroids mimic tumor architecture, diffusion limits, and drug resistance more effectively than two-dimensional (2D) monolayers. Triple-negative breast cancer (TNBC) remains highly aggressive, with limited benefits from anti-vascular endothelial growth factor (VEGF) therapy. We investigated the synergistic effects of a novel two-domain soluble Fms-like tyrosine kinase-1 (2d-sFlt-1), in enhancing paclitaxel efficacy compared with bevacizumab using 3D breast cancer models.

METHODS: 3D spheroids derived from triple-negative (MDA-MB-231 and MDA-MB-468) and luminal (MCF-7) breast cancer cell lines, as well as tumor-endothelial co-culture spheroids, were treated with paclitaxel alone or in combination with 2d-sFlt-1 or bevacizumab. Treatment efficacy was evaluated through drug-sensitivity, proliferation, viability, migration, and morphometric analyses, along with assessments of angiogenesis, epithelial-to-mesenchymal transition (EMT), and focal adhesion kinase (FAK) signaling. Statistical significance was determined using non-parametric tests or one- and two-way ANOVA with appropriate multiple comparisons.

RESULTS: Transition from 2D monolayer to 3D spheroid culture markedly increased paclitaxel resistance, with IC₅₀ values elevated by roughly 25-fold. Co-treatment with 2d-sFlt-1 markedly enhanced paclitaxel efficacy, reducing the IC₅₀ values by approximately tenfold in MDA-MB-231 spheroids and sixfold in MDA-MB-468 spheroids, whereas bevacizumab produced only modest effects. Paclitaxel and 2d-sFlt-1 combination further suppressed spheroid growth and proliferation in both TNBC and luminal breast cancer models. In MDA-MB-231 spheroids, combination therapy reversed epithelial-to-mesenchymal transition by increasing E-cadherin while downregulating N-cadherin, SNAIL, and TWIST, and further reduced VEGF secretion and angiogenic tube formation. In tumor-endothelial co-cultures, FAK signaling was markedly reduced after combination treatment. Across all models and assays, paclitaxel and 2d-sFlt-1 combination consistently outperformed monotherapy and paclitaxel plus bevacizumab, underscoring its potential as a mechanistically synergistic strategy for overcoming chemoresistance in triple-negative breast cancer.

CONCLUSIONS: 2d-sFlt-1 enhanced paclitaxel efficacy in physiologically relevant 3D breast cancer models. In MDA-MB-231 spheroids, the combination reduced chemoresistance and invasive growth through coordinated modulation of angiogenesis, EMT, and FAK signaling. In MDA-MB-468 and MCF-7 spheroids, it primarily increased cytotoxicity and growth inhibition, indicating a conserved functional benefit across subtypes. These findings provide a rationale for further mechanistic validation and preclinical evaluation of 2d-sFlt-1 plus paclitaxel to define dosing, safety, and translational feasibility in aggressive breast cancers.

PMID:41422245 | DOI:10.1186/s12967-025-07585-x

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Malocclusion in 12-13-years old Polish adolescents – an analysis across a spectrum of parental, birth, and developmental factors

BMC Oral Health. 2025 Dec 20. doi: 10.1186/s12903-025-06887-2. Online ahead of print.

ABSTRACT

BACKGROUND: Knowledge on the frequency of malocclusion and associated factors allows planning adequate financing in public health care systems for both preventive and treatment measures. The aim of this study was to assess the prevalence of malocclusion in Polish adolescents (from West Pomeranian region) and perform an analysis across a spectrum of factors, including BMI, parental age and education, maternal smoking during pregnancy, gestational age and Apgar at birth, breastfeeding, bottle feeding, eruption age of deciduous teeth, eruption age of permanent teeth, lingual frenulum and frequency of dental appointments.

METHODS: The study included 738 children aged 12-13 years subjected to a written interview with the parents and a clinical examination by a specialist in orthodontics or pedodontics.

RESULTS: Distal occlusion was found in 22.09%, deep bite was found in 19.92%, dental crowding was observed in 19.51%, crossbite-in 6.23%, anterior open bite-in 1.63%, mesial occlusion in 2.30%, dental spacing-in 2.71%, and scissor bite in 0.68%. The prevalence of malocclusion did not statistically significantly differ between the sexes. A higher proportion of adolescents without malocclusion were children of parents with a higher education level and they visited the dentist more frequently than adolescents with malocclusion. No statistically significant difference was found referring to gestational age at birth, delivery (cesarean or natural), birth weight, Apgar score, maternal smoking during pregnancy, breastfeeding or bottle feeding. Adolescents with malocclusion had fewer permanent teeth erupted. A short lingual frenulum was more prevalent in teenagers with malocclusion. Body height was identified as significant in logistic regression-each additional cm of height resulted in a 3% decrease in malocclusion odds.

CONCLUSION: 1. Malocclusion is highly prevalent among Polish adolescents. 2. Factors associated to malocclusion in adolescents are: parents’ level of education, frequency of dental appointments, short tongue frenulum, number of permanent teeth erupted and body height. 3. Gender, body mass index, feeding practices in infancy, pregnancy and birth condition (Apgar, method of delivery and mother smoking while being pregnant) have no association to malocclusion in 12-13 years old adolescents.

PMID:41422235 | DOI:10.1186/s12903-025-06887-2

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Effects of photobiomodulation therapy on orthodontically induced inflammatory root resorption: a systematic review and meta-analysis

BMC Oral Health. 2025 Dec 20. doi: 10.1186/s12903-025-07512-y. Online ahead of print.

ABSTRACT

INTRODUCTION: Orthodontically induced inflammatory root resorption (OIIRR) is a common complication of orthodontic treatment that may compromise tooth health and treatment outcomes. Photobiomodulation (PBM) therapy has emerged as a potential modality to mitigate against OIIRR. However, clinical studies have shown inconsistent efficacy and there is a lack of consensus on functional parameters, underscoring the need for evidence-based reviews.

METHODS: Randomized controlled trials (RCTs) investigating PBM for OIIRR mitigation with quantitative root resorption assessment were included in the review. An electronic search was conducted across six databases (PubMed, Web of Science, Cochrane Library, Embase, MEDLINE, and Scopus) and the OPENGREY.EU for grey literature. References of included articles and relevant reviews were manually screened. The search was last updated on May 27th, 2025, with no publication date restrictions. The quality of included studies and evidence certainty of outcomes were assessed using the Cochrane Risk of Bias Tool 2.0 (RoB 2) and the ‘Grading of Recommendations, Assessment, Development and Evaluations’ (GRADE) framework. Following the heterogeneity evaluation, meta-analysis was performed on eligible studies using RevMan 5.3 software. Inter-rater agreement during study selection and quality assessment was quantified using Cohen’s kappa statistics. The significance threshold was set at p < 0.05.

RESULTS: From a total of 893 records, 13 RCTs were included in the systematic review, with 4 selected for meta-analysis. Among all the included studies, only two demonstrated low risk of bias. Possible functional settings of PBM for OIIRR varied across studies (output power 100-200 mW, energy density 5-10 J/cm², and per-session dose 10-100 J/tooth). Within these ranges, appropriate cumulative doses and a tapered irradiation frequency protocol could influence PBM efficacy. The meta-analysis revealed that PBM was associated with a statistically significant (p < 0.01) but modest reduction (MD: -0.13 mm³, 95% CI: -0.17 to -0.09 mm3) in OIIRR of maxillary first premolars undergoing buccal tipping movement.

CONCLUSIONS: PBM shows potential in reducing OIIRR in the maxillary first premolar during buccal tipping, especially in the early stages of treatment. However, variability in PBM parameters and limited studies with low risk of bias indicate the need for standardized protocols and higher-quality research.

PMID:41422215 | DOI:10.1186/s12903-025-07512-y

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ProAE: an R package for graphical tools and standardized analysis of patient-reported outcomes and adverse events data

BMC Med Inform Decis Mak. 2025 Dec 20. doi: 10.1186/s12911-025-03320-0. Online ahead of print.

ABSTRACT

BACKGROUND: Patient-reported symptomatic adverse events (AE) are increasingly collected in oncology clinical trials to characterize treatment tolerability and inform clinical decision making using the Patient-Reported Outcomes (PRO) version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE®). Although there are numerous analysis methods and graphical approaches used for PRO-CTCAE data, the current PRO literature is limited in unified reporting and graphical approaches as well as public-facing analysis tools.

RESULTS: Collaborative efforts from the Standardization Working Group of the National Cancer Institute Cancer Treatment Tolerability Consortium worked to develop the R package, ProAE. Testing and validation of widely used methods were implemented in the R package and deployed to various open-source outlets including the Comprehensive R Archive Network (CRAN).

CONCLUSION: ProAE is a free and publicly available collection of standardized statistical analysis tools for PRO-CTCAE and other PRO data used in patient care and research. The ProAE package provides oncology researchers with an efficient and modern means to apply the published analysis approaches, including hypothesis testing, descriptive and inferential tables, and longitudinal graphics, without the need for costly software or licensing.

PMID:41422214 | DOI:10.1186/s12911-025-03320-0

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Type of information source and healthcare avoidance: insights from two population-based studies during the COVID-19 pandemic

BMC Public Health. 2025 Dec 20. doi: 10.1186/s12889-025-25927-8. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic generated major disruptions in primary and specialist care, and there were global trends of reduced healthcare-seeking behaviour. Previous studies showed that use of information sources is linked to psychological well-being and compliance with public health measures. It is unclear if the type of information source is also associated with healthcare avoidance.

METHODS: Between April and October 2020, we sent a questionnaire to participants of two population-based cohort studies including middle-aged and older adults from Rotterdam, the Netherlands: the Rotterdam Study (N = 8,732, response rate 71.5%) and the Generation R Study (N = 4,904, response rate 22.7%). We defined healthcare avoidance as not seeking care despite experiencing symptoms that participants would otherwise interpret as requiring medical attention. We pooled the data from both studies and used logistic regression analyses to examine the adjusted association between type and number of information sources and healthcare avoidance. Additionally, we investigated if symptoms of depression and anxiety modified and/or mediated this association.

RESULTS: Among 6,702 respondents (mean age 67.0 years, 61.8% women), 96.0% used traditional media, 15.5% used social media, and 1,197 (17.9%) avoided healthcare. Compared to non-avoiders, avoiders more often reported poor/fair self-appreciated health (28.9% versus 9.7%), and symptoms of depression (31.9% versus 11.6%) or anxiety (29.2% versus 11.1%). Odds of healthcare avoidance were lower for those who consulted traditional media (adjusted OR (aOR): 0.72, 95% CI: 0.53-1.00) and higher among individuals using social media (aOR: 1.21, 95% CI: 1.02-1.44), compared to those who did not use these sources. Additional adjustment for self-appreciated health and anxiety/depressive symptoms attenuated the latter association. Stratified analyses showed a stronger association between social media use and healthcare avoidance among individuals with anxiety symptoms (aOR: 1.34, 95% CI: 0.94-1.89), yet not statistically significant. Additionally, in a fully adjusted model, part of the association between social media and healthcare avoidance was mediated by anxiety symptoms, although the effect estimate of the mediated effect was small (p-value 0.14, natural indirect effect OR: 1.03, 95% CI: 1.01-1.05).

CONCLUSIONS: Social media use was associated with higher odds of healthcare avoidance as compared to not using social media, whereas use of traditional media was related to lower avoidance. We found suggestive evidence for a role of anxiety symptoms in these associations, which should be validated by future studies. These findings emphasise the importance of disseminating accessible, objective information across a variety of media platforms, where needed tailored to vulnerable populations, to support informed decision-making during and beyond health crises.

PMID:41422209 | DOI:10.1186/s12889-025-25927-8