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Nevin Manimala Statistics

Serum uric acid mediates the association between the estimated glucose disposal rate and chronic kidney disease in patients with diabetes or prediabetes: an analysis from NHANES 2005-2018

BMC Endocr Disord. 2025 Nov 13;25(1):262. doi: 10.1186/s12902-025-02081-1.

ABSTRACT

BACKGROUND: The estimated glucose disposal rate (eGDR), a novel composite indicator for assessing insulin resistance (IR), remains underexplored for its ability to predict the risk of chronic kidney disease (CKD) in individuals with diabetes or prediabetes.

METHOD: A total of 17,595 patients with diabetes or prediabetes from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018 were included. CKD is defined based on the estimated glomerular filtration rate and the urine albumin-to-creatinine ratio. The calculation of eGDR is based on the waist circumference, hypertension status and glycated hemoglobin. Multivariable logistic regression was used to evaluate the association between eGDR and CKD. Restricted cubic spline (RCS) regression was used to assess dose-response relationships. Subgroup analysis explores the differences in effects among different populations. Mediating analysis was used to quantify the role of serum uric acid (SUA) in the eGDR-CKD association. Receiver operating characteristic curve (ROC) curves were used to compare the predictive performance of eGDR with that of other IR indices.

RESULTS: After full adjustment, the eGDR showed a significant inverse association with CKD risk. The RCS curves confirmed a linear negative relationship between eGDR and CKD. Subgroup analysis revealed stronger associations in men. Mediation analysis indicated that SUA partially mediated the eGDR-CKD association, accounting for 6.2% of the total effect. ROC analysis revealed that the eGDR shad a moderate predictive ability for CKD in patients with diabetes or prediabetes.

CONCLUSION: This cross-sectional study confirmed that the eGDR is linearly negatively correlated with CKD in a population with diabetes or prediabetes and that its discriminative power is moderate but superior to that of traditional IR indicators. The statistical overlap of SUA on the total association was approximately 6.2%, but the mediating effect was fragile. This finding should be verified in prospective cohorts in the future.

PMID:41225507 | DOI:10.1186/s12902-025-02081-1

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Nevin Manimala Statistics

Exploring the correlation between academic achievement and self-regulated learning on critical thinking in undergraduate medical students

BMC Med Educ. 2025 Nov 12;25(1):1587. doi: 10.1186/s12909-025-07866-5.

ABSTRACT

OBJECTIVE: This study examines the relationship among medical students’ academic achievement, self-regulated learning, and critical thinking ability.

METHODS: This study employed a cross-sectional analytical design involving 120 medical students. The Critical Thinking Tools (CriTT) questionnaire, validated instrument for measuring critical thinking skills, was used. Academic achievement was assessed using Grade Point Average (GPA), and self-regulated learning was evaluated using the Motivated Strategies for Learning Questionnaire (MSLQ). Data analysis included Spearman’s rank correlation and multiple linear regression using SPSS version 24 to examine association between variables with statistical rigor.

RESULTS: This study shows that the respondents demonstrated an average critical thinking score of 198.13 ± 25.14. The average GPA of the respondents was 3.60 ± 0.16. The respondents exhibited an average self-regulated learning score of 184.12 ± 19.68. Bivariate analysis showed significant relationships between critical thinking ability and self-regulated learning (p = 0.000).

CONCLUSION: The findings highlight the significant role of self-regulated learning in fostering critical thinking, whereas academic achievement, as measured by GPA, was not a significant predictor. These insights advocate for pedagogical reforms in medical education to nurture reflective and analytical learning environments.

PMID:41225506 | DOI:10.1186/s12909-025-07866-5

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Nevin Manimala Statistics

Associations of urinary phytoestrogen biomarkers with uric acid and hyperuricemia, and the mediating role of kidney function

Nutr J. 2025 Nov 12;24(1):171. doi: 10.1186/s12937-025-01241-2.

NO ABSTRACT

PMID:41225494 | DOI:10.1186/s12937-025-01241-2

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Nevin Manimala Statistics

Postoperative pain following root canal treatment with XP-Endo Finisher-assisted irrigant activation: a double-blind randomized controlled trial

BMC Oral Health. 2025 Nov 12;25(1):1777. doi: 10.1186/s12903-025-07024-9.

ABSTRACT

BACKGROUND: Postoperative pain is a common occurrence following root canal treatment, with reported incidence ranging from 3% to 58%. Contributing factors include insufficient canal debridement, extrusion of debris, and limitations in irrigation. While mechanical instrumentation aids in reducing microbial load, effective irrigation is essential for cleaning anatomically complex areas. The XP-Endo Finisher (XPF) is an innovative instrument designed to enhance irrigation efficacy. This study aimed to compare postoperative pain outcomes following final irrigation with either the XP-Endo Finisher or conventional needle irrigation in patients diagnosed with symptomatic irreversible pulpitis.

METHODS: A double-blind randomized controlled trial was conducted on 80 systemically healthy patients aged 18 years and above, presenting with symptomatic irreversible pulpitis and preoperative pain scores ≤ 3 on the Numerical Rating Scale (NRS-11). Participants were randomly assigned to two equal groups: final irrigation using either the XP-Endo Finisher or traditional needle irrigation. Patients with recent analgesic use, non-restorable teeth, or known NSAID allergies were excluded. Root canal therapy was completed in two visits. Postoperative pain levels were recorded at 6 h, 12 h, 24 h, and daily up to 7 days using the NRS-11. Statistical analysis involved descriptive statistics, normality checks, and non-parametric tests for group comparisons.

RESULTS: At 6 h, the difference in pain scores between the groups was not statistically significant (XP-Endo Finisher: 2.40 ± 1.77; Needle: 1.73 ± 1.52; p = 0.090). However, significantly lower pain was reported in the XP-Endo Finisher group at 12 h (p = 0.044) and on day 2 (p = 0.027). No significant differences were observed from day 3 to day 7. Analgesic intake was comparable across both groups (p > 0.05).

CONCLUSIONS: The XP-Endo Finisher resulted in reduced early postoperative pain compared to needle irrigation at specific time points, although both methods showed similar outcomes in long-term pain resolution and analgesic consumption. Improved irrigant activation may influence short-term postoperative comfort.

TRIAL REGISTRATION: This trial was retrospectively registered with the Kasturba Hospital Institutional Ethics Committee (KH IEC) under registration number 860/2020, dated 19/03/2021. It was also registered in the Clinical Trials Registry – India (CTRI) under registration number CTRI/2021/04/032667, dated 08/04/2021.

PMID:41225492 | DOI:10.1186/s12903-025-07024-9

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Nevin Manimala Statistics

Socioeconomic status, depressive symptoms and cardiometabolic kidney syndrome: an analysis based on national representative data

BMC Public Health. 2025 Nov 12;25(1):3916. doi: 10.1186/s12889-025-25228-0.

ABSTRACT

BACKGROUND: Cardiometabolic Kidney Syndrome (CKM) is a global chronic disease challenge. While links between socioeconomic status (SES) and individual CKM components exist, research often overlooks CKM’s multi-system interactions and the role of psychosocial factors. Depression, prevalent in low SES groups and linked to CKM risk, may mediate the SES-CKM relationship.

METHODS: Using 2005-2018 NHANES data with 11,367 participants, this study quantified SES via the family poverty-income ratio (PIR), assessed depressive symptoms with the PHQ-9 scale, and defined CKM per AHA criteria. Statistical analyses included multivariable logistic regression and structural equation modeling to examine associations and mediating effects.

RESULTS: High SES was associated with 81% lower odds of advanced CKM (OR = 0.19, 95% CI: 0.10-0.36). Each unit increase in PIR was associated with 33% lower odds of depression (OR = 0.67, 95% CI: 0.63-0.72). Depression mediated 27.64% of the SES-advanced CKM link. A nonlinear threshold effect between SES and depression was found at PIR = 3.28, with subgroup analyses highlighting stronger SES-CKM associations in non-Hispanic Blacks and Whites.

CONCLUSION: Socioeconomic disadvantage is significantly associated with depressive symptoms and advanced CKM in this cross-sectional study. Depressive symptoms may play a substantial mediating role based on structural equation modeling of observational data. These findings suggest that incorporating mental health interventions into CKM prevention strategies and implementing targeted policies to address health inequities could potentially enhance health equity. Future prospective studies are needed to validate these findings before refining the CKM prevention framework.

PMID:41225483 | DOI:10.1186/s12889-025-25228-0

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Nevin Manimala Statistics

Prophylactic effects of non-steroidal anti-inflammatory drugs on heterotopic ossification after total hip arthroplasty: a Bayesian network meta-analysis of randomized controlled trials using cumulative logistic regression

BMC Musculoskelet Disord. 2025 Nov 12;26(1):1039. doi: 10.1186/s12891-025-09277-5.

ABSTRACT

PURPOSE: Most of the previous meta-analyses examining the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on preventing heterotopic ossification (HO) following total hip arthroplasty (THA) have separately analyzed Brooker’s classification I, II, III, and IV which may misrepresent their ordinal nature. We therefore applied a Bayesian network meta-regression that incorporates the ordinal nature of Brooker’s classification to more robustly assess NSAID efficacy and determine the optimal regimen.

METHODS: We searched the Cochrane Library, Embase, and PubMed for randomized controlled trials (RCTs). Cumulative regressions were conducted for ordinal variants to generate Napierian Logarithm odds ratios (lnOR) and the standard error of lnOR (selnOR) for each study. Subsequently these data were used to conduct Bayesian network meta-analysis and further network meta-regression to generate pairwise ORs, showing pairwise effect sizes (ESs).

RESULTS: 17 studies (5436 patients,14 regimens) were eligible. In the raw data analysis, celecoxib 400 mg/d, etoricoxib 90 mg/d, ibuprofen 1200 mg/d, indomethacin 75 mg/d, indomethacin 100 mg/d, indomethacin 150 mg/d, meloxicam 7.5 mg/d, meloxicam 15 mg/d, and naproxen 750 mg/d were conspicuously effective (OR: 0.048 ~ 0.351) compared with placebo. The ESs were comparable among these regimens except for ibuprofen 1200 mg/d, which was inferior to indomethacin 100 mg/d (OR = 0.382, 95%CI: 0.171 to 0.887) and indomethacin 150 mg/d (OR = 0.136, 95%CI: 0.020 to 0.970). In the network meta-regression analysis, after adjusting for follow-up time, the significance of diclofenac 150 mg/d (OR = 0.102, 95%CI: 0.013 to 0.835) emerged compared with placebo. The results of effective regimens aforementioned resembled the initial findings (OR: 0.039 ~ 0.249). All the effective agents, including diclofenac 150 mg/d, were comparable in ESs.

CONCLUSIONS: Considering the efficacy of preventing HO following THA observed in our research, together with analgesic effect and gastrointestinal tract safety from previous literature, etoricoxib 90 mg/d is recommended as the optimal choice for patient undergoing THA. More head-to-head and long-term studies are needed.

PMID:41225475 | DOI:10.1186/s12891-025-09277-5

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Nevin Manimala Statistics

Associations of Adherence to the 24hour Movement Guidelines with Depressive Symptoms and Anxiety: the Mediating Role of Physical Fitness

BMC Public Health. 2025 Nov 12;25(1):3910. doi: 10.1186/s12889-025-24543-w.

ABSTRACT

BACKGROUND: Mental health problems such as depression and anxiety were increasingly prevalent among students. Emerging evidence links adherence to 24-hour movement guidelines-including adequate physical activity, limited screen time, and sufficient sleep-with improved mental well-being. However, the mechanisms underlying these associations remained poorly understood.

OBJECTIVES: This study aimed to examine the association of adherence to 24-hour movement guidelines with symptoms of depression and anxiety among Chinese students, and to explore the mediating role of perceived fitness in these relationships.

METHODS: A cross-sectional survey was conducted among 1674 students (mean age = 11.4 ± 0.8 years; 47.6% boys) from Chinese elementary schools. 24-hour movement behaviours were assessed using validated self-report measures. Mental health outcomes were measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7). Perceived fitness was assessed using the International Fitness Scale. Structural equation modelling was used to evaluate direct and indirect pathways, adjusting for relevant covariates.

RESULTS: Only 1.4% of participants met all components of the 24-hour movement guidelines. Adherence to the guidelines was significantly associated with lower levels of depressive (β = -0.125) and anxiety symptoms (β = -0.107). Perceived fitness was also significantly associated with reduced symptoms of depression (β = -0.111) and anxiety (β = -0.049). However, the mediating effects of perceived fitness in both models were minimal or not statistically significant (depression symptoms: β = 0.002; anxiety symptoms: β = 0.001).

CONCLUSIONS: Better adherence to 24hour movement guidelines was associated with fewer symptoms of depression and anxiety in Chinese students. While perceived fitness was independently linked to improved mental health, its mediating role appears limited. Future studies should incorporate objective fitness assessments and explore additional mediating pathways to fully understand how movement behaviours impact students mental well-being.

PMID:41225473 | DOI:10.1186/s12889-025-24543-w

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Nevin Manimala Statistics

Global burden and trends of common head and neck cancers between 1990 and 2021: findings from the Global Burden of Disease Study 2021

BMC Oral Health. 2025 Nov 12;25(1):1773. doi: 10.1186/s12903-025-07140-6.

ABSTRACT

BACKGROUND: The burden of head and neck cancers (HNC) is a significant global health challenge, necessitating a comprehensive analysis of incidence and mortality trends. This study aimed to estimate the lastest disease burden and change trends of HNC in 2021 and examine trends from 1990 to 2021 using the Global Burden of Disease (GBD) Study 2021.

METHODS: We comprehensively focused on all HNC in GBD, including lip and oral cavity cancer (LOC), nasopharynx cancer (NPC), other pharynx cancer (OPC), and larynx cancer (LC), estimating incidence, prevalence, disability-adjusted life years (DALYs), and mortality rates, including age-standardized rates (ASR) and 95% uncertainty intervals (UIs) on global, regional, and national levels.

RESULTS: Our results revealed that, in 2021, there were approximately 0.91 million new cases of HNC globally, representing significant increases from 1990, with specific increases in LOC (142.18%), NPC (55.89%), OPC (163.17%), and LC (60.48%). Additionally, around 0.5 million deaths were attributed to HNC. Notably, age-standardized incidence of nasopharyngeal cancer is increasing from 1990 to 2019, but decreasing from 2019 to 2021. Age-standardized mortality for LOC have declined among men but are rising among women between 1990 and 2021 (male: -6.61%, female: 7.95%). The burden of these HNC predominantly affected middle-aged and older populations. As the socio-demographic index rises, the incidence of LOC and OPC displayed a J-shaped relationship, but nasopharyngeal cancer, revealed a downward trend.

CONCLUSIONS: The global burden of HNC grew steadily from 1990 to 2021, the variation in incidence and mortality rates across regions highlights the need for tailored prevention and treatment strategies to address the changing HNC landscape.

PMID:41225462 | DOI:10.1186/s12903-025-07140-6

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Nevin Manimala Statistics

Quantitative real-time PCR detection of Porphyromonas gingivalis and Filifactor alocis in peri-implantitis

J Med Microbiol. 2025 Nov;74(11). doi: 10.1099/jmm.0.002091.

ABSTRACT

Introduction. Peri-implantitis is a prevalent and challenging complication in implant dentistry, primarily induced by biofilm-associated pathogens. Among these, Porphyromonas gingivalis and Filifactor alocis have emerged as key contributors, with evidence suggesting their potential synergistic role in exacerbating peri-implant inflammation and tissue destruction.Hypothesis/Gap Statement. While P. gingivalis is a well-characterized periopathogen, the specific role of F. alocis, alone or in combination with P. gingivalis, in peri-implantitis remains underexplored. This study addresses the gap in quantifying their presence in diseased versus healthy peri-implant sites.Aim. To assess the prevalence and microbial load of P. gingivalis and F. alocis in peri-implantitis and healthy peri-implant sites using quantitative real-time PCR (qPCR) and to investigate their correlation with clinical parameters.Methodology. This cross-sectional study included 110 participants: 52 diagnosed with peri-implantitis and 58 with healthy peri-implant tissues. Clinical examination recorded probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BOP). Submucosal biofilm samples were collected and analysed using species-specific qPCR. Statistical analysis employed the Mann-Whitney U test for intergroup comparisons and Spearman’s rank correlation for associations between microbial levels and clinical indices.Results. Both P. gingivalis and F. alocis were significantly elevated in peri-implantitis sites compared to healthy controls. Mean P. gingivalis levels were 4.80×10⁶ ± 4.78×10⁶ copies µl-1 in peri-implantitis and 2.09×10³ ± 1.26×10³ copies µl-1 in healthy sites (P<0.001). F. alocis levels averaged 4.58×10⁵ ± 3.40×10⁵ copies µl-1 in peri-implantitis and 2.45×10³ ± 1.64×10³ copies µl-1 in healthy sites (P<0.001). P. gingivalis showed strong positive correlations with PD, CAL and BOP, while F. alocis correlated moderately with PD and CAL but not significantly with BOP.Conclusion. The significant elevation of P. gingivalis and F. alocis in peri-implantitis supports their potential synergistic involvement in disease pathogenesis. These findings underscore the need for antimicrobial strategies that target both organisms and disrupt their cooperative biofilm behaviour. Further research should clarify their pathogenic interplay and inform the development of precise therapeutic interventions.

PMID:41222987 | DOI:10.1099/jmm.0.002091

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Nevin Manimala Statistics

A Statistical Approach for Evaluating the Spatial Distribution and Local Atomic Environment of Dopants Using Atom Probe Tomography

Microsc Microanal. 2025 Nov 12;31(6):ozaf114. doi: 10.1093/mam/ozaf114.

ABSTRACT

An approach to characterize dopant spatial inhomogeneity at the nanoscale along with its local chemical environment has been developed using atom probe tomography. We achieve this through the combination of a local composition analysis using the nearest-neighbor atoms combined with a nonparametric Kolmogorov-Smirnov or Anderson-Darling statistical test. Using an in situ highly boron-doped silicon germanium layer we demonstrate that all three elements have an inhomogeneous distribution. Moreover, by subdividing the local dopant composition distribution, a correlation between the boron doping level and variations in the surrounding matrix composition was determined. These atomic-scale measurements provide new experimental insights into the dopant incorporation behavior in technologically relevant semiconductors and its relationship to the epitaxial growth processes.

PMID:41222977 | DOI:10.1093/mam/ozaf114