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Nevin Manimala Statistics

Social Determinants of Health and Cancer Prevention Guideline Behaviors

JAMA Netw Open. 2025 Nov 3;8(11):e2542330. doi: 10.1001/jamanetworkopen.2025.42330.

ABSTRACT

IMPORTANCE: The American Cancer Society (ACS) Guideline Score captures collective adherence to health behavior recommendations, including a healthy diet, physical activity (PA), alcohol intake, and body mass index (BMI). Exploring the role of social determinants of health (SDoH) in health behavior engagement may present opportunities for improving health equity.

OBJECTIVE: To identify SDoH associated with co-occurring health behaviors captured by the ACS Guideline Score in a large US cohort.

DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study included adults in the Cancer Prevention Study-3 who enrolled between 2006 and 2013 at ACS community events across 35 US states, the District of Columbia, and Puerto Rico using data from comprehensive follow-up surveys administered in 2015. Data were analyzed from June to September 2024.

EXPOSURES: Self-reported race and ethnicity, marital status, education, household income, secondhand smoke exposure, and work status were examined. Rural-Urban Commuting Area codes and food desert status were classified according to US Department of Agriculture definitions.

MAIN OUTCOMES AND MEASURES: Co-occurring health behaviors were measured using a 0-to-8-point score quantifying adherence to the 2020 ACS Guidelines for Diet and PA for Cancer Prevention on diet, alcohol, healthy BMI maintenance, and PA. Scores of 8 represent complete adherence. Ordinal logistic regression models were used to cross-sectionally assess SDoH factors associated with co-occurring health behaviors measured by ACS Guideline Scores.

RESULTS: Of 142 085 participants (mean [SD] age, 52.0 [9.6] years; 111 694 women [78.6%]), 2415 identified as Asian, Native Hawaiian, or Pacific Islander (1.7%), 3267 identified as Black (2.3%), 7814 identified as Latino (5.5%), 126 739 identified as non-Hispanic White (89.2%), and 1989 identified as another racial and/or ethnic group (1.4%). The mean (SD) ACS Guideline Score was 4.6 (1.7). Compared with White participants, Asian, Native Hawaiian, and Pacific Islander participants had increased odds of higher ACS Guideline Scores (odds ratio [OR], 1.99; 95% CI, 1.86-2.14). Holding a graduate degree was associated with a 33% higher likelihood of a higher ACS Guideline Score (OR, 1.33; 95% CI, 1.30-1.36) compared with college graduates. Compared with working full-time, working part-time (OR, 1.62; 95% CI, 1.57-1.66) or being retired (OR, 1.26; 95% CI, 1.22-1.30) was associated with a higher score.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, multiple SDoH factors associated with co-occurring health behaviors for diet, PA, BMI, and alcohol consumption were identified. These findings may aid in identifying populations most vulnerable to poor health behaviors, guiding future approaches for advancing health equity.

PMID:41201801 | DOI:10.1001/jamanetworkopen.2025.42330

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Does Maximal Strength or Speed-Strength Have Stronger Associations with Performance Indicators in the Rugby Football Codes? A Systematic Review and Meta-analysis

Sports Med. 2025 Nov 7. doi: 10.1007/s40279-025-02342-y. Online ahead of print.

ABSTRACT

BACKGROUND: Both maximal strength and speed-strength are considered key aspects of rugby league and rugby union match-play yet represent distinct physical qualities. Establishing whether maximal strength or speed-strength has a greater association with game performance in these sports can help direct resistance training interventions towards the physical quality most likely to transfer to the outcome of interest. It is therefore important to develop a clearer understanding of whether it is maximal strength or speed-strength that has stronger links to key aspects of rugby union and rugby league competition.

OBJECTIVES: To systematically review and meta-analyse the literature to compare maximal strength versus speed-strength measures in their associations with within-game key performance indicators (KPIs) in rugby union and rugby league. Further, sub-group analysis was undertaken to determine whether the type of KPI (tackles, rucks, line breaks, carries/hit-ups, errors, and miscellaneous) moderated the extent to which the observed effect favoured maximal strength or speed-strength for a given KPI.

METHODS: A systematic search, conducted in accordance with PRISMA guidelines, of Web of Science, PubMed, and SportDiscus was conducted up to December 2024. Studies meeting the inclusion criteria provided correlation coefficients that were converted into Fisher’s z-transformed effect sizes to standardise the measures and allow for consistent comparison across studies. These effect sizes were analysed using a multivariate meta-analysis framework.

RESULTS: Six studies containing 41 maximal strength versus speed-strength comparisons and 134 players were included in the final analysis. Of the 786 studies initially identified, 28 underwent full-text screening, with 22 ultimately excluded. The overall pooled effect was 0.24 [0.11: 0.37] in favour of strength; however, the prediction interval ranged from g = – 0.58 to g = 1.06. The moderator analysis revealed a statistically significant effect of type (p = 0.038), indicating stronger associations for maximal strength compared to speed-strength. Residual heterogeneity (p = 0.005) suggested substantial variability in effect sizes across studies that was not fully explained by the model.

CONCLUSIONS: Within-game rugby union and rugby league KPIs typically have stronger links to maximal strength than to speed-strength. However, the wide prediction interval underscores that the observed maximal strength advantage may not generalise across all types of KPIs or predictably translate to all future settings.

PMID:41201787 | DOI:10.1007/s40279-025-02342-y

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Nevin Manimala Statistics

Knowledge and attitude regarding preventive and minimally invasive caries treatments: a cross-sectional survey among Dutch dental professionals

Eur Arch Paediatr Dent. 2025 Nov 7. doi: 10.1007/s40368-025-01130-6. Online ahead of print.

ABSTRACT

INTRODUCTION: The Dutch guideline “Oral care for children: prevention and treatment of caries” describes how to prevent, stabilise, or treat caries lesions using minimally invasive methods in children. The objectives of the present study were to 1) evaluate to what extent oral healthcare professionals (OHCPs) in the Netherlands apply preventive and minimally invasive caries management according to the guideline, 2) evaluate their attitudes towards these treatments, and 3) assess differences between OHCPs in general oral health practice and paediatric dentistry.

METHODS: In this cross-sectional survey study, OHCPs completed questions on guideline knowledge, and practice regarding primary (5 items), secondary and tertiary (9 items) caries prevention was asked using a 5-point Likert scale (1 = never, 5 = always). Attitude towards minimally invasive caries treatments was evaluated as sum score over six statements (range 6 [negative] to 30 [positive]).

RESULTS: Amongst 187 participants (36.7% paediatric dentists; 79.1% female), 134 (71.7%) OHCPs reported being familiar with the guideline content. OHCPs working in paediatric dentistry applied statistically significantly more primary and (partially) secondary and tertiary prevention than OHCPs in general oral health practice. Median score of attitude towards minimally invasive caries treatments was neutral at 17.2 (SD = 2.6).

CONCLUSION: The majority of OHCPs in the present study reported being familiar with the guideline. However there is room for improvement in its implementation in practice. OHCPs working in paediatric dentistry reported greater familiarity with the guideline. Generally, OHCPs had a neutral attitude towards preventive caries management.

PMID:41201776 | DOI:10.1007/s40368-025-01130-6

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Comparison of Mid- and Long-term Outcomes of Antrum-Resecting Versus Antrum-Preserving Laparoscopic Sleeve Gastrectomy

Obes Surg. 2025 Nov 7. doi: 10.1007/s11695-025-08354-x. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study is to compare the mid- and long-term results after laparoscopic sleeve gastrectomy (LSG) according to the distance of the first staple from the pylorus.

METHODS: This study is a retrospective analysis of prospectively collected data of patients who underwent LSG. While the distance of the first staple from the pylorus was 2-3 cm in group A, the distance of the first staple to the pylorus was 5-6 cm in group B. Laboratory parameters, comorbidity resolution, anthropometric measurements, and complications were documented at the end of the first, third, and fifth postoperative years.

RESULTS: Of the total 376 patients, 127 were excluded for various reasons, 102 patients were lost to follow-up, and 147 patients were included in the final analysis. Upon examining the follow-up data at the 1st, 3rd, and 5th years, a statistically significant difference was observed between the groups in terms of total weight loss (TWL%), excess body mass index loss (EBMIL%), and recurrent weight gain (RWG)%, with group A showing an advantage. The majority of the patients requiring conversional metabolic and bariatric surgery (MBS) were in group B, and the difference was significant (p = 0.017).

CONCLUSION: The distance of the first staple from the pylorus may significantly influence the outcomes related to RWG%, TWL%, and type 2 diabetes mellitus (T2DM) resolution in the medium-long-term. Furthermore, additional research is needed to determine the optimal positioning for enhanced patient results.

PMID:41201754 | DOI:10.1007/s11695-025-08354-x

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From patient voices to optimal PROMs: a mixed methods framework for cancer survivorship care

J Cancer Surviv. 2025 Nov 7. doi: 10.1007/s11764-025-01899-x. Online ahead of print.

ABSTRACT

PURPOSE: Selecting patient-reported outcome measures (PROMs) that accurately reflect the unmet needs of cancer survivors (CSs) remains a challenge in oncology, as current processes lack a structured methodology. This study aimed to develop and test the feasibility of a replicable, patient-centred framework for PROM selection, ensuring alignment between survivors’ lived experiences and standardised outcome measures across diverse healthcare settings.

METHODS: Our methodology integrated qualitative and quantitative approaches, mapping patient-expressed unmet needs onto the International Classification of Functioning, Disability, and Health (ICF). The process involved three steps: (1) identifying survivors’ needs through focus groups, interviews and questionnaires, (2) linking these needs to ICF categories using validated methodologies and (3) systematically evaluating existing PROMs based on their coverage of these categories.

APPLICATION AND RESULTS: To demonstrate feasibility, we conducted a feasibility study involving 35 CSs and seven caregivers within the Italian healthcare context. Among the 14 PROMs analysed, the Cancer Rehabilitation Evaluation System (CARES) covered 94.3% of ICF-linked needs, emerging as the most suitable option. The framework’s adaptability allows clinicians and researchers to identify context-specific PROMs for diverse populations and healthcare systems.

CONCLUSIONS: This study provides a robust, evidence-based methodology for optimising PROM selection, bridging the gap between patient narratives and standardised measurement. This feasibility study demonstrates the framework’s practical applicability in clinical practice, with potential for broader implementation across diverse healthcare contexts. Its global applicability ensures that survivorship care remains patient-centred, data-driven and contextually relevant.

IMPLICATIONS FOR CANCER SURVIVORS: By facilitating the selection of tailored PROMs, this framework enhances patient-centred survivorship care, ensuring that outcome assessments remain relevant to survivors’ experiences and improving care quality across different settings.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT06236373.

PMID:41201742 | DOI:10.1007/s11764-025-01899-x

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Color stability of multilayer resin composite versus feldspathic ceramics after immersion in different beverages

Odontology. 2025 Nov 7. doi: 10.1007/s10266-025-01243-w. Online ahead of print.

ABSTRACT

The objective of this study was to assess the color stability of multilayer resin composite (RC) blocks by immersing them in staining solutions. Four RC blocks, Cerasmart Layer (CL), Block HC Hard AN (HC), KZR-CAD HR4 E-VA (EV), and Katana Avencia N (KA), were tested, with a ceramic block, Vita Mark II, serving as the control. All specimens were prepared using #2000 SiC paper and stored in ultrapure water. The immersion tests were performed using five staining solutions (coffee, Coke, tea, red wine, and Milli-Q) at 37 °C, with measurements taken at 24 h; 1, 2, 3, and 4 weeks; and 3, 6, 9, and 12 months. Color parameters (L*, a*, b*) were measured, and the color differences (∆E) were calculated using the color parameters obtained before immersion tests and at each interval. Statistical analysis was performed using three-way ANOVA (α = 0.05). Results showed that red wine caused the most significant ΔE (16.6) across all materials, followed by tea (2.19), Coke (1.94), coffee (1.73), and Milli-Q (0.99), with significant differences (p < 0.05). Several RCs demonstrated color differences compared with ceramic, particularly EV and KA in coffee, all RC blocks in Coke, CL in tea, CL and KA in red wine, and EV and KA in Milli-Q. The changes in color parameters over time differed between the solutions; notably, red wine showed the most significant color changes in all beverages. These findings suggest that multilayer RC blocks exhibit discoloration resistance comparable to that of ceramic materials.

PMID:41201740 | DOI:10.1007/s10266-025-01243-w

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Efficacy and safety of Lutetium-177 (177Lu)-PSMA-617 in metastatic Castration-Resistant prostate cancer patients with superscan pattern: A retrospective cohort study

Ann Nucl Med. 2025 Nov 7. doi: 10.1007/s12149-025-02127-3. Online ahead of print.

ABSTRACT

BACKGROUND: Lutetium-177 (177Lu)-PSMA-617, a targeted radioligand therapy, has demonstrated significant survival benefits in patients with metastatic castration-resistant prostate cancer (mCRPC). Its application in patients with a superscan pattern, indicative of extensive skeletal metastases, is less studied due to concerns about hematologic toxicity from bone marrow involvement.

METHODS: This study analyzed 133 mCRPC patients treated with 177Lu-PSMA-617, divided into Superscan and Non-superscan groups. PSA response (≥ 50% decline), PSA progression free survival (PFS), overall survival (OS), and treatment safety were assessed.

RESULTS: Among 133 patients, 17 (12.8%) exhibited a superscan pattern. The overall PSA response rate was 45.8%, (47.0% in the superscan group versus 45.6% in the non-superscan group; p = 0.485). Median PSA PFS was 8 months overall (95% CI: 5.5-10.4), with 4 months (95% CI: <1-10.5) in the superscan group and 8 months (95% CI: 5.6-10.3) in the non-superscan group (p = 0.311). Median OS was 13 months overall (95% CI: 8.6-17.3), with 6 months (95% CI: <1-18.7) in the superscan group and 14 months (95% CI: 9.3-18.6) in the non-superscan group (p = 0.052). Significant but manageable decreases were seen in platelet (PLT) and Alkaline phosphatase (ALP), and no significant changes in Hemoglobin (Hb), white blood cells (WBC), Lactate dehydrogenase (LDH), or creatinine, with no differences between superscan and non-superscan groups. Baseline hemoglobin was a significant predictor of OS (HR = 0.6, p = 0.001), while superscan pattern did not show statistical differences (HR = 1.0, p = 0.949).

CONCLUSION: This retrospective study suggests that ¹⁷⁷Lu-PSMA-617 is a feasible and safe radioligand therapy for mCRPC patients with a superscan pattern, showing comparable PSA response rates to non-superscan patients.

PMID:41201730 | DOI:10.1007/s12149-025-02127-3

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Patient and clinician perspectives on test result communication in dermatology

Ir J Med Sci. 2025 Nov 7. doi: 10.1007/s11845-025-04154-5. Online ahead of print.

ABSTRACT

AIMS: To evaluate patient and clinician preferences for communicating dermatology test results (skin biopsies, swabs and blood results) with a focus on differences in preferred methods for normal and abnormal findings.

METHODS: A cross-sectional study was conducted involving two anonymised surveys. A structured questionnaire was distributed to 100 consecutive dermatology outpatients attending a dermatology centre over a four-week period from May to June 2025. Concurrently, an electronic survey was distributed nationally to dermatology clinicians, including consultants and registrars (n = 25). Descriptive statistics and chi-square testing were used to analyse differences.

RESULTS: For abnormal results, both patients (64%) and clinicians (60%) preferred face-to-face appointments, a further 33% of patients favoured mobile contact compared with 20% of clinicians. A statistically significant difference was observed in preferences for normal result communication between patients and clinicians (χ2 = 92.6, p < 0.001) with patients preferring mobile phone contact (53%) and text message (19%) and clinicians overwhelmingly preferring postal letters (72%). 59% reported that their preference would change depending on whether the result was normal or abnormal. Speed of communication was rated “very important” by 73% of patients. Concerns about digital confidentiality were moderate, with mean ratings of 2.33 for text and 2.32 for email on a 5-point scale.

CONCLUSIONS: Patients favour fast, digital methods for receiving normal results, while clinicians largely continue using traditional postal communication. Greater alignment exists for abnormal result delivery. These findings support a stratified approach to result communication that balances patient preferences, clinical context and confidentiality considerations.

PMID:41201726 | DOI:10.1007/s11845-025-04154-5

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Impact characteristics of suspected concussions in elite Gaelic football and hurling: a video-based analysis

Ir J Med Sci. 2025 Nov 7. doi: 10.1007/s11845-025-04163-4. Online ahead of print.

ABSTRACT

BACKGROUND: Sport-related concussion is a significant concern in contact sports, yet research in amateur Gaelic games is limited.

AIMS: To examine the characteristics and mechanisms of suspected concussions in elite Gaelic football and hurling using video-based analysis.

METHODS: A retrospective video analysis was conducted on 96 suspected concussions (58 Gaelic football, 38 hurling) identified from broadcast footage during the 2018-2019 inter-county seasons. Events were coded for type of play, player role, object/body part striking the head, collision direction, legality, referee penalisation, and match quarter. Descriptive statistics, Chi-square Goodness-of-Fit test and standardised residuals assessed distributions.

RESULTS: In Gaelic football, suspected concussions were evenly distributed across quarters, χ²=6.23, p = 0.101. In hurling, incidents were overrepresented in the fourth quarter, χ²=14.00, p = 0.003, residual = + 3.08. Tackles were significantly more frequent in football (residual = + 8.63, χ²=95.79, p < 0.001) and hurling (residual = + 4.14, χ²=28.58, p < 0.001), while off-the-ball collisions and goalpost impacts were less frequent. Ball carriers were overrepresented in football (residual = + 5.99, χ²=48.38, p < 0.001) and hurling (residual = + 3.41, χ²=16.32, p = 0.001). Arms were the main impact source in football (residual = + 8.08, χ²=79.93, p < 0.001) with shoulders/torsos in hurling (residual = + 4.24/+2.87, χ²=36.53, p < 0.001). Front-on collisions predominated in both codes. Illegal play was significant in football (residual = + 2.6, χ²=13.52, p < 0.001), with illegal incidents penalised (residual = + 3.34, χ²=22.35, p < 0.001).

CONCLUSION: The findings underscore the need for targeted rule enforcement, player education, and management to reduce concussion risk in Gaelic football and hurling.

PMID:41201725 | DOI:10.1007/s11845-025-04163-4

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Computed tomographic measurements of adipose tissue and adiposity index as predictors of femoral artery pseudoaneurysm following coronary angiography: a retrospective cohort study

Int J Cardiovasc Imaging. 2025 Nov 7. doi: 10.1007/s10554-025-03554-z. Online ahead of print.

ABSTRACT

Femoral artery pseudoaneurysms are a recognized complication of coronary angiography performed via femoral access, with incidence rates ranging from 0.2% to 8%. Identifying high-risk patients could guide procedural modifications to reduce this risk. This study evaluated whether computed tomography (CT)-derived measurements of adipose tissue and muscle mass predict femoral artery pseudoaneurysm development. In this retrospective cohort study, we included 148 patients who underwent coronary angiography via femoral access and had a thorax CT scan with 3 months of angiography at Health Sciences University Sultan 2. Abdülhamid Han Training and Research Hospital. CT images were analyzed at the 12th thoracic vertebra to measure adipose and muscle tissue areas, normalized by height squared to derive adiposity and muscularity indices. Patients were divided into those with pseudoaneurysms (n = 49) and controls (n = 99). Statistical analyses included t-tests, Mann-Whitney U tests, logistic regression, and receiver operating characteristic (ROC) curve analysis. Patients with pseudoaneurysms had significantly higher adipose tissue (median 241 cm² vs. 104 cm², p < 0.001) and adiposity index (median 14.11 vs. 7.29, p < 0.001) compared to controls. Multivariate logistic regression identified adipose tissue (OR 1.038, 95% CI 1.007-1.071, p = 0.017) and adiposity index (OR 1.294, 95% CI 1.065-1.572, p = 0.010) as independent predictors of pseudoaneurysm development. ROC analysis showed adipose tissue (AUC 0.801, threshold > 136 cm², specificity 75%, sensitivity 86%) and adiposity index (AUC 0.774, threshold > 10.03, specificity 71%, sensitivity 78%) had good predictive ability. CT-derived adipose tissue and adiposity index measurements are significant predictors of femoral artery pseudoaneurysm following coronary angiography. Pre-procedural CT assessment could identify high-risk patients, potentially guiding safer procedural strategies.

PMID:41201707 | DOI:10.1007/s10554-025-03554-z