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Nevin Manimala Statistics

The diagnostic value and efficacy evaluation of lung ultrasound score in neonatal respiratory distress syndrome: a prospective observational study

Front Pediatr. 2025 Jan 30;13:1500500. doi: 10.3389/fped.2025.1500500. eCollection 2025.

ABSTRACT

OBJECTIVE: To evaluate the diagnostic efficacy and determine the optimal cut-off values of lung ultrasound score for diagnosing neonatal respiratory distress syndrome and its accuracy in assessing the efficacy of neonatal respiratory distress syndrome.

METHOD: This prospective study included 100 neonates with suspected neonatal respiratory distress syndrome. Each patient underwent both the 14-zone and 12-zone lung ultrasound methods, as well as a chest x-ray, performed after birth and before initiating drug treatment. Surfactant replacement therapy was administered to patients who were diagnosed with neonatal respiratory distress syndrome and met the criteria for medication. Lung ultrasound was conducted and recorded at the 24th hour, the 48th hour, the 72nd hour, and the 7th day after drug administration. ROC curve analysis, Kappa statistics, and ANOVA were utilized to identify the optimal cut-off values for the lung ultrasound scores in diagnosing neonatal respiratory distress syndrome.

RESULTS: 89 neonates were diagnosed with respiratory distress syndrome, of whom 64 received surfactant replacement therapy. The mean scores of 12-zone lung ultrasound score, 14-zone lung ultrasound score, and chest x-ray score are 18.22 ± 7.15, 38.92 ± 9.69, and 2.15 ± 0.97, respectively. The diagnostic AUC for the 12-zone lung ultrasound score is 0.84 (95% CI: 0.73-0.95), with an optimal cut-off value of 13.5 for diseased vs. not diseased, while the AUC for the 14-zone lung ultrasound score is 0.88 (95% CI: 0.76-0.99), with an optimal cut-off value of 34 for diseased vs. not diseased. There is significant concordance between the neonatal lung ultrasonography scores and the chest x-ray score for diagnosis respiratory distress syndrome (P < 0.01). The optimal cut-off values for the grading diagnosis of neonatal respiratory distress syndrome using the 14-zone lung ultrasound score are identified as 36.5, 40.5, and 44.5. The 12-zone lung ultrasound score does not have a significant difference between the 12th hour after receiving surfactant replacement therapy and the 48th hour after treatment (P = 0.08). All other comparisons demonstrated significant differences.

CONCLUSION: The 14-zone lung ultrasound score demonstrates higher diagnostic efficacy in diagnosing neonatal respiratory distress syndrome and can accurately evaluate the early efficacy of surfactant replacement therapy in neonates.

PMID:39950156 | PMC:PMC11821582 | DOI:10.3389/fped.2025.1500500

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Correlation between gallstones and fasting blood glucose to serum high-density lipoprotein cholesterol ratio among American adults

Front Med (Lausanne). 2025 Jan 30;12:1528613. doi: 10.3389/fmed.2025.1528613. eCollection 2025.

ABSTRACT

BACKGROUND: Research indicates that the ratio of fasting blood glucose (FBG) to serum high-density lipoprotein cholesterol (HDL-C) (GHR) can accurately predict many diseases. Nevertheless, the relationship between GHR and the risk of gallbladder stones remains unclear. This study investigates the possible relationship between GHR and the incidence of gallbladder stones.

METHODS: This research used information gathered from the National Health and Nutrition Examination Survey (NHANES) between March 2017 and March 2020. A calculation was made to determine the GHR by dividing the fasting blood glucose level by the HDL-C level. Several statistical methods, including analysis of threshold effects, smoothed curve fitting, multiple logistic regression modeling, and subgroup analysis, were utilized to investigate the connection between GHR and gallstones.

RESULTS: In 3898 U.S. adults, GHR was significantly positively associated with the prevalence of gallbladder stones. In a fully adjusted model, the incidence of gallbladder stones increased by 7% with each 1-unit increase in GHR (OR [95% Cl] = 1.07 [1.02, 1.14]). Compared with members in the low group, those in the high group had a 100% higher likelihood of getting gallbladder stones (OR [95% CI] = 2.00 [1.31, 3.04]), and this stabilizing connection was always present in the different subgroups. With the help of smooth curve fitting, the research also showed that there was a connection that was formed like an upside-down L shape between GHR and gallbladder stones. The analysis of the threshold effect revealed that the inflection point was 4.28.

CONCLUSION: The results revealed an inverted L-shaped connection between GHR and gallbladder stones. Keeping GHR levels within a certain range is associated with a lower incidence of gallstones in the general population.

PMID:39950129 | PMC:PMC11821630 | DOI:10.3389/fmed.2025.1528613

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Prediction of traditional Chinese medicine for diabetes based on the multi-source ensemble method

Front Pharmacol. 2025 Jan 30;16:1454029. doi: 10.3389/fphar.2025.1454029. eCollection 2025.

ABSTRACT

INTRODUCTION: Traditional Chinese medicine (TCM) prescriptions are generally formulated by experienced TCM researchers based on their expertise and data statistical methods.

METHODS: In order to predict TCM formulas for diabetes more accurately, this paper proposes a novel multi-source ensemble prediction method that combines machine learning ensemble techniques and multi-source data. In this method, the multi-source data contain datasets based on the components and targets (DPP-4 and GLP-1). Gradient boosting decision tree (GBDT), flexible neural tree (FNT), and Light Gradient Boosting Machine (LightGBM) algorithms are trained using these two types of datasets, respectively. The compound dataset from the TCMSP database is then used as testing data to predict and screen the active ingredients. The frequencies of occurrences of medicinal herbs corresponding to these three algorithms are obtained, each containing an active ingredient list. Finally, the frequencies of occurrences of the medicinal herbs obtained from the three algorithms using the component and target datasets are integrated to select duplicate drugs as the candidate drugs for diabetes treatment.

RESULTS: The identification results reveal that theproposed ensemble method has higher accuracy than GBDT, FNT, and LightGBM. The medicinal herbs predicted include Lycii fructus, Amygdalus communis vas, Chrysanthemi flos, Hippophae fructus, Mori folium, Croci stigma, Maydis stigma, Ephedrae herba, Cimicifugae rhizoma, licorice, and Epimedii herba, all of which have been proven effective in the treatment of diabetes.

DISCUSSIONS: The results of network pharmacology show that myrrha can play a role in treating diabetes through multiple targets and pathways.

PMID:39950110 | PMC:PMC11822566 | DOI:10.3389/fphar.2025.1454029

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Traditional herbal medicine legislative and regulatory framework: a cross-sectional quantitative study and archival review perspectives

Front Pharmacol. 2025 Jan 30;16:1475297. doi: 10.3389/fphar.2025.1475297. eCollection 2025.

ABSTRACT

BACKGROUND: The World Health Organization (WHO) reports that a significant portion of the global population relies on traditional herbal medicine (THM) due to limited access to safe and high-quality modern medical care. In developing countries, it is difficult to guarantee the safety and quality of THM due to weak enforcement of the legal and regulatory framework. Hence, the study attempted to evaluate the country’s legislative and regulatory framework by comparing it with developed and developing countries that have well-established systems and identify gaps for future roadmaps in the THM landscape.

METHODS: A cross-sectional study and archival review were performed from November 2021 to March 2022 G.C. to contrast the legislative and regulatory framework for THM regulation with other selected countries like Africa, India, and China. A total of 237 regulatory personnel participated in the study. Data were collected through an archive assessment, self-administrative questionnaires, and literature searches. Secondary data were extracted from the archival review, and the findings were summarized and presented in tabular and text formats. The quantitative data were analyzed using Statistical Package for the Social Sciences (SPSS) software version 26, with outputs presented in text, table, and figure form.

RESULTS: The archival review of the study found that Ethiopia’s THM legislative and regulatory framework is still in a developmental phase, particularly when compared with countries that have more established systems. A cross-sectional study indicated that approximately 79.7% of participants were aware of THM-related content in the current legislation. However, 82.3% reported they had not received any formal training on THM regulations. For future roadmaps, 73.8% of respondents believed the government showed a commitment to supporting THM regulation, though 51.9% of participants noted limited knowledge and awareness of THM practices and product regulations. In terms of quality, safety, efficacy, rational use, and storage conditions, 49.8% of respondents rated regulatory implementation practice as not satisfactory. In this study, most study participants raised concerns about the performance of quality control parameters. Among regulatory experts, weak performance was identified in the practical implementation of THM regulatory activities, with 70.2% of weak performance observed at the federal level and 41.7% at the regional level. Key barriers to effective regulation included a lack of research on herbal medicines (90.3%) and insufficient regulatory mechanisms (87.8%). Additional challenges for regulatory offices included traditional healers’ reluctance to engage with scientific communities (56.5%), inadequate inspections (55.3%), and limited data on the safety, quality, and efficacy of certain medicinal plants (54.4%).

CONCLUSION: Overall, the Ethiopian Food and Drug Authority (EFDA) is significantly strengthening the legislative and regulatory framework for traditional herbal medicines (THM), although full implementation is still forthcoming. This study highlights the need for comprehensive policy development, improved training initiatives, and reinforced regulatory systems to effectively monitor and regulate THM practices. For future roadmaps, collaboration among traditional healers, regulatory bodies, and scientific communities, along with supporting evidence-based research, could further enhance THM regulation in Ethiopia. These collaborative endeavors are critical for promoting the safety and quality of products derived from herbal medicines.

PMID:39950109 | PMC:PMC11821589 | DOI:10.3389/fphar.2025.1475297

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Prostate cancer incidence and mortality linked to metalworking fluid exposure: a systematic review and meta-analysis

Front Oncol. 2025 Jan 30;14:1491159. doi: 10.3389/fonc.2024.1491159. eCollection 2024.

ABSTRACT

BACKGROUND: Prostate cancer is the second most diagnosed cancer in men globally, with high prevalence in North America, Europe, and Australia. Occupational exposures, including metalworking fluids (MWFs), have emerged as a potential risk factor for prostate cancer, yet comprehensive studies on this association are limited.

OBJECTIVE: This study aims to systematically review and conduct a meta-analysis to examine the incidence and mortality of prostate cancer linked to MWF exposure.

METHODS: A systematic review and meta-analysis were conducted following the PRISMA guidelines. A comprehensive search strategy was developed to identify relevant studies from PubMed, Scopus, Embase, and Web of Science. Inclusion criteria encompassed studies reporting on the association between MWF exposure and prostate cancer incidence or mortality. Data extraction and risk of bias assessment were performed independently by two reviewers, with discrepancies resolved by a third reviewer. Statistical analyses were conducted using STATA version 17.

RESULTS: The search identified 1376 unique references, with 5 studies meeting the inclusion criteria for the meta-analysis. These studies, conducted in the USA, primarily involved auto workers and reported Standardized Mortality Ratio (SMR), Relative Risk (RR) and 95% Confidence Interval (95%CI) measures. Meta-analysis revealed an overall RR of 1.06 (95% CI: 1.01-1.11) for prostate cancer incidence and an overall SMR of 1.20 (95% CI: 1.09-1.31) for prostate cancer mortality, indicating a statistically significant increased risk and mortality among MWF-exposed workers.

CONCLUSIONS: These findings carry significant implications for workplace safety regulations. Given the observed association between MWF exposure and prostate cancer risk, it is imperative to minimize occupational exposure through the implementation of effective engineering controls, personal protective equipment, and substitution of less hazardous fluids. Regular health surveillance and education programs for workers in industries utilizing MWFs are also essential to mitigate risk. Additionally, regulatory agencies should consider revising exposure limits and safety guidelines to account for emerging evidence on the carcinogenic potential of newer MWF formulations.

PMID:39950100 | PMC:PMC11821483 | DOI:10.3389/fonc.2024.1491159

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Probing Depth Reduction Following Peri-Implantitis Treatment: A Systematic Review and Component Network Meta-Analysis

Clin Implant Dent Relat Res. 2025 Feb;27(1):e70010. doi: 10.1111/cid.70010.

ABSTRACT

OBJECTIVE: In this update of a previous systematic review, we compared the effects of surgical and non-surgical treatments for peri-implantitis through the component network meta-analysis (CNMA) with probing depth (PD) reduction as the outcome.

MATERIALS AND METHODS: Literature search was conducted in PubMed, Cochrane Central Register of Controlled Trials, and Embase databases from August 2010 to June 2023. Randomized controlled trials (RCTs), comparing non-surgical or surgical treatments for peri-implantitis with 6-12 months of follow-up and reported changes in PD, were included. Treatment effects were assessed using a CNMA model based on additivity assumption. We calculated the intraclass correlation coefficient (ICC) to adjust the standard errors for multiple implants within the same patient.

RESULTS: Our systematic review identified 44 RCTs, which included 46 treatment regimens consisting of 15 components. These RCTs formed a disconnected network consisting of 11 subnetworks. Surgical treatments with bone grafts and membranes generally attained greater PD reduction than non-surgical treatments, although bone grafts and membranes as components provided moderate benefits. The effect size of antibiotics is greater in non-surgical than surgical treatments, while there is considerable uncertainty regarding the effect size of implantoplasty. Additionally, the effectiveness of components varied between surgical and non-surgical treatments.

CONCLUSION: Current evidence does not yield sufficiently robust estimates for identifying optimal surgical and non-surgical treatment regimens for peri-implantitis, so the findings of our study should be interpreted cautiously. A coordinated strategy is required for designing future trials to fill the gaps in our current knowledge and develop more reliable recommendations.

PMID:39948703 | DOI:10.1111/cid.70010

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Curcumin Supplementation as a Preventive Strategy Against Tamoxifen-Induced Nonalcoholic Fatty Liver Disease in ER+ Breast Cancer Patients: A Triple-Blind Randomized Placebo-Controlled Trial

J Diet Suppl. 2025 Feb 13:1-10. doi: 10.1080/19390211.2025.2465412. Online ahead of print.

ABSTRACT

Tamoxifen, a common treatment for estrogen receptor (ER)‑positive breast cancer, is associated with an increased risk of developing nonalcoholic fatty liver disease (NAFLD). Curcumin, a compound in turmeric, has shown potential in mitigating liver disease progression. This study aims to evaluate the efficacy and safety of curcumin in preventing NAFLD in breast cancer patients initiating tamoxifen therapy.In this 6‑month triple‑blind, randomized placebo‑controlled trial, 44 ER+ breast cancer patients scheduled to receive tamoxifen were assigned to receive either curcumin (500 mg daily) or a placebo. NAFLD grade was assessed via ultrasound at baseline and after 6 months. Laboratory values and demographic data were collected, and adverse effects were monitored. Statistical analyses was performed using SPSS version 16.Data of a total of 44 participants (22 participants in each group, mean age: 47.1 ± 6.0 years) were analyses. There were no significant differences between the placebo and curcumin groups regarding the demographic and baseline laboratory values. At study completion, significantly fewer patients in the curcumin group showed an increased NAFLD grade compared to the placebo group (13.6% vs. 54.5%; p = 0.03). Additionally, the prevalence of NAFLD grade ≥ 2 was lower in the curcumin group (13.6% vs. 40.9%; p = 0.04). No adverse effects related to curcumin were reported. Curcumin supplementation demonstrated a protective effect against tamoxifen‑induced NAFLD in ER+ breast cancer patients, suggesting its potential as a prophylactic adjunct to tamoxifen therapy. Larger multi‑centric trials are warranted to confirm these findings.

PMID:39948699 | DOI:10.1080/19390211.2025.2465412

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Longevity of terminal abutment teeth retaining maxillary obturator prostheses

J Prosthodont. 2025 Feb 13. doi: 10.1111/jopr.14026. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the longevity of terminal abutment teeth retaining maxillary obturator prostheses.

MATERIALS AND METHODS: This was a retrospective study of patients who underwent maxillectomy followed by delivery of definitive obturator prostheses between 1994 and 2020. Details on patient demographics, primary tumor, and radiation therapy were collected. The tooth closest to the defect was identified as the terminal abutment, and information such as tooth type, condition of tooth at the time of maxillectomy, Aramany classification, and cause of abutment loss were noted from the dental charts. Survival time of the terminal abutment tooth was calculated from the date of maxillectomy to the last dental follow-up visit or the date of abutment loss. Univariate analyses were performed to test for the association between survival time and each of the four covariates.

RESULTS: In the 26-year study period, 148 teeth in 130 patients met the inclusion criteria. Ninety-eight (66.2%) terminal abutment teeth survived, and 50 (33.8%) were lost. Squamous cell carcinoma was the leading tumor diagnosis (51%). Aramany Class II was the most predominant arch configuration (51%). The majority of the terminal abutment teeth were maxillary incisors (43%). The chief cause of terminal abutment loss was bone loss and mobility (46%). The 10-year survival probability was 65%. Radiation therapy did not statistically contribute to terminal abutment loss. Terminal abutment teeth with dental treatment showed higher failure than those without any prior treatment or dental disease.

CONCLUSION: Clinicians must be aware of the various factors affecting the survival of terminal abutment teeth which can ultimately affect the success of the maxillary obturator prostheses.

PMID:39948686 | DOI:10.1111/jopr.14026

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Association between Heavy metals and triglyceride-glucose-related index: a mediation analysis of inflammation indicators

Lipids Health Dis. 2025 Feb 13;24(1):46. doi: 10.1186/s12944-025-02441-9.

ABSTRACT

BACKGROUND: In cardiovascular diseases (CVD) and insulin resistance (IR), elevated blood lipids and glucose are common. These abnormalities accelerate atherosclerosis and may impair insulin signaling via oxidative stress and inflammation. The triglyceride-glucose (TyG) index is a cost-effective marker for assessing IR and CVD risk, reflecting insulin resistance and early atherosclerosis. However, research on factors affecting the TyG index, especially mixed heavy metal exposure, is limited. Heavy metals might alter the TyG index by inducing oxidative stress and inflammation, affecting lipid and glucose metabolism. This study explores the link between heavy metal exposure and TyG index changes, focusing on inflammation’s mediating role, aiming to offer new strategies for CVD and IR prevention and management.

METHOD: This research explores the association between heavy metal concentrations and TyG indicators, drawing on data from the National Health and Nutrition Examination Survey spanning 2011 to 2016. It employs a range of statistical approaches, such as linear and non-linear analyses, multiple linear regression, weighted quantile sum regression, and Bayesian kernel machine regression. Additionally, a mediation analysis investigates the role of inflammation in modifying the effects of heavy metal exposure.

RESULT: The research analyzed data from a sample of 2,050 individuals, finding notable links between mixed heavy metals and variations in TyG markers. Specifically, the presence of heavy metal mixtures was associated with significant increases in these indicators. Additionally, six inflammatory markers were identified that act as intermediaries in the process leading from heavy metal exposure to alterations in TyG indicators.

CONCLUSION: The study establishes a clear association between heavy metal and adverse changes in TyG markers, influenced in part by inflammation. These insights highlight the urgent need for improved monitoring of environmental health and specific strategies to decrease heavy metal exposure, thus lessening their harmful impact on cardiovascular health. The research enhances understanding of the dynamic interactions between environmental exposures and metabolic health, laying groundwork for public health initiatives aimed at curtailing chronic disease risks linked to heavy metals.

PMID:39948676 | DOI:10.1186/s12944-025-02441-9

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Association between spiritual care competency and spiritual health among nursing interns: a cross-sectional study

BMC Nurs. 2025 Feb 13;24(1):168. doi: 10.1186/s12912-025-02809-3.

ABSTRACT

AIMS: This study aimed to investigate the current state of nursing interns’ spiritual care competency (SCC) and its relationship with their spiritual health.

BACKGROUND: Spiritual care is a vitally important component of holistic nursing. Understanding the spiritual care competency of nursing interns can help nursing managers and educators identify weaknesses in spiritual care practices, develop intervention measures to enhance SCC, and improve the quality of nursing services. However, the relationship between spiritual health and SCC among nursing interns remains unclear.

METHODS: A total of 361 nursing interns were recruited from three general hospitals. An online questionnaire assessed nursing interns’ sociodemographic characteristics, spiritual care competency, and spiritual health. Statistical analyses included Pearson’s correlation analysis, T-test, analysis of variance (ANOVA), and multiple stepwise linear regression analysis.

RESULTS: The average spiritual care competency score among nursing interns was 107.24 ± 21.67 out of a possible 135, indicating a medium-high level of competency. Spiritual care competency was positively correlated with spiritual health (P < 0.01). The multiple stepwise linear regression model (n = 361) had an explained variance (R2 = 0.300), showing that spiritual health and the manner of receiving spiritual training were the main factors influencing the interns’ spiritual care competency (P < 0.001).

CONCLUSION: The findings suggest that improving the spiritual health of nursing interns can enhance their spiritual care competency.

PMID:39948658 | DOI:10.1186/s12912-025-02809-3