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Nevin Manimala Statistics

IDA study: post-COVID-19 school readiness vulnerability in children entering primary school in Lazio Region

Epidemiol Prev. 2025 Jan-Feb;49(1):27-34. doi: 10.19191/EP25.1.A749.003.

ABSTRACT

OBJECTIVES: to describe the ‘IDA’ study, which aims to estimate the prevalence of School Readiness Vulnerability (SRV) in children at the beginning of primary school and the associated socioeconomic characteristics, to stimulate the attention of decision-makers on the consequences of the COVID-19 pandemic and the need for specific and timely interventions by the school community, thus preventing negative effects on children’s present and future health.

DESIGN: cross-sectional study based on a random sample of children extracted using the cluster sampling technique on the first primary school classes.

SETTING AND PARTICIPANTS: in October 2022, the IDA study assessed the SRV prevalence and associated risk factors in 628 children of the Lazio Region, aged 67-89 months, 328 males and 292 females.

MAIN OUTCOMES MEASURES: the individual school readiness score was calculated by a validated questionnaire (Early Identification of Learning Difficulties, IPDA); socioeconomic characteristics were measured by administering a questionnaire to parents (child’s age, kindergarten attendance, parents’ education, parents’ occupation).

RESULTS: the SRV prevalence was 44.9%. The most affected development areas were motor skills, pre-mathematics, and pre-literacy. SRV was associated with low educational levels of the mother, father, or both parents, and maternal and paternal unemployment. The comparison with reference values (pre-pandemic) places the subjects studied one year behind in terms of psycho-motor development.

CONCLUSIONS: because of potential negative effects, institutions and stakeholders need to intervene to promote children’s reinforcement activities and equity of access to education.

PMID:40066635 | DOI:10.19191/EP25.1.A749.003

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Novel predictors of infection-related rehospitalization in older patients with heart failure in Japan

Geriatr Gerontol Int. 2025 Mar 11. doi: 10.1111/ggi.70019. Online ahead of print.

ABSTRACT

AIM: Rehospitalization of patients with heart failure (HF) incurs high health care costs and increased mortality. Infection-related rehospitalizations in patients with HF occur frequently, and the risk increases with age. This study aimed to identify the factors associated with infection-related rehospitalizations in older patients with HF.

METHODS: Demographic, clinical, and pharmacological data from 1061 patients with acute HF who were enrolled in the Kochi Registry of Subjects With Acute Decompensated Heart Failure (Kochi YOSACOI study) were analyzed. Additionally, a machine learning approach was applied in addition to the traditional statistical analysis model. Of the patients hospitalized for HF, 729 were ultimately analyzed.

RESULTS: During the 2-year postdischarge follow-up period, 121 (17%) patients were readmitted for infections. Logistic regression analysis identified a Japanese Cardiovascular Health Study (J-CHS) score of ≥3 (odds ratio, 1.83 [95% confidence interval, 1.18-2.83]; P = 0.007) at discharge as a key factor for infection-related rehospitalizations. Machine learning models confirmed that a higher J-CHS score and lower estimated glomerular filtration rate (eGFR) increased the risk of infection-related rehospitalizations. Decision tree analysis classified the risk into high (J-CHS score ≥3), medium (J-CHS score <3; eGFR ≤35.0) and low (J-CHS score <3; eGFR >35.0) groups.

CONCLUSIONS: Infection-related rehospitalizations occur in older patients with HF and are associated with frailty and eGFR. These findings provide valuable insights for health care providers to better manage the risk of infection-related rehospitalizations in older patients with HF, potentially improving patient outcomes. Geriatr Gerontol Int 2025; ••: ••-••.

PMID:40066617 | DOI:10.1111/ggi.70019

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The Effect of Heparin on Bone Metabolism and Orthodontic Tooth Movement in Rats

Clin Exp Dent Res. 2025 Feb;11(1):e70061. doi: 10.1002/cre2.70061.

ABSTRACT

OBJECTIVES: Various attempts have been made to increase the rate of orthodontic tooth movement (OTM). The aim of this study was to determine the effect of different doses of heparin on OTM and paraclinical factors related to bone metabolism in rats.

METHODS AND MATERIALS: A total of 24 Sprague-Dawley rats were randomly divided into three groups of 8 animals each and injected with 0 (control), 3000, and 6000 U/Kg/d heparin sulfate for 4 weeks. Radiographs were obtained at the initiation and at the end of the study period. Orthodontic forces were applied on Day 14 and continued for the next 2 weeks, after which, OTM, optical density, parathyroid hormone (PTH) level, and histologic variables were assessed for each rat. The latter was performed on hematoxylin/eosin-stained sections of the mesial roots of the first molar and included calculation of the osteoclast number, and resorption lacunae depth and number. One-way analysis of variance, the Tukey test, and a paired-t-test were used for statistical analysis (p < 0.05).

RESULTS: A significant increase in OTM, the number of resorptive lacunae, and PTH secretion was observed in the group that received 6000 U/Kg/d compared with both the other groups. There was no significant difference in optical density, and, therefore, bone density, among the study groups (p > 0.05).

CONCLUSION: Heparin injection affects bone metabolism in rats, as shown by the increases in OTM and PTH and its impact on histologic parameters. These effects seem to be dose-dependent and may be a factor that should be taken into consideration during orthodontic treatment planning.

PMID:40066602 | DOI:10.1002/cre2.70061

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Cumulative blood pressure predicts risk of cardiovascular outcomes in middle-aged and older population

Ann Med. 2025 Dec;57(1):2476735. doi: 10.1080/07853890.2025.2476735. Epub 2025 Mar 11.

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) remains a major health concern globally, contributing to a considerable disease burden. However, few studies have considered long-term cumulative blood pressure (cBP) exposure in middle-aged and older population in China. The aim of this study was to investigate whether long-term cBP was associated with subsequent cardiovascular outcomes among participants without CVD at baseline in Chinese over 45 years old.

METHODS: 6435 participants in China of the CHARLS (The China Health and Retirement Longitudinal Study) were included. Cumulative BP was calculated as the area under the curve using measurements from wave 1 (2011) to wave 2 (2013). Outcomes included CVD, heart disease and stroke.

RESULTS: During a median follow-up period of 5 years, 1101 CVD events, 826 heart disease, and 351 stroke were recorded. Each 1-SD increase in cumulative systolic blood pressure (cSBP), cumulative diastolic blood pressure (cDBP), and cumulative mean arterial pressure (cMAP) was associated with increased risk of CVD (HR, 1.12; 95%, 1.05-1.20, HR, 1.14; 95%, 1.07-1.22, HR, 1.14; 95%, 1.07-1.22), heart disease (HR, 1.05; 95%, 0.97-1.13, HR, 1.09; 95%, 1.01-1.17, HR, 1.08; 95%, 1.00-1.16) and stroke (HR, 1.35; 95%, 1.21-1.51, HR, 1.31; 95%, 1.17-1.46, HR, 1.36; 95%, 1.22-1.51). The relationship between cBP and CVD has only been found in people younger than 60 years of age. A significant association was observed for cumulative pulse pressure (cPP) with stroke (HR, 1.23; 95%, 1.10-1.38). None nonlinear relationships were identified (p-nonlinear > .05). For the prediction of cardiovascular outcomes, cBP load outperformed baseline BP in terms of C statistics (p < .001).

CONCLUSIONS: Long-term cSBP, cDBP and cMAP were associated with subsequent CVD and only found in people younger than 60 years of age, whereas cPP was associated with stroke only across all ages. Cumulative BP may provide a better prediction of cardiovascular outcomes compared with single BP measurement. Efforts are required to control long-term BP in assessing cardiovascular risks.

PMID:40066575 | DOI:10.1080/07853890.2025.2476735

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Macitentan for Heart Failure With Preserved or Mildly Reduced Ejection Fraction and Pulmonary Vascular Disease: Results of the SERENADE Randomized Clinical Trial and Open-Label Extension Study

Circ Heart Fail. 2025 Mar 11:e011381. doi: 10.1161/CIRCHEARTFAILURE.123.011381. Online ahead of print.

ABSTRACT

BACKGROUND: Despite favorable hemodynamic and neurohormonal effects, endothelin receptor antagonists have not improved outcomes in patients with heart failure (HF), possibly because they cause fluid retention.

METHODS: In this randomized, double-blind, multicenter trial (SERENADE [Macitentan in Heart Failure With Preserved Ejection Fraction and Pulmonary Vascular Disease]), we evaluated the effects of an endothelin receptor antagonist, macitentan, in patients with HF, left ventricular ejection fraction ≥40%, and pulmonary vascular disease. After a 4-week placebo run-in (to ensure clinical stability), followed by a 5-week single-blind macitentan run-in, patients who did not exhibit fluid retention were randomized to macitentan or placebo. The primary end point was change in NT-proBNP (N-terminal pro-B-type natriuretic peptide; baseline to 24 weeks); secondary end points included change in KCCQ (Kansas City Cardiomyopathy Questionnaire) clinical summary score (baseline to 24 weeks) and time to worsening HF by 52 weeks.

RESULTS: Of 230 patients enrolled, 28 were excluded during the placebo run-in, 60 excluded during the macitentan run-in, and 142 were randomized. Macitentan had no effect on change in NT-proBNP (geometric mean ratio [macitentan/placebo], 1.02 [90% CI, 0.88-1.19]; P=0.79) or on secondary end points (placebo-corrected change in KCCQ clinical summary score, -3.5 [90% CI, -8.2 to +1.2]; P=0.22). Worsening HF occurred in 20 (28%) patients assigned to macitentan and 13 (18%) assigned to placebo (hazard ratio, 1.48 [90% CI, 0.83-2.67]; P=0.24). More macitentan-treated patients developed fluid retention (16 [23%] versus 10 [14%]) and cardiac adverse events (33 [46%] versus 22 [31%]) versus placebo.

CONCLUSIONS: Despite a novel enrichment trial design to target pulmonary vascular disease and exclude treatment-related fluid retention in patients with HF and preserved/mildly reduced left ventricular ejection fraction, macitentan neither lowered NT-proBNP nor improved HF outcomes.

REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifiers: NCT03153111 and NCT03714815.

PMID:40066571 | DOI:10.1161/CIRCHEARTFAILURE.123.011381

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Large-scale evidence of a general disease (‘d‘) factor accounting for both mental and physical health disorders in different age groups

Psychol Med. 2025 Mar 11;55:e78. doi: 10.1017/S0033291725000522.

ABSTRACT

BACKGROUND: It is unknown whether there is a general factor that accounts for the propensity for both physical and mental conditions in different age groups and how it is associated with lifestyle and well-being.

METHODS: We analyzed health conditions data from the Millennium Cohort Study (MCS) (age = 17; N = 19,239), the National Child Development Study (NCDS) (age = 44; N = 9293), and the English Longitudinal Study of Ageing (ELSA) (age ≥ 50; N = 7585). The fit of three Confirmatory Factor models was used to select the optimal solution by Comparative Fit Index, Tucker-Lewis Index, and Root Mean Square Error of Approximation. The relationship among d factor, lifestyles, and well-being was further explored.

RESULTS: Supporting the existence of the d factor, the bi-factor model showed the best model fit in 17-year-olds (MCS:CFI = 0.97, TFI = 0.96, RMSEA = 0.01), 44-year-olds (NCDS:CFI = 0.96, TFI = 0.95, RMSEA = 0.02), and 50+ year-olds (ELSA:CFI = 0.97, TFI = 0.96, RMSEA = 0.02). The d factor scores significantly correlated with lifestyle and well-being, suggesting healthier lifestyles were associated with a reduced likelihood of physical and mental health comorbidities, which in turn improved well-being.

CONCLUSIONS: Contrary to the traditional dichotomy between mental and physical conditions, our study showed a general factor underlying the comorbidity across mental and physical diseases, related to lifestyle and well-being. Our results inform the conceptualization of mental and physical illness as well as future research assessing risk and pathways of disease transmission, intervention, and prevention. Our results also provide a strong rationale for a systematic screening for mental disorders in individuals with physical conditions and vice versa, and for integrated services addressing multimorbidity.

PMID:40066566 | DOI:10.1017/S0033291725000522

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A Meta Analysis of RBC Alloimmunization in Transfused Sickle Cell and Thalassemia Patients in Saudi Arabia

Clin Lab. 2025 Mar 1;71(3). doi: 10.7754/Clin.Lab.2024.240827.

ABSTRACT

BACKGROUND: Alloimmunization to red blood cells (RBCs) presents a significant challenge in blood transfusion for individuals afflicted with sickle cell disease (SCD) and thalassemia. However, there is a scarcity of data regarding the prevalence of RBC alloimmunization in such patients in Saudi Arabia. To address this gap, a comprehensive meta-analysis was undertaken to ascertain the rate of RBC alloimmunization in SCD and thalassemia patients who receive regular transfusions in Saudi Arabia.

METHODS: A systematic search and subsequent meta-analysis, following PRISMA guidelines, were carried out. We meticulously combed through six prominent scientific databases, including PubMed, Web of Science, SCOPUS, EMBASE, MEDLINE, and Google Scholar, up to July 20, 2023, to identify pertinent English-language articles. Data were meticulously extracted from the selected studies. The meta-analysis adopted a random-effects model and included subgroup analyses to delineate the RBC alloimmunization rates specifically for SCD and thalassemia patients receiving regular transfusions. Heterogeneity was assessed through Cochran’s Q and I2 tests. The study protocol was registered under PROSPERO, with the code CRD42023440761.

RESULTS: Our comprehensive search yielded a total of 983 articles, with 12 meeting the criteria for the final analysis, encompassing a total of 1,811 SCD and thalassemia patients. The collective RBC alloimmunization rate across all the eligible articles for patients with SCD and thalassemia who received regular transfusions in Saudi Arabia was determined to be 18.2%. Subgroup analysis, comprising nine articles, indicated that the RBC alloimmunization rate among SCD patients was 18.6%, while analysis of six articles revealed that the rate among thalassemia patients stood at 19.5%.

CONCLUSIONS: This meta-analysis underscores that the RBC alloimmunization rate in SCD and thalassemia patients who regularly receive transfusions in Saudi Arabia stands at 18.2%. Considering these findings, it is essential to prioritize extended phenotyping prior to transfusion to significantly reduce the risk of RBC alloimmunization.

PMID:40066558 | DOI:10.7754/Clin.Lab.2024.240827

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Early Diagnosis of Colorectal Cancer via Plasma-Derived SDC2, KCNQ5, and IKZF1 Methylation Levels

Clin Lab. 2025 Mar 1;71(3). doi: 10.7754/Clin.Lab.2024.240146.

ABSTRACT

BACKGROUND: The incidence of colorectal cancer (CRC) is rapidly increasing, and early detection plays a crucial role in improving the prognosis and survival rates of patients. This study aimed to assess the diagnostic ability of combined SDC2-KCNQ5-IKZF1 methylation levels in plasma for CRC detection.

METHODS: A total of 92 patients were recruited from the Department of General Surgery at the Second Hospital of Hebei Medical University, including 56 CRC patients, 22 polyp and adenoma patients, and 14 healthy controls. Plasma cfDNA was extracted for methylation test of SDC2, KCNQ5, and IKZF1. Sanger sequencing was conducted to verify the methylation results. The performance of single-gene methylation and triple-gene methylation combined test were analyzed. The positive detection rates of methylation and CEA test were compared to the colonoscopy gold standard. ROC curve was utilized to evaluate the diagnostic value in CRC.

RESULTS: The positive detection rates of triple-gene tests in CRC and precancerous lesions were 87.50% and 95.45%, respectively. The triple-gene test performed better than single-gene or CEA test. Combined analysis of triple-gene and CEA test could further improve the detection rate. Univariate analysis showed no statistical correlation between the methylation levels and patients’ gender, age, history of diabetes, tumor site, lymph node metastasis, and tumor stage. In ROC curve analysis, AUC areas of SDC2, KCNQ5, and IKZF1 were 0.700, 0.646, and 0.645, respectively. The AUC area of triple-gene test was 0.924.

CONCLUSIONS: The triple-gene combined methylation test demonstrated excellent diagnostic performance for CRC and precancerous lesions.

PMID:40066557 | DOI:10.7754/Clin.Lab.2024.240146

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Positive Relationship between Total Calcium and Hyperuricemia in Adults: a Cross-Sectional Study

Clin Lab. 2025 Mar 1;71(3). doi: 10.7754/Clin.Lab.2024.240726.

ABSTRACT

BACKGROUND: Calcium (CA) is crucial for a wide range of biological functions. However, the correlation between total calcium and hyperuricemia in US adults remains unclear. This study aimed to assess whether total calcium is associated with hyperuricemia.

METHODS: Based on data from the NHANES (2011 – 2018), we conducted a cross-sectional study involving 20,028 US adults aged 18 or older. Logistic regression, fitting smooth curves, and interaction effects were utilized to support the research objectives.

RESULTS: Regression analyses demonstrated a positive relation between total calcium and hyperuricemia (p < 0.001). Positive association between levels of total calcium and the risk of hyperuricemia was observed after full adjustment for all the confounding variables (odds ratio: 13.28, 95% confidence interval: 10.38 – 16.99, p < 0.001). The interaction of total calcium and hyperuricemia with age and gender was significant (p values for interaction < 0.05), while there was no interaction in other subgroups (p-values for interaction > 0.05). In addition, curve fitting after adjusting for all the confounding variables indicated a nonlinear positive correlation between total calcium and hyperuricemia (p for nonlinearity = 0.024).

CONCLUSIONS: The present cross-sectional study revealed that a nonlinear positive association existed between total calcium and hyperuricemia in US adults. The results could be beneficial for the management and treatment of hyperuricemia.

PMID:40066556 | DOI:10.7754/Clin.Lab.2024.240726

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The Expression and Clinical Significance of CCDC12 in the Initial Diagnosis of Acute Myeloid Leukemia

Clin Lab. 2025 Mar 1;71(3). doi: 10.7754/Clin.Lab.2024.241015.

ABSTRACT

BACKGROUND: This study investigated the expression and clinical significance of coiled-coil domain containing 12 (CCDC12) in the initial diagnosis of acute myeloid leukemia (AML).

METHODS: A total of 80 AML patients were enrolled as the experimental group, and 20 normal bone marrow specimens were used as the control group. Clinical data of AML patients were collected. The expression level of CCDC12 was measured using real-time fluorescent quantitative PCR (QRT-PCR) in both groups. The relationship between CCDC12 expression and clinical pathological characteristics and prognosis in AML patients was analyzed. Kaplan-Meier curves were used to evaluate the effect of CCDC12 expression on overall survival (OS) in AML patients, while Cox proportional hazards regression analysis was performed to assess prognosis.

RESULTS: CCDC12 expression was significantly higher in AML patients compared to the control group (p < 0.05). Patients in the high CCDC12 expression group were older, had higher platelet counts (PLT), poorer treatment responses, and worse prognoses, with statistically significant differences (p < 0.05). The OS in the high CCDC12 expression group was significantly shorter (p < 0.05). High CCDC12 expression was identified as an independent risk factor for poor AML prognosis.

CONCLUSIONS: CCDC12 is highly expressed in AML patients. Elevated CCDC12 expression is associated with unfavorable clinical pathological characteristics and poor prognosis. This marker may provide a new approach for the diagnosis, monitoring, and targeted therapy of AML.

PMID:40066551 | DOI:10.7754/Clin.Lab.2024.241015