Tag: statistics

Afr J Reprod Health. 2025 Dec 23;29(12):42-50. doi: 10.29063/ajrh2025/v29i12.5.

ABSTRACT

The study employed a comprehensive graphical presentation and statistical analysis using data from 2017 to 2023 to assess how different dimensions of foreign aid impact the HIV/AIDS prevalence rate in South Africa. The finding suggests that as the proportion of foreign aid increases, HIV/AIDs prevalence tends to decrease. Consequently, result of funding for treatment has correlation (r = -0.657). This moderate negative association reinforces the traditional belief that investments in direct treatment are effective in reducing disease prevalence. The relationship between funding allocated to education reveals a notable positive correlation (r = 0.33) with HIV prevalence. Against this backdrop, the policymakers in South Africa should prioritize allocating resources to quality programs that have robust passthrough effects on HIV/AIDs reduction in the country. Also, given the current termination of about 40 USAID funded projects in South Africa, if the policymakers in South Africa desire to prevent further escalation of HIV prevalence in the country, they should explore substantive internal sources of fundings.

PMID:41456115 | DOI:10.29063/ajrh2025/v29i12.5

Inflamm Bowel Dis. 2025 Dec 28:izaf312. doi: 10.1093/ibd/izaf312. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with Crohn disease (CD) face an elevated risk of developing small bowel adenocarcinoma (SBA), a malignancy characterized by late-stage diagnosis and poor prognosis. In this study we aimed to characterize surgical management and oncologic outcomes for CD-associated SBA.

METHODS: A retrospective review was conducted across 3 tertiary IBD centers, analyzing 99 patients with CD who underwent surgery for SBA between 1992 and 2025. Data included patient demographics, CD history, surgical details, and oncologic outcomes.

RESULTS: The median time from CD diagnosis to SBA was 25 years. The SBA diagnosis was incidental in 74.8% of cases, discovered during surgery for other complications. Tumors were predominantly located in the ileum (80.8%) and showed aggressive features: 56.6% were poorly differentiated (grade 3), and 85.9% were pathologically advanced (T3/T4 on TNM staging). Nodal involvement was present in 45.5% of patients, and 18.2% had distant metastases at diagnosis. A complete (R0) resection was achieved in 90.9% of surgeries, with a 30-day morbidity rate of 26.3%. After a median follow-up of 36 months, the distant recurrence rate was 28.3%, and overall mortality was 27.3% (18.2% cancer related).

CONCLUSION: In patients with long-standing CD, SBA is typically an incidental diagnosis made at an advanced stage. While high rates of complete surgical resection are possible, the prognosis remains guarded due to aggressive tumor biology and high recurrence rates. These findings highlight a critical need for improved risk stratification to guide surveillance and for the development of evidence-based adjuvant treatment strategies.

PMID:41456110 | DOI:10.1093/ibd/izaf312

J Clin Anesth. 2025 Dec 26;109:112110. doi: 10.1016/j.jclinane.2025.112110. Online ahead of print.

ABSTRACT

PURPOSE: This Bayesian network meta-analysis (NMA) aimed to compare the perioperative efficacy of various ultrasound-guided regional blocks in individuals on total hip arthroplasty (THA).

METHODS: An extensive search was implemented across PubMed, Cochrane Library, Web of Science, and Embase up to December 9, 2024. Randomized controlled trials (RCTs) were selected to appraise postoperative analgesia and complications following ultrasound-guided lumbar plexus block (LPB), suprainguinal fascia iliaca block (SIFIB), pericapsular nerve group block (PENG), femoral nerve block (FNB), fascia iliaca block (FIB), quadratus lumborum block (QLB), erector spinae plane block (ESPB), periarticular injection (PAI), and saline control (CONTROL). Primary outcomes encompassed scores of movement-evoked pain (MEP) and pain at rest (PAR) within 12 and 24 h postoperatively.Secondary outcomes encompassed postoperative morphine equivalent consumption and the incidence of nausea and vomiting. Statistical analyses were carried out utilizing R 4.4.2 and Stata 18.

RESULTS: Eighteen studies (2016-2024) involving 1424 participants were included. Network analysis revealed that, for the primary outcome, The MEP scores in the PAI, PENG, and QLB groups were significantly lower within 12 and 24 h postoperatively.No significant differences were discovered in PAR scores within 12 h or 24 h postoperatively. Within the bupivacaine subgroup, the QLB group had lower consumption of morphine within 24 h postoperatively. Compared to others, the QLB group had the lowest consumption of morphine during the hospital stay.In terms of postoperative nausea and vomiting (PONV), regional blockade had a statistically substantial difference against the placebo control cohort.

CONCLUSION: No single regional block technique demonstrated superiority across all postoperative outcomes. Ultrasound-guided QLB was particularly effective in reducing morphine consumption, alleviating pain, and decreasing PONV. PAI and PENG also demonstrated efficacy in reducing postoperative pain and consumption of morphine. Future large-scale multi-center RCTs are necessary to further validate these findings.

PMID:41455152 | DOI:10.1016/j.jclinane.2025.112110

Gait Posture. 2025 Dec 16;125:110085. doi: 10.1016/j.gaitpost.2025.110085. Online ahead of print.

ABSTRACT

BACKGROUND: Foot orthosis hardness governed the trade-off between medial arch correction, plantar pressure redistribution, and load transfer along the lower limb, yet the relationship between hardness and biomechanical improvement in flexible flatfoot remains unclear.

AIM: To investigate how different arch support hardness levels affect biomechanics and muscle forces in adults with flexible flatfoot, and to determine how these effects vary with hardness.

METHODS: Twenty women aged 18-40 years with flexible flatfoot (navicular drop > 10 mm, arch height index < 0.31), all asymptomatic, with no prior foot orthosis use and no recent lower-limb injury, were recruited from campus. Participants walked at a self-selected speed under four conditions: no arch support, arch support with shore C 30, shore C 50, and shore C 70 hardness. Research integrated bayesian statistical analysis and musculoskeletal simulations. Biomechanical data were collected via Vicon motion capture system and Kistler force plate and analyzed using OpenSim and JASP.

RESULTS: Foot orthosis improved rearfoot biomechanics: they reduced frontal plane range of motion, moment, and joint reaction forces at the ankle, subtalar, and midtarsal joint, and decreased tibialis posterior peak muscle force; however, these benefits plateaued as hardness increased. Harder foot orthosis (shore C 70) increased knee coronal range of motion and moment, knee sagittal peak joint reaction force, and vastus medialis peak muscle force, and shifted loading distally, increasing metatarsophalangeal joint range of motion, moment, and joint force.

CONCLUSION: Increasing hardness can, within limits, enhance rearfoot control and reduce tibialis posterior force, but progressively increases loading at the knee and forefoot. The prescription of arch support hardness should balance corrective benefits against the risk of knee and metatarsophalangeal joint loading.

PMID:41455151 | DOI:10.1016/j.gaitpost.2025.110085

Clin Imaging. 2025 Dec 17;130:110700. doi: 10.1016/j.clinimag.2025.110700. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examined global research trends in Radiology, Nuclear Medicine, and Medical Imaging by analyzing the 500 most-cited articles in the Web of Science (WoS) Core Collection.

METHODS: A bibliometric search was conducted on June 15, 2025. Biblioshiny and VOSviewer 1.6.20 were used for network visualization, including institutional collaboration, co-authorship, keyword co-occurrence, and country-level contributions. Temporal patterns were analyzed with Python 3.13.3, and descriptive statistics summarized publication data.

RESULTS: Harvard University led institutional contributions with 54 publications, followed by Massachusetts General Hospital (n = 49), University of Oxford (n = 35), Washington University (n = 29), and University of Texas (n = 26). The United States accounted for 53.4 % of all outputs, followed by the United Kingdom (21.6 %), Germany (12 %), Canada (9 %), and France (8 %). Among authors, Stephen M. Smith contributed most (19 publications), followed by Jenkinson, M (n = 14), and Friston, KJ (n = 13). The most frequent keywords were “MRI” (n = 65), “Brain” (n = 43), “fMRI” (n = 37), “Segmentation” (n = 25), and “PET” (n = 24). In addition to leading all journals in citation impact (citations per article), Neuroimage was also identified as the most productive journal overall. Regarding the average citation impact, the top-performing entities in their respective categories were: the University of Oxford (among organizations), Germany (among countries), Smith Stephen M (among authors), and the journal Neuroimage (among journals). Emerging terms included “deep learning” and “artificial intelligence.” The most-cited article was Ronneberger et al.’s U-Net (2015), cited 63,448 times.

CONCLUSION: High-impact radiology research is concentrated in North America and Western Europe, with neuroimaging and artificial intelligence representing key emerging domains. These insights provide a roadmap for research prioritization and collaboration strategies.

PMID:41455150 | DOI:10.1016/j.clinimag.2025.110700

Phys Life Rev. 2025 Dec 22;56:202-203. doi: 10.1016/j.plrev.2025.12.014. Online ahead of print.

NO ABSTRACT

PMID:41455146 | DOI:10.1016/j.plrev.2025.12.014

Clin Chem Lab Med. 2025 Dec 29. doi: 10.1515/cclm-2025-1339. Online ahead of print.

ABSTRACT

OBJECTIVES: The Kappa Index has proven its diagnostic value for multiple sclerosis (MS), while its prognostic potential remains to be fully explored. The objective of this study is thus to investigate the value of the Kappa Index at disease onset in predicting disease activity and high-efficacy therapy (HET) initiation.

METHODS: We enrolled MS patients with available Kappa Index values at disease onset and a follow-up of at least two years. Primary outcome was the time to loss of NEDA3 (no evidence of disease activity-3) defined as the absence of relapses, MRI activity, and disability progression. Secondary outcome was the time to HET initiation.

RESULTS: Of 120 enrolled patients (36 M, 84 F, mean age: 35 ± 11 years), NEDA3 loss occurred in 89 (74 %) by the end of the follow-up period. A total of 98 (82 %) initiated a moderate efficacy therapy (MET); of these, 34 (28 %) transitioned to a HET during follow-up. Kappa Index values above the maximally selected log-rank statistic-derived cut-off of 38 were independent risk factors for NEDA3 loss (HR 1.75, 95 % CI: 1.09-2.80, p=0.021) and HET initiation (3.25, 95 % CI: 1.54-6.87, p=0.002) and also independently predicted HET following MET failure (2.54, 95 % CI: 1.17-5.51, p=0.018).

CONCLUSIONS: Elevated Kappa Index values at diagnosis predict disease activity, MET failure and HET initiation and may be a valuable adjunctive tool in identifying patients in need of prompt HET initiation.

PMID:41455127 | DOI:10.1515/cclm-2025-1339

Med Phys. 2026 Jan;53(1):e70208. doi: 10.1002/mp.70208.

ABSTRACT

BACKGROUND: Sacral chordoma (SC) is a rare and locally aggressive tumor, characterized by a high risk of local recurrence (LR). Advanced imaging biomarkers capturing tumor heterogeneity and treatment response may help refine patient stratification and improve outcomes.

PURPOSE: This study aims to explore the potential of microstructural parameters and habitat analysis derived from diffusion-weighted MRI (DW-MRI) to characterize intratumoral heterogeneity, assess treatment-induced changes, following carbon ion radiotherapy (CIRT), and investigate their association with recurrence patterns in SC patients.

METHODS: A retrospective analysis was performed on 40 SC patients treated with CIRT. Microstructural parameters-cell radius (R), eccentricity (ecc), diffusion coefficient (D), cell volume fraction (vf), and apparent cellularity (ρ-app)-were estimated from DW-MRI using a computational model based on Monte Carlo simulations. Longitudinal changes were assessed from DW-MRI scans acquired at baseline, first follow-up (3 months after CIRT), and, for LR patients, at the time of recurrence. Habitat imaging analysis was performed by applying K-means clustering (k = 2) independently to each map of the six microstructural parameters. A joint clustering approach was then used to combine these binary maps, resulting in 64 unique microstructural configurations (2⁶ habitats). The spatial distribution of these habitats was quantified within the gross tumor volume (GTV) and recurrence regions. Associations with clinical outcomes were explored by analyzing habitat fractions in patients with early (early-LR) vs. late recurrence (late-LR), and by comparing recurrences predominantly located within the high-dose clinical target volume irradiated during CIRT (in-field-LR) vs. those partially outside the target (marginal-LR). Statistical tests, multiregional spatial interaction (MSI) matrix analysis, Cox regression, Spearman correlation and Kaplan-Meier survival analyses were performed.

RESULTS: Treatment-induced changes in microstructural parameters were statistically significant in both local control (LC) and LR patients, characterized by an increase in cell radius, eccentricity, ADC, and diffusion, and a concomitant reduction in cell volume fraction and apparent cellularity. This pattern suggested a reduction in cell density and increased tissue disorganization, likely reflecting CIRT-induced cell damage and extracellular matrix remodeling. Habitat analysis revealed distinct microstructural configurations associated with clinical outcome. A favorable microstructural pattern-high diffusivity and low cellularity-was predominantly found in LC patients (HABITAT47_212221), whereas more aggressive configurations (low diffusivity and high cellularity) were enriched in LR patients (HABITAT26_122112 and HABITAT28_122122). Univariate Cox regression identified these high-risk habitats as significantly associated with recurrence (hazard ratio > 1, p-value < 0.05). Moreover, habitat fractions showed a progressive trend across recurrence risk subgroups (LC, late-LR, early-LR; LC, in-field-LR, marginal-LR), while spatial analyses revealed increased co-localization of high-risk habitats in LR patients based on MSI matrix analysis. Finally, Kaplan-Meier analysis based on hazard ratios predicted at first follow-up using Cox models trained on baseline habitat fractions revealed significant differences in progression-free survival.

CONCLUSION: This study demonstrates the potential of DW-MRI-derived microstructural parameters and habitat imaging to capture intratumoral heterogeneity, assess treatment-induced microstructural changes, and identify high-risk patterns associated with LR in SC patients treated with CIRT. These findings support the integration of microstructural and habitat-based imaging as a non-invasive tool for risk stratification and personalized treatment planning in CIRT for SC.

PMID:41455110 | DOI:10.1002/mp.70208

Environ Sci Technol. 2025 Dec 27. doi: 10.1021/acs.est.5c10153. Online ahead of print.

ABSTRACT

Knowledge of ground-level ozone (O₃) formation in the Southern Hemisphere is limited due to the lack of long-term in situ O₃ observations. Here, we analyzed the ground-based measurement data of O₃, formaldehyde (HCHO), nitrogen dioxide (NO₂), and benzene, toluene, and xylene (BTX) collected from 2011 to 2020 at two sites in eastern Australia, namely, Memorial Park and Springwood. Only HCHO at Memorial Park showed a statistically significant upward trend (0.19 ppb yr^-1). Compared with the sea-influenced air masses, the land-influenced air masses were observed to enhance all pollutant concentrations at two sites. According to the site-specific sensitivity of the O₃ to the HCHO-to-NO₂ ratio (FNR), the daytime formation of the O₃ at two sites was mainly in the volatile organic compound (VOC)-limited regime. When the long-term variability of NO₂ was weak, HCHO, particularly from primary emissions indicated by BTX, was observed to predominantly control the monthly FNR at each site over time. Our work underscores the importance of long-term in situ measurements in interpreting ground-level O₃ formation and potentially informs future O₃ studies in other areas in the Southern Hemisphere.

PMID:41455097 | DOI:10.1021/acs.est.5c10153

Aliment Pharmacol Ther. 2025 Dec 27. doi: 10.1111/apt.70492. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Disentangling whether disordered eating is a cause, consequence or manifestation of inflammatory bowel disease (IBD) symptoms remains a challenge. We conducted an updated systematic review and the first meta-analysis to estimate the prevalence of eating disorders in individuals with IBD.

METHODS: We systematically searched MEDLINE, Embase and PsycINFO from inception to 28 October 2025, for original observational studies reporting the prevalence of at least one eating disorder in an IBD population. Pooled prevalence estimates were calculated using random-effects models and stratified by IBD type, sex, age and assessment method. Between-study heterogeneity was assessed using Q and I² statistics.

RESULTS: Twenty-three studies were included. Prevalence estimates varied substantially depending on how eating disorders were assessed. Studies using self-report questionnaires yielded a pooled prevalence of 13.60% (95% CI = 9.86%-17.81%; I² = 90.7%; n = 18), whereas studies employing physician-assigned diagnoses yielded a lower pooled prevalence of 2.84% (95% CI = 0.00%-9.03%; I² = 99.9%; n = 5). The highest prevalence was observed in studies using the Nine-Item Avoidant/Restrictive Food Intake Disorder Screen, with a pooled estimate of 17.10% (95% CI = 12.81%-21.88%; I² = 87.4%; n = 9). No significant differences in prevalence were found by sex, IBD subtype, age at time of study or disease activity.

CONCLUSIONS: Eating disorders are prevalent among individuals with IBD, particularly avoidant/restrictive types. These findings highlight the need for improved screening and greater clinical awareness to better detect and manage disordered eating in the IBD population.

PMID:41455094 | DOI:10.1111/apt.70492