Tag: statistics

Expert Rev Med Devices. 2025 Sep 19. doi: 10.1080/17434440.2025.2563619. Online ahead of print.

ABSTRACT

BACKGROUND: The goal of this study is to perform a propensity score matched analysis of sutureless AVR and TAVR to compare patient characteristics and postoperative outcomes including hemodynamic performance.

METHODS: Patients treated by either sutureless aortic valve replacement (SU-AVR) using Perceval^TM or transcatheter aortic valve replacement between Oct. 2017 and June 2022 were included. Propensity score matching (PSM) was used to limit the bias of a non-randomized study.

RESULTS: After PSM, 118 pairs of patients were obtained. The in-hospital mortality rate was 0% in SU-AVR and 4.2% in TAVR (p = 0.063). Postoperative complications rates including disabling stroke (0% vs 2.5%, p = 0.250), new need for dialysis (1.7% vs 0%, p = 0.500) and permanent pacemaker implantation at 30 days (5.9% vs 10.2%, p = 0.332) showed no statistical difference. At discharge, TAVR showed significantly lower peak and mean gradients, while paravalvular leakage higher than 1/4 significantly higher in TAVR (11% vs 0%, p < 0.001).

CONCLUSIONS: TAVR offers significantly better transprosthetic gradients, shorter ICU and hospital stay and less need for postoperative dialysis. Surgery using a sutureless valve showed less paravalvular leakage.

PMID:40970339 | DOI:10.1080/17434440.2025.2563619

Am J Biol Anthropol. 2025 Sep;188(1):e70126. doi: 10.1002/ajpa.70126.

ABSTRACT

OBJECTIVES: This study evaluates molar wear progression in a captive baboon population under controlled dietary and environmental conditions. By comparing the dentin exposure ratio (DER) with a newly developed quadrant-based modification of Scott’s dental wear scoring system (Krueger-Scott method), we evaluate how wear patterns vary by age, sex, and occlusal region.

MATERIALS AND METHODS: Mandibular second molars (M₂) were assessed at two timepoints, during life and postmortem, in 201 captive baboons from the Southwest National Primate Research Center. Krueger-Scott and DER data were collected from 3D intraoral scans processed in MEDIT Link software. The Krueger-Scott scores assigned ordinal scores (1-10) to four equal quadrants of each M₂ based on enamel facet development and dentin exposure. Statistical analyses tested relationships between wear progression, quadrant location, sex, and age.

RESULTS: Krueger-Scott scores and DER values increased significantly between timepoints, indicating wear progression. However, Krueger-Scott scores revealed strong functional patterning: buccal and lingual cusps showed high within-group correlations and weaker cross-group correlations. Males showed significantly higher wear than females, despite being younger on average. The relationship between age and wear progression differed by sex.

DISCUSSION: The Krueger-Scott method provided a more anatomically informative and efficient approach to tracking occlusal wear than DER. It captured regional wear variation and functional asymmetries that DER could not detect. Even under controlled conditions, sex-based differences in wear emerged, likely reflecting behavioral, morphological, or enamel structural variation. These findings offer a comparative baseline and demonstrate the utility of quadrant-level scoring for interpreting wear in extant and extinct taxa.

PMID:40970332 | DOI:10.1002/ajpa.70126

Euro Surveill. 2025 Sep;30(37). doi: 10.2807/1560-7917.ES.2025.30.37.2500119.

ABSTRACT

INTRODUCTIONTuberculosis (TB) is curable and preventable, yet remains a health concern in vulnerable populations. Individuals experiencing homelessness are at increased risk owing to medical, environmental and social factors.AIMWe aimed to evaluate a 20-year TB screening programme in people experiencing homelessness in Brno, Czechia (2005-2024), and analyse additional TB diagnoses in this population made outside the project, to inform public health strategies for TB control in vulnerable groups in a low-incidence country.METHODSClinical examination and chest X-ray screening were offered to people without stable housing, incentivised by meal vouchers. Individuals with pathological findings underwent further diagnostic evaluation and treatment. Demographic and clinical data were collected. Additional TB diagnoses made in this population through other detection methods were analysed for comparison.RESULTSBetween 2005 and 2024, of 3,918 individuals approached, 2,664 participated in screening (average participation rate: 68.0%), and 18 were diagnosed with TB through the project. Another 132 individuals experiencing homelessness were diagnosed with TB through other pathways, yielding 150 diagnoses, representing 19.3% of TB notifications in Brno. The estimated TB incidence among people experiencing homelessness was 24.4 times higher than in the general population (95% confidence interval: 20.5-28.9). Despite a citywide decline in TB incidence, the proportion of TB diagnoses among people who experience homelessness increased over time.CONCLUSIONHomelessness is a risk factor for TB in low-incidence settings. This long-term screening initiative proved feasible and valuable, demonstrating how outreach-based screening can support early detection and contribute to TB prevention among socio-economically marginalised populations.

PMID:40970305 | DOI:10.2807/1560-7917.ES.2025.30.37.2500119

Stroke. 2025 Sep 19. doi: 10.1161/STROKEAHA.125.052121. Online ahead of print.

ABSTRACT

BACKGROUND: The benefit of endovascular thrombectomy (EVT) beyond 24 hours from last known well in acute ischemic stroke remains uncertain. Although some slow progressors may retain salvageable tissue, supporting evidence in this ultra-late window comes mainly from small observational studies.

METHODS: We systematically searched PubMed, Embase, Scopus, Web of Science, and Cochrane Central up to February 2025 for studies comparing EVT and best medical therapy in patients with acute ischemic stroke treated >24 hours from last known well. Eligible studies reported functional independence (90-day 0-2 modified Rankin Scale score), excellent clinical outcome (90-day 0-1 modified Rankin Scale score), symptomatic intracranial hemorrhage, or 90-day mortality. Pooled unadjusted and adjusted odds ratios (ORs) with 95% CIs were calculated using random-effects meta-analyses. Subgroup analyses were performed by study design, stroke severity, imaging modality, and occlusion territory. Statistical heterogeneity was assessed using the I² statistic and the Cochran Q test, and the certainty of evidence (CoE) was assessed using the Grading of Recommendation, Assessment, Development, and Evaluation approach.

RESULTS: Ten observational studies (3 prospective and 7 retrospective) comprising 1871 patients (EVT: 866; best medical therapy: 1009) were included. EVT was associated with significantly higher odds of functional independence (8 studies; adjusted OR, 4.62 [95% CI, 3.30-6.47]; I²=0%; low CoE) and excellent clinical outcome (2 studies; adjusted OR, 5.68 [95% CI, 2.49-12.97]; I²=0%; very-low CoE). EVT increased the risk of symptomatic intracranial hemorrhage (4 studies; adjusted OR, 9.54 [95% CI, 3.78-21.07]; I²=0%; low CoE), but 90-day mortality did not differ significantly between groups (4 studies; adjusted OR, 0.63 [95% CI, 0.30-1.31]; I²=41.2%; very-low CoE). All subgroup analyses aligned with the main findings.

CONCLUSIONS: Our results revealed that EVT was associated with improved functional outcomes without an increase in 90-day mortality, despite a higher symptomatic intracranial hemorrhage risk. Given the limited CoE and overall study quality, ongoing randomized trials are essential to confirm these findings and guide patient selection in the ultra-late time window.

PMID:40970285 | DOI:10.1161/STROKEAHA.125.052121

J Addict Dis. 2025 Sep 19:1-8. doi: 10.1080/10550887.2025.2464328. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study is to report on a patient case in which transcranial direct current stimulation (tDCS) was used to treat gambling disorder (GD).

METHODS: The research method used is a single case study, with the participant selected using purposive sampling. The patient is a 28-year-old married man who has been gambling for five years. Research tools included Gambling Symptoms Assessment scale, Impulsiveness Scale, Depression and Anxiety Inventory, and functional magnetic resonance imaging (fMRI). The intervention protocol included stimulation for 10 consecutive days, 20 min per day, with a current of 1.5 mA, and montage with the anodal electrode over F3 and the cathodal electrode over F4. Data were analyzed by fMRI and statistical parametric mapping (SPM) software.

RESULTS: Findings suggest that intervention with tDCS may be effective in reducing the symptoms of GD, depression, anxiety and impulsivity.

DISCUSSION: This is the first report of tDCS effectiveness and feasibility in a case report utilizing an fMRI outcome. While results of this case report are promising, more robust studies are required to establish therapeutic efficacy of tDCS in GD.

PMID:40970274 | DOI:10.1080/10550887.2025.2464328

Int J Womens Health. 2025 Sep 13;17:3031-3044. doi: 10.2147/IJWH.S525981. eCollection 2025.

ABSTRACT

BACKGROUND: Breast density is an important yet often overlooked factor in breast cancer screening. Limited awareness among women can hinder informed decision-making, especially in regions without standardized breast density notification, such as Saudi Arabia.

OBJECTIVE: This study aimed to assess awareness, knowledge, and educational needs related to breast density among women in Saudi Arabia.

METHODS: A nationwide, cross-sectional survey was conducted using a structured online questionnaire. Saudi women aged 30 years and older were recruited via convenience sampling through social media platforms and targeted mailing lists. The survey collected demographic data and assessed participants’ breast density (BD) awareness, knowledge, perceived risk, and preferred information sources. Data analysis included both descriptive and inferential statistical methods.

RESULTS: 1,021 Saudi women (30-75 years old) participated in this study. Only 11.4% of the sample had heard of breast density, and less than half of those (5%) understood its association with breast cancer risk. Women with higher education and previous mammography experience had significantly higher awareness (OR: 5.00, 95% CI: 2.18-11.45; p<0.001 and 1.81, 95% CI: 1.15-2.86; p=0.010, respectively). A vast majority (80%) expressed interest in being informed about their breast density, and more than half (56.3%) are willing to pay for additional imaging if they had dense breast tissue.

CONCLUSION: Awareness of breast density among women in Saudi Arabia is remarkably low, likely due to the absence of structured education, lack of provider-patient communication, and no national notification policy. Despite this, women express a clear willingness to receive related information. There is a critical need for targeted education on breast density. National health strategies should prioritize breast density awareness and standardized communication in breast cancer screening programs.

PMID:40970264 | PMC:PMC12442907 | DOI:10.2147/IJWH.S525981

Western Pac Surveill Response J. 2025 Sep 1;16(3):1-7. doi: 10.5365/wpsar.2025.16.3.1176. eCollection 2025 Jul-Sep.

ABSTRACT

OBJECTIVE: To outline the management of an outbreak of invasive group A Streptococcus (iGAS) in a residential aged-care facility in rural Queensland, Australia, comparing outbreak management with the newly released Australian Series of National Guidelines (SoNG) for this disease and exploring unique aspects of rural iGAS outbreak management.

METHODS: An outbreak of iGAS was identified in a rural Queensland residential facility, where two cases occurred within 24 hours. A confirmed case was defined as any individual linked to the facility who had laboratory evidence of group A Streptococcus (GAS) in a sterile site. Whole genome sequencing was performed on all confirmed cases. The public health management of this outbreak was conducted according to the Queensland Communicable Disease Control guidelines and was compared with the new SoNG.

RESULTS: A phylogenetic tree confirmed that the two samples clustered closely together with a single allele difference. Chemoprophylaxis was offered to all residents and staff in the affected part of the facility; 95% (42/44) of residents consented to chemoprophylaxis. Increased surveillance for GAS and increased facility cleaning were recommended by the public health unit. No additional cases were identified after 30 days of surveillance. Management of the outbreak largely aligned with the SoNG except for post-outbreak surveillance, which would have been extended under the new guidelines.Discussion: This paper highlights factors unique to managing iGAS outbreaks in rural areas. Rural workforce factors and access to pathology services impact rural outbreak management, and thus involving local services and considering the local context are vital. The use of chemoprophylaxis continues to be recommended by the SoNG, and in this case was considered to be an important adjunct to other management strategies.

PMID:40970256 | PMC:PMC12441184 | DOI:10.5365/wpsar.2025.16.3.1176

Cureus. 2025 Sep 6;17(9):e91713. doi: 10.7759/cureus.91713. eCollection 2025 Sep.

ABSTRACT

Introduction Successful laryngeal mask airway (LMA) insertion requires suppression of airway reflexes and adequate jaw relaxation. Although propofol is the preferred induction agent, higher doses may cause adverse hemodynamic and respiratory effects. Adjuvants such as opioids or dexmedetomidine can enhance insertion conditions while minimizing propofol requirements. This pilot study compared dexmedetomidine-propofol and fentanyl-propofol combinations in terms of LMA insertion conditions and hemodynamic responses. Materials and methods In this prospective, randomized, double-blind pilot study, 40 American Society of Anesthesiologists (ASA) I and II patients were randomized to receive either an intravenous infusion of 1 microgram per kilogram of dexmedetomidine (Group D, n=20) diluted to 20 ml, or normal saline 20 ml (Group F, n=20) administered over 10 minutes. Following this, Group F received 1 microgram per kilogram of fentanyl over two minutes, while Group D received an equivalent volume of normal saline. All patients were induced with 1.5 mg/kg of propofol. The primary outcome was the ease of LMA insertion, assessed by jaw mobility and the presence of adverse airway reflexes (coughing, gagging, or movement during insertion), which was noted and scored. Secondary outcomes included heart rate (HR), systolic and mean arterial pressure, respiratory rate, and oxygen saturation, measured at baseline, pre-insertion, and at one, three, five, 10, 15, and 20 minutes post-insertion. Both the anesthesiologist administering the drugs and the investigator performing the insertion were blinded to group allocation. Results All patients in Group D had favorable LMA insertion scores (<2), while 30% in Group F had unfavorable scores (>2) (p=0.020). Apnea occurred in two patients in Group D and six patients in Group F. A statistically significant reduction in HR was observed in group D compared to group F; however, the values remained within the clinically acceptable range, without evidence of hemodynamic instability (HR before insertion (p<0.001), HR at one minute (p<0.001), HR at three minutes (p=0.026), HR at five minutes (p=0.022), and HR at 10 minutes (p=0.038)). Respiratory rate was significantly higher in Group D at the time points of one minute (p=0.003), three minutes (p=0.002), five minutes (p=0.011), 10 minutes (p=0.024), 15 minutes (p=0.007), and 20 minutes (p =0.002) post insertion. Conclusion When compared to fentanyl with propofol, dexmedetomidine with propofol provided effective conditions for LMA insertion with preserved respiratory function and comparable hemodynamic stability. Larger randomized studies are needed to confirm these findings and optimize dosing.

PMID:40970230 | PMC:PMC12441473 | DOI:10.7759/cureus.91713

Cureus. 2025 Sep 14;17(9):e92331. doi: 10.7759/cureus.92331. eCollection 2025 Sep.

ABSTRACT

BACKGROUND: Lipedema is a chronic disorder characterized by symmetrical and disproportionate fat accumulation, pain, and easy bruising, often resistant to conventional treatments. Functional dysmetria (FD), a maladaptive neuromotor response linked to epigenetic stress, has been proposed as a relevant contributor to pain in lipedema.

OBJECTIVE: This retrospective observational study aimed to evaluate whether correcting FD through the radioelectric asymmetric conveyer (REAC) technology Neuropostural Optimization (NPO) protocol can reduce pain in patients with lipedema, using a sham-controlled design.

METHODS: In this retrospective observational study, 83 consecutive women with stage 2-5 lipedema underwent both sham and real NPO procedures during a single session. Pain intensity was measured using the visual analog scale (VAS) immediately after each procedure. Statistical analyses were performed using paired t-tests with effect sizes (Cohen’s dz) and 95% confidence intervals.

RESULTS: Baseline pain was uniformly high (mean 7.41 ± 0.53), with some pre-sham values reaching 10/10. Pain reduction was observed exclusively after real NPO and not after sham. Sham NPO induced no significant changes, whereas real NPO yielded a mean pain reduction exceeding 3.5 VAS points across all stages (mean change -3.65 ± 0.62; 95% CI: -3.79 to -3.51; Cohen’s dz = 5.88, 95% CI: 4.85-6.92; p < 0.0001).

CONCLUSIONS: These findings suggest that correction of FD by REAC NPO provides rapid and clinically meaningful analgesic effects in lipedema patients, addressing an upstream neuropsychomotor dysfunction that may contribute to disease progression. However, given the retrospective single-center design and absence of long-term follow-up, these conclusions are limited to the short-term effects observed. Further multicenter and longitudinal studies are warranted to confirm these results and evaluate long-term outcomes.

PMID:40970229 | PMC:PMC12441218 | DOI:10.7759/cureus.92331

Bayesian Anal. 2022 Dec;17(4):1043-1071. doi: 10.1214/21-ba1287. Epub 2021 Sep 27.

ABSTRACT

Stacking is a widely used model averaging technique that asymptotically yields optimal predictions among linear averages. We show that stacking is most effective when model predictive performance is heterogeneous in inputs, and we can further improve the stacked mixture with a hierarchical model. We generalize stacking to Bayesian hierarchical stacking. The model weights are varying as a function of data, partially-pooled, and inferred using Bayesian inference. We further incorporate discrete and continuous inputs, other structured priors, and time series and longitudinal data. To verify the performance gain of the proposed method, we derive theory bounds, and demonstrate on several applied problems.

PMID:40970226 | PMC:PMC12442486 | DOI:10.1214/21-ba1287