Tag: statistics

Acta Epileptol. 2025 Jul 15;7(1):39. doi: 10.1186/s42494-025-00230-6.

ABSTRACT

Deep brain stimulation (DBS) has emerged as an important therapeutic intervention, effectively addressing a spectrum of drug-resistant neurological and psychiatric disorders. Although its efficacy has been validated in adult populations, the current literature reveals a significant gap concerning its application in pediatric patients. Specifically, pediatric populations afflicted with severe conditions such as dystonia, drug-resistant epilepsy, Tourette syndrome, and some other neuropsychiatric conditions demonstrate an urgent need for alternative therapeutic options. This review systematically examined the existing literature on the application of DBS in pediatric neurological disorders, focusing on the aforementioned conditions. Preliminary findings indicate that while DBS shows potential for a specific subset of pediatric patients, the current data is limited and lacks statistical power. Reported cases exhibit varying degrees of therapeutic success. Although adverse effects associated with DBS in pediatric populations are rare, further investigation is essential to define safety profiles accurately. Future research should focus on conducting large-scale, randomized controlled trials to validate outcomes and determine optimal patient selection criteria, thereby broadening its clinical application within the pediatric population.

PMID:40665432 | DOI:10.1186/s42494-025-00230-6

Eur J Med Res. 2025 Jul 16;30(1):632. doi: 10.1186/s40001-025-02893-w.

ABSTRACT

OBJECTIVE: Plenty of evidence proves the prospective diagnostic and prognostic utility of inflammatory markers in osteoporosis (OP). However, the relations of immune-inflammatory indices to OP remain elusive, with scarce conclusive evidence-based findings. Our systematic review and meta-analysis endeavored to unveil the links between immune-inflammatory indices and OP.

METHODS: PubMed, Web of Science, Embase, as well as Cochrane Library, were thoroughly retrieved for research investigating the links of immune-inflammatory indices to OP, from database inception to February 20, 2025. Data were analyzed using odds ratio (OR), standardized mean difference (SMD), as well as corresponding 95% confidence interval (CI). Sensitivity and subgroup analyses were carried out for result robustness evaluation and heterogeneity source identification. Review Manager 5.4 and STATA 18.0 were utilized in every statistical analysis.

RESULTS: A total of 24 studies were included in this analysis. Eight cohort studies and 16 case-control studies based on 397,525 subjects and 11,904 cases were eventually screened and retained. The findings indicated significant positive relations of immune-inflammatory indices to OP risk. For categorical variables, elevated neutrophil-to-lymphocyte ratio (NLR) (OR = 2.34, 95% CI 1.77-3.11; P < 0.00001), platelet-to-lymphocyte ratio (PLR) (OR = 1.05, 95% CI 1.01-1.08; P = 0.01), as well as systemic immune-inflammation index (SII) (OR = 1.16, 95% CI 1.04-1.30; P = 0.01) notably correlated with a increased OP risk. For continuous variables, individuals with OP exhibited significantly higher levels of NLR (SMD = 0.71, 95% CI 0.35-1.07; P = 0.0001), PLR (SMD = 0.43, 95% CI 0.17-0.68; P = 0.001), monocyte-to-lymphocyte ratio (MLR) (SMD = 0.54, 95% CI 0.16-0.91; P = 0.005), and SII (SMD = 0.25, 95% CI 0.03-0.47; P = 0.03) compared to non-OP populations. Subgroup analyses revealed that geographic region and age were major contributing factors influencing the association between immune-inflammatory indices and OP.

CONCLUSION: Immune-inflammatory indices such as NLR, PLR, MLR, and SII are significantly linked to increased risk of OP. These indices may facilitate the early identification of individuals at high risk for OP and support timely preventive strategies. Given the inherent limitations of the current study, further prospective, multicenter clinical investigations are warranted to validate the relations of immune-inflammatory indices to OP. Trial registration Systematic review registration: PROSPERO, identifier: CRD420250656296.

PMID:40665418 | DOI:10.1186/s40001-025-02893-w

Eur J Med Res. 2025 Jul 16;30(1):633. doi: 10.1186/s40001-025-02900-0.

ABSTRACT

BACKGROUND: Inflammation is a crucial factor in the development of both osteoporosis and sleep disturbances; however, the mechanisms that connect these two conditions are not yet fully understood. This study aims to investigate the relationship among inflammation, osteoporosis, and sleep disturbances, and to assess whether osteoporosis acts as a mediating factor between inflammation and sleep disturbances.

METHODS: This study conducted a cross-sectional analysis utilizing data from participants aged 50 and older, sourced from the NHANES database for the years 2005-2010 and 2017-2018. The primary objective was to investigate the associations among inflammatory markers, the Dietary Inflammatory Index (DII), osteoporosis, and sleep disturbances. All participants underwent measurement of inflammatory markers, including C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR). Additionally, DII scores were computed to assess dietary inflammation. To account for potential confounding variables, such as age, sex, and body mass index (BMI), we conducted multivariable regression analyses.

RESULTS: The results demonstrated that the ‘osteoporosis with sleep disturbances’ group exhibited significantly higher CRP levels and DII scores but lower NLR levels compared to the ‘without osteoporosis and sleep disturbances’ group. Among the four groups, two groups without sleep disturbances showed notably lower CRP levels. After controlling for potential confounding variables, we found a positive correlation among inflammatory markers, osteoporosis, and sleep disturbances. Notably, sex (with males as the reference group) moderated the relationship between inflammatory markers and sleep disturbances, demonstrating an adjusted effect size of – 0.430 for NLR (interaction p value = 0.008) and – 0.163 for CRP (interaction p value = 0.012). Additionally, a non-linear relationship was observed between NLR and sleep disturbances, as well as between NLR, DII, and osteoporosis. Mediation analysis indicated that osteoporosis partially mediates the effect of DII on sleep disturbances, accounting for 5.4574% of the total effect (p = 0.002).

CONCLUSIONS: Men may exhibit a reduced resistance to inflammation-induced sleep disturbances in comparison to women. An increase in the DII may serve as a risk factor for both osteoporosis and sleep disturbances. Furthermore, osteoporosis partially mediates the relationship between the DII and sleep disturbances.

PMID:40665412 | DOI:10.1186/s40001-025-02900-0

BMC Sports Sci Med Rehabil. 2025 Jul 15;17(1):202. doi: 10.1186/s13102-025-01225-z.

ABSTRACT

PURPOSE: We conducted a systematic review and meta-analysis to identify factors influencing physical activity (PA) in children and adolescents aged 5-18 years through a social-ecological model (SEM) perspective. Additionally, we examined the combined effects of factors across SEM levels on PA behaviors.

METHODS: Following a comprehensive search of Chinese and English databases, two researchers independently screened studies, assessed quality, and selected 15 articles meeting inclusion criteria. A dual analytic approach was employed: semi-quantitative evaluation Method (systematic scoring of study findings to synthesize directional associations) and meta-analysis using R4.4.2 to pool effect sizes (Cohen’s d) with random-effects models. Subgroup analyses addressed heterogeneity sources.

RESULTS: Semi-quantitative synthesis revealed consistent positive associations for interpersonal-level factors, including parental co-participation in PA (83.3%), parental rules (66.7%), peer support (66.7%), and team sports participation (100%). At the individual level, self-efficacy (84.6%) and enjoyment (62.5%) showed the strongest effects. Meta-analysis confirmed multilevel SEM influences (SMD = 0.443,95%CI [0.784,0.885]), Due to variations in statistical methods (I² = 45.9-99.8%), survey setting scope (I² = 0-99.6%), geography (I² = 0.86-99.7%), and Research design (I² = 67.5-99.8%), there was a considerable degree of heterogeneity among the included studies.

CONCLUSIONS: Key findings indicated that at the individual level, PA engagement was significantly associated with perceived barriers, self-efficacy, motivation, and enjoyment. At the interpersonal level, parental co-participation, rule-setting, peer support, and team sports emerged as critical facilitators. However, meso-level factors (e.g., school physical education curricula, accessibility of community sports facilities, extracurricular programming) and macro-level structural determinants (e.g., national physical education policy alignment, urban built environment planning, sociocultural sports values) remain underexplored, with current research disproportionately focused on micro-level individual traits (e.g., motivation) and interpersonal dynamics (e.g., family support). The study recommends: (1) individual-level interventions prioritizing self-efficacy and intrinsic motivation enhancement; (2) interpersonal strategies fostering family-peer collaborative networks; (3) meso-level improvements to school PA curricula and equitable community infrastructure; and (4) macro-level research on policy coherence and sociocultural value systems. Future investigations should integrate longitudinal designs within social-ecological frameworks to elucidate dynamic interactions across multilevel factors, thereby advancing theoretical and policy frameworks for youth PA promotion. These insights provide empirical foundations for optimizing school-based PA initiatives, urban planning for active spaces, and culturally responsive community interventions.

TRIAL REGISTRATION: PROSPERO CRD420250651231.

PMID:40665401 | DOI:10.1186/s13102-025-01225-z

Parasit Vectors. 2025 Jul 15;18(1):284. doi: 10.1186/s13071-025-06917-6.

ABSTRACT

BACKGROUND: Chagas disease, caused by the protozoan Trypanosoma cruzi, remains a significant public health issue in South America, with increasing concern over its potential transmission in the USA. Triatoma sanguisuga, a triatomine vector, is found in Southern states of the USA, including Texas, raising questions about the local transmission dynamics of T. cruzi. This study aims to characterize Trypanosoma cruzi infection in Triatoma sanguisuga collected from dog kennels in Bulverde and Spring Branch, Texas, with a focus on parasite prevalence and load, genotypic diversity, and blood-feeding sources.

METHODS: A total of 48 T. sanguisuga insects were collected from kennels in Bulverde (N = 37) and Spring Branch (N = 11). DNA extraction was followed by quantitative polymerase chain reaction (qPCR) to detect and quantify T. cruzi, genotyping via Oxford Nanopore Sequencing of the Miniexon gene, and blood-feeding source identification using the 12S rRNA gene was also conducted. Statistical analysis was performed to assess differences in parasitic load among the locations.

RESULTS: Of the 48 insects, 81.1% from Bulverde and 100% from Spring Branch tested positive for T. cruzi. The median parasitic load was log₁₀ 8.09 equivalent parasites/mL, with significant differences in parasitic load between locations. Genotyping revealed that all samples were infected with TcI, with some co-infection of TcI and TcIV. Blood meal analysis identified multiple feeding sources, including dogs (Canis lupus), humans (Homo sapiens), and wildlife species.

CONCLUSIONS: This study provides insights into T. cruzi transmission dynamics in southern Texas, demonstrating the active role of domestic dogs and wildlife in the local cycle of infection suggesting endemism of T. cruzi in this region. These findings emphasize the need for continued surveillance and vector control measures to mitigate the risk of Chagas disease transmission in the USA.

PMID:40665373 | DOI:10.1186/s13071-025-06917-6

Child Adolesc Psychiatry Ment Health. 2025 Jul 15;19(1):77. doi: 10.1186/s13034-025-00942-0.

ABSTRACT

BACKGROUND: Burnout symptoms and secondary traumatic stress are especially high among Child Welfare Workers (CWWs) and psychotherapists and might have increased since the recent increase in refugee numbers. Little is known about the wellbeing of CWW and psychotherapists working with unaccompanied young refugees (UYR), especially in German child and youth welfare facilities where they work closely together. This study aims to assess levels of compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in German CWWs and psychotherapists, examining connections to demographic variables and group differences.

METHODS: N = 198 CWW and N = 97 psychotherapists were assessed via the Professional Quality of Life Scale (ProQOL). Descriptive statistics, t-test for independent samples, correlations between the ProQOL scales and hierarchical regression analyses with demographic variables as predictors were computed.

RESULTS: Both samples showed average to high levels of CS, and low to average levels of BO and STS. CWWs scored significantly higher than psychotherapists on BO and STS. In CWW, demographic variables were not associated with CS, BO or STS. Among psychotherapists, previous experiences in working with UYR (β = 0.38; p <.001) were positively associated with CS. Factors such as weekly therapy sessions (β = – 0.35, p =.001) and the psychotherapist’s migration background (β = – 0.20, p =.048) were negatively associated with STS. The number of PTSD cases treated (β = 0.27, p =.018) and additional training (β = 0.31, p =.006) were positively associated with STS.

CONCLUSION: Among psychotherapists, prior experience in working with UYRs may contribute to elevated levels of CS, whereas a higher number of previously treated PTSD cases appears to be associated with increased STS. Further research on the influence of sociodemographic variables is needed for CWWs to identify protective and risk factors. Supporting and training CWWs and psychotherapists is crucial for quality treatment of traumatized UYRs.

PMID:40665365 | DOI:10.1186/s13034-025-00942-0

Cardiovasc Diabetol. 2025 Jul 15;24(1):289. doi: 10.1186/s12933-025-02824-3.

ABSTRACT

BACKGROUND: We investigated the risk of type 2 diabetes (T2DM) and related comorbidities including cardiovascular disease (CVD), and mortality, based on changes in metabolic dysfunction associated steatotic liver disease (MASLD).

METHODS: We analyzed data from the Korean National Health Insurance Service for individuals aged ≥ 20 years. MASLD was defined as a fatty liver index (FLI), a prediction formula based on metabolic parameters, with a cutoff of ≥ 60. FLI measurements were compared within each individual over a 2 years period. Based on changes in FLI between two health checkups, individuals were classified into four categories; never MASLD (FLI consistently < 60), incident MASLD (FLI < 60 to ≥ 60), regressed MASLD (≥ 60 to < 60), and persistent MASLD (FLI consistently ≥ 60). The primary outcome was T2DM occurrence in the general population and myocardial infarction (MI), ischemic stroke, heart failure (HF) and mortality events in individuals with preexisting T2DM with adjustment for age, sex, smoking, alcohol drinking, and regular exercise.

RESULTS: In 4,397,808 individuals without T2DM, 229,475 (5.2%) developed T2DM during a median follow-up period of 7.3 years. The risk of incident T2DM was the highest in individuals with persistent MASLD compared to those who never had MASLD (HR = 5.28, 95% CI = 5.22-5.34). Individuals with incident or regressed MASLD also had increased risk of developing T2DM (HR = 3.30, 95% CI = 3.25-3.35 for incident MASLD, HR = 2.87, 95% CI = 2.82-2.92 for regressed MASLD). In a cohort of 636,520 individuals with preexisting T2DM followed for a median of 6.2 years, those with persistent MASLD had a higher risk of HF (HR = 1.28, 95% CI = 1.25 to 1.32), MI (HR = 1.15, 95% CI = 1.10 to 1.20), stroke (HR = 1.14, 95% CI = 1.09 to 1.19) and all-cause mortality (HR = 1.11, 95% CI = 1.09-1.14) compared to individuals who never had MASLD. Similarly, both incident and regressed MASLD were associated with an increased risk for HF, MI, stroke and all-cause mortality.

CONCLUSIONS: Persistent MASLD is associated with an increased risk of incident T2DM, and further elevates the risk of CVD, and mortality among individuals with T2DM. Even individuals with incident or regressed MASLD exhibit an increased risk of these adverse outcomes compared to those who never had MASLD.

TRIAL REGISTRATION: N/A.

PMID:40665356 | DOI:10.1186/s12933-025-02824-3

BMC Vet Res. 2025 Jul 15;21(1):468. doi: 10.1186/s12917-025-04919-1.

ABSTRACT

BACKGROUND: Non-invasive temperature measurement using infrared cameras has become increasingly important for monitoring physiological changes and stress responses in animals, offering advantages over traditional rectal thermometry. However, previous methods often suffered from limitations such as environmental interference, instantaneous measurement, and inaccurate region of interest (ROI) selection due to manual settings. To overcome these limitations, studies have combined infrared cameras with AI-based segmentation to enable accurate ROI detection and to capture temporal temperature change patterns in cattle. Furthermore, the interpretability of eye and muzzle temperature measurements can vary depending on which subregions are analyzed, as areas with richer vascularization tend to display more representative temperature characteristics. To address these issues, the present study applied AI-based segmentation to infrared thermography and focused on the analysis of high-temperature, vascularized subregions within the eyes and muzzles of calves. By doing so, we aimed to enhance the clarity and reliability of temperature change pattern analysis for non-invasive monitoring of physiological status in cattle.

METHODS: Thermal images were captured using a mobile infrared camera, and video recordings were obtained simultaneously from 11 calves. AI-based segmentation, utilizing previously trained weights, was used to automatically extract eye and muzzle ROIs from video images. 33 imaging sessions where the majority of frames exhibited reliable segmentation were selected for analysis. In Experiment 1, temperature data corresponding to the mean, top 10%, and top 30% values within each ROI underwent preprocessing steps (outlier rejection, standardization, and low-pass filtering) to derive temperature change patterns. This process generated six patterns per session (three for eyes and three muzzle regions), yielding a total of 198 patterns across all 33 image sessions. Cosine similarity analysis was then applied to quantify similarity within the same session. In Experiment 2, each ROI was divided into a 3 × 3 grid to map the distribution of high temperature values for spatial analysis. Statistical analyses included Kruskal-Wallis tests with Bonferroni corrections to assess regional differences.

RESULTS: In Experiment 1, for the eyes, the patterns derived from the top 10% and 30% of temperatures had high cosine similarity (0.94). In contrast, the patterns based on the mean values had relatively lower similarities with the top 10% and 30% patterns (0.81 and 0.86, respectively). A similar trend was observed for the muzzle: the top 10% and 30% patterns had a high cosine similarity (0.93), while the patterns based on the mean values showed lower similarities (0.80, and 0.86). In Experiment 2, for the eyes, the top 10% of temperature values were mainly in the bottom region. In comparison, the top 30% of values were more evenly distributed in the mid and bottom regions. For the muzzles, the top 10% of temperature values were mainly distributed in both the top and bottom regions, and the top 30% of values were concentrated in the mid region.

CONCLUSION: This study demonstrates that integrating AI-based segmentation with infrared thermography enables precise identification of thermally reliable subregions within the eyes and muzzles of calves, leading to the extraction of temperature change patterns with high temporal consistency. The top 10% and 30% temperature values within these regions show higher pattern similarity than mean values, with distinct spatial distributions reflecting underlying vascular anatomy. Focusing on these high-temperature, vascularized subregions enhances the interpretability and reliability of temperature change pattern analysis for non-invasive monitoring of stress and physiological status in cattle, contributing to enhanced animal welfare.

PMID:40665350 | DOI:10.1186/s12917-025-04919-1

J Orthop Surg Res. 2025 Jul 15;20(1):659. doi: 10.1186/s13018-025-06092-5.

ABSTRACT

BACKGROUND: Novel oral anticoagulants (NOACs), including rivaroxaban, apixaban, edoxaban and dabigatran, are increasingly used for orthopaedic surgery patients. The aim of this study was to evaluate the efficacy and safety of NOACs in preventing venous thromboembolism (VTE) among patients with lower limb fractures.

MATERIALS AND METHODS: This meta-analysis included randomized controlled trials (RCTs). The PubMed, Embase, Cochrane Library, and Web of Science databases were comprehensively searched from inception to November 27, 2024. We evaluated the risk of bias via the Cochrane Risk of Bias Tool 2.0 (RoB 2.0). The efficacy outcomes focused on VTE, deep vein thrombosis (DVT), and pulmonary embolism (PE), and the safety outcomes focused on major bleeding events. Two researchers screened the literature on the basis of the inclusion and exclusion criteria, evaluated the quality of the included studies, extracted the data, and conducted a meta-analysis using RevMan 5.4.1.

RESULTS: The systematic search yielded 2,873 unique citations after deduplication. Ultimately, five RCTs involving 4,092 participants (2,066 participants in the NOAC group (rivaroxaban and edoxaban) and 2,026 participants in the LMWH group) were included. Pooled analysis revealed that NOACs reduced the incidence rate of DVT [OR = 0.48, 95% CI (0.23-0.97), P = 0.04; I²=10%]. However, there was no significant difference in the incidence of VTE [OR = 0.42, 95% CI (0.16-1.11), P = 0.08; I²=34%], PE [OR = 0.33, 95% CI (0.05-2.08), P = 0.24; I²=0%] or major bleeding [OR = 1.01, 95% CI (0.57-1.77), P = 0.98; I²=0%] between the LMWH group and the NOACs group.

CONCLUSIONS: Compared with LMWH, NOACs were associated with a lower risk of DVT in patients with lower limb fractures, although there was no statistically significant difference in preventing VTE, PE and major bleeding.

CLINICAL TRAIL NUMBER: No. CRD42024619453.

PMID:40665327 | DOI:10.1186/s13018-025-06092-5

BMC Med Educ. 2025 Jul 15;25(1):1058. doi: 10.1186/s12909-025-07673-y.

ABSTRACT

BACKGROUND: Cone Beam Computed Tomography (CBCT) plays a critical role in oral and maxillofacial surgery (OMFS), yet the training needs of residents regarding CBCT viewer interfaces remain underexplored. Effective utilization of these interfaces is essential for accurate diagnosis and treatment planning. This study aims to assess OMFS residents’ competencies in CBCT viewer interfaces and identify training gaps through a usability framework.

METHODS: OMFS residents participated in a usability evaluation of five CBCT viewer interfaces (VIS: Icad Vision, NNT: Newtom, ODM: OnDemand, OVV: OneVolume Viewer, ROM: Planmeca Romexis). Effectiveness was measured through task completion rates, efficiency through task duration, mouse clicks, and cursor distance, and satisfaction using the System Usability Scale (SUS) and the Computer System Usability Questionnaire (CSUQ). Statistical analysis included Friedman and Dunn’s tests with Benjamini-Hochberg correction.

RESULTS: Residents reported receiving no hands-on CBCT training and relied only on verbal instruction during dental school, suggesting a lack of structured training. All of them successfully completed tasks on all interfaces, indicating 100% effectiveness. However, significant differences in efficiency and satisfaction were observed, reflecting varying levels of proficiency and highlighting areas where further training could be beneficial. VIS interface required significantly more time (198.4 ± 70.44 s) and mouse clicks (69.82 ± 33.17, p < 0.05) compared to other interfaces, suggesting a need for additional practice with this interface. The ODM interface achieved the highest SUS score (69.89 ± 22.79), while the VIS interface had the lowest (41.82 ± 22.90) (p < 0.05). Only ODM approached the industry-standard threshold for user satisfaction, while the remaining systems failed to meet this criterion.

CONCLUSIONS: This study highlights the need for structured training in CBCT viewer interfaces for OMFS residents. Findings suggest that a standardized, hands-on multi-software program should be integrated into residency curricula to improve efficiency, reduce cognitive load, and enhance clinical decision-making. Future research should focus on the long-term impact of usability-driven training on clinical performance and patient outcomes.

PMID:40665326 | DOI:10.1186/s12909-025-07673-y