Tag: statistics

Pediatr Blood Cancer. 2025 Feb 16:e31609. doi: 10.1002/pbc.31609. Online ahead of print.

ABSTRACT

BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a red cell enzymopathy in which exposure to oxidative stressors, such as drugs or fava bean ingestion, can trigger acute hemolytic episodes (AHEs). This study aimed to compare the clinical characteristics of fava bean-induced hemolysis (FBIH) with non-fava bean-induced hemolysis (NFBIH) in children with G6PD deficiency in a high-prevalence setting.

METHODS: A prospective cohort study was conducted at a region referral hospital in Oman. Hospital records of children hospitalized for AHE due to G6PD deficiency over a 3-year period were analyzed. Participants were categorized into FBIH and NFBIH groups based on the documented precipitating factor.

RESULTS: Among the 236 recruited cases, 51.6% AHEs were attributed to FBIH. Children with FIBH were younger, more likely to present with abdominal pain, and had greater severity of hemolysis upon admission (hemoglobin: 4.8 vs. 6.7 g/dL; p < 0.001). Lab markers such as serum ferritin, blood urea, lactate dehydrogenase, and alkaline phosphatase were significantly elevated in FBIH. The least squares regression model demonstrated a strong link between various predictor variables and hemoglobin levels, explaining about 76.6% of the variance in the study cohort.

CONCLUSION: Children with FBIH experience more severe hemolytic episodes compared to those with NFBIH. Our statistical model identified clinical and laboratory parameters potentially useful in early risk stratification during AHEs. Culturally sensitive dietary education of patients and caregivers is necessary, particularly in regions where fava beans are a dietary staple. The potential influence of specific G6PD genotypes within the NFBIH group merits future investigation.

PMID:39956941 | DOI:10.1002/pbc.31609

J Int AIDS Soc. 2025 Feb;28(2):e26422. doi: 10.1002/jia2.26422.

ABSTRACT

INTRODUCTION: Oral HIV pre-exposure prophylaxis (PrEP) is highly effective, but adherence is challenging for young women. Products centred around women’s preferences could address adherence barriers. Using a longitudinal discrete choice experiment (DCE), we examined young African women’s preferences around PrEP product formulation and delivery attributes before and after initiating oral PrEP.

METHODS: We enrolled HIV-negative women from six African countries in a prospective cohort from August 2022 to June 2023. Women completed two DCEs on PrEP products and PrEP delivery. At enrolment and month 1, participants completed the DCE about PrEP products with 16 randomly assorted choice sets assessing product form and dosing, dose forgiveness, drug reversibility, weight change and antiretroviral or immune-based mechanism attributes. At month 3, participants completed the DCE about PrEP delivery evaluating preferences related to location to collect doses, packaging, product storage, type of HIV test and costs. Preference weights (PW) were estimated with a hierarchical Bayesian model; higher positive numbers indicate greater preference for an attribute. Importance scores compare relative importance across the five attributes; higher scores indicate greater importance.

RESULTS: Two thousand eight hundred and forty-seven women completed enrolment and month 1 DCEs; the median age was 24 years (range: 16-30) and 92.8% initiated daily oral PrEP. Product form and dosing was the most important attribute at enrolment and month 1. At enrolment, women preferred small oral pills taken monthly (preference weight [PW]: 0.67; 95% confidence interval [CI]: 0.58-0.77), and at month 1, they preferred a 6-monthly injection (PW: 0.56; 95% CI: 0.46-0.65). In the month 3 DCE, location was the most important PrEP delivery attribute with a strong preference for a youth-friendly or non-governmental organization (PW: 0.25; 95% CI: 0.19-0.30) or health facility (PW: 0.21; 95% CI: 0.17-0.25); mobile clinic or van was least preferred. The cost of the product was the second most important product delivery attribute.

CONCLUSIONS: Young African women preferred discreet, less frequently administered PrEP formulations, particularly after 1 month of taking daily oral PrEP. Long-acting formulations are needed to meet women’s preferences. Coupled with the preferred PrEP delivery location and cost, the highlighted PrEP product characteristics have the potential to increase PrEP uptake.

PMID:39956930 | DOI:10.1002/jia2.26422

BMC Res Notes. 2025 Feb 16;18(1):69. doi: 10.1186/s13104-025-07147-w.

ABSTRACT

OBJECTIVE: Stunting is a condition of impaired growth in children resulting from chronic malnutrition, characterized by shorter stature compared to peers of the same age. This condition leads to salivary gland dysfunction, which triggers oral dysbiosis and increases the risk of periodontal disease in children. Scaling and root planing (SRP) is the gold standard treatment for periodontal disease, aimed at reducing pathogenic bacterial populations. This study aimed to evaluate the effect of SRP treatment on the oral microbiome profile in the saliva of stunted children. A pre- and post-test study design was employed, involving 10 elementary school children divided into two groups: normal children and stunted children. Each participant underwent scaling, with saliva samples collected before and after the procedure. The oral microbiome profile was analyzed using next-generation sequencing, generating taxonomic data at the phylum, genus, and species level.

RESULT: Statistical analysis revealed significant changes in the gingival index, a clinical parameter, in the normal group but not in the stunted group. Scaling resulted in shifts in the microbiome profile in both groups, with the dominant phyla identified as Proteobacteria, Bacteroidota, and Firmicutes. Scaling procedure alters the oral microbiome profile in stunted children without affecting the clinical parameter.

PMID:39956914 | DOI:10.1186/s13104-025-07147-w

BMC Health Serv Res. 2025 Feb 17;25(1):260. doi: 10.1186/s12913-025-12392-7.

ABSTRACT

BACKGROUND: The goal of the Integrated Access to Cancer Screening (IACS) initiative was to help reduce the disparity in cancer screening participation across Alberta by implementing an integrated mobile service delivery model for breast, cervical, and colorectal cancer screening in rural and remote communities in Northern Alberta, performed by Nurse Practitioners (NPs) that addressed barriers to access. The aim of this study was to evaluate the outcomes and impact the IACS initiative had on the communities and residents of Northern Alberta. This article describes the initiative design, implementation, outcomes, and impact of the initiative.

METHODS: The IACS model was implemented in a total of 36 visited communities in Northern Alberta from December 2020 to December 2021. The impact of the IACS initiative was measured using a mixed methods approach. The participation rate, cancer screening overdue status, and connection to a PCP were assessed using quantitative data collected through the existing clinical information system. Patient and provider feedback were collected from opened-ended surveys, and all data was analyzed by the research team. This study evaluated the impact the IACS initiative had on patient cancer screening participation and cancer screening knowledge, addressing known barriers to service delivery in rural and remote Northern Alberta, and to understand how this service might be sustained for future operation.

RESULTS: Six hundred fifty-three people participated in screening offered through the IACS initiative. 99% of Pap screenings offered to patients were accepted, and 98% of FIT kits were accepted from the NPs, with a completion rate of 84%. The clinical data and survey responses from patients and providers indicated support for sustaining the IACS initiative. The IACS model of screening was favoured by most female patients. It also increased screening uptake in the communities we visited in the North Zone of Alberta, where screening rates are low.

CONCLUSION: These findings highlight that the IACS initiative was well-received and brought value to underserved communities in Northern Alberta. The IACS model effectively facilitated screening for those who were overdue or have never been screened before. The reach of the IACS model was broader than anticipated, with those who are attached to a PCP also finding the integrated mobile screening model beneficial, bringing the services closer to home.

PMID:39956908 | DOI:10.1186/s12913-025-12392-7

BMC Med Educ. 2025 Feb 17;25(1):249. doi: 10.1186/s12909-025-06837-0.

ABSTRACT

BACKGROUND: Stroke is currently the second leading cause of death in Saudi Arabia (SA), with an annual incidence rate of 29 per 100,000 people. There is a huge demand for rehabilitation services for people who have had a stroke living in the community; however, the services in SA do not meet this need due to a lack of community rehabilitation services. Additionally, rehabilitation staff have reported a lack of knowledge and skills to deliver rehabilitation services for people post-stroke in the community. A first step towards developing these services is to train professionals working in this area to deliver community-based rehabilitation for patients with stroke. This is the first study to evaluate an online stroke training programme (STP) for physiotherapists in SA to enhance stroke care and enable them to deliver long-term care following the discharge of stroke patients.

METHODS: A sequential mixed methods design was adopted with three measurements undertaken pre-training, post-training questionnaires and one-month follow-up interviews. Participants were eligible if they were physiotherapists of any gender who were currently providing therapy to stroke patients and working in SA. The STP consisted of four modules and was delivered via an online platform. Questionnaires developed for this study were key outcome measures used to measure the change in the participants’ knowledge, confidence and attitude. Chi-Square test and Wilcoxon test were used to compare pre- and post-training results.

RESULTS: Twenty-six physiotherapists completed the STP. The results demonstrated a statistically significant increase (P < 0.05) in the participants’ knowledge and confidence in providing long-term care for patients with stroke. Additionally, the STP had a positive impact on the participants’ attitudes. Qualitative interviews post-training suggested that participants’ experiences of STP were positive. However, the training had limitations such as the lack of practical content and a short duration.

CONCLUSION: The STP was seen to be acceptable and found to improve participants’ knowledge and confidence in delivering long-term care for patients with stroke in this study. Future research should focus on evaluating impact of training in improvements in service delivery by physiotherapists.

PMID:39956892 | DOI:10.1186/s12909-025-06837-0

Eur Spine J. 2025 Feb 16. doi: 10.1007/s00586-025-08703-5. Online ahead of print.

ABSTRACT

PURPOSE: CT is considered the gold standard to assess bone morphology, whereas MRI is the imaging modality of choice to assess soft tissue. To reduce the ionising radiation exposure of the patient from CT, new MRI technologies have been developed to obtain images of bone. Two promising methods include MRI-based synthetic CT (sCT) and T1-weighted isotropic MRI.

METHODS: A prospective study including twenty-four adult patients receiving lumbar or sacral spine stabilisation surgery was performed. For each patient, two scans were acquired: a 3D dual echo T1-weighted gradient image, from which a sCT was reconstructed, and a 3D isotropic T1-weighted MRI sequence. Three observers assessed the sCT images for adequate visualisation of relevant vertebral anatomies and confidence using sCT in preoperative planning compared to the isotropic MRI based on a series of statements scored using a Likert-scale. Summary statistics and intraclass correlation coefficients were calculated.

RESULTS: All observers agreed that the sCT provided adequate visualization (94% of cases). Compared to the isotropic MRI, the sCT provided added value (89% of cases) and improved confidence (92% of cases) for the preoperative planning stage. No unexpected poor intraclass correlations were identified. The observers diagnosed patients with spondylolysis, scoliosis, arthrosis, spina bifida occulta, various Castellvi classifications, or without pathology.

CONCLUSIONS: sCT adequately visualised vertebral structures relevant for surgical spine planning with good confidence and added value for sCT compared to 3D T1-weighted isotropic MRI is shown. sCT could be a valuable method to reduce the radiation exposure associated with CT.

PMID:39956884 | DOI:10.1007/s00586-025-08703-5

Sci Rep. 2025 Feb 16;15(1):5686. doi: 10.1038/s41598-025-90462-w.

ABSTRACT

To investigate the causal relationship between inflammatory bowel disease (IBD) and uveitis, we conducted a two-sample bidirectional Mendelian randomization (MR) analysis utilizing summary data from genome-wide association studies (GWAS). The primary statistical analysis was performed using the inverse-variance weighted (IVW) method. False discovery rate (FDR) correction was used to control for false positives in multiple testing. In addition, sensitivity analyses were carried out using the MR Egger intercept test and Cochran’s Q test. The MR analysis revealed that genetically determined IBD (OR = 1.141, 95% CI 1.080-1.205, P = 2.21 × 10^-6, P_FDR = 6.90 × 10^-6), ulcerative colitis (UC) (OR = 1.113, 95% CI 1.032-1.201, P = 0.006, P_FDR = 0.009), and Crohn’s diseases (CD) (OR = 1.073, 95% CI 1.017-1.133, P = 0.010, P_FDR = 0.011) had a causal effect on uveitis. Conversely, the reverse MR analysis did not reveal significant causal link of uveitis on IBD, including its two subtypes. Furthermore, the results of the MR-Egger and weighted median methods were consistent with the IVW method. No evidence of heterogeneity or pleiotropy was detected by sensitivity analysis. Our findings confirm that IBD and its main subtypes had a causal connection with uveitis. Further research is needed to elucidate the underlying pathophysiological mechanisms driving this association.

PMID:39956872 | DOI:10.1038/s41598-025-90462-w

Eur J Drug Metab Pharmacokinet. 2025 Feb 16. doi: 10.1007/s13318-025-00937-4. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Atorvastatin is dosed in its active acid form although it exists in equilibrium with its inactive lactone form in vivo. Although in vitro atorvastatin acid displays pH-dependent conversion to the lactone metabolite, pharmacokinetic (PK) data on the effect of elevated gastric pH on atorvastatin and major atorvastatin-related species are not currently available. In this dedicated study, we investigated the effect of food and acid-reducing agents on the PK of atorvastatin and its three major metabolites in humans.

METHODS: This was an open label, randomized, crossover study conducted in 17 healthy volunteers. Part 1 examined the PK of a 10-mg dose of atorvastatin co-administered with or without a 600-mg dose of sodium bicarbonate in fasted and fed states. Part 2 was a single assessment to examine the PK of a 10-mg dose of atorvastatin in the fasted state following a 5-day treatment course of 40-mg daily esomeprazole. Gastric pH was monitored during treatments using Heidelberg capsules. A linear mixed effects model was used to derive ratios for PK parameters of atorvastatin and metabolites between treatments.

RESULTS: Similar to previous food effect studies, food significantly decreased the maximum concentration (C_max) and increased the time to C_max (t_max) of atorvastatin, with minimal effect on total exposure of atorvastatin or metabolites. Neither sodium bicarbonate, in the fed or fasted state, nor treatment with esomeprazole had a clinically meaningful effect on the exposure of atorvastatin or its metabolites.

CONCLUSIONS: According to these results, atorvastatin PK does not appear to be sensitive to changes in gastric pH.

PMID:39956861 | DOI:10.1007/s13318-025-00937-4

Sci Data. 2025 Feb 16;12(1):280. doi: 10.1038/s41597-025-04533-8.

ABSTRACT

Historical population grids are scarce or rather non-existent. This work represents a first effort in this direction. Using historical cadastral data and homogeneous population data at municipal level, we generate, for the whole of Spain, population grids with 100 m × 100 m and 1 km × 1 km resolutions and all census years from 1900 to 2021. These grids are top-down. The methods used are like those employed in the generation of population grids for the entire globe in the last decades by combining satellite imagery with demographic information from censuses. Given the richness of cadastral information, and the possibility of going much further back in time than satellite information, we can generate much older population grids. Although far from perfect, these grids provide a better approximation to the spatial distribution of the population in those years than the simple consideration of the municipal population or the count in the settlements derived from the gazetteers associated with the censuses. The possibility of taking our estimates up to 2021, where we have a bottom-up population grid from the Spanish National Statistical Institute (INE) derived from the 2021 census allows us to validate our methods, albeit only for the most recent dates.

PMID:39956832 | DOI:10.1038/s41597-025-04533-8

Sci Data. 2025 Feb 16;12(1):277. doi: 10.1038/s41597-025-04550-7.

ABSTRACT

This paper provides the background, methodology and validation for constructing a representation of the European high-voltage grid (AC lines from 220 to 750 kV and all DC lines) based on OpenStreetMap data. Grid components include commissioned substations, transmission lines and cables, transformers, and converters as well as technical parameters based on standard types. The data is provided as easy-to-access comma-separated values files which makes it suitable for model-independent, large-scale electricity and energy system modelling. For further ease-of-use, an interactive map is included to enable visual inspection. To assess the data quality, this paper compares the dataset with official statistics and representative model runs using PyPSA-Eur based on different electricity grid representations. The dataset and workflow are provided as part of PyPSA-Eur, an open-source, sector-coupled optimisation model of the European energy system. By integrating with the codebase for initiatives such as PyPSA-Earth, the benefits of this work of this work extend to the global context. The dataset is published under the Open Data Commons Open Database (ODbL 1.0) licence.

PMID:39956804 | DOI:10.1038/s41597-025-04550-7