Tag: statistics

Phys Sportsmed. 2025 Apr 9. doi: 10.1080/00913847.2025.2491111. Online ahead of print.

ABSTRACT

OBJECTIVES: Females participate in clinical research at a much lower rate than males, leading to clinical outcome disparities. The objective of this study was to determine whether gender-based disparities exist in orthopedic sports medicine injury research on NCAA college student-athletes.

METHODS: A PubMed search was conducted in September 2023 using the search terms ‘NCAA,’ ‘injury,’ and each of the 24 individual NCAA sports between 1980 and 2023. Statistical analysis was performed via determination of adjusted correlation coefficient R² and multiple linear regression models. Gender was the independent variable, number of studies was the dependent variable.

RESULTS: Of 1,553 studies initially identified, 790 met inclusion criteria and underwent full text review. Of NCAA studies that assessed injury rates (injury rate studies) and those that evaluated other outcomes such as performance (non-injury rate studies), 468 of 790 (59%) discussed male collegiate athletes and 318 (40%) discussed females. For females, there was a negative association between athlete-exposure rate and injury rate studies (expected decrease of 0.31 studies per 100,000 athlete-exposures) and between athlete-exposure rate and non-injury rate studies (decrease of 0.007). For males, there was a positive association for each (increase of 1.15 and 1.96). Injury rates were positively associated with injury rate study numbers for both males and females (increase of 3.71). There was no significant relationship between injury rates and non-injury rate study numbers for either gender.

CONCLUSION: This study demonstrates gender disparities in orthopedic sports medicine injury research for collegiate athletes. There was a negative association between athlete-exposure rate and injury rate or non-injury rate studies for female NCAA athletes, but a positive association for males.

CLINICAL RELEVANCE: It is important to ensure that sports medicine research is focused on both male and female NCAA athletes to be able to evaluate injuries, outcomes, and opportunities for injury prevention.

PMID:40203455 | DOI:10.1080/00913847.2025.2491111

Pak J Pharm Sci. 2025 Jan-Feb;38(1):299-313.

ABSTRACT

This study aimed to develop SNEDDS to address the issue of low water solubility of escitalopram (ETP), which consequently leads to inadequate oral bioavailability. The formulation consisted of Tween 80, geranium oil, and polyethylene glycol 400. An evaluation was conducted to determine the surface charge and particle size of ETP-SNEDDS. The stability and compatibility of excipients were evaluated by TGA, DSC and FTIR. Studies were carried out to examine the dissolution, digestion, permeability, in in-vitro, in-vivo, and ex-vivo settings. ETP-SNEDDS bioavailability was assessed in a group of six albino rats under normal conditions. The synthesized SNEDDS exhibited thermodynamic stability, characterized by a 145nm droplet size with a polydispersity index of 0.120 and a minute emulsification duration. Developed SNEDDS containing ETP in FSSIF had a dissolution rate of 96%. Based on the permeation results, the SNEDDS demonstrated a 4.2-fold and 3.1-fold increase in drug penetration relative to standard powder-ETP drug and a reference tablet, correspondingly. Statistically significant improvements (p<0.05) were reported in in-vitro digestion, dissolution and ex-vivo permeability. SNEDDS exhibited a 5.34-fold increase in Cmax and a 4.71-fold rise in AUC compared to the reference. Based on findings, the formulated SNEDDS have a valuable method for enhancing ETP oral bioavailability.

PMID:40203451

Pak J Pharm Sci. 2025 Jan-Feb;38(1):219-232.

ABSTRACT

The structure of active compounds determines their functions. This study investigates the phytochemical composition of five plant species, tests their capacity to obstruct the growth of four pathogenic bacteria (Bacillus subtilis, Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli) and to scavenge free radicals and inspects the relationship between the biological activities and the phytochemical structural frameworks. GC-MS analysis was employed for specifying phytochemicals. The plant methanolic and ethanolic extracts and the antibiotic (AMC30), were evaluated for antibacterial capability utilizing the disc diffusion method. For assessing antioxidant activity, the DPPH method was used. Achillea fragrantissima exhibited the highest phytochemical diversity. Gram-negative bacteria were less sensitive to plant extracts. Pulicaria undulata and Pulicaria incisa demonstrated greater efficacy in suppressing bacterial proliferation. Artemisia judaica and P. undulata extracts showed higher free radicle scavenging relative to other species. The antioxidant action, antibacterial properties against B. subtilis, S. aureus and E. coli exhibited a statistically significant correlation with aromatic monocyclic compounds. A significant negative correlation was also observed between aliphatic polycyclic compound contents and E. coli growth inhibition, indicating that this compound category may have an E. coli growth stimulating capacity. This study proposes research into phytochemical frameworks and their target-specific properties.

PMID:40203443

Medwave. 2025 Apr 9;25(3):e2937. doi: 10.5867/medwave.2025.03.2937.

ABSTRACT

The study aimed to assess the quality and applicability of current maternal-fetal health clinical practice guidelines that countries can adopt or adapt. A systematic search was conducted in the International Database of GRADE Guidelines (BIGG) for practice guidelines developed with the GRADE system (Grades of Recommendation, Assessment, Development, and Evaluation) and related to maternal-fetal care. The selected guidelines were evaluated with the AGREE-REX (Appraisal of Guidelines REsearch and Evaluation-Recommendations Excellence) tool to assess clinical applicability (domain-1), values and preferences (domain-2) and applicability (domain-3). The variables were presented descriptively, and a statistical analysis was performed on the domains according to institution and country of origin. Of 1,212 clinical practice guidelines, 72 met the inclusion criteria. According to the type of collaborating organization, the World Health Organization predominated with 58.3%, versus specialized medical societies. Domain 1, “Clinical applicability,” was the best rated by the reviewers (68.5%) compared to domain 2, “Values and preferences” (60%). According to the type of institution that developed the clinical practice guideline, a significant difference was demonstrated in domains 1 (p= 0.000), 2 (p= 0.006) and 3 (p= 0.000). Only domains 1 (p= 0.000) and 3 (p= 0.018) were statistically significant based on country of origin. This study emphasizes the importance of improving the quality of maternal-fetal clinical practice guidelines developed by organizations and governmental institutions and the need to strengthen the institutionalization of the use of evidence to develop, adapt and implement practice guidelines in countries such as the United Kingdom, Canada, Spain, Colombia, the United States, among others.

PMID:40203435 | DOI:10.5867/medwave.2025.03.2937

Issues Ment Health Nurs. 2025 Apr 9:1-12. doi: 10.1080/01612840.2025.2475356. Online ahead of print.

ABSTRACT

While antipsychotic medications remain the primary treatment for schizophrenia, they often have limitations in addressing all symptoms and can lead to adverse side effects, prompting researchers to explore complementary approaches such as physical activity to enhance overall patient outcomes. This study investigates the effectiveness of physical activity on psychosis and sleep quality in patients with schizophrenia. This quasi-experimental study involved 70 male inpatients with schizophrenia, divided into an activity group (structured physical activity program) and a control group (standard care). The intervention group showed significant improvements across multiple symptom domains (positive and depression-anxiety) with large effect sizes (η² ranging from 0.553 to 0.705) compared to the control group. These improvements, including reductions in grandiosity, emotional withdrawal, and anxiety, were maintained at the 3-month follow-up. The study group also exhibited significant improvements in several aspects of sleep quality, including subjective sleep quality (p < 0.001, η² = 0.612), sleep duration (p < 0.001, η² = 0.877), and sleep disturbances (p < 0.001, η² = 0.623). The physical activity program demonstrated significant improvements in sleep quality and various symptoms of schizophrenia, notably hallucinations and unusual thought content. Although the changes in negative symptoms were not statistically significant between groups, the overall findings suggest that physical activity can play a beneficial role in symptom management and enhance sleep quality for patients with schizophrenia.

PMID:40203433 | DOI:10.1080/01612840.2025.2475356

J Med Internet Res. 2025 Apr 9;27:e66366. doi: 10.2196/66366.

ABSTRACT

BACKGROUND: Considering that most patients with low or no significant risk factors can safely undergo noncardiac surgery without additional cardiac evaluation, and given the excessive evaluations often performed in patients undergoing intermediate or higher risk noncardiac surgeries, practical preoperative risk assessment tools are essential to reduce unnecessary delays for urgent outpatient services and manage medical costs more efficiently.

OBJECTIVE: This study aimed to use the Observational Medical Outcomes Partnership Common Data Model to develop a predictive model by applying machine learning algorithms that can effectively predict major adverse cardiac and cerebrovascular events (MACCE) in patients undergoing noncardiac surgery.

METHODS: This retrospective observational network study collected data by converting electronic health records into a standardized Observational Medical Outcomes Partnership Common Data Model format. The study was conducted in 2 tertiary hospitals. Data included demographic information, diagnoses, laboratory results, medications, surgical types, and clinical outcomes. A total of 46,225 patients were recruited from Seoul National University Bundang Hospital and 396,424 from Asan Medical Center. We selected patients aged 65 years and older undergoing noncardiac surgeries, excluding cardiac or emergency surgeries, and those with less than 30 days of observation. Using these observational health care data, we developed machine learning-based prediction models using the observational health data sciences and informatics open-source patient-level prediction package in R (version 4.1.0; R Foundation for Statistical Computing). A total of 5 machine learning algorithms, including random forest, were developed and validated internally and externally, with performance assessed through the area under the receiver operating characteristic curve (AUROC), the area under the precision-recall curve, and calibration plots.

RESULTS: All machine learning prediction models surpassed the Revised Cardiac Risk Index in MACCE prediction performance (AUROC=0.704). Random forest showed the best results, achieving AUROC values of 0.897 (95% CI 0.883-0.911) internally and 0.817 (95% CI 0.815-0.819) externally, with an area under the precision-recall curve of 0.095. Among 46,225 patients of the Seoul National University Bundang Hospital, MACCE occurred in 4.9% (2256/46,225), including myocardial infarction (907/46,225, 2%) and stroke (799/46,225, 1.7%), while in-hospital mortality was 0.9% (419/46,225). For Asan Medical Center, 6.3% (24,861/396,424) of patients experienced MACCE, with 1.5% (6017/396,424) stroke and 3% (11,875/396,424) in-hospital mortality. Furthermore, the significance of predictors linked to previous diagnoses and laboratory measurements underscored their critical role in effectively predicting perioperative risk.

CONCLUSIONS: Our prediction models outperformed the widely used Revised Cardiac Risk Index in predicting MACCE within 30 days after noncardiac surgery, demonstrating superior calibration and generalizability across institutions. Its use can optimize preoperative evaluations, minimize unnecessary testing, and streamline perioperative care, significantly improving patient outcomes and resource use. We anticipate that applying this model to actual electronic health records will benefit clinical practice.

PMID:40203300 | DOI:10.2196/66366

J Cardiovasc Med (Hagerstown). 2025 Apr 7. doi: 10.2459/JCM.0000000000001719. Online ahead of print.

ABSTRACT

AIMS: While timely reperfusion is known to reduce mortality, the extent to which the severity of heart failure, as classified by the Killip system, influences treatment delays remains unclear. Our study aims to address the existing gap in evidence regarding the relationship between Killip classification at presentation and treatment times in ST-elevation myocardial infarction (STEMI) patients.

METHODS: We conducted a correlative analysis using data from patients treated in our hospital and enrolled in the FITT-STEMI Register from 2009 to 2022. We focused on the relation of treatment times allocating patients into the four Killip classes and used an ANOVA test (significance level: P < 0.05). Killip class and intrahospital mortality were studied via binary logistic regression.

RESULTS: In total, 1264 patients were identified. Door-to-balloon time among Killip I patients was 54 (±35) min (mean ± SD) and 53 (±26) min among Killip II and prolonged up to 77.5 (±46) min for class III and 79.7 (±45) min for class IV (overall P-value < 0.001). This remained statistically significant even after the exclusion of patients with out-of-hospital cardiac arrest (OHCA) (overall P-value: <0.001).Post hoc analysis showed a significant difference between Killip II and III classes for both all-comers (P = 0.014) as well as after the exclusion of OHCA patients (P = 0.012).Intrahospital mortality increased from <5% for classes I and II up to 10.3% for class III and 35.4% for class IV.

CONCLUSION: The severity of heart failure among STEMI patients significantly affects the duration of treatment times. Patients presenting with Killip class III and IV demonstrate high intrahospital mortality rates.

PMID:40203294 | DOI:10.2459/JCM.0000000000001719

PLoS One. 2025 Apr 9;20(4):e0316648. doi: 10.1371/journal.pone.0316648. eCollection 2025.

ABSTRACT

Active tuberculosis (TB) is caused by Mycobacterium tuberculosis (Mtb) bacteria and is characterized by multiple phases of infection, leading to difficulty in diagnosing and treating infected individuals. Patients with latent tuberculosis infection (LTBI) can reactivate to the active phase of infection following perturbation of the dynamic bacterial and immunological equilibrium, which can potentially lead to further Mtb transmission. However, current diagnostics often lack specificity for LTBI and do not inform on TB reactivation risk. We hypothesized that immune profiling readily available QuantiFERON-TB Gold Plus (QFT) plasma supernatant samples could improve LTBI diagnostics and infer risk of TB reactivation. We applied a whispering gallery mode, silicon photonic microring resonator biosensor platform to simultaneously quantify thirteen host proteins in QFT-stimulated plasma samples. Using machine learning algorithms, the biomarker concentrations were used to classify patients into relevant clinical bins for LTBI diagnosis or TB reactivation risk based on clinical evaluation at the time of sample collection. We report accuracies of over 90% for stratifying LTBI + from LTBI- patients and accuracies reaching over 80% for classifying LTBI + patients as being at high or low risk of reactivation. Our results suggest a strong reliance on a subset of biomarkers from the multiplexed assay, specifically IP-10 for LTBI classification and IL-10 and IL-2 for TB reactivation risk assessment. Taken together, this work introduces a 45-minute, multiplexed biomarker assay into the current TB diagnostic workflow and provides a single method capable of classifying patients by LTBI status and TB reactivation risk, which has the potential to improve diagnostic evaluations, personalize treatment and management plans, and optimize targeted preventive strategies in Mtb infections.

PMID:40203284 | DOI:10.1371/journal.pone.0316648

Aesthet Surg J. 2025 Apr 9:sjaf059. doi: 10.1093/asj/sjaf059. Online ahead of print.

ABSTRACT

Buttock augmentation has become one of the most sought-after cosmetic procedures, but concerns over fat embolism-related fatalities have raised significant safety issues. Guidelines emphasize that fat grafting should remain in the subcutaneous layer, avoiding intramuscular injection. This systematic review and meta-analysis assess the efficacy and safety of ultrasound-guided gluteal fat grafting. A systematic search of PubMed, Cochrane Central Register of Controlled Trials, and Embase was conducted until July 2024, analyzing patient satisfaction, complication rates, mortality, fat embolism, fat necrosis, infection, and seroma. Statistical analyses, including the Freeman-Tukey Double Arcsine Transformation, were performed using R version 4.1.2. Four studies with a total of 6,235 female patients (mean age 34 years, BMI 30.1 kg/m²) met the inclusion criteria. The pooled analysis showed no reported mortality (0.00 per 100, 95% CI: 0.00-0.00) or fat embolism (0.00 per 100, 95% CI: 0.00-0.00). Minor complications occurred at a rate of 6.32 per 100 (95% CI: 3.23-10.27), with seroma at 2.94 per 100 (95% CI: 0.97-5.75), infection at 0.23 per 100 (95% CI: 0.00-0.96), and fat necrosis at 0.09 per 100 (95% CI: 0.01-0.23; I² = 0). The findings indicate that ultrasound-guided gluteal fat grafting is associated with low complication rates and no reported serious adverse events such as death or fat embolism, reinforcing its role as a safer technique for buttock augmentation.

PMID:40203280 | DOI:10.1093/asj/sjaf059

PLoS One. 2025 Apr 9;20(4):e0319074. doi: 10.1371/journal.pone.0319074. eCollection 2025.

ABSTRACT

Causal mediation analysis decomposes the total effect of an exposure on an outcome into: 1. the indirect effect through a mediator and 2. the remaining “direct” effect through all other pathways. When the outcome is a time-to-event/survival time, censoring makes identifying the indirect and direct effects on the expected value scale untenable. We propose a semi-parametric estimator of the indirect and direct effects on the restricted mean survival time (RMST) scale using the pseudo-value approach for estimating conditional RMSTs. The pseudo-value approach is generalizable to various forms of outcome censoring. We demonstrate the use of the pseudo-value based estimator to right and interval censored data. Our estimator applies to any set of identification assumptions that lead to the Mediation Formula, including natural, organic, randomized and separable indirect and direct effects. A simulation study demonstrates the performance of the estimators for right and interval censored outcomes under various scenarios. The methodology is applied to an HIV cure example with the intention of estimating the indirect effect of a putative treatment on time-to-viral rebound mediated through the viral reservoir.

PMID:40203275 | DOI:10.1371/journal.pone.0319074